Contents
Approximately 10% of the population cannot distinguish between fear and hunger and sometimes behave like insensitive robots. We understand how people with alexithymia live and how they can be helped
Content
- What’s this
- Evidence
- Causes
- How does it affect life
- How to communicate with people with alexithymia
- How to handle
What is alexithymia
Alexithymia (from the Greek a-lexis-thymos, that is, “there are no words for feelings”) is the inability to express one’s experiences and recognize others. It is sometimes referred to as emotional deafness or insensitivity.
A person with alexithymia—sometimes called an alexithymic—does not recognize his emotions well. Often it is difficult for him to separate them from bodily sensations, such as anxiety from hunger. He has difficulty describing his feelings in words, he does not know how to talk about them to other people. The imagination of a person with alexithymia is limited – he does not imagine abstract things well and fantasizes with difficulty. Other people may find his behavior unemotional and strange.
Psychologist and founder of the online school “Psychodemia” Maria Danina:
“People with alexithymia are intellectually intact, but it is difficult for them to understand their own feelings – they seem to have lost access to them. Their emotional world turned out to be locked up, and one has to look at it as if through a keyhole: something is visible, but bad, and it is not clear what exactly is happening on the other side. For such people, it is very difficult, and sometimes impossible, to solve problems that are simple and accessible to most people.
There is evidence that alexithymia occurs in one in ten people [1]. From a medical point of view, it is not a disease or mental illness. In psychology, alexithymia is considered as a personality characteristic, not a disorder [2]. But some psychosomatic or mental problems are often accompanied by alexithymia [3].
Signs of alexithymia
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes the criteria by which mental illness can be diagnosed. Alexithymia is not there – it is not a disease, but a symptom, one of the manifestations of some kind of disorder. Just like high fever is not a disease in itself, but only a symptom of some disease.
There is no single approved test for alexithymia. A psychotherapist or clinical psychologist recognizes alexithymia based on the patient’s responses.
Most psychologists and psychotherapists are guided by the Toronto Alexithymia Scale. In the form of a test, 25 statements must be evaluated on a five-point scale [4]. In our country, it was adapted by scientific institutes in the 2000s [5].
According to the Toronto scale, a person is evaluated according to the following criteria [6]:
Anastasia Vlasenko, a psychologist at the Gran service, explains that people with alexithymia may not feel happiness, pleasure, or joy, but they feel pain, anger, or fear well. Perhaps, after some kind of psychological trauma, they made a choice in favor of not feeling negative emotions. But it turned out that negative experiences did not disappear anywhere, but the joy and pleasure from life disappeared. Another typical example is that a person with alexithymia lives a very even and boring life, without emotional fluctuations. Often such people do not understand what they want, what their desires are, and they don’t mention dreams at all.
Psychiatrist and psychotherapist Mikhail Valuysky tells about a typical manifestation of alexithymia: “A girl in a relationship can complain about her young man – he is emotionally cold, distant, and she does not understand whether she lives with a man or a robot. Her young man with alexithymia is sincerely perplexed that she does not like it. He works, takes care of her, does not change. And at the same time, he does not realize that an important component is missing in their relationship – a manifestation of tenderness, attention, care, a sense of acceptance and love.
Causes of alexithymia
What exactly causes alexithymia is not known for certain. Perhaps it can be congenital, that is, associated with some genetic disorders or problems in the structures of the brain [7]. Acquired alexithymia can manifest itself under the influence of the environment or, for example, due to psychological trauma.
According to Mikhail Valuysky, alexithymia has two main causes.
- In about 90% of cases, in the family of a person with alexithymia in childhood, there was a ban on emotions – it was impossible to show one’s grief or joy. Everything had to be strict, reasonable, correct, logical. There are quite a lot of such families, and children can grow up in them who feel everything, but do not know what kind of emotions they are. Nobody explained to them what love, tenderness, anger, happiness are. Most often, a child from such a family can describe well the emotions of shame and guilt, because all his childhood he was shamed and blamed. But with anger or with positive emotions there will be problems. In addition to the prohibition on the manifestation of emotions, there is also a prohibition on demanding feelings from parents. “Get off me”, “get off me” – so they say in emotionally cold families. And the child suffers not from the fact that he does not feel emotions, but from the fact that he does not understand others. Other people, unlike his parents, express their feelings, but he cannot recognize them and respond adequately.
