#Alexithymia isn’t only a problem of not understanding our emotions

argument between fuzzy figuresI’ve been reading up on alexithymia – inability to identify and describe emotions in the self. There appears to be a number of possible explanations for causes, which seems to be a bit of a mystery. Research suggests a brain-based source of the issue, with reduced connectivity and blood flow correlating with alexithymia. Additionally, the condition has been characterized as “an extremely arrested and infantile psychic structure”. Hm. Not sure how I feel about that.

I think we need a better way of understanding alexithymia — especially from the viewpoint of those affected. Just because we can’t think of ways to describe what we’re feeling in the moment, doesn’t mean we can’t put words to it later, when we’ve had a chance to think about it. This seems like a worthy exercise, since the neurotypical world deals widely in “emotional currency” — relying on emotion to orient individuals to one another, determine priorities, and measure success of interactions. Alexithymia combined with autism (which can already complicate matters with sensory overload and difficulty reading faces and social cues) can negatively impact an autistic individual in significant ways.

In times of stress, it can complicate sensitive social interactions with peers, medical personnel, mental health clinicians, and other influential figures who may misinterpret unexpected emotional responses as a threat – or a sign of dangerous pathology. This can put alexithymic individuals at risk for missed cues about pressing needs, or inappropriate treatments and medication, which may actually prevent effective emotional processing, and ironically make matters even worse.

Now, alexithymia has been studied for 40 years “from a distance” by researchers who do not experience it themselves, leading to attempts to categorize it along psychiatric lines (see Moorman, et al Emotion Regulation pp 27-42). Five different types have been proposed, centering around emotionality, fantasy life, and cognition. These categories are psychiatric in nature.

In addition to this approach, I think it’s also beneficial to understand alexithymia from the “inside-out”. Studying this cognitive/emotional/behavioral phenomenon from the viewpoint of the alexithymic individual could yield useful information, which not only allows the individual to better understand the nature of their situation, but may also help clinicians and other helpers find complementary / alternative means to communicate in situations where successful social interaction is critical.

To follow are some proposed descriptive sub-types (or categories, if you will) of alexithymia, which identify the nature of the communication issues and also indicate potential remedial approaches.

Alexithymia SubTypes

1. Lexical Deficit Alexithymia – (Shortage of good word choices) When words available do not adequately suffice to describe one’s feelings. This indicates insufficient vocabulary choices (a failing on the side of available terminology) rather than the individual’s inability to think of the right word. The right word for what they’re feeling may not even exist. Or it may not be well-known.

2. Hypervarithymic Alexithymia – (Hyper-variable absence of emotional sense) When emotions are overwhelming and changing too quickly for the individual to summarize what they’re feeling in the moment. The intensity is matched by the speed with which they change, which doesn’t lend itself to quick articulation.

3. Corporeal Alexithymia – (Bodily sensation competition for feeling senses) When physical sensations (including sensory overload) are so intense that they mix with emotions and obscure the true nature of the experience. Intrusions of noise, light, balance problems, taste, touch, can all distract from deciphering what’s going on in your emotions.

4. Temporathymia – (Time-lag absence of emotion processing) When there is a cognitive processing time lapse between when an impression is made… and the individual is able to sort out what emotions are being experienced… and then figures out how to describe them. It’s not that the words aren’t there – the emotions haven’t coalesced sufficiently to describe them.

5. Perceived Exathymic Alexithymia – (Exterior lack of emotional potential – It looks like they won’t understand you) When the emoting individual does not perceive or believe in the ability of others to fully comprehend the emotions they are trying to express and is therefore reluctant or refuses to communicate their experience, to avoid embarrassment or further confusion.

6. Endathymic Alexithymia – (Interior absence of emotion – Yeah… I’ve got nothing to share…) When the individual does not feel anything inside themself, either physically or emotionally, and there is literally nothing in their experience for them to describe. The feelings may come in a little bit, and they may have words put to them, eventually, but “in the moment”, nothing is there to even detect.

