Alexithymia, when I don’t realize how I feel.

It is quite common that some people, at certain times in their lives, have difficulty being aware of what they are feeling. This is not a mental illness or a psychological disorder, we simply need to learn to connect with our own emotions and not all of us have had the same opportunities in the past to do so.


Alexithymia is the term that psychologists use to refer to the difficulty that people may experience to connect, become aware and clearly identify the emotions that they are feeling at any given time.

Like so many other things in life, identifying our own emotions, even recognizing the emotions other people feel, is something you learn from early childhood. For many reasons this learning process may not go through the most appropriate path and we may find that in adolescence or adulthood we do not have a good ability to know what we really feel.

When we have a high degree of alexithymia, it is very difficult for us to clearly discriminate what is happening to us. Others may notice that we are unwell, but if they ask us about our feelings we shrug our shoulders and give a simple answer:

- What's wrong?
- I don't know... I just feel bad.

Answering a question about our feelings this way is very typical of someone with difficulty identifying their own emotions. In the case of alexithymia, it is not that the person wants to hide his emotions from the other, it is that he literally does not know what is happening to him, he simply knows that he is feeling bad, he realizes that he is experiencing a positive or negative emotion, but he’s not certain about what specific emotions he is feeling or why.

In fact, it is common for the person with a high degree of alexithymia to be surprised when they ask for more explanations, since they often do not even imagine that they can access to more specific information about what they are feeling. The ability to feel and discriminate between a wide variety of different emotions is simply out of their current ability.

If we imagine another person without alexithymia in a similar situation, the answer to the question about their emotional state is very different:

- What's wrong?
- Today I am exhausted, not feeling like doing anything, I feel sad and disappointed with myself. I had an exam yesterday, I think I failed, I was nervous and it was awful. Ugh, I also feel guilty, I think I should have studied more.

In this case, we can see how there is a much more detailed and precise knowledge of the emotions that people are feeling, including their origin. Consequently, people are more likely to also know how to manage these emotions and decide how they can act to resolve the situation.

People with a high degree of alexithymia do not have these highly developed emotional introspection capacities and are often involved in a mental block that prevents them from making adaptive decisions. Not being clear about what is happening to them, they are also not clear about what they can do to solve it. Remember that emotions are a guide, a compass for behavior, without being able to recognize them properly we feel lost.

Furthermore, emotions are eminently physiological (bodily) processes. Emotions directly modulate the functioning of our body. All physiological functions are altered when emotions are not properly managed. We already know that our energy level or activation, heart rate, blood pressure, respiration, digestive function, etc. they are in constant interaction with our emotional state. What happens then with our body when we are not able to identify our own emotions?

Well, psychosomatic disorders are very common in people with a high degree of alexithymia. Since emotion is not resolved adaptively by proper identification and a healthy coping strategy is not deployed, the physiological activation pattern associated with emotion persists in the body and ends up causing a wide variety of dysfunctions and physical symptoms. In short, we see that the person “somatizes” their emotional distress. That is, as the person does not have the necessary resources to consciously identify and manage emotion, the body ends up expressing it in the form of physical (psychosomatic) symptoms.

Currently we have great scientific evidence on the influence caused by psychological distress in many organic disorders: endocrine, immunological, gastrointestinal, respiratory, dermatological, sexual, muscular, etc.

In fact, the concept of alexithymia itself was coined from the work of Sifneos (1973) with patients with psychosomatic illnesses. This researcher realized that there was a fairly frequent psychological pattern in this group of patients, which included:

  • Degraded emotional functioning.
  • Imagination poverty.
  • Inability to find the right words to describe your emotions.

Although alexithymia is very likely to appear in people with psychosomatic disorders, as we have seen, it is also closely related to other psychological disorders, especially depression, autism spectrum disorder, post-traumatic stress and chronic pain. However, in general, alexithymia is present in approximately 10% of the general population (Arrabales, 2019).

The good news is that alexithymia is relatively easy to detect, either through an evaluation interview with a psychologist or through self-report tests such as the TAS-20 (Toronto Alexithymia Scale) (test available only in Spanish).

Furthermore, if, as usual, the high degree of alexithymia does not originate from an injury to the nervous system or a severe neurodevelopmental disorder, it is a problem that can be treated quite effectively through psychotherapy. In fact, it is an aspect with which psychologists are used to working and obtaining good results. To do this, we use multiple techniques that allow the person to establish an effective connection with their own emotions.

These changes are possible thanks to neural plasticity, our brain never stops learning new things and connecting with what we feel is one of the most beneficial learnings that can be carried out in life.


Arrabales, R. “Evaluación y Tratamiento de la Alexitimia con Herramientas de Inteligencia Artificial“. Proyecto Fin de Máster. Universidad Internacional de la Rioja. Mayo, 2019.

Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2), 255-262.

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