Do you often draw a blank when someone asks you how you’re feeling? It might not be because you have something to hide, but because you genuinely don’t know how to respond. This is the reality for many people with alexithymia. And, unfortunately, over time this lack of ability to access emotions could create a chasm between people and their loved ones.
Also sometimes called “emotional blindness,” alexithymia is not a formal diagnosis. However, it can quietly shape your relationships, your work, and your mental health. The good news is that emotional awareness is a skill that can be learned at any age. A mental health expert is best positioned to offer specialized guidance.
In this article, we’ll cover the ins and outs of alexithymia, focusing on:
“Alexithymia” is derived from Greek and loosely translates to “no words for emotion.”[1] It describes difficulty in identifying emotion, naming it, and telling it apart from other physical sensations. By estimates, about one in every ten people in the general population shows observable symptoms of alexithymia.[2] As such, the condition is likely more common than people imagine.
A part of the story that people often misunderstand is that people with alexithymia still have feelings. The emotions are there, but the ability to read and express them might not be. It’s like the body is trying to send out signals in a language it never learned.
So, a knot in your stomach could be anger, anxiety, or your last dinner party not going as well as you wanted it to. But until you can adequately understand and name it, there is little you can do about it.
Experts usually describe alexithymia as having three core features:[1][3]
What’s more, the severity of alexithymia is on a spectrum. Some people might notice mild gaps in emotional awareness. Other people describe their inner state as “completely silent.”
Right now, alexithymia is not classified as a mental health condition. It doesn’t appear in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) as a disorder yet, and clinicians generally treat it as a personality trait with varied severity in the population.
Alexithymia rarely happens alone. It is common to have it diagnosed in people with autism, depression, or post-traumatic stress disorder (PTSD).[4][5][6] Additionally, symptoms like pain, fatigue, and other physical complaints have been observed in people with alexithymia.
In essence, while the condition itself is not considered a mental disorder, it is an indication that mental health therapies may considerably improve life for people living with it.
The inability to identify and name emotions can be different from one person to another. However, the most reported signs and symptoms include:
The last sign is often a surprise to many people. But if your emotional awareness is low, chances are that regulating emotions is hard because it is impossible to manage a feeling you never noticed building. Many times, an over-accumulation and explosion of emotions is the first clue that something is significantly wrong, followed by a genuine confusion about their origin.
It is also important to differentiate alexithymia from emotional intelligence. The latter describes a broad set of abilities for understanding and managing relationships. Alexithymia, on the other hand, is more concerned with the ability to process emotions adequately, and it often presents in people who are otherwise perceptive and deeply caring.
Alexithymia has no single cause. Studies have shown that it is caused by a collection of factors that may vary among individuals. These factors may include:[7]
Trauma can rewire the brain, impacting how emotions are processed. If your feelings become overwhelming or unsafe, the brain disconnects from feeling. This happens often and becomes entrenched as a coping mechanism. Over time, the coping mechanism hardens into a fixed pattern. In fact, systematic studies have found higher rates of alexithymia in people who were diagnosed with post-traumatic stress disorder.
There is a similar link with depression too. In one large population study, scientists also discovered that adults with depression are very likely to show traits of alexithymia.
Alexithymia and autism seem to overlap. However, it’s important to understand that alexithymia is not a feature of autism. About half the population of people with autism show significant alexithymia traits, compared with roughly 10% of the general population.[4]
In practice, this subtle distinction matters. In many cases, difficulties with empathy and emotional expression earlier blamed on autism may actually stem from alexithymia. In adults with autism, a high alexithymia score is linked with severe depression and anxiety symptoms, making it worthwhile to address it directly.[2]
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
Alexithymia can put a heavy strain on relationships. A partner may ask questions about well-being and get answers like: “I don’t know.” As a result, they might assume they are being shut out. An honest answer may simply sound like avoidance, hence the silence. If this happens consistently:
Work might also receive a hit. Conflict, feedback, and deadline pressure can worsen the situation, stirring up emotions that go unexpressed until they manifest as irritability, exhaustion, or burnout.
Physical health shares in the burden too. People with alexithymia are more likely to report consistent bouts of headache, unexplained pain, and stomach trouble compared to the average population. This is partly because distress that cannot be adequately described surfaces as physical symptoms.[3]
In clinical practice, these physical complaints are a common occurrence. A doctor might witness expressions of discomfort, such as chest tightness or constant fatigue. So they order a test, but the test comes back clean. The primary root remains undiagnosed, and the patient has limited emotional vocabulary to describe how they really feel inwardly.
Finally, self-awareness is perhaps the highest quiet cost. To make a good decision, you need to understand how the options you have make you feel. Without this feeling, choices might feel arbitrary, and quality of life could slowly drift away.
Alexithymia is not a permanent condition; there are effective treatment options suited to the severity of the case. A review of intervention studies shows that alexithymia symptoms resolve after psychotherapy in many clinical instances.[8]
Reading your own emotions is a skill you can develop at any stage, and with constant practice, your symptoms may improve. Managing alexithymia requires combining daily skill building and caring for co-occurring conditions.
With the help of experts, you can leverage psychotherapy to study your inner signals and notice if you miss anything. Psychotherapy approaches known to help with alexithymia include:
Small habits can rewire and strengthen your ability to process emotions over time. Steps recommended by experts for strengthening this ability include:
At first, these practices might feel awkward and clumsy. But over time, your self-awareness tends to grow. Noting what happens right before you experience a physical sensation could also help on this journey, as this practice can provide you with context you might have missed.
Because alexithymia often presents with conditions like anxiety, depression, and post-traumatic stress, a potent therapy option often considers the whole picture.
When symptoms seriously disrupt daily life, residential treatment offers a level of structure that outpatient care can’t quite match. Daily therapy, round-the-clock support, and distance from everyday stressors create room to practice new emotional skills without pressure. For someone who has spent decades cut off from their feelings, an immersive setting is often where things finally start to click.
It’s also good to know that, since alexithymia is not a mental health condition, no single medication can resolve its many symptoms. Although medications may offer relief for the co-occurring conditions.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Mental Health support is a phone call away – call 866-478-4383 to learn about our current treatment options.
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Living without easy access to your own emotions can be isolating, but it isn’t a character flaw. It’s a pattern with identifiable causes, and patterns can change with the right support.
At AMFM (A Mission For Michael) Mental Health Treatment, we help adults address the conditions that often co-occur with alexithymia, including depression, anxiety, and trauma. Our treatment programs pair evidence-based psychotherapy with calm, comfortable settings and clinicians who understand that “I don’t know how I feel” is a starting point, not a dead end.
In addition to residential care, we also offer multiple levels of outpatient programming. Our team of expert clinicians believes in treatment persistence and will personalize your treatment plan so you can achieve lasting, life-changing outcomes.
Our locations in California, Minnesota, and Virginia accept insurance and are in-network with most major providers. To check your insurance coverage for mental health care, simply complete our confidential online verification form or call us at 866-478-4383.
Reach out to us if you would like to start the admissions process or learn more about how we can support your mental well-being. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation. Naming your feelings may be difficult right now, but asking for support takes only one step.
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