Possible Mitigating/Remedial Approaches

1. Lexical Deficit AlexithymiaDevelop a lexicon that more fully describes complex combinations of emotion we actually feel. We frankly need more and better ways of describing our emotions, than the standard handful, or interspersing our sentences with “like”. There are new projects underway to do this – e.g.,  The Dictionary of Obscure Sorrows. We also need to use old words that have fallen out of use.

By enlarging our vocabulary and actively finding ways to put into words what it is we autistic folks are feeling (can also be through art and music), we might possibly dispel the misconception that we feel nothing, and that we can’t describe what we’re feeling because we’re internally deficient.

2. Hypervarithymic Alexithymia – Neurotypical people need to realize that this happens. Our emotional state can be so hyper, so variable, so overwhelming… and our processing speed can be significantly slower than the “norm”… that putting words to what we really feel can be all but impossible. Especially when we’re “put on the spot” and feeling the pressure to perform in ways that make sense to NT folks. The autistic internal world can be so much more vibrant and mutable than the allistic counterpart, and that variation needs to be taken into consideration.

Just understanding that this is the case with us, and not pressuring us to come up with an instant summary of our basic state, would be a step in the right direction. Also, I find body movements are helpful — waving of hands to illustrate the wild flow of information coursing through my system. And drawing. Perhaps some non-verbal approaches would help.

3. Corporeal Alexithymia – Sensory overwhelm is an issue for me, in most cases, alexithymia or not. Stress heightens sensory overwhelm. So, reducing stress, as well as learning how to identify the sensory factors coming into play, can be helpful. If I know that the overhead lights are bothering me, I can ask that they be turned off, and then it’s easier for me to think. In fact, turning off overhead lights can turn me into a completely different-presenting sort of person. It’s interesting to watch, from my own perspective. Doing things like wearing sunglasses or earplugs, wearing clothing without tags or scratchy interior seams, also goes a long way towards that.

For me, just knowing that my sensory issues are “spilling over” into my emotional processing is helpful. I can explain that to others, even if it doesn’t make sense to them… and/or I can stall for time with an explanation that “I’m still thinking”, while I collect myself.

4. Temporathymia – Because it takes time to sort through everything. The temporal aspects of the absence of emotion (that’s ‘-athymia’) can be confounding, especially in frenzied emotional circumstances. When I’m put on the spot by someone who wants to know right now what I’m thinking, I pause and say, “Well, it’s complicated. I’m not sure there’s an easy answer to that.” And they often back off, because they don’t want to hear a lengthy, detailed explanation… even if it’s far more accurate than what they’re expressing. The main thing, with me, is letting people know that it takes time to sort things out… it’s complicated… there’s a lot to consider. I’m a grown-up with a lot of life experience, so I have a lot of points to reference. NT people tend to accept that, whereas no explanation — just a blank stare — doesn’t play so well with them.

5. Perceived Exathymic Alexithymia – Why bother, if others aren’t going to get it? To the point above, telling someone, “It’s complicated. There’s no easy answer.” gets them to back down. Who has the time or the patience for my detailed explanations? Not many people. And telling them they’re going to get an earful, gives them the chance to withdraw their incessant demands for emotional processing from me.

6. Endathymic Alexithymia – Sometimes, there’s just nothing there. This especially happens when I’m tired, very stressed, or completely caught up in thinking about something engaging. If I’m locked onto one of my Compelling Subjects of Study (I like that better than “special interests”), I won’t feel anything — physical or emotional. I’m just thinking. Thinking hard. It takes me a while to shift my attention to my body and emotions. That’s usually about the time I realize I really need to empty my bladder.

So, while alexithymia may be brain-based, in my lived experience, it’s also a problem of not having adequate words to describe what we’re feeling at a given point in time. Either available words are too simplistic, or our feeling state is so intense and so variable, mutable, that we can’t come up with words quickly enough to describe them. Or we don’t think that others will understand, so we don’t even try. At least, I don’t. And then there’s the time factor. My processing speed is slow, whether I like it or not — especially if I’m shifting gears between different thought patterns.

