Alexithymia
A stable difficulty identifying and describing one's own feelings and telling them apart from bodily sensations, with an externally focused, concrete thinking style.
What drives it
Not a defence chosen in the moment but a trait-like gap in emotional awareness; it explains people who seem cut off, report physical symptoms instead of feelings, and struggle with other people's emotions.
How it shows
Work
Asked how they feel about a reorganisation, they describe the plan or say 'tired' or 'fine'. Talks in facts and logistics; struggles with feedback on interpersonal style. Reports headaches or stomach trouble during stressful periods.
Relationships
Partners complain 'I never know what you feel'; responds to a partner's distress with fixes. Can be warm in actions while unable to say what they feel.
Self
Feeling something but only as 'bad', 'off' or a physical state; finding questions about feelings confusing rather than threatening.
What tells it apart
Isolation of affect: Isolation is a defence in specific painful areas: the person can name feelings about neutral things but goes flat on loaded topics. Alexithymia is across the board, including for happy events.
Emotional numbing: Numbing follows trauma or depression and the person often remembers feeling more before; alexithymia is lifelong.
Autism in adults: Alexithymia is common in autistic adults but separate; it also occurs without autism's social-communication differences and sensory profile.
A test
Ask about a recent happy event and a recent hard one and how each felt; if both answers come back as facts, body states or 'good/bad', alexithymia is likely.
Questions to carry
- Asked how a recent good day and a recent hard one felt, what kind of answer comes back?
- When someone asks how I feel, what do I find when I look: a word, a sensation, or a blank?
How strong the research is
strong
Where it comes from
Peter Sifneos, 1973; Graeme Taylor, Michael Bagby and James Parker, 1994 (Toronto Alexithymia Scale)