Emotionless: Alexithymia?

Originally Published: December 15, 2006
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I'm told alexithymia is a condition related to an inability to express one's emotions as a result of not understanding them. Those who have the condtion usually appear very stoic and tend not to react in what would be considered a "normal" way, and they probably won't understand when others do react "normally." That is pretty much the extent of my knowledge on the subject, though the research I've done suggests that I potentially have this condition. I wanted to know if you knew where I could find further information about diagnosis and treatment.

— Wondering about Alexithymia

Dear Wondering about Alexithymia,

Most people can remember certain times when they found it hard to talk about their feelings or figure out what someone else was feeling. People with alexithymia, however, almost always have trouble expressing their own feelings or perceiving others' feelings. Although people with alexithymia may be perfectly capable of and willing to converse and socialize, they may come across as overly rational. They may also be able to focus on the physical world in great detail without attaching any emotional meaning.

In most cases, alexithymia is a symptom of a broader mental health condition(s). To diagnose alexithymic symptoms, a person would be evaluated for and diagnosed with a primary mental health condition. Treatment of alexithymia would be worked into the overall treatment of the broader condition.

Alexithymic symptoms may be seen in people who experience:

  • post-traumatic stress disorder
  • certain brain injuries
  • eating disorders (i.e., bulimia, anorexia, or binge-eating disorder)
  • substance use dependence
  • depression
  • other mental health conditions

It sounds like you may be concerned that you're experiencing alexithymia. Are you currently diagnosed with any mental health conditions that would have alexithymic symptoms? If so, how would you feel about talking this through with a mental health provider? S/he could assess your symptoms and lead you to more information and treatment options. If you don't carry a diagnosis already, is it possible you're experiencing a mental health condition that might need to be addressed?

As always, formal diagnosis and treatment should be done by a mental health professional with expertise in the area. If you're a Columbia student, you can call Counseling and Psychological Services at x4-2878 to set up an appointment.

During an evaluation, your clinician will probably talk with you for a while and ask you to complete surveys and other psychological tests. Based on the results of the psychological evaluation, your clinician will have a better idea of how alexithymic symptoms might appear within one or more mental health conditions.

From here, your clinician should explain treatment options to you and help you decide the next step. Treatment options will be influenced by the specific diagnosis/es that you receive, if any. S/he may recommend skills training in a group setting or on a one-on-one basis with the goal of increasing your ability to recognize and express emotion. It's most likely, though, that s/he will focus on treating the primary disorder and keeping an eye on improvements in your alexithymic symptoms along the way.

If you decide to talk about your concerns with a trained professional, you'll be taking the next step in figuring out what's bothering you. This may lead to some diagnosis and treatment. Hopefully, this will bring some peace of mind to you in the near future.