 

Perhaps the problem of alexithymia isn’t entirely with us, or our brains.

Maybe, just maybe, it’s the world we live in, that’s deficient.

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20 thoughts on “#Alexithymia isn’t only a problem of not understanding our emotions

  1. Hello: I write a blog – aspergerhuman.wordpress.com. I have addressed “alternative” explanations and possibilities regarding “Alexithymia” in four posts. “Alexithymia as an Asperger Experience” “Let’s Revisit Alexithymia / Predatory Psychology” “Learning Emotion Words” and “How Society Corrupts Alexithymia / Neurotypical Nonsense”

    Liked by 3 people

      1. VisualVox

        Thanks for posting the links on your blog – I’ve been looking at them, and they need to look at them on my laptop, instead of my phone. I think that we are in a situation where alexithymia for Aspergers or autistic people is actually a different type and other kinds of alexithymia. Researchers are now saying that autism and alexithymia or actually distinct conditions, and I am starting to concur. I think that our version is physiological and experiential, versus only psychological or only brain – based. The idea that alexithymia is specific to brain structure, I believe, clouds the issue for autistic folks. It also oversimplifies things and overlooks the dynamic nature of it. We can lose access to words that describe our situation for a number of reasons, and I think we are in a different quadrant, if you will, then what others have up to no described. I think, as you say, neurotypical folks are not going to have a lot of use for this information, unless they are clinicians who are trying to understand and help us. That is the one and maybe only instance where I think this information would be useful to non-– autistic individuals. Thanks for your writing and thoughts on this. All great considerations.

        Liked by 2 people

      2. I trace a lot of Asperger symptoms to having a visually-dominant sensory acquisition and processing “brain” rather than the typical word-dominant brain. I agree that it is physiological – which creates an entirely separate perception of reality (concrete) and therefore, a separate distinct “psychology”. Judging our behavior by “typical” standards is simply all wrong; like calling “eagles” defective chickens. LOL

        Liked by 2 people

      3. VisualVox

        Yep. Me too. I personally think that our “slower processing” is a product of converting words into pictures… and then into concepts which we work with… and then back into pictures… and then back into words. It’s not that we’re slow. We just have a lot more going on, than people who are verbal-dominant do. And our visual-spatial information streams are vastly more rich and detail-packed than verbal streams. Of course we think at a different pace. We’re working a lot more and getting a lot more done.

        Eagles and chickens is a good analogy. Staying up high, rather than pecking each other to death in the holding pen.

        Liked by 3 people

      4. VisualVox

        Ouch – I just read through your pieces. The one on predatory psychology – I couldn’t get through the whole thing. It’s way too late in the day for that, for me. You’ve got a stronger stomach than I!

        Liked by 1 person

      5. I have a “tolerance” for enduring the awful prejudices one finds within psychology papers, which few “outsiders” read. It is often “stomach-churning” and tedious, but necessary. ASD people need to know what’s going on behind the “public image” of psychology. – Often, it’s shocking.

        Liked by 2 people

  2. One could expect that researchers would be keen to know how autistics experience and understand the world but that assumes they are actually interested in more than their narrow assumptions being ” verified” via research questions & designs that are geared to confirm their hypotheses.

    VV Really agree with your “reply ” above , alexithymia is more complex than assumed… it is natural that researchers only concentrate on what they think is measurable… brain structure etc… but to understand the relevance in real life an appreciation of lived experience can be informative in understanding brain functions and the physiological manifestations of such experientially.

    That was a bit clumsy.

    Liked by 1 person

    1. VisualVox

      Brain stuff – especially fMRI – is so sexy and cool. Lots of data to crunch, lots of stuff to visualize. What I’d like to see is studies of the brain’s reaction to changing situations over time. I’m positive they’d have a very different view of things if they didn’t just study individual moments in time, but watched the progression of alexithymic traits developing under specific scenarios.

