Alexithymia

Alexithymia refers to a difficulty in identifying, processing, and expressing one’s own emotions with appropriate language as well as differentiating those feelings from bodily sensations. Alexithymia was widely explored by two known psychiatrists named Peter Emanuel Sifneos and John Case Nemiah. The former coined the term alexithymia, which has roots from the Greek words “a” meaning lack or without, “lexis” meaning word, and “thymos” meaning emotions or feelings. Taken altogether, alexithymia means “a lack of words for emotion.” 

Alexithymia is not a symptom or disorder but rather a psychiatric construct (i.e., a model used in psychiatry to understand and categorize mental health conditions) and a personality trait (i.e., relatively stable characteristics that describe the typical way of thinking, feeling, and behaving). Individuals with alexithymia are at higher risk of other psychiatric conditions as well as various somatic symptoms and behavioral disorders.

The lifetime risk of alexithymia in the general population is estimated to be around 10%. Alexithymia is more prevalent among individuals with psychiatric or neurodevelopmental disorders, including Parkinson disease. People with autism spectrum disorder (ASD) are particularly at a higher risk, and studies suggest that the co-occurring alexithymia may partly contribute to the severe empathy deficits observed in ASD.

People with alexithymia have limited ability to verbally describe their emotions, and their speech and thought are often reported as solid or mundane. They tend to describe daily activities and external events in a factual way without any sentiment or affect. Moreover, some individuals with alexithymia are unable to recognize negative emotions as signals of emotional distress. Some may be unable to express and elaborate on their bodily sensations, making it difficult for healthcare professionals to understand and treat them. When healthcare professionals assess their patient’s emotional responses after an intense life event, such as loss of a job or even death of a family member, individuals with alexithymia may respond in an unexpressive way, describing physical rather than emotional symptoms.

Studies showed that the rates of anxiety disorders and major depressive disorders are increased in individuals with alexithymia, which may be related to their inability to regulate and resolve negative emotions. In addition, individuals with alexithymia quite commonly report multiple somatic symptoms, such as pain and fatigue, as they have minimal emotional awareness and are unable to explain their psychological conflicts.