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Alexithymia diagnosis


Alexithymia diagnosis

Does your mind go blank when someone asks you how you feel? Do people accuse you that you don’t understand them or that you do not show enough empathy? Do you have to listen to this often, even if you try your best? It can be because of a personality trait called “Alexithymia.”  It is not a mental health disorder. People who have alexithymia may find it challenging to identify and express their emotions. This also makes maintaining relationships challenging.

Some researches suggest that about 13% of the population experience this personality trait. Some studies also suggest that it is more common in men than in women. In this article, I am going to discuss alexithymia with you. I will talk about alexithymia, meaning its causes, symptoms, treatments, and how it affects a person’s relationships. So let’s get started:

Alexithymia meaning

The word “alexithymia” is a combination of Greek words “a” means lack, “lexis” means word and “thymos” means emotion. It is used mostly in Freudian psychodynamic theories, alexithymia, meaning“no words for emotion.” According to researchers, it is a construct related to experiencing difficulty in identifying and expressing feelings.

It is not a clinical diagnosis. It is not considered a disorder by mental health professionals. However, a person may experience it along with some mental health conditions.

People who experience alexithymia have:

  • Issues in observing their own emotional and mental processes or introspection
  • Feel confusion regarding bodily sensations linked to emotions
  • Issues in communicating their feelings to others

Alexithymia also makes it difficult for a person to understand and repose the feelings of others. So these problems make social interactions and relationships challenging.

Narcissistic alexithymia

Narcissistic alexithymia is related to a narcissist’s inability to identify, describe, or differentiate emotions. This trait would be experienced during the devaluation phase when a narcissist is highly responsive towards negative triggers. Instead of understanding his own emotions, he may project rage onto another person because of narcissistic alexithymia.

Alexithymia scale

Just like other psychological problems, alexithymia also comes up with a range of variations. So alexithymia scale is vast. Some Psychologists divide it into two types primary and secondary.

  • Primary: means a person will have symptoms all the time
  • Secondary: means symptoms will only appear when a person is under stress

There are also some other differences; for instance, some people experiencing alexithymia will have emotional outbursts while others do not. Outbursts a person will have tend to be extreme and quick, comprising of tears and rage. And after that, he may not understand how to describe what happened; moreover, the individual may be interested in understanding what happened but struggle to do so.

What causes alexithymia?

Alexithymia is not well understood yet. So, experts do not know much about the causes of alexithymia. But some studies suggest that there are certain causes of alexithymia. If you are wondering what causes alexithymia? These are mentioned below:

Linked to autism

Symptoms of autism spectrum disorder are vast but still some stereotypes linked with this condition. One main stereotype is a lack of empathy.

A study in 2018 has suggested that about half of autistic people are more likely to experience alexithymia. In simple words, we can say that lack of empathy is because of alexithymia and not because of autism.


What causes alexithymia? There is a possibility that Alexithymia is because of genetic issues. Research has made on twins, which indicates that there is a genetic component of alexithymia. Chances of a person experiencing alexithymia are higher if a close relative also has it.

Environmental factors

The same study made on twins also indicated that alexithymia could result because of certain environmental factors. Some common examples of environmental factors include mental or physical health conditions, socioeconomic factors, or childhood trauma history.

Depression and emotions

Alexithymia depression is also common in people experiencing alexithymia. As the name indicates, depression can be a cause of alexithymia. It has been noted in postpartum and depressive disorders and also in cases of schizophrenia. Research shows that about 32-51 percent of people suffering from depressive disorders also experience alexithymia.

depressed woman sitting head in hands in the dark bedroom


Alexithymia’s condition is also noted in people who have been through trauma, especially in early childhood. Neglect and trauma during this phase can cause changes in the brain and make it difficult to identify and express feelings later in life.

Brain injury

Research has shown that brain injury can also cause alexithymia if there is damage to the insula. It is a part of the brain known for its role in empathy, emotions, and social skills. Insula lesions are also linked with anxiety and apathy, according to some studies.

Some other conditions

Research has also shown that alexithymia can be present in the case of certain neurological injuries and diseases. These may include the following:

  • Traumatic brain injury
  • Multiple sclerosis
  • Parkinson’s disease
  • Alzheimer’s disease
  • Dystonia
  • Stroke
  • Epilepsy
  • Huntington’s disease

Symptoms of Alexithymia

As this condition involves a lack of emotions, it can be difficult to understand and recognize alexithymia symptoms since it is all about the inability to express feelings, so you may find a person apathetic and out of touch. However, a person may experience the following symptoms of Alexithymia.

