Imagine living in a world where feelings are blurry, like looking at an old photograph that just won’t come into focus. You sense something is there—maybe sadness, maybe excitement—but giving it a name feels almost impossible. This is what it’s like for people with alexithymia, a psychological trait that makes it difficult to identify and express emotions. And while it’s not a disease or disorder, it affects relationships, communication, and overall quality of life.

Let’s explore what alexithymia really is, where it comes from, and what you can do to make life easier if you or someone you know struggles with it.

What Is Alexithymia?

The term "alexithymia" comes from Greek and literally means “without words for emotions.” The concept was first identified in the late 1960s by psychiatrist Peter Sifneos, who noticed that some of his patients struggled to describe their feelings or even distinguish between physical and emotional sensations.

For instance, someone with alexithymia might feel tightness in their chest but label it as “tiredness” instead of realizing they’re experiencing anxiety. They often focus on external events rather than their internal emotional world, making their thoughts logical and concrete but emotionally disconnected.

This doesn’t mean people with alexithymia don’t have emotions. They feel them just like everyone else but face difficulty in understanding and expressing what’s happening inside.

What Causes Alexithymia?

There’s no single cause of alexithymia—it’s often the result of a mix of biological, psychological, and social factors.

• Brain Structure: Studies show that alexithymia is linked to reduced gray matter in parts of the brain like the amygdala and the insula, regions responsible for processing emotions. This could mean some people are simply wired differently.

• Genetics: Your genes might play a role too. If family members experience alexithymia, you may be more likely to have it as well.

• Childhood Environment: Growing up in a home where emotions were suppressed or discouraged can also lead to alexithymia. For example, children taught to “stay strong” or “not cry” may learn to disconnect from their feelings entirely.

• Trauma and Brain Injuries: Emotional trauma or physical damage to the brain (even minor) can interfere with emotional processing, leading to alexithymia later in life.

• Mental and Neurological Conditions: Alexithymia is often associated with other conditions, including autism spectrum disorder (ASD), depression, anxiety disorders, and neurological issues like Parkinson’s disease or stroke. While it’s not a mental illness itself, it frequently coexists with these challenges.

How Alexithymia Affects Daily Life

Living with alexithymia can be isolating and frustrating, both for the person experiencing it and those around them. Let’s break this down a bit:

• Struggles in Communication: Because they can’t easily name or describe feelings, people with alexithymia might come across as cold or detached. Conversations with them often revolve around facts and events rather than emotions.

• Difficulty in Relationships: Emotional intimacy becomes a challenge when someone can’t understand their partner’s emotions, let alone their own. Misunderstandings can breed resentment, and partners may feel unloved or unheard.

• Confusion Between Physical and Emotional Sensations: Stress or sadness might manifest as headaches, rapid heartbeat, or other physical symptoms—but someone with alexithymia may mistake these for illness rather than recognizing their emotional roots.

• Psychosomatic Issues: Over time, unprocessed emotions can lead to psychosomatic disorders like chronic pain, skin conditions, or gastrointestinal problems. Stress builds up in the body, finding other ways to express itself.

• General Life Dissatisfaction: Without the ability to identify needs and desires, it’s hard to make meaningful changes. People with alexithymia might feel stuck, unhappy, or out of place without understanding why.

Recognizing Alexithymia

If you suspect you may have alexithymia, tools like the Toronto Alexithymia Scale (TAS-20) can help assess your emotional awareness. This popular test consists of a series of questions to identify difficulty in recognizing, describing, and processing emotions.

Another tool is the Reading the Mind in the Eyes Test (RMET), which measures how well you recognize emotions in others. While these tests aren’t a diagnosis, they can provide insight and help you decide if speaking with a mental health professional might be the next step.

What Can You Do About Alexithymia?

Overcoming alexithymia is not about “curing” it but about learning to connect with emotions in a manageable way. Here are some practical strategies:

• Psychotherapy is one of the most effective approaches. Therapists, especially those trained in dialectical-behavioral therapy (DBT) or cognitive therapies, can guide you through identifying and labeling emotions. Group therapy can also be helpful, providing a supportive space to learn from others facing similar challenges.

• Keep a Journal of Emotions. Writing about your feelings every day—even when it feels silly or unclear—can help build awareness over time. Tools like the “wheel of emotions” can make this easier by offering a visual guide to basic and complex emotions.

• Try Meditation and Mindfulness. Practices like meditation allow you to slow down, tune into physical sensations, and develop a deeper awareness of what’s happening internally. This can be especially powerful for those who feel disconnected from their emotions.

• Express Yourself Creatively. You don’t need to paint like Picasso or compose like Mozart. Drawing, playing music, or even dancing can help release emotions without needing words. Creativity becomes a bridge to understanding your feelings.

• Read Fiction or Study Facial Expressions. Fictional stories often focus on emotional experiences, helping you “borrow” language to describe your own emotions. Books like Paul Ekman’s work on facial expressions can also teach you to recognize and interpret feelings in others.

Supporting a Loved One with Alexithymia

If someone you care about struggles with alexithymia, patience and clear communication are key. Be direct about your emotions and offer gentle observations like, “You seem tired” or “It looks like you’re upset.” These prompts can help them identify feelings over time.

Support them in seeking professional help if needed, and remember to appreciate their strengths. Alexithymic people may not be emotionally expressive, but they often excel in logical thinking, problem-solving, and staying calm under pressure.

Final Thoughts

Alexithymia is not about lacking emotions; it’s about lacking the words and tools to express them. By increasing emotional literacy, building self-awareness, and seeking support, it’s entirely possible to bridge this gap. Whether through therapy, journaling, or creative outlets, connecting with your emotions can transform not just your internal world but also how you relate to the people around you. After all, everyone deserves to understand and share what’s in their heart—even when it feels like the words just aren’t there yet.