“How are you feeling?” “Fine.”
“How are you feeling?” “I don’t know.”
“How are you feeling?” “Okay.”
Have you heard of alexithymia?
Sometimes called “emotional blindness,” alexithymia is a condition where someone has a difficulty connecting the thread between experiences, feelings and words. It’s a personality feature, or a pattern in how someone processes (or rather, doesn’t) emotional information.
Basically, it’s when you have a hard time describing what you’re feeling when you’re feeling it, or can’t connect your behavior to your emotional experiences.
Alexithymia was coined by psychiatrist and Harvard professor Peter Sifneos in 1972, but it’s not a disorder or a diagnosis one can get. It’s merely a tool that a therapist can use along the way in getting to a diagnosis or creating an effective treatment plan.
If you’re answering “fine,” “I don’t know,” or “okay,” when someone asks how you’re feeling–no matter the circumstances–that can be an indication of alexithymia.
Alexithymia isn’t uncommon–about 10% of the population experience it, and it’s even more common amongst women and neurodivergent folks. It’s not a lack of emotional experience–people who experience alexithymia still have emotions, it’s just harder for them to connect what they’re feeling to what’s happening within and around them. Their internal experiences feel severed from the world around them, and their behavior can often feel totally separate from their emotions, like the two are completely disconnected.
While some of us can quite easily connect our feelings to our behaviors, like getting upset and lashing out at the next person we talk to, someone who experiences alexithymia won’t recognize the connection between the two. There’s an overall loss for explanation that can be isolating, and make it difficult to connect and relate to others.
When you can’t put words to your own emotional experiences, it can be hard to understand others’ emotional experiences as they come up, which in turn can cause interpersonal relationships to suffer. Emotions also tell us when situations need our urgent attention or when something needs to change–so when we’re not able to clock those feelings or interpret those signals, decisions can become more difficult, and in turn we can begin to feel very passive in our own lives; like things happen around us and we’re just witness to them.
Somatic experiences of emotions are also harder to identify for those who experience alexithymia.
While others may feel their chest tighten when angry or their heart pound when anxious, someone who experiences alexithymia won’t notice the connection between the physical experience and the emotional experience–or they won’t have the words to connect the two. There is often a limited emotional vocabulary that goes along with alexithymia, which makes it difficult to both identify what you’re feeling as well as to communicate that experience to someone else.
Folks who experience alexithymia may also be less tuned into their own internal experiences than others; their internal world isn’t filled with the fantasies that many of us find ourselves wading into, or they may feel a lack of awareness of what is going on internally, feeling an overall lack of agency in their lives.
How can you manage alexithymia?
Alexithymia, while not (again) not a disorder or diagnosis, is something you can work on in therapy. Modalities such a Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Interpersonal Therapy (IPT), and group therapy have been effective in working through obstacles that alexithymia presents, and helping folks begin the process of noticing the connection between their emotions, behaviors and finding the language to communicate those connections.
Alongside therapy, practicing observing and noting emotions when they come up through journaling and mindfulness practices can build on the skills worked on within therapy. It’s often recommended to begin with noticing your heart rate–noticing when it goes up and down, documenting physical responses and emotions that go along with them and starting to distinguish between fear, excitement, and anger. A helpful tool to use is an emotion wheel which can help give language to what you’re feeling when you’re at a loss for words.
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