Alexithymia refers to difficulty identifying and describing one’s emotions. While alexithymia is often viewed as an all-or-nothing trait, new research suggests there may be milder forms of alexithymia. Here’s what the experts have to say about mild alexithymia.
What is alexithymia?
Alexithymia literally means “no words for emotion.” People with alexithymia have trouble identifying and describing their feelings. This results in:
- Difficulty distinguishing between different emotions
- Limited imagination and fantasy life
- Concrete, utilitarian thinking
- Reduced ability to cope with negative emotions
People with severe alexithymia show:
- An inability to identify specific emotions beyond basic ones like “happy” or “sad”
- No words to describe subjective emotional experiences
- Impoverished fantasy and dream life
- A cognitive style that focuses on external events rather than inner experience
Alexithymia occurs in about 10% of the general population. It’s more common in males and is associated with a variety of psychiatric and medical disorders.
The alexithymia spectrum
In the past, alexithymia was viewed categorically – you either had it or you didn’t. But research now shows that alexithymia exists on a spectrum, ranging from mild to severe.
On the mild end, people may have some difficulty identifying and describing emotions. Their inner emotional life isn’t as rich or vivid as most people’s. But they don’t have an absolute inability to recognize or verbalize feelings.
Signs of mild alexithymia
People with mild alexithymia may:
- Struggle to find the right words to describe their feelings
- Have trouble distinguishing between similar emotions like anger and irritation
- Appear reserved, detached, or socially withdrawn
- Seem concrete or literal in their thinking
- Have a limited fantasy life
- Cope by focusing on tasks rather than emotions
Unlike severe alexithymia, the mild form doesn’t completely impair emotional awareness and expression. But it does make processing emotions more challenging.
Assessing mild alexithymia
Clinicians use questionnaires like the Toronto Alexithymia Scale (TAS-20) to assess alexithymia. The TAS-20 measures three factors:
- Difficulty identifying feelings. Hard time recognizing one’s own emotions.
- Difficulty describing feelings. Not able to verbalize emotions to others.
- Externally oriented thinking. Tendency to focus on external events rather than inner experience.
Each factor is scored separately. Mild alexithymia shows up as slight-to-moderate difficulty on one or more factors, while severe alexithymia involves major impairment across all three.
So mild alexithymia could mean you identify emotions fairly well but have some trouble describing them. Or you might have good emotional insight but a strongly external thinking style.
Causes
Alexithymia appears to involve deficits in the communication between the emotional and language processing centers of the brain. Contributing factors may include:
- Genetics – a family history of alexithymia increases risk
- Altered brain structure and function in areas like the anterior cingulate cortex
- Disruptions in early social attachment and emotional bonding
- Trauma or chronic stress
- Mental health conditions like depression, PTSD, and substance abuse
- Neurological disorders such as autism
In mild alexithymia, these brain-based and environmental influences likely exert a subtle effect compared to severe forms.
Is mild alexithymia “normal”?
Since alexithymia exists on a continuum, there’s no clear dividing line between mild alexithymia and normal individual differences in emotional processing. Still, mild features may signal a tendency toward the more severe end of the spectrum.
Traits considered mild alexithymia include:
- Needing a long time to identify how you’re feeling
- Struggling to put feelings into words
- Confusing emotions with body sensations like hunger or fatigue
- Difficulty reflecting on your emotions or inner life
- Preferring to focus on facts and details rather than feelings
If these traits significantly impact your relationships or well-being, it may be worthwhile discussing them with a mental health professional.
Treatment
Alexithymia treatment depends on its severity. Mild features can improve through:
- Psychotherapy. Counseling teaches you to identify emotions and connect them to your thoughts and behaviors.
- Journaling. Writing down feelings helps you label and process them.
- Relaxation practices. Meditation, yoga, deep breathing heighten emotional awareness.
- Group therapy. Sharing feelings with others models emotional communication.
Severe alexithymia requires professional treatment like psychotherapy, cognitive-behavioral therapy, or medication.
The key is tailoring interventions to the degree of difficulty identifying and verbalizing emotions. Mild impairment may benefit from self-help strategies like journaling, while severe alexithymia needs clinical support.
Prognosis
The outlook for mild alexithymia is generally good. With insight and practice, people can learn to become more aware of and articulate about their inner emotional world. Core personality factors can make this challenging, but improvement is possible.
One study found that after 20 weeks of group therapy, people with mild-to-moderate alexithymia showed significant reductions in difficulty identifying and describing feelings. The gains held up over 18 months.
This suggests that mild alexithymia responds well to targeted intervention. With proper support, people can develop greater emotional awareness and expression.
Coping strategies
If you relate to having mild alexithymia, here are some tips for coping:
- Use emotion words. Expand your feelings vocabulary so you can label nuances.
- Notice physical cues. Recognize where you feel emotions in your body.
- Talk to trusted friends. Verbalizing feelings helps improve awareness.
- Keep a journal. Recording your inner state improves emotional literacy.
- Try talk therapy. Counseling provides structured practice with emotions.
- Relax and reflect. Meditation helps connect you to your feelings.
- Go slowly. Improving emotional awareness takes time and practice.
When to seek help
Consider seeing a mental health professional if mild alexithymia:
- Strains your relationships
- Leaves you feeling isolated, empty or depressed
- Prevents you from coping with stress
- Gets in the way of work, school or daily life
A therapist can assess the extent of your difficulty identifying/expressing emotions and design targeted interventions to improve your emotional awareness and communication.
The bottom line
Mild alexithymia involves subtler impairment in emotional processing compared to severe forms. With insight into one’s inner life and practice expressing feelings, mild alexithymia can improve. Seeking professional help is recommended if it significantly impacts relationships, mood or functioning.