Alexithymia is when a person is not able to express, tell the difference between, and name emotions. Most of us learn early – before we even learn language – how to express and tell the difference between emotions. Babies learn this when they see their emotions amplified on the face of a caring parent or caregiver. Most caregivers intuitively sense and mirror back an infant’s emotional state. This mirroring-in-the-face-of-a-parent helps a child’s brain begin to know and recognize their emotions, eventually enabling the infant to feel their feelings openly – without shame – and communicate their feelings with words.
Alexithymia can have a number of causes, but often it develops in childhood in response to a caregiver who is unable to be emotionally present to their child due to their own trauma, postpartum depression, or their own lack of emotional awareness.
Learning to Name Emotions
Our ability to name our own emotions begins through an emotional connection with other people. These connections help brains learn to recognize sensations, label them with a feeling word, describe that feeling to another person, and receive a supportive, appropriate response from the other person. This process, repeated countless times, builds an ability to recognize and express emotion, while also helping to build satisfying relationships that support good mental health.
Ideally, this process of having our emotions noticed, responded to, and integrated back into our own awareness happens in early childhood. For example, when a parent notices a frustrated toddler and validates that frustration, the toddler is learning to integrate 1. the internal feeling of “being frustrated” and 2. the cognitive awareness “I am frustrated.” In normal development, the child becomes increasingly capable of automatically intuiting the physical, emotional, and social experiences within their body and connecting them with an emotion.
Historically, researchers believed this naturally happened in childhood – with emotional development occurring as automatically as a child growing in height or progressing through puberty. We now know that developing awareness and language to describe the emotions we experience is a learned skill that requires some basic support for people to develop – support that not every parent is able to provide (perhaps due to the parents own lack of emotional awareness, trauma, or discomfort with their own or their child’s emotions). Social emotional learning curriculum in schools is beginning to address these deficits in school-age children, but how to help the millions who didn’t get early emotional needs met or early intervention? Psychotherapy and counseling.
Psychodynamic therapy, like the work I do in my clinical practice, addresses alexithymia by offering to clients the attunement and mirroring of emotion that may have been missing in childhood. Over time, this type of therapy can strengthen the neural pathways in the brain that make it possible to notice, name, express, and get care for the emotions they experience, in the process helping people to develop a wider emotional range, more satisfying relationships outside of therapy, and richer life experiences.
Where We Start: Emotions in the Body
Emotions are experienced throughout the body.
For many people, practicing noticing emotions can be part of effective treatment for Alexithymia. When we bring in tension and mindfulness to checking-in with ourselves to notice what our body might be telling us about our emotional state, we can build neurological connections that help support our emotional growth. In other words, building these neural connections as a way to decrease the symptoms of Alexithymia is sort of like the brains equivalent to how physical therapy might work with a specific muscle to help it grow stronger in order to support a person’s body.
We can learn to recognize a particular emotion by learning to recognize and name the associated body sensations. A skilled therapist can provide the essential one-on-one care to recover from Alexithymia. In support of that recovery, you may find my printable emotion sensation wheel, which takes a traditional feeling wheel and modifies it to include the physical sensations that often accompany emotions, a helpful resource.
Alexithymia and Trauma
While it is not unusual for alexithymia to be diagnosed as part of an autism, major depression, or even personality disorder diagnosis, MANY individuals without these diagnoses experience the symptoms of alexithymia to some degree. Struggling to notice, name, or express emotions is common to many individuals who have survived trauma or emotional neglect – even those who may otherwise be thriving.
Trauma survivors may develop alexithymia as a way to cope with overwhelmingly negative emotions. For these individuals, blocking emotions may have been adaptive for much of their life, but not being able to feel and express their emotions may eventually leave them feeling isolated and lonely, cut-off from relationships with others and even from themselves. For trauma survivors who experience alexithymia, treatment from an experienced trauma-informed counselor or therapist may provide containment for the overwhelming emotions while the person grows a greater capacity to experience and express them.
Treatment for alexithymia can improve general well-being and satisfaction with life, as well as improving the quality of our relationships, strength of marriage and partnerships, and even lead to more satisfying sexual experiences through a deeper relationship with our partner and more mindful presence to our own emotional-physical experience.