Alexithymia is a disorder of emotional regulation, widely observed in psychosomatic illnesses. It manifests itself in great difficulty in identifying and describing his feelings and those of others. Alexithymia is also involved in a wide variety of psychological problems, such as depression and schizophrenia. The disease affects about 10% of the general population.

Definition of alexithymia

Alexithymia is a disorder of emotional regulation, widely observed in psychosomatic illnesses. It manifests itself in great difficulty in identifying and describing his feelings and those of others.

Alexithymia can be summarized in four main manifestations:

• The inability to verbally express emotions or feelings;
• The limitation of imaginary life;
• The tendency to resort to action to avoid and resolve conflicts;
• The detailed description of the facts, events, physical symptoms.

The term alexithymia is a neologism – a = absence, lexis = word, thymos = mood, affectivity, feeling, emotion – coined by the psychiatrist Sifneos in 1973 to describe people who do not have the capacity to communicate their feelings or have a limited imagination: “a poor fantasy life resulting in a utilitarian form of thought, a tendency to use action to avoid conflicts and stressful situations, a marked restriction in the expression of emotions and particularly difficulty in finding words to describe his feelings. “

Types d’alexithymies

Two types of alexithymia can be distinguished:

• State alexithymia has a specific cause and is often a temporary condition. Post-traumatic stress disorder, caused by a horrific event, is an example known to trigger this type of alexithymia.
• Character alexithymia is considered to be an inherent characteristic of a person’s personality. It can be primary or secondary – caused by events that occur in a person’s early childhood, such as neglect or violence.

Alexithymia is also understood to have two components:

• A cognitive component where people can face challenges with thinking and emotions while trying to name, understand and talk about their feelings;
• An emotional component where people may have difficulty sharing, responding to and feeling their emotions.

Causes de l’alexithymie

In the past, alexithymia was classified and limited to psychosomatic disorders – disorders involving physical symptoms of the body but created and exacerbated by the mind. For example, a person who is very angry, but does not express their anger, may have a stomach ache.

However, alexithymia is involved in a wide variety of psychological problems, such as depression and schizophrenia. Much of the emotional deficits in autism spectrum disorders can be attributed to it.

But alexithymia is also associated with changes in the activity of the sympathetic nervous system – one of the three components of the autonomic nervous system that manages the activity of visceral organs and automatic functions of the body such as breathing and heartbeat. heart–, immune system and brain activity.

Some researchers link alexithymia to insecure parental attachment or negative childhood experiences.

Other research on alexithymia in dermatology shows that it seems to be associated with alopecia areata –or alopecia areata, an autoimmune disease causing hair loss–, psoriasis, atopic dermatitis –a type of eczema–, with vitiligo or chronic urticaria.

Diagnosis of alexithymia

Alexithymia is still not recognized by official classifications of diseases. But its diagnosis can be carried out using different measures and scales.

The TAS-20 – for “Toronto Alexithymia Scale” – is one of the most commonly used instruments to assess alexithymia in research and clinical practice: http://www.antidouleur59.fr/douleursquestionnairetas20.pdf.

This scale is made up of 20 items, which study three dimensions:

• Difficulty in identifying emotional states;
• Difficulty describing emotional states to others;
• Operative thinking.

Responses range from 1 to 5 from full disagreement to full agreement.

There are other instruments for measuring alexithymia:

• The Beth Israel Questionnaire (BIQ) or the Beth Israel Psychosomatic Questionnaire;
• Le Bermond-Vorst Alexithymia Questionnaire (BVAQ);
• And many more

During an assessment, the clinician will also interact for a period of time with the patient and ask them to take additional surveys and psychological tests.

People affected by alexithymia

Alexithymia affects about 10% of the general population.

Some research suggests that alexithymia is predominant in men and among doctors.

Factors favoring alexithymia

Different factors can promote or amplify alexithymia:

• Fibromyalgia;
• The Depression ;
• Eating disorders;
• Drug addiction ;
• Some brain damage;
• Post-traumatic stress disorder;
• And many more

Difficulty communicating feelings

The first characteristic of alexithymia is the difficulty in being able to communicate your feelings to others. The alexithymic is unable to express his emotions verbally.

Inability to identify feelings

People with alexithymia are unable to identify their feelings and be able to distinguish them from their bodily sensations. The patient repeatedly describes physical symptoms instead of attempts to express his feelings.

Poverty of imaginary life

The alexithymics dream little – or remember it very little – and when the dream exists, its content is poor, factual and realistic. Moreover, the difficulty in verbalizing the dream is real. Fantasies are rare and memories appear very disturbed. Alexithymia breeds a lack of imagination and a cognitive style focused on stimuli and external influences.

Thoughts with pragmatic content

The thoughts of alexithymics are outward rather than inner sensations. The patient makes a very detailed description of the facts, events or physical symptoms that produced the emotions but does not express the emotions in themselves.

Misinterpretation of physical sensations

The inability to adequately identify physical sensations as somatic manifestations of emotions can make people with alexithymia likely to incorrectly interpret their emotional arousal as signs of illness, leading them to seek medical attention for symptoms. for which no clear medical explanation can be found.

Other symptoms

• Poor words and phrases used;
• Emotional speech absent;
• Poverty of feeling in speeches;
• Factual narrative diagram, without fantasy or symbol;
• Lack of impulse control;
• Violent or disruptive eruptions;
• Indifference towards others;
• Difficulty identifying the emotions expressed by others;
• Increased sensitivity to looks, sounds or physical touch.

For people with alexithymia, a mental health professional will often focus on establishing a basis for naming emotions and appreciating a range of feelings. The process will include both taking into account other people’s experiences and self-reflection through:

• Group therapy;
• A daily newspaper ;
• Competency-based therapy;
• Engagement in the creative arts;
• Various relaxation techniques;
• Reading books or moving stories;
• And many more

Over the past four decades, alexithymia has inspired much research that has shed light on many aspects of the disease but has yet to develop new evidence-based treatments to improve the lives of people. alexithymic people. Nonetheless, behavioral, linguistic and neuroscientific research on alexithymia appears to have progressed to such an extent that it could translate into effective treatments for people with alexithymia. These treatments can be offered in innovative forms, such as Internet programs: online communication provides a means of keeping people-to-people contact to a minimum, thus reducing the need to openly share emotions.

Learning to verbalize your feelings and emotions from an early age can help limit the occurrence of alexithymia.