Alexithymia

Alexithymia translates roughly from Greek to “no word for emotions.”  While it is not an official disorder in the DSM, it is often used as a clinical term for individuals who have difficulty recognizing and/or naming emotions in themselves or others.

Isn’t that just an autistic trait?

It has long been assumed that difficulty recognizing emotions was an “autism thing,” however, recent research shows that only about 52% of autistic individuals are also Alexithymic.  Autistic individuals who are not alexithymic (nearly half), do not show the same type of difficulty recognizing emotions.

You can read more about differentiation of alexithymia from autism here (Neurodivergent Insights).

Alexithymic processing can look like:

Less significant alexithymic processors who recognize bigger emotions more easily than smaller emotions:

  • An ability to identify the BIG emotions in yourself (and others): Happy, sad, angry, afraid, etc.

  • More difficulty recognizing the more subtle emotions in yourself (and others): frustrated, nervous, disappointed, jealous, etc.

  • Difficulty recognizing your emotions until they feel bigger and more out of control (making it harder to self-regulate)

  • Limited or unhealthy coping strategies for self-regulation

  • Difficulty describing your emotions with others

  • Missing some of the subtle signs of emotions in others (such as noticing tension between people, irritation, disinterest, etc.)

    More significant alexithymic processors who have a general difficulty recognizing emotions:

  • Difficulty identifying most emotions, even the bigger ones

  • Potential difficulty with noticing that a big emotional shift has taken place

  • Typically operating in an emotionally “neutral” way, with rare but big jumps in emotion

  • Potential difficulty recognizing when over-stimulation is building

  • Limited self-regulatory coping skills (or sometimes unhealthy coping strategies such as heavy alcohol or substance use)

  • Feeling fufillment from limited friendships (online friendships, 1-2 friends seen a few times a year)

  • Desire to connect and communicate based more on logic and facts

Does this sound familiar?

You can check out the Toronto Alexithymia Scale (TAS) for further exploration. Just keep in mind, this is a screening tool and not a diagnostic test.

You can read about more about Alexithymia and how to interpret your TAS results from Dr. Megan Anna Neff here.

Emerging research is linking alexithymia to interoception processing differences.

Interoception is the processing of our internal signals.  It’s now recognized as the 8th sensory system!

Examples of interoceptive signals:

  • Hunger/stomach fullness

  • Thirst

  • Feeling hot or cold

  • Feeling bladder or bowel fullness

  • Pain

  • Feeling changes in your heart, breath or muscles (these can provide us important clues to our emotional and regulatory state!)

Interoception is like any other sensory system, in that we can notice these signals either significantly more or, significantly less, than others.

If you have a lower threshold for receiving a signal, you notice the signal in a BIG way.

This can look like:

  • Frequently/more often than others needing to manage thirst/hunger signals

  • High sensitivity to pain, stomach upset, or typical digestive processes

  • Feeling dyregulated by temperature being “off” and feeling that it’s very difficult to get a temperature that’s just right (and not distracting or dysregulating)

  • Feeling like you frequently need to use the restroom

  • Being very sensitive and aware of emotional shifts (sometimes with corresponding anxiety and panic disorders)

If you have a bigger threshold for receiving a signal, you notice it in a smaller way, or sometimes hardly notice it at all.

This can look like:

  • Forgetting to drink water/hydrate until you notice secondary signals (feeling tired, irritable, light-headed), or until you are VERY thirsty (sometimes towards the end of the day)

  • Forgetting to eat or not feeling like you can eat until you notice secondary signals of hunger (feeling tired, irritable, light-headed), or until you are VERY hungry (after an extended time without food)

  • Not noticing or feeling discomfort with stomach tightness when you are full from eating.

  • Not noticing an injury/illness until it is very significant, or maybe not noticing at all

  • Not noticing heat or cold discomfort when others seems to, or maybe dressing in a way that doesn’t match the weather (Ex: Wearing long sleeves and long pants in 90 degree weather)

  • Not noticing that you are starting to become overwhelmed/dyrsregulated until you are VERY overwhelmed/dysregulated

  • Not noticing that you are experiencing an emotional shift until the emotion is very big (and difficult to manage).  *These interoceptive differences are now thought to be the underlying neurological mechanisms for Alexithymia.

Exploring Alexithymia & Interoception

Ted Talk on Interoception

Dr. Sarah Garfinkel gives a Ted Talk about her research on interoception.

Understanding Alexithymia & Interoception

Occupational Therapist, researcher, and interoception guru Kelly Mahler talks about the connection between alexithymia and interoception.

Kelly offers courses, workbooks, and other interoception-related resources on her website.

Interested in a deep dive on how alexithymia & interoception are connected?

Researcher Geoff Bird gives an in-depth presentation on recent research connecting the two processing differences.

Looking for a therapist who “gets” your emotional processing differences or interoception differences?

You can express your interest at info@autisticadultandteen.com or set up a phone consultation to learn more.