Alexithymia In Relationships

What is Alexithymia?

Some people struggle when asked to explain or share their emotions. They lack words for their for emotions. Their partners don’t feel emotionally intimate. They’ll describe having an emotionally unavailable partner.

This personality trait is known as alexithymia. People with alexithymia have difficulty expressing and identifying their emotions. They can, however, describe their physiological reactions.The following traits diagnose alexithymia:

  • Difficulty in identifying feelings
  • Hard time describing feelings to other people
  • Difficulty distinguishing between feelings
  • Trouble recognizing bodily sensations as emotional arousal
  • Constricted visual imagination
  • Fewer fantasies or vivid imaginings
  • They have a concrete cognitive style

They may have some emotional awareness of being happy, sad, or angry, in their emotional worlds. It is, however, almost impossible for them to put into words.

Alexithymics are also unable to identify the source of their emotions or describe moment-by-moment shifts in their emotional states.

It is no surprise that alexithymics struggle in their romantic relationships and are uneasy with intimate conversation. Partners describe them as “emotionally unavailable.”

All of us have feelings, even if we have trouble identifying or processing them.

But they still form “attachments,” possessing as all humans do, the fundamental need for community.

What causes Alexithymia?

There are five main categories that are correlated with alexithymic traits: Autism, trauma, certain medical conditions, modeling, and psychiatric disorders.


Multiple studies showed that alexithymia is a common symptom of people with neuro-atypical brains. Over 80% of those on the high-functioning end of the autism spectrum exhibit it to some extent. Due to this strong correlation, therapists typically start with the possibility of Asperger’s when making a differential diagnosis.


Alexithymia is a trait often found to some degree in those who have suffered trauma.

Alexithymia and PTSD was found to coexist in over 40% of Vietnam veterans. There is some evidence that consistent trauma produces alexithymia.

Psychiatric Disorders

Studies have identified Alexithymia in anorexics (63%), bulimics (56%), and those with major depressive disorder (50%). Many depressed mothers often show reduced facial expressions.

Alexithymia is also present in people with panic disorder (34%), alcoholics and drug addicts (50%), and those with social phobia (30%).

Those with traumatic brain injury also were found to have alexithymia.

Medical Conditions

People who suffer from medical issues, including fibromyalgia, migraine, IBD, hypertension, asthma, and serious allergies, may also experience episodes of Alexithymia.

Modeling by Society or Family Members

All infants are born unaware of how to express emotions facially. They rely on caregivers to demonstrate this to them. Caretakers help growing children connect their facial expressions to their bodily sensations using feeling words like “happy” “sad” “angry” or “proud.”

Modeling links feelings and facial expressions with related words.

An individual’s family background impacts their attachment styles. Avoidant attachment is the most frequent type connected to Alexithymia.

Some experts suggest a gender component. Men in counseling may experience difficulty articulating feelings. They may be prone to avoidance and disengaging from their partners. Culturally, men are rewarded for focusing their energies on:

  • resolving problems,
  • striving for success, and
  • wanting physical intimacy

as a means of avoiding more meaningful connections.

These theorists call it “normative male alexithymia.” For these men, being asked, “How does that make you feel?” leaves them anxious and uncertain. They like to steer clear of conversations involving strong feelings. They typically opt for a more neutral and unemotional approach when talking.

Treating Alexithymia in couples therapy

In healthy relationships, partners look for the expression of feelings and emotional vulnerability. Without that emotional intimacy, they don’t trust what their partner says.

People who are emotionally unavailable can be emotionally unregulated, having trouble handling strong emotions. Often someone who doesn’t express most emotions can recognize a more negative emotion like anger.

A good couples therapist recognizes that partners who lack emotional intimacy in their relationship need warmth and guidance. Even holding hands can help the couple bring back to intimacy. They explain the condition and try to create a safe space. Here the emotionally unavailable person opens up and begins to describe their inner world.

Our weekend intensives allow time and space for skill-building. Those with alexithymia practice recognizing and identifying their feelings.

Partners are often delighted to realize that in that impassive presentation, there is a genuine human being wanting to come out.

Those who struggle with alexithymia often have difficulty recognizing the origin of their emotions. They can have trouble understanding how their feelings change over time. This can lead to challenges in their romantic relationships and make it hard to engage in intimate conversations.

Those with alexithymia still have a deep-seated need to connect and form relationships.

Nevertheless, they often find difficulty in creating meaningful, intimate attachments due to the stress that these bonds bring.