What Causes Alexithymia, and Why It's So Troubling

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Cowritten by Charlie Huntington and Tchiki Davis.

All of us sometimes find ourselves at a loss for words, unable to describe our experience in the moment. When you receive unexpected news or have to make a decision with long-term consequences, for example, you may find it hard to say exactly what you’re feeling at the moment.

While most of us have moments like these, there are some people who regularly have great difficulty tuning into their internal experience—what emotions and bodily sensations are happening for them. When someone constantly has difficulty identifying or describing their own emotions, they are experiencing alexithymia (Sifneos, 1973). The word alexithymia combines several words from the Greek language—a for “no,” lexi for “words,” and thymia for “emotions”—and was created when a Greek doctor started to notice that many of his psychiatric clients had trouble describing their emotions (Sifneos, 1973).

What does alexithymia look like? Many people with this condition have trouble explaining why they took certain actions. For example, if I am short-tempered with my partner, or yell at the car in front of me in traffic, I can usually (at least eventually!) identify an emotion by my actions—perhaps anger or frustration—and an event that triggered the anger—perhaps an argument with a housemate or receiving bad news on the phone. By contrast, people with alexithymia may lash out at somebody but not be able to identify a reason why they yelled or the feelings associated with it. In their mind, the event sort of just happened, and the connection between an earlier event or emotion and their behavior is not clear to them.

People with alexithymia are also less tuned in to other aspects of their internal experience; for example, they have fewer fantasies and less complex dreams and use their imaginations less than other people (Taylor et al., 1997). Since people with alexithymia are less aware of what’s going on in their own heads, they tend to see the world as being a place where they have little agency and things just happen to them (Taylor et al., 1997).

Alexithymia in Relationships

Simply put, communicating emotions, particularly positive ones, is essential to feeling close to another person (Floyd, 2006). People with alexithymia may avoid relationships because they are not sure how to relate, and then they have difficulty expressing important feelings when they do try to relate (Montebarocci et al., 2004; Qualter et al., 2009). The inability to recognize emotions often extends to other people’s emotions, too, making it hard to develop and maintain close relationships (Hesse & Gibbons, 2019; Humphreys et al., 2009). As a result, they have more difficulty keeping and building connections, especially romantic relationships (Eid & Boucher, 2012; Humphreys et al., 2009).

You, like most people, have probably had moments when you thought, “It’s hard to tell my partner what I’m feeling!” The difference between those moments and the experience of people with alexithymia is that you likely knew what you were feeling but weren’t sure how to say it in an effective or tactful way. People with alexithymia, as much as they might want to communicate their feelings and participate in their relationship, struggle to identify and describe their feelings.

What Causes Alexithymia?

Alexithymia may be caused in part by genetics (Picardi et al., 2011). Alexithymia also seems to develop as a reaction to stressful or traumatic life events (Krystal, 1979; Zeitlin et al., 1993). For many people, these events happened in childhood, but they can happen at any life stage. People who develop alexithymia at an earlier age may have a harder time overcoming it, probably because their brains were still developing at the time, or the events happened again and again over many years (Freybarger, 1977).

Let’s think about an example of each of these. Imagine a child growing up in a home where one or both parents rarely talk about emotions, display emotions, or respond effectively when the child shows emotion. Such a child would grow up with very few skills for understanding emotions. On the other hand, imagine that same child growing up in a household with an abusive parent who did not tolerate any displays of emotion or a neglectful parent that did not meet their basic needs. As you can imagine, a child might cope with either environment by tuning out their emotions as much as possible.​

Although eliminating alexithymia is difficult and rare, many people have successfully reduced the severity of their alexithymia, improving their quality of life (Cameron et al., 2014). So, while, for most people with alexithymia, it will always be present for them to some degree, it is possible to overcome alexithymia in the sense of becoming more attuned to one’s emotions, able to connect with other people, and able to respond to emotions effectively. ​

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A version of this post also appears on The Berkeley Well-Being Institute Web site.

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