      It would probably make a lot more sense to people, too. Chunking things out into distinct and separate scenarios is only practical in a lab – not in the real world. And not for real-world scenarios and applications.

      That’s just what I think. But who am I?

      Liked by 1 person

      1. That is exactly what I think too! I’m fascinated with the the possibilities that fMRI studies could reveal.

        The current approach is so limited and really doesn’t do justice to the understanding of alexithymia, and / or autism ,not to mention it really doesn’t utilise the possibilities of fMRI to its full potential.

        Financial limitations or lack of imagination?

        Liked by 1 person

  3. I have especially 1 and 3. Can’t troubleshoot if something is a bodily sensation or part of emotions or feelings, and suck st describing them.
    On the same time… i love animals as they are easier to understand than humans, and dogs and cats don’t care if you can’t articulate orally about how your emotions are feeling tonight. Also animals have actually honest emotions and are just so much more lovely to spend time with than most humans.

    Liked by 2 people

  4. I had a conversation with my current psychologist about emotions. He suggested that one could think of it as three different “states” one is the actual physical sensation of emotion, the other is the actual sensation in our selves of the emotion we feel and the third is the abstraction of emotions if you will, the idea of thinking about them and putting words to them.

    This came up in a conversation when I tried to explain that although I have managed to learn how to physically identify emotions (cold sweats means I’m anxious for example) I still feel like I’m missing a connection between that and relating it to something I feel since I don’t feel anxious per se, if that makes sense.

    I feel as though, for me at least, it’s a combination of slow-processing, un-precise words (hurray for writing poetry, makes things much more precise I find) or not enough words, not relating to emotions as described by others to my own emotional states, not relating at all to certain emotions (when people describe sadness I’m just left feeling blank), sensory overload complications and emotions just being too damned overwhelming when they do decide to rear their heads.

    I feel there is much more going on here than researches realise, I do wish for more of the science and talking to us folk who process/feel emotions differently than others, and keeping an open mind whilst doing so instead of pasting the “non-emotional cold hearted label” on my forehead.

    Liked by 3 people

  5. Good Morning from Wyoming! Have been catching up on comments: I’m encouraged by the awareness going on here, and I too doubt that social typical people “get it” – or ever will, so long as the “helping, caring, fixing industry”, (which is what I call the profit-making autism business) rakes in over $9 BILLION / year in the U.S. alone. This mega-business literally owns “autism” because they define it; present it to the public and to government agencies. Receive millions in funding, fuel Big Pharma profits, and they really don’t care whose lives they “screw up”.

    It is in their primary interest ($$$) to treat “us” like a commodity (like chickens, hogs or soybeans) – and to control that commodity in the “marketplace”. “Chronic illness” of every type, (such as diabetes, heart disease) is so profitable because each patient becomes a lifelong “slave” to the medical system. Ring a bell? That’s what has been done to “autism” – a manufactured epidemic sucking in billions and “trapping” hundreds of thousands of people, from birth to death, in the system. The last thing the HCFI want is accurate diagnosis or “effective treatment” As it stands, almost any child can be thrown into the “autistic” pot because there is no “real” diagnosis.

    I understand that the last thing that ASD people want to do is to confront this ugly stuff; that’s okay. It’s my self-assigned “task” to expose this mess. The observation that 99% of our “problem” is environmental is accurate: and that environment is the social hierarchy: A pyramid of “power” that dictates “who counts and who doesn’t”. Until and unless ASD people “claim ownership” of who we are and how we wish to live, we will merely be one more profit source in a parasitic economy.

    Liked by 4 people

  6. mattiekate78

    Just chiming in to stay I’m a neurotypical reading this and I find it helpful. Showing this post to my daughter when she gets home from school to get her thoughts/opinions. I specifically want to ask her if she can identify any sub-types in herself. If you have any more advice on verbage she can use when “dealing” with neurotypicals in conversation I would love to hear it….

    Liked by 1 person

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