What is Alexithymia? (Inability to Express or Recognize Emotions)

This video describes the concept of alexithymia. Alexithymia is a construct, which is sometimes thought of as a personality construct or condition, that involves difficulty identifying feelings or recognizing feelings or emotions in other people. Alexithymia is not a mental health disorder but it is a construct we oftentimes see when certain mental health disorders are present. We could think of alexithymia as having both internal and external components. With the internal component, we see that somebody has difficulty identifying their own feelings, describing those feelings, and expressing those feelings. There's a deficit in awareness of feeling also there's difficulty differentiating between feelings and bodily sensations. We also see a decrease in imagination and thinking is restricted to more concrete and logical than abstract. Dreams can be affected by this internal component of alexithymia. Dreams are basic and realistic as opposed to having a lot of fantasy, again consistent with the decrease in imagination. There is oftentimes increased impulsivity with alexithymia. As far as the external component, this is a failure to recognize emotions in other people, and just like the internal component, this can be specific to certain emotions. Alexithymia is on a continuum, so someone could have difficulty recognizing sadness or fear but be able to recognize enthusiasm. We see that alexithymia can be challenging because it causes suffering, it damages relationships, and can hurt careers. Even though it's not a mental health disorder it certainly has mental health consequences in a number of presentations. We can also think of alexithymia as having two dimensions, the cognitive and the affective. On the cognitive side, there is a deficit with identifying, interpreting, and describing feelings. On the affective side, it's experiencing and expressing feelings. Somebody could have a deficit in the cognitive dimension but not as much in the affective and the opposite can be true. Most times we think of alexithymia though, we think of deficits being present on both the cognitive and affective dimensions. Alexithymia is not a mental health disorder but it's often comorbid with specific mental health disorders. We tend to see alexithymia more with narcissistic personality disorder, antisocial personality disorder, borderline personality disorder, some depressive and anxiety disorders, and substance use disorders. Alexithymia affects about 8% of males and 2% of females. Alexithymia can interfere with mental health treatment, so if somebody has one of those mental health disorders or another mental health disorder and alexithymia, the alexithymia can get in the way of the treatment because a lot of the mental health modalities focus on being in touch with feelings and being able to identify feelings in other people.