- In the remaining 10% of cases, alexithymia is one of the symptoms of a severe mental disorder, such as schizophrenia. A person may have apathy, he does not experience any emotions, and he is quite comfortable. There is alexithymia in severe depression. Painful mental insensitivity (anaesthesia psychica dolorosa) also correlates with the concept of alexithymia. In this state, a person does not experience any emotions and is very tormented because of this. For example, a mother suffering from severe depression does not feel love for her children and reproaches herself for it. But in such cases, alexithymia is accompanied by other symptoms.
How alexithymia affects life
Alexithymia in life can manifest itself in varying degrees: from mild to severe, complicated by concomitant mental disorders, explains psychologist Maria Danina. A person with alexithymia can be as well socially adjusted – have a job, relationships, friends, or be in a very difficult condition, when even basic social situations present difficulties.
In friendships and family relationships, a person with alexithymia sometimes appears cold and distant. It is difficult for him to explain to others how he feels in a relationship, to demonstrate his attitude towards someone. Spontaneous aggressive outbreaks are also possible. This negatively affects relationships with others, conflict situations, misunderstanding, resentment arise.
As a rule, such people rarely turn to a psychologist with a problem of emotional coldness. Most often they complain of depression, burnout, loss of interest in life. For example, a person with alexithymia does not understand how he feels at work, so he ignores situations that cause discomfort, misses signs of fatigue and dissatisfaction. As a result, neither colleagues nor management know about his burnout, and he feels bad “for no reason.”
Also, people with alexithymia may not only have problems in relationships with others, but also with understanding themselves. They do not know what they want from themselves and from life, they feel like passive observers of what is happening and, as it seems to them, they are wasting time.
How to communicate with people with alexithymia
Psychotherapist Philip Tatarenko explains how to help a person with alexithymia:
In some cases, the only way to help a loved one is to advise him to seek professional help.
How to deal with alexithymia
There is no cure for alexithymia. Working with a psychotherapist will help develop the ability to recognize emotions. Lahta Clinic psychologist Anastasia Zhdanova talks about some techniques that you can practice on your own.
- If it is difficult to recognize emotions, you can search the Internet for photographs of various emotional reactions with descriptions. When comparing photos, pay attention to facial expressions: the position of the eyes, mouth, characteristic wrinkles. This exercise will help you understand how the experiences of other people are reflected on their faces, what is the difference between one emotion and another at the level of facial expressions.
- To understand the full range of emotions, you can study the wheel of emotions of Robert Plutchik (Robert Plutchik). It clearly shows how wide the palette of feelings is. With it, you can study the relationship between emotions, the degree of their intensity and understand where complex emotional states come from.
- When emotions that you know well appear, you should pay attention to your bodily sensations. What happens to the body when you experience them? It can be tension in the legs or arms, a lump in the throat, heaviness in the shoulders or chest. Or vice versa – warmth and lightness. In this way, you can train the recognition of emotions and learn to separate feelings from bodily sensations.
- Practicing self-awareness in the present moment can also help. When picking up a cup of coffee, pay attention to the details: surface texture (smooth or rough), temperature (cold, warm or burning), weight, comfortable position in the hand. As you take a sip, note the taste, the temperature, the smell—anything you can notice. Such an exercise can easily be extended to everyday situations, such as walking in the park or cleaning the house.
To learn to be aware of your emotions, you can imagine them as energy, which, having arisen, does not disappear into nowhere. Philip Tatarenko explains that psychology knows three ways to discharge such energy: into the body, into actions, or into words. The last way is the healthiest for accepting your emotions. If the discharge of emotions does not occur, a person will either get sick or behave unpredictably – for example, get angry or burst into tears from scratch. Therefore, for a person who does not know how to recognize his feelings, methods of expressing emotions through words are useful. In addition to working with a psychotherapist, this can be, for example, keeping an “emotion journal”. It notes events, triggers – factors that provoke an emotion, and the type of reaction to them. Records must be kept regularly.
It is important for a person with alexithymia to track and name their positive and negative feelings, recognizing the significance of both. Contrary to what he may have been told as a child, negative feelings – anger, sadness, fear – are not bad, they are just as normal to experience as positive ones.