If You Have Alexithymia, Here’s How Somatic Therapy Can Help

What is Alexithymia?

Alexithymia literally means “no words for emotions.” It is not a mental health disorder, but considered a personality trait. People who have alexithymia generally struggle to notice and name what they are feeling. Some people with alexithymia can identify that they feel “good” or “bad,” while others struggle to even discern that. 

Alexithymia can make you feel confused about physical body signals. If you have a headache or feel tired, it can be confusing to identify the source of these symptoms. It can also be difficult to track when you are hungry or need to use the bathroom, for instance.

It also makes it confusing to understand body signals that indicate distress or safety. As a result, you might misread certain body signals like a racing heart or a stomach ache with certain emotional states. While these body signals can and often do signal emotional states, the accuracy with which you read them may be mismatched. This makes it hard to understand when you are triggered, as well as what caused the shift.

Finally, alexithymia can cause you to experience communication challenges in social situations. You may struggle to interpret facial expressions, tones, or body language. For others, this may come across as detached or lacking emotion. It can cause people in your life to struggle feeling close to you, especially in situations where they may be interested in talking about creative ideas or being playful, which might feel uninteresting or unfamiliar to you.

What Causes Alexithymia?

The cause of alexithymia varies from person to person. Two common causes of alexithymia include neurodivergence and childhood trauma. Another includes neurological differences that may be present at birth or acquired later in life.

Alexithymia in Neurodivergent Populations

While the lifetime prevalence of alexythymia is about 10% in the general population, it is closer to 50% in individuals who are autistic and 30-40% in people with ADHD. It is important to note, however, that not all autistic or ADHD people have alexithymia.

The reason for higher prevalence of alexithymia in neurodivergent people is because neurodivergent people sometimes have distinct brain wiring for processing sensory and emotional signals. This makes something called interoception difficult. Interoception is our 8th sensory system (you have more than just 5!) and refers to your ability to perceive internal signals like tension, temperature, thirst, pain, fullness, hunger, cramps, heartbeat, emotions, and so on.

In people with ADHD specifically, the co-occurence of ADHD and alexithymia can make emotion regulation very difficult, because while ADHDers have heightened emotional reactivity and impulsivity, people with alexithymia may not register emotions fast enough to manage them.

As a result of poor interoception, neurodivergent people with alexithymia are more likely to:

• Identify as Aro or Ace

• Engage in disordered eating behaviors

• Engage in substance abuse behaviors

• Struggle with social anxiety

• Have difficulty regulating emotions

• Attempt to numb or distract of overwhelming emotions

• Have higher rates of impulsivity

Alexithymia Stemming from Childhood Trauma

Growing up in environments where your emotional needs were neglected, or even punished, can cause you to suppress your feelings as a strategy to avoid feeling the intense pain of neglect, or to stay on your caregivers' good side. Furthermore, in cases of emotional neglect, a child does not develop the skills for understanding and regulating their emotions. 

This is true even in settings where the neglect was unintentional, or due to competing demands on your caregivers, like working multiple jobs, taking care of elderly grandparents, or having another child with more intense needs.

In these instances, the alexithymia is a survival adaptation. While for some people, the adaptation causes the nervous system to jack up the internal signals in the body, in people with alexithymia, it’s like the body turns the signals down to a lower volume. Down the road, it can lead to depression, anxiety, disordered eating, substance abuse, or even borderline personality disorder.

Alexithymia Stemming from Neurological Differences

While some individuals are predisposed to alexithymia due to neurological differences, alexithymia can also develop as a result of traumatic brain injuries or Parkinson’s Disease, for instance.

Do I Have Alexithymia?

A common assessment tool for alexithymia is the Online Alexithymia Test, which asks respondents to choose what response best describes how each item applies to you, on a scale from:

• Strongly disagree 

• Disagree

• Neither agree nor disagree

• Agree

• Strongly agree. 

This test captures seven areas of alexithymia traits including:

1. Difficulty Identifying Feelings

2. Difficulty Describing Feelings

3. Externally Oriented Thinking

4. Vicarious Interpretation of Feeling

5. Restricted Imaginative Processes

6. Interpersonal Relationship Difficulties

7. Sexual Difficulties and Disinterest

You can take the test here.

The higher your score, the more alexithymic traits are present.

How Somatic Therapy Can Help with Alexithymia

You might think that in order to start somatic therapy, you already need to be able to describe what you’re feeling. But somatic therapy actually has all the tools you need to start addressing your alexithymia, no matter where you’re starting from. Good somatic therapy meets you where you are.

During somatic therapy sessions, I can help you:

• Build your emotional vocabulary by sharing tools that offer different language

• Link physical symptoms to emotional states

• Experiment with different temperatures and textures

• Use different kinds of scales to guage how intense a feeling is, like rating from 1-10 or starting by noticing if you feel “good,” “bad,” “pleasant,” or “unpleasant”

• Find new doorways into feeling, such as describing what you are feeling through words, shades of colors, images, and more

Additionally, if the cause of your alexithymia is trauma, it's important that we do this work slowly, while building insight around the adaptiveness and functionality of not feeling. We want to understand and respect that the alexithymia feels safe for your body, while building your nervous systems capacity to feel safe with actually feeling.

Doing this work will help you take better care of your body and improve your relationships, because you’ll be able to track what’s happening in your body, and understand what’s happening in the people who you are interacting with.

I work with clients everyday who have alexithymia. Some of them have childhood trauma, some are autistic or ADHD, and others aren’t sure where their alexithymia stems from. I bring a diverse range of training and expertise to help you.

If you want support addressing alexithymia and the challenges it adds to your life and relationships, let’s meet and discuss working together.

Book a FREE 20-minute consultation here

Resources

I have learned a lot about alexithymia through trainings and books by Dr. Megan Anna Neff, an AuDHD clinical psychologist and founder of Neurodivergent Insights.