Alexithymia: The Emotion-Processing Dysfunction That Makes It Hard to Identify Emotions

At some point in our lives, most of us have answered the question, “How are you?” with an honest, “I don’t know.” 

It’s natural to struggle with knowing how we really feel from time to time. Sometimes life is going so fast that we don’t have a moment to slow down and check in with our emotions. Other times, we’ve been cycling through so many emotions at once that we don’t know which one is affecting us most.

But for people with alexithymia, identifying and processing emotions isn’t a now-and-then kind of struggle. It’s something that can feel next to impossible the majority of the time.

What Is Alexithymia?

If you’ve even heard the word “alexithymia” before, it’s likely because actress and Disney alum, Alyson Stoner, opened up about her struggles with it earlier this year. But if you haven’t heard of it, you’re in good company. 

Though alexithymia is fairly well-known in clinical circles, it’s not as well known outside of them — perhaps because it is not an official diagnosis recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Alexithymia can best be described as an emotion-processing dysfunction. 

“Alexithymia is essentially a dysfunction in the normal emotional awareness processes that make it difficult for people to put a name to their feelings,” John Richey, Ph.D., clinical psychologist and associate professor in the department of psychology at Virginia Tech, told The Mighty.

According to the Journal of Neuropsychiatry, psychiatrist Dr. Peter Sifneos coined the term “alexithymia” back in 1973 to describe patients who struggled to identify their emotions and therefore had trouble engaging in certain types of psychotherapy. 

The lack of emotional awareness people with alexithymia experience can sometimes also affect their ability to empathize with others. One study found that participants with alexithymia were less able to recognize emotional expressions in faces than people without alexithymia. 

“A child or adult with alexithymia often struggles to understand his or her own self experience,” Deborah Serani, Psy.D., who specializes in treating depression, said. “Individuals with alexithymia have difficulty understanding how others feel and think too.”

At the moment, there isn’t much research on alexithymia, so experts aren’t able to definitively say what causes it. Dr. Richey told The Mighty there is still much to explore when it comes to alexithymia, but he felt reasonably confident in the belief that alexithymia could be impacted by how much emotional labeling was modeled, and reinforced or punished in childhood.

Who Can Have Alexithymia?

Anyone can have alexithymia, but it’s slightly more common in men than women. Dr. Serani told The Mighty approximately 8% of males and 2% of females will experience this emotion-processing dysfunction.

Alexithymia also shows up in people with certain mental health conditions, most notably, post-traumatic stress disorder (PTSD) and depression. In addition to people with mental illnesses, some studies have linked alexithymia and autism. 

In their piece, “Am I Ready for an Autism Diagnosis?” Mighty contributor Anonymously Autistic wrote about how alexithymia made it difficult to describe their experience of autism in therapy:

I have alexithymia. It is part of my autism that makes it hard to describe my autism. I have had to teach myself to describe my feelings because if I don’t consciously ask myself how I feel, I don’t know. Before I started asking myself this question, I never would have been able to explain what I was feeling because people always told me how I was feeling growing up.

If the description of alexithymia sounds similar to your experience, you’re not alone. There are tangible ways to work on expanding your emotional repertoire — we’ve outlined a few of them below.

Treatment for Alexithymia

Though there isn’t a treatment out there that targets alexithymia specifically, people with alexithymia can benefit from existing forms of therapy, including cognitive behavioral therapy (CBT). CBT can help individuals focus on identifying and understanding the connection between thoughts and emotions. For people with both alexithymia and depression, this can be particularly useful.

“When someone with alexithymia says, ‘I’m depressed,’ it could be that he or she is very sad. But it might also mean frustrated, lonely, disappointed, mournful, empty, fatigued, lost, helpless,” Dr. Serani explained, adding:

Much of depression can be reduced with shifts in thinking and feeling. So, it’s vital for a person who has depression to become well-versed in the textures of their own symptoms to know what techniques to put into action. While it can be very challenging for those who struggle with alexithymia to broaden their emotional awareness, psychotherapy greatly reduces [the struggle].

Dr. Richey also encourages people with alexithymia to pay attention to the physical sensations that accompany the emotions they do feel. For example, you might notice your heart beat faster when you feel angry or upset. You might notice your body feels sluggish when you’re sad. You might notice yourself sweating when you feel embarrassed or anxious. Learning to link your physical sensations to emotions takes time, but as you work on emotion identification, it will slowly get easier.

Whether you have alexithymia or not, struggling with identifying and processing your emotions can be difficult and sometimes discouraging. While your feelings are always valid, we want you to know there is hope. 

“The best thing I could say as a word of encouragement is that you’re certainly not alone. There are many people who struggle with alexithymia,” Richey said. “There are also many people who are thinking about it from a research perspective. So I think there is a community of people who are very interested in understanding this problem and developing better treatments.” 

If you’re struggling, we encourage you to reach out to a trusted mental health professional. If you don’t have a therapist or don’t know where to look for one, check out this handy therapist finder tool. And as always, if you need support, you can always turn to our community by posting a Thought or Question on The Mighty with the hashtag #CheckInWithMe. Our community wants to support you, no matter what you’re facing.

For more from our mental health community, check out the following stories:

• The ‘Emotion Chart’ My Therapist Gave Me That I Didn’t Know I Needed 
• When BPD Makes It Hard to Identify Your Emotions
• 5 Kinds of Anxiety and Depression We Don’t Talk About