alexithymia

Alexithymia is a subclinical personality trait characterized by difficulty identifying and describing one’s own emotions, a tendency toward externally oriented thinking, and a limited imagination. It is not a mental disorder itself but a construct that can accompany various psychiatric and medical conditions and can affect emotional awareness and expression.

Core features include difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and an externally oriented thinking style (EOT). People may experience a blunted affect, struggle to distinguish emotions from bodily sensations, and have a sparse fantasy life. These traits can hinder interpersonal communication and complicate the treatment of co-occurring conditions such as depression or somatic disorders.

Causes are multifactorial, involving genetic, neurobiological, and psychosocial factors. Neuroimaging studies suggest altered connectivity in emotion-processing circuits. Childhood environment and parenting may contribute. Assessment is primarily via self-report scales, with the Toronto Alexithymia Scale (TAS-20) being the most widely used; it measures DIF, DDF, and EOT. There is no single diagnostic threshold.

Treatment does not target alexithymia as a stand-alone disorder but aims to improve emotional awareness and expression, often through psychotherapy such as cognitive-behavioral, emotion-focused, or psychodynamic approaches. Some studies report gains in emotional identification and social functioning, particularly when addressing coexisting conditions. Prevalence estimates in the general population vary, commonly cited around 8–15%, with higher rates in clinical samples; cross-cultural factors can influence assessment.