Alexithymia: the inability to say “I love you”

the Alexithymia it is a neurological disorder that causes the inability to control and recognize one’s emotions and, as a result, it makes it impossible for the person suffering from this affect to express themselves emotionally.

What is alexithymia?

Not all people with alexithymia have the same degree of involvement, as experts say there are two types: primary alexithymia, which is more severe and is a consequence of brain damage caused, for example, by multiple sclerosis or stroke; and secondary alexithymia, due to emotional trauma suffered or poor emotional learning.

Symptoms of alexithymia can also appear in patients with Parkinson’s disease, in the early stages of the disease’s development, and in most people with autism.

Statistics indicate that alexithymia affects 8% of men and 1.8% of women. In addition, 30% of people with psychological disorders and 85% of people with autism suffer from this disorder.

History and construction

Alexithymia was first named as a psychological construct in 1972 by Peter E. Sifneos, and was considered a emotional awareness deficit. Studies underline that this pathology has two dimensions: a cognitive dimension, when the person has difficulty identifying, interpreting and verbalizing his feelings and emotions; and an emotional dimension, when there are difficulties in reacting, expressing, feeling and imagining emotionally (ie having emotional experiences).

As already mentioned, alexithymia is associated with various psychological disorders, such as autism, depression or schizophrenia. Coexistence with other psychological pathologies complicates the patient’s recovery.


Regarding Alexithymia, it is important to know that does not appear in the DMS (Diagnostic and Statistical Manual of Mental Disorders). However, it can be defined by the following psychological, cognitive and behavioral characteristics:

  • Difficulty verbalizing emotions, recognizing them and using them as internal signals.
  • Difficulty locating sensations in one’s own body.
  • Tendency to use action as a coping strategy in conflict situations.
  • Concrete thought, devoid of symbols and abstractions.
  • Rigidity of preverbal communication, with little mimicry and few bodily movements.

Types of alexithymia

Researchers and experts in this pathology differentiate between two types of alexithymia:

1. Primary alexithymia

He has a biological originAs neurologists claim that there is a neurological deficit that interferes with communication between the limbic system (manages emotions) and the neocortex (our rational brain), or that there is a communication deficit between the left hemisphere ( in charge of language production) and straight (regulates emotions).

This type of alexithymia can have a hereditary origin (with an onset in childhood) or can be due to certain neurological diseases: multiple sclerosis, stroke, Parkinson’s, etc.

2. Secondary alchemy

This type of alexithymia it occurs because of a traumatic experience that a person may have had, Both in childhood and adulthood. Its symptoms can be explained in the context of post-traumatic stress disorder (PTSD) in victims of kidnapping, rape or war conflicts. But secondary alexithymia can also be caused by depressive disorder, substance abuse, eating disorders (anorexia or bulimia), or poor emotional upbringing.

Treatment and therapy

Starting treatment for a patient with alexithymia requires their own motivation or that of a loved one. If this first request does not exist (from a subject or from a family member or friend), it will be difficult to specify the treatment. In this regard, it is rarely the patient who seeks help because of their ignorance or lack of awareness of the problem.

Family support is necessary for this type of patient, because the treatment will be effective if it is worked from three sources: the application of appropriate drugs (in case of primary alexithymia), psychotherapy and a planned life strategy . In this last source, the support of relatives is particularly important.

When it comes to psychotherapy, a distinction should be made between primary and secondary alexithymia, as therapies aimed at self-awareness and emotional management are likely to work only with patients with secondary alexithymia.

Bibliographical references:

  • Rieffe, C., Villanueva, L., Adrián, JE and Górriz, AB (2009). Somatic complaints, moods and emotional awareness in adolescents. Psicotheme, 21 (3), 459- 464
  • Swiller, HI (1988). Alexithymia: treatment that uses combined individual and group psychotherapy. International Journal of Group Psychotherapy, 38 (1), 47-61.

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