Alexithymia

What Is Alexithymia?

Alexithymia comes from the Greek roots a (lack or without), lexus (word), and thymos (mood or emotion). It literally means “without words or emotions.”

Though it was originally thought to be linked to psychosomatic disease, it is currently viewed as a personality characteristic, cognitive language style, deficit in processing emotional information, or deficit in affect regulation (Zech, Luminet, Rimé, & Wagner, 1999).

In 1963, French psychoanalysts M’UzanOpens in new window and MartyOpens in new window used the term pensée d’opétoire to describe the manner in which psychosomatic patients generally reported on events and their own actions without utilizing emotional descriptions (Zech et al., 1999).

In 1973, psychiatrist Peter SifneosOpens in new window (1920 – 2008) coined the term alexithymia. Sifneos was born on the Greek island of Lesbos, educated in Paris, and later taught at Harvard Medical School.

Sifneos noted that characteristics of individuals with alexithymia included difficulty recognizing and describing emotions, difficulty distinguishing between emotions and bodily sensations, little imagination and few fantasies, and preferring to focus on external events (rather than internal experience; Zech et al., 1999).

Research has been conducted looking at alexithymia as an aspect of personality as it relates to emotional awareness and to emotional intelligence. Instruments used to measure alexithymia include the self-report questionnairesOpens in new window, the Observer Alexithymia ScaleOpens in new window (OAS; Haviland, Warren, & Riggs, 2000), Toronto Alexithymia Scale (TAS-20), and Bermond-Vorst Alexithymia Questionnaire (BVAQ)Opens in new window. Many other self-rating questionnaires are available (e.g., on the Internet); however, they may lack reliability and validity (Zech et al., 1999).

Alexithymia has been associated with schizophreniaOpens in new window, aphasia (loss of ability to speak or understand speech), brain injury, Parkinson’s diseaseOpens in new window, insecure attachment, psychosomatic disease, stress-related illnesses, depressionOpens in new window, posttraumatic stress disorderOpens in new window, dysphoria (feeling unwell or unhappy), substance abuse, eating disordersOpens in new window, panic disorderOpens in new window, and severe trauma.

Mild to moderate alexithymia has been posited to be a by-product of normal male role socialization, wherein boys grow up unaware of their emotions (Levant, 2004). There is some overlap between alexithymia and Asperger’s syndrome (an autistic spectrum disorderOpens in new window).

TenHouten, Hoppe, Bogen, and Walter (1986) performed research with individuals in whom connections between the left and right hemispheres of the brain were severed (cerebral commisurectomyOpens in new window). Connections between hemispheres were completely severed in some individuals, partially severed in others, and not severed at all in control subjects.

Individuals with fewer working connections between right and left brain hemispheres demonstrated greater degrees of alexithymia (TenHouten et al., 1986).

TenHouten and colleagues hypothesized that because of the tendency of the right hemisphere (in right-handed adults) to be involved in cognitive representations of emotions and the left hemisphere in verbal expression, lack of communication between right and left hemispheres of the brain contributed to alexithymia.

Brain structures implicated in alexithymia include the right and left hemisphere, corpus callosum, anterior commissure, anterior cingulated, prefrontal cortex, amygdala, and insular cortex (insula; Bermond, Vorst, & Moormann, 2006). The corpus callosum and anterior commissure are involved in facilitating communication between right and left brain hemispheres.

Because of difficulty identifying and describing emotions, traditional insight-oriented psychotherapy is typically not an effective treatment for alexithymia. More effective treatments for alexithymia include cognitive-behavioral, psychoeducational, skills training, family systems, and group therapies (Levant, 2004).