  • Feel difficulty distinguishing between bodily sensations related to emotions; for instance, it may be difficult for them to understand whether the heart is racing because of fear or excitement.
  • Feel difficulty in communicating his own emotions
  • Lack of imagination and fantasies
  • Rigid and logical thinking style
  • Inability to deal with stress
  • Less altruistically behavior
  • Appearing humorless, rigid, and distant
  • No or poor life satisfaction
  • Prefer doing things than thinking about them

The following are some other symptoms of alexithymia.

  • Anger
  • Confusion
  • Difficulty “reading faces.”
  • Discomfort
  • Emptiness
  • Increased heart rate
  • Lack of affection
  • Panic

Alexithymia test

As I have mentioned above, it is not a mental health disorder. It is not officially recognized by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So mental health professionals and doctors cannot diagnose the phenomenon formally. All they can is to ask you specific questions to check if there are certain symptoms of alexithymia or not.  There are also certain alexithymia scales to assess the situation. The Alexithymia test may include the following.


TAS-20 is the abbreviation of the Twenty-Item Toronto Alexithymia Scale (TAS-20). It is a trendy scale to identify the symptoms of alexithymia. It can assess:

  • The ability of a person to understand emotions and to separate them from bodily sensations
  • The ability of a person to communicate feelings with others
  • The ability of a person to show logical thinking toward a particular situation instead of introspection thinking style


BVAQ is an abbreviation of The Bremond–Vorst Alexithymia Questionnaire. It enables a professional to assess both affective and cognitive aspects of alexithymia more descriptively. It is consists of 40 components comprising of the following five subscales:

  • Emotionalizing
  • Fantasizing
  • Identifying
  • Analyzing
  • Verbalizing


OAS is an abbreviation of the Observer Alexithymia Scale. It consists of 33 components under the following five-factor composition:

  • Distant
  • Uninsightful
  • Somatizing
  • Humorless
  • Rigid

Online tests

There are plenty of online Alexithymia tests available on the internet; with the help of these, you can identify whether you have alexithymia or not. These are just for a rough idea and diagnosis and can help you in identifying the symptoms. These questionnaires do not have any scientific or clinical base, so if you feel like these are symptoms, it would be better to consult a professional.

Questions will be as following:

  • Do you feel difficulty in communicating with others?
  • Do you describe nauseam and details but can’t actually describe feelings?
  • Do you use action for expressing emotion?
  • Do you feel confused about your emotions?
  • Are you preoccupied with physical problems?
  • Do you not have a dream or daydream or consider yourself playing a negligible role in someone’s life?
  • Do you prefer action movies over psychological dramas?
  • Do you feel that life is boring, and there is no excitement?
  • Do you feel a lack of imagination or fantasy?
  • Do people always accuse you as heartless and emotionless?

If the answer to most of these questions is yes, there is a chance that you might be experiencing alexithymia.

Alexithymia treatment

As I have mentioned above, professionals do not know much about it, so there is no single individual treatment of alexithymia. The treatment totally depends on your overall health, needs, and severity of symptoms. For instance, if you are experiencing anxiety or depression or taking medications for these mental health conditions could also help with some emotional symptoms. Therapies may prove helpful in this condition. There is no medication recommended, so do not try anything on your own.

Here are some possible Alexithymia treatment options for alexithymia

Talking therapies

What is the best treatment of alexithymia? Well, Talking therapies such as coaching or talking treatments involve counseling that can prove helpful in dealing with alexithymia. In this treatment, a person experiencing alexithymia will talk to highly trained professionals about how he feels or thinks and his behavior. Aims of talking therapies are as follows:

  • Making you able to recognize repeating patterns of your actions and thoughts and finding a way to change them
  • Helping you to resolve complicated feelings or to find a middle way to accept and live with them.
  • Helping you understand yourself better
  • Providing you with a safe place to talk about your fears and insecurities without passing any judgment

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy involves an approach that helps to identify negative thoughts and their changing patterns. What people think about affects their behavior. A simple CBT technique involves saying “STOP” either aloud or in your head when you are experiencing a rush of negative thoughts and rage. It is suggested that Cognitive Behavioral Therapy, combined with Systematic Desensitization Therapy, can bring remarkable results in treating alexithymia. Here are some of the very popular techniques used in CBT:

SMART Goals: Specific, Measurable, Achievable, Realistic, and Time-limited goals. Your therapist will motivate you in setting these kinds of goals and then in achieving them.

Questioning: by asking about assumptions you have about yourself or the current scenario, your therapist can challenge these and have a different perspective.

Self-talk: your therapist may ask you about what you tell yourself regarding a certain experience or situation and challenge you to replace critical and negative self-talk with positive and compassionate self-talk.

Journaling: your therapist may ask you to practice writing negative beliefs that come during the whole week and positive ones that are replaceable with them.

Cognitive restructuring: it covers looking at cognitive distortions that are affecting your thoughts. For example, black and white thinking, catastrophizing, or jumping to conclusions and starting to unravel them.

group psychotherapy

It is a form of therapy in which one or more therapists deal with a small group of clients. It is an excellent way to interact with other people and understand their experiences in the presence of a professional who can assess the whole situation. It is one of the most effective alexithymia treatment options.

