What Is Alexithymia?
What Is Alexithymia?
When Miguel was eight, he constantly asked his mother if she was "mad" at him. He misinterpreted her everyday stress as anger: her urgency when he was late for school, her frustration after a repeated request, or her irritation at an unexpected errand. In reality, she was rarely angry with him.
Miguel's emotional world was limited; he could primarily discern "happiness" and "anger." This misconception, which deeply saddened his mother, likely contributed to his own anxiety. Unknown to them, Miguel was grappling with alexithymia. Coined by psychotherapist Peter Sifneos in 1973, the term comes from the Greek for "no words for emotion" and describes a difficulty in understanding, processing, and describing emotions.
While not a formal mental disorder in the DSM-5, alexithymia is a personality trait that frequently co-occurs with other conditions. Research suggests a particularly strong link between autism and alexithymia, with studies indicating that a significant portion of autistic people experience it—far exceeding the prevalence in the general population.
This post will explore the connection between autism and alexithymia, highlighting how these overlapping yet distinct conditions can affect the lives of autistic individuals.
The Autism-Alexithymia Connection
The high prevalence of alexithymia in the autistic population has led researchers to question how much the two conditions overlap. Some research suggests that alexithymia, rather than autism itself, may account for some of the social and emotional challenges commonly associated with autism. For example, difficulty interpreting why someone is crying or how to respond might be more-closely linked to alexithymia.
It is crucial to understand this distinction: not all autistic individuals have alexithymia, and not all people with alexithymia are autistic. They are separate, though often related, conditions.
How Alexithymia Affects Autistic Individuals
When an autistic person also has alexithymia, it can amplify existing challenges and create new ones.
Difficulty Identifying Feelings: It can be hard to identify an internal feeling or articulate it to others.
Misinterpreting Sensations: Alexithymia can make it difficult to distinguish between emotions and bodily sensations. For example: "Is my stomach upset because I'm anxious, or am I sick?"
Social Complications: Understanding and responding to the emotions of others is a key part of social communication. Alexithymia can make this even more complex.
"Expressive Incoherence": The condition may lead to a mismatch between a person's internal emotions and their external expression, which can result in social misunderstandings.
Heightened Stress: Not being able to understand or express one's own emotions can be highly stressful and anxiety-provoking.
Support and Final Thoughts
Understanding the intersection of autism and alexithymia is essential for developing effective support.
Miguel's story shows a practical path forward: his mother learned to give him concrete, real-life explanations for her emotions ("I am not mad; I am frustrated because we are late"), helping him build a better emotional vocabulary. This highlights the importance of tailored support.
Therapies like Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) can also be adapted to help individuals with both conditions, offering significant benefits for emotional understanding and regulation.
The relationship between autism and alexithymia is a vital area of research. Recognizing the unique challenges of those experiencing both conditions is the first step toward providing meaningful support and fostering a better quality of life.
More Information
Alexithymia and Autistic Traits: Associations With Social and Emotional Challenges Among College Students, Vaiouli and Panayiotou, 2021.
Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism, Bird and Cook, 2013.
