What is Alexithymia?
By Amelia Zannoni
All About Alexithymia
Everyone in their life has had at least one occurrence where it was difficult to express the emotion they feel inside. For specific people, this is harder to accomplish than others. Alexithymia is not a mental disorder, and has no clinical diagnosis; although it can be concurrent with some mental health disorders. Alexithymia is a trait describing one’s difficulty expressing, identifying, and experiencing emotions. Around 13% of the population experiences alexithymia, and it has shown to be more common in males than females. Where alexithymia has links with autism, it can show up in people with other mental health conditions as well, including depression; people with no diagnosable health conditions can also show symptoms of this.
- Problems internally observing or considering their mental and emotional processes.
- Experience uncertainty around bodily feelings in accordance with emotions.
- Issues with communicating their emotions to other people.
According to MedicalNewsToday:
- Problems relating to identifying feelings and emotions.
- Difficulties differentiating between emotions and bodily feelings relating to those emotions.
- Poor communication in relaying feelings to others.
- Lack of imagination or fantasies.
- A thinking style that lacks account for emotions.
- Limited coping skills in handling stress.
- Coming off as distant, rigid, and/or humorless.
Although the exact cause of alexithymia is still not understood, there are some studies that suggest genetics, environmental factors, and brain injuries could play a role.
A research report done on over 8,700 danish twin pairs suggests a moderate influence of shared environmental factors; whereas the results should be genetic factors adding to all features of Alexithymia. The same research report, found that heritabilities of certain facets of Alexithymia were greater in nonshared environments of twins than shared environments. Some examples of environmental factors studied are history of childhood trauma, presence of a physical or mental health condition, and/or socioeconomic factors (Leonard, 2019.)
Another research report suggests that brain injuries to the anterior insula could be another cause for the subclinical condition. The study looks at two groups of vietnam vets;, group 1 with a penetrating traumatic brain injury (TBI), group 2 with no TBI. The study observed various measures including; age, education, pre-injury intelligence, and handiness (right v. left handed). Researchers collected CT scans and observed behavior. The research found compelling evidence in support of their hypothesis; showing that pronounced damage to the Anterior Insula (AI) causes impaired awareness of emotional states (J. Hogeveen, G. Bird, A. Chau, F. Krueger, and J. Grafman, 2016). The findings also suggest preliminary evidence that AI damage is associated with elevated levels of alexithymia, whereas Agenesis of the corpus callosum (ACC) damage is not.
Although Alexithymia is primarily associated with Autism Spectrum Disorder; more and more research shows that this condition can be acquired due to traumatic brain injuries as well.
Links with Autism
Some studies suggest that approximately half of autistic people are likely to have Alexithymia, showing to be more prevalent in those with complex ASD. However, other research suggests emotional and social difficulties observed in those with ASD may not be a feature of autism; rather of co-occurring Alexithymia (Leonard, 2019).
Links with other Health Conditions
Alexithymia has been shown to be concurrent with various mental health disorders including; depression, PTSD, ADHD, eating disorders, suicidality, schizophrenia, and neurodegenerative disease. Those co-occurring depressive episodes and alexithymia show more severe symptoms of depression, psychosis, and phobias. It is believed that with Alexithymia every symptom of these mental health conditions are heightened, making it more difficult for the person to gain a high quality of life.
According to MedicalNewsDaily:
- Being male (one finish study found Alexithymia to be twice as common in male than in females)
- Low level of education
- Low socioeconomic status
- Low emotional intelligence
Doctors and other health care providers cannot formally diagnose the condition of Alexithymia because it is not a mental health disorder. In cases they see fit, doctors and HCP’s will administer various questionnaires and scales in order to check for signs of the condition.
Some common tests are the Twenty-Item Toronto Alexithymia Scale (TAS-20) which tests; the ability to identify feelings and to separate these from physical sensations, their ability to tell others about their feelings, and their tendency to show externally oriented thinking (rather than introspective). Another test is the Bermond-Vorst Alexithymia Questionnaire (BVAQ). The test is made of 40 questions aimed at observing five subcategories; emotionalizing, fantasizing, identifying, analyzing, and verbalizing. A third test is the Observer Alexithymia Scale (OAS) that asks 33 questions looking at a five-factor structure; distant, insightful, somatizing, humorless, and rigid.
Where coming to terms with the difficulties people with this sub condition have may be hard; there is a silver lining. It is not impossible to fix a problem; any problem always has a solution. There are medications, therapy, and mindfulness meditations that have shown to help people begin to identify their emotions and bodily sensations better.
This article says it is difficult for people with Alexithymia to identify and process their emotions, it never says it is impossible.
Exercising, practicing meditation in various forms such as mindfully walking, cooking, or just breathing can be a good place to start to try and identify emotions better.
Symptoms of Alexithymia have shown to improve once other co-occurring conditions are treated accordingly.
J. Leonard. (2019). What to know about alexithymia, MedicalNewsToday. https://www.medicalnewstoday.com/articles/326451
J.K., Salminen, S. Saarijarvi, E. Aarela, T. Toikka, J. Kauhanen. (1999). Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland, Journal of Psychosomatic Research, 46;1: 75-82. https://www.sciencedirect.com/science/article/abs/pii/S0022399998000531
M.M. Jorgensen, R. Zachariae, A. Skytthe, K. Kyvik. (2007). Genetic and environmental factors in alexithymia: A population-based study of 8,785 Danish twin pairs, Psychotherapy and Psychosomatics. 76: 369-375. https://www.karger.com/Article/Abstract/107565
J. Hogeveen, G. Bird, A. Chau, F. Krueger, and J. Grafman. (2016). Acquired alexithymia following damage to the anterior insula, National Library of Medicine. 82: 142-148. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752907/
Amelia Zannoni is currently an undergraduate student at Nova Southeastern University studying neuropsychology. She is currently studying how neuropathologies work and hopes to go onto developing many beneficial techniques in her field.