Because of people’s behavior, a person experiencing alexithymia may feel alone, but with group therapy, he will not feel alone at all. It is an excellent way to give and receive support. With the help of this, you can understand your own feelings and decide what do you want from your life and what needs change. With the help of this, you can relate yourself to others but in a healthy way. The most important thing is that the connection is authentic, and you will feel secure.

Overcoming alexithymia

In order to deal with alexithymia, you have to be mindful of your own thoughts. Some research suggests that it is really helpful to start with your heart rate. Notice whether the heart rate increases or decreases in certain situations. You can also take help from a fitness or heart monitor watch. This way, you can distinguish between fear, anger, and excitement.

You also have to keep in mind that negative feelings are as important as positive feelings; you cannot ignore them. Identifying these emotions can help in leading a fulfilling life. Here are some other things that can help you in overcoming alexithymia.

Changing lifestyles

You cannot overcome issues like alexithymia just with the help of therapy or meditation. If you are not prepared and willing to deal with it mentally, you can’t get rid of alexithymia. To bring a positive change in your life, changing your lifestyle habits in addition to regular therapy works best and brings remarkable results. Doctors or your therapist will also recommend you some relaxation or mindfulness techniques and exercises. Also, work on your diet.


Several forms of meditation can help one in overcoming alexithymia. Mindfulness meditation has been proven most effective in dealing with this issue. There are different ways to implement this meditation. There are also meditation applications that are specifically designed to help you with this. Mindfulness helps people in diverting their attention to some other things. It helps them refocus their attention to somewhere that does not come up with any sort of emotional baggage or negativity, for example, suggesting that they focus on breathing and positive thoughts.

Alexithymia in relationships

People who are dealing with alexithymia in relationships are unaware of their emotions. They are not able to show empathy towards you. They fall in love, they even get married, but they do not know how to show affection. On the other hand, significant others may feel themselves in a vacuum where their basic emotional needs are not fulfilled. So it can be tough to deal with this whole complicated situation. Alexithymia in relationships, can ruin the essence of a relationship.

Alexithymia and marital quality are related to each other. Research has shown when one spouse is suffering from alexithymia, the other spouse may feel lonely, and there is a lack of intimacy, leading to poor marital quality. But if the significant other knows how to deal with the whole situation, the negative impacts of alexithymia in intimate relationships can be reduced. In the following section, I will help you deal with a person who is experiencing alexithymia.

How to help someone with alexithymia

Loving someone dealing with alexithymia is not easy; they are dealing with emotional issues, which means you also have to deal with their problem. I am not saying living with someone who is experiencing alexithymia is so bad and you shouldn’t do it. But if you fall in love with a person dealing with Alexithymia, you have to be stronger. Alexithymia and marital quality are also connected, so you may also have to deal with poor marital quality if you are married. You have to support them and be there whenever they need you. With your help and support, they may cure quickly but you need patience. I know it will not be easy for you, but it helps to have people around who love you unconditionally and are ready to help you and support you.

If someone you love is experiencing Alexithymia, you need to understand that it is a serious issue, and you cannot ignore it even if you are finding it difficult to understand  know that it is real, so do not take it lightly. Here is how to help someone with alexithymia:

Educate yourself

If you are wondering how to live with someone experiencing Alexithymia? First of all, you need to educate yourself about this condition. Learn how it affects people and how differently people can react when they have a particular situation or they are presented with a problem. When you understand alexithymia a little bit, it becomes easy to deal with them.

Do not rush things

If a person you love has Alexithymia, do not push him/her to do things he may not want to do. Do not get upset if they are not expressive. Rushing things will not help at all; you cannot force someone to be expressive when they can’t understand how they feel and how they can express what they feel. Expression of love must be organic and never manipulated.

Encourage them to get help.

Take things slowly and help them understand the problem. Encourage them to seek professional help and don’t be judgy. It will only make them uncomfortable around you.

Be there for support.

How to help someone with alexithymia? Try to talk to them about their fears, understand them, and ask them how they want you to help, what they need? If they can trust you, it would be easy for them to deal with their problem for tthey can confide in you about their emotions and thoughts.


Alexithymia is a complicated personality trait. It is not widely known yet, but there has been a lot of research in the last four decades. It is presented in people who find difficulty in identifying and expressing their own feelings. Moreover, it also coincides with other mental health disorders or neurological conditions.

Alexithymia does not only affect your social life but also your close relationships. Alexithymia may cause frustration in people who are experiencing it. If you feel like you or any of your close friends, relatives, or partner has symptoms of alexithymia, make sure to go for professional help. Call 03333443853 for a free consultation today

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