20 Questions To Tell If You're Grappling With 'Alexithymia'

If you have trouble making sense of your emotions, you might be dealing with 'alexithymia.' Here's how to tell.

By Mark Travers, Ph.D. | March 29, 2024

Many people come to therapy when they feel as though they are disconnected from their own emotions. They may say things like:

• "I can't seem to understand what I'm feeling most of the time. It's like everything is just blank inside."
• "Sometimes I feel like I'm just going through the motions of life without really experiencing any of it."
• "I often feel overwhelmed by my emotions, but can never seem to pinpoint exactly what's wrong."
• "I find it really hard to relate to others. I struggle to understand my own feelings, let alone theirs."

Feeling disconnected from your emotions can be profoundly frustrating, and can lead to a pervasive sense of disorientation and unease. This emotional disconnection can strain various pillars of one's well-being, including mental, emotional and social dimensions.

However, research offers hope by revealing that this experience is not unique; it is referred to as "alexithymia," and many individuals grapple with its challenges. Through psychological findings, we are empowered with the knowledge of what alexithymia entails—as well as how to identify it.

What Is Alexithymia?

Alexithymia, a complex psychological phenomenon, is characterized by a distinct set of features that profoundly impact emotional experiences and expression. According to research from The Canadian Journal of Psychiatry, alexithymia encompasses four features:

1. Difficulty in identifying and describing one's emotions
2. Difficulty in differentiating between one's emotions and the bodily sensations associated with them
3. A limited capacity for imaginative thought, often evident in a scarcity of fantasies
4. An externally oriented cognitive style, which prioritizes superficial information over internal emotional processes

To exemplify this, imagine a scenario in which you've felt anxiety. In response, you'd likely recognize this emotion, and therefore retreat from the situation, or address your feelings head on. Similarly, feeling unhappy might prompt you to reflect on its causes, and thereafter, you'd likely consider making changes to prevent further unhappiness.

Conversely, a person with alexithymia may struggle to identify these emotions altogether. Instead of recognizing anxiety as a signal to retreat, they might feel overwhelmed by vague physical sensations without understanding their underlying cause. Similarly, feelings of unhappiness may linger without external prompts for introspection or action, as the individual lacks the awareness to connect their emotions with potential solutions.

What It's Like To Live With Alexithymia?

At its core, alexithymia disrupts the typical interactions between one's emotions, cognition and behavior, resulting in a disjointed understanding of one's inner world. Research from the Handbook of Clinical Neurology highlights how alexithymia can lead to frustrating difficulties in one's interpersonal relationships, decision-making and overall well-being.

This condition can pose an array of challenges in daily life. Individuals may struggle to understand and articulate their own feelings, which can lead to difficulties in forming meaningful relationships with others, or even being able to contribute to social interactions. This emotional disconnect can also diminish their abilities for self-awareness and introspection, making it challenging to identify the root causes of their stress or cope effectively with it.

Moreover, the inability to identify and communicate emotions may lead to misunderstandings and strained relationships, which can escalate their pre-existing feelings of isolation and loneliness. These individuals may also experience heightened levels of anxiety and depression as they battle their pervasive sense of emotional detachment. This can be exacerbated by the frustration of not being able to connect with their own feelings, nor with those of others.

How To Tell If You Have Alexithymia

For those with alexithymia, they may feel as though they're stuck in a lose-lose situation. With significant difficulties in making sense of their feelings, attempting to address them can feel like an inexplicable hurdle. Given the extremely limited ways in which they can truly express their emotions, it can be a lengthy and tedious process to identify the issue at all.

Because of this, researchers sought to develop a psychometric instrument for the purpose of identifying alexithymia. To use the measure, respondents rate their level of agreement to the following 20 statements, from "strongly disagree" to "strongly agree:"

1. I am often confused about what emotion I am feeling.
2. It is difficult for me to find the right words for my feelings.
3. I have physical sensations that even doctors do not understand.
4. I am unable to describe my feelings easily.
5. I prefer to describe problems rather than just analyze them.
6. When I am upset, I do not know if I am sad, frightened or angry.
7. I am often puzzled by sensations in my body.
8. I prefer to just let things happen rather than to understand why they turned out that way.
9. I have feelings that I cannot quite identify.
10. Being in touch with emotions isn't essential to me.
11. I find it hard to describe how I feel about people.
12. People tell me to describe my feelings more.
13. I do not know what's going on inside me.
14. I often do not know why I am angry.
15. I prefer talking to people about their daily activities rather than their feelings.
16. I prefer to watch 'light' entertainment shows rather than psychological dramas.
17. It is difficult for me to reveal my innermost feelings, even to close friends.
18. I struggle to feel close to others, especially in moments of silence.
19. I do not find examination of my feelings useful in solving personal problems.
20. Looking for hidden meanings in movies or plays distracts from their enjoyment.

If you find yourself grappling with alexithymia, it's important to know that you're not alone in this journey. Taking the first step to acknowledge your struggles can be incredibly daunting, but it's also the beginning of a path towards healing and understanding. With the support of a therapist or counselor, you can begin to untangle the knots of confusion and isolation. With time, effort and the right guidance, your life, relationships and overall well-being can flourish in ways you may never have imagined.

Worried if you are suffering from alexithymia? Take the Alexithymia Scale to gain clarity.

A similar version of this article can also be found on Forbes.com, here.