What is Alexithymia?
Some people struggle when asked to explain or share their emotions. They lack words for their 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 can also not 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.”
We all have feelings, even if we have trouble identifying or processing them.
But they still form “attachments,” possessing the fundamental need for community as all humans do.
What causes Alexithymia?
Five main categories are correlated with alexithymic traits: Autism, trauma, certain medical conditions, modeling, and psychiatric disorders.
Autism
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.
Trauma
Alexithymia is a trait often found to some degree in those who have suffered trauma.
Alexithymia and PTSD were 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 severe 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 style. 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.
Emotionally unavailable people can be emotionally unregulated, having trouble handling intense 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 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 describes 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, a genuine human wants to come out.
Those who struggle with alexithymia often have difficulty recognizing the origin of their emotions. and 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 it difficult to create meaningful, intimate attachments due to the stress these bonds bring.
My husband and I have been together 37 years. We raised our two children and they no longer live with us. Our journey has been bumpy. We have faced many challenges. I would describe myself as an empath and my husband who suffered severe trauma as a child does not share that identity. My husband, I just found out approximately 4 weeks ago, pendulates between anger and happiness. I understood that he had difficulty with his emotions but not until recently did I find out that he cannot identify any emotions other than anger and happiness. He has believed our whole marriage that if I was not doing what he wanted, it was solely because I wanted to spite him. I cannot even begin to express my devastation. After so many years of counseling on my own, countless books, videos and resources trying to understand our differences and try to find a way to truly understand and appreciate each other, I feel so much pain right now I do not know if I can continue my marriage. I have tolerated his rage full verbal violations, his cold shoulder, his manic episodes in an effort to understand him and to try to build our relationship into wholeness. I, after finding out his truth about emotions, stated to him that I could no longer live with this and that if he did not get help I must leave. He has begun counseling and I am finding myself feeling like I cannot go through all of this again. I just do not know if I have it in me to give any more. I do not know if he actually has alexithymia but it seems to describe very clearly his personality. I must say though, as he spoke to the marriage counselor and the words came out of his mouth that he could only identify the two above noted emotions, I had a moment where I realized, I am not crazy. All of these years I believed it was my fault, and his behaviors supported that disempowering belief, but I finally no longer feel like I am crazy. It is a small but important shift.
Anger operates differently than other emotions. I am glad you are getting the help you need. Your intolerance of bad behavior led to change. -Dr. K
I was married to someone for almost 20 years with Alexithymia. I was so confused by his total lack of emotions. I would ask him if he loved me and he would reply “I married you.” There were SO many things that left me feeling sad, frustrated, and so alone. I had to tell him I wanted a divorce 3 times before he acknowledged I even said said anything. When he finally responded he said he didn’t want to be alone or move out of the house. I gave him almost everything so he could stay in our house. I just wanted out so bad and at that point didn’t feel like I had much self worth. It took a lot to heal from those years. I wish more people knew about this because it can have devastating effects.
Such an incredibly sad story. Yes, I also wish it were more widely known. Especially since a person can learn to display emotions on their face that reflects how they cognitively process the feelings. Thank you for your comment, Christina. -Dr. K
This was helpful, thank you. Do you offer marriage counselling to couples in Australia? I see a very lonely, sad, empty existence ahead. I feel like I’m in hell most of the time. My daughter is also effected by his angry outbursts, inability to empathise, his selfishness and innate need to twist truths and manipulate outcomes to suit and promote self.
We do! Just use the contact us page.
I was currently in a relationship with a guy who has alexithymia it took me 20yrs to realise what he had. I was so lonely. My mother died and he was just so emotionally empty. This wasn't the only time it had happened. He told me only ever worked on the premises of logical thinking. I worked on a premis of emotions. Needles to say the relationship ended.
I feel so deeply validated reading these comments…seeing that I’m not alone… and considering for the first time that it isn’t my partner’s “fault”, ie., it isn’t entirely, or simply, intentional avoidance or just a total lack of care/consideration. I don’t even know where to begin to start the process of healing
Same here. I’ve struggled in relationships my whole life. My wife has asked for a divorce and that made me look deeply into why I struggle with so many things emotionally.
I am dealing with this with my husband. It is absolutely devastating to both us and our marriage.
Me too. We will be not celebrating our 34th wedding anniversary in a couple of weeks!
I would like more Information about this and if there are any therapist in Wilmington North Carolina that practice in this field
I am most likely Alexithymic and it appears my spouse is OCD/OCPD, making me inherently introverted and her extroverted along with the rest of the unbalances symptoms. Despite our differences, we love each other very much.. is there a way to balance this out?