What is Alexithymia? 

Most people haven’t heard of alexithymia, and yet it’s estimated that one in ten people struggle with it (Goerlich, 2018). The word was coined by two psychologists in the 70s (Nemiah & Sifneos, 1972), meaning an “inability to describe feelings correctly” or “no words for emotions.” This describes one aspect; it’s so much more under the surface. 

Signs of Alexithymia

Do you ever feel unsettled, overwhelmed, or emotionally ‘off’ but can’t figure out why? Do you feel your default emotions are “okay” and “not okay” and often default to answering with “Fine” when someone asks how you are? Maybe you only realize you were anxious after getting a headache, clenching your jaw all day, or snapping at someone you care about. Have you mistaken someone’s happy tears for sadness? Maybe people have described you as distant, flat, cold, or difficult to read, even when you care deeply. 

These are just a few examples of what it’s like. Some people describe feeling emotionally colourblind – knowing something is happening internally but not being able to clearly identify it. Others say it feels like everyone else got a “manual for emotions” that they somehow missed. 

More Than Just Difficulty Identifying Emotions 

There are two main aspects to alexithymia: difficulty identifying feelings (both your own and others’) and difficulty expressing or describing emotions. For those of us who are non-alexithymic, we don’t often give much thought to the difference between identifying and describing our feelings; they just exist, and we have words for them. 

Some might:

• focus more on facts or practical matters than emotions
• try to understand feelings through logic
• struggle to daydream or mentally picture things
• feel misunderstood in relationships
• experience challenges with intimacy or emotional closeness

Many people with alexithymia feel emotions deeply, even if identifying them is difficult.

Different Types of Alexithymia 

It’s important to know that alexithymia is not a mental health diagnosis in the DSM. Instead, it’s considered a personality trait or way of experiencing emotions that can overlap with things like autism, ADHD, PTSD, depression, trauma, and burnout.

For some people, these experiences have always been part of how they move through the world. This is often called “primary alexithymia” and is more commonly associated with neurodivergence. For others, it can develop during periods of stress, trauma, depression, or emotional overwhelm. This is sometimes called “secondary alexithymia” and may lessen over time with support and healing.

Can Alexithymia be “Cured”? 

So, can primary alexithymia be overcome? Not in the sense that it can be eliminated entirely, but it’s very possible to become more aware of and better able to label emotions, body signals, and ways to express feelings over time. Up to 55% of autistic folks (Hus & Segal, 2025), and up to 41% of ADHDers (Suslow & Donges, 2021) live with alexithymia, and their experiences may shift as they go through difficult life experiences and stressors. 

Many people with alexithymia grow up believing they are ‘bad at emotions’ or somehow broken. Often, they’ve spent years trying to understand reactions that never seemed to come naturally. Alexithymia is not a character flaw or lack of caring. It’s a different relationship with emotional awareness.

How Therapy Can Help

As you can imagine, traditional talk therapy can feel uncomfortable or frustrating at times. Questions like “Where do you feel that in your body?” can feel confusing, frustrating, or impossible to answer beyond “I don’t know.” 

So how might therapy approach these experiences differently? Here are some examples: 

• We’d look at the 7 Traits of Alexithymia together to discover where your relative strengths lie, as well as your challenges, to see where you’ll want to focus your efforts. We’ve only been able to talk about a few here, but we’d do a deep dive together so you can better understand yourself. 
• We could work on building (or rebuilding) your connection to your body’s signals. For example, what does it mean when you feel a tightness in your chest or heat in your face? 
• We’d look at the emotion wheel to build up your emotional vocabulary and challenge yourself to go beyond words like “angry” or “sad” to better express your emotions to yourself and others. 
• Your therapist might help you slow reactions down in real time. You may pause together when there’s a change in your facial expression, body language, or tone of voice. Over time, this can make those shifts easier to notice on your own.
• We might use DBT (Dialectical Behavioural Therapy) skills to support mindfulness and build up interoception (awareness of your body’s signals), as well as tolerate distress. 
• We might use techniques from ACT (Acceptance and Commitment Therapy) to reduce your avoidance of difficult emotions or the situations that can bring them up in confusing ways. This might look like improving your ability to tolerate uncertainty around feelings or staying present instead of shutting down or over-intellectualizing. 

What Does Progress With Alexithymia Look Like? 

Learning to understand your emotions can take time, patience, and support. The goal is to build a clearer connection with yourself and your experiences, one small step at a time.

Over time, building emotional awareness and understanding your body’s signals can help you: 

• Recognize your emotions earlier
• Notice your body’s cues more clearly
• Experience fewer emotional shut-downs or meltdowns
• Strengthen self-trust
• Improve your relationships
• Identify being overwhelmed before reaching burnout
• Notice you need rest before your body forces you to stop

You might have specific goals, like wanting to connect more meaningfully to important life experiences like taking in the complex feelings of major life events like your wedding day, or supporting your children through emotionally difficult moments. We’re here for it and would love to support you, no matter what it means to you to work on alexithymia. 

Resources: 

Goerlich, K. (2018). The Multifaceted Nature of Alexithymia – Link 

Bird, G. & Cook, R. (2013). Mixed Emotions: The Contribution of Alexithymia to the Emotional Symptoms of Autism – Link 

Suslow, T. & Donges, U. (2021). Alexithymia and Mental Health – Link

Neurodivergent Insights — What is Alexithymia? – Link

Hus, Y. & Segal, O. (2025) – ADHD and alexithymia comorbidities impact on developmental language disordered and autistic youths: a dimensional treatment approach – Link