Alexithymia: A Guide to “Emotional Blindness”

What Is Alexithymia?

The term “alexithymia” first appeared in the 1970s and loosely translates to “without words for feelings” in Greek. To properly explain what alexithymia is, it’s actually helpful to identify what it isn’t. Alexithymia isn’t a condition or disorder, nor is it a lack of emotion. Instead, it’s a personality trait that makes it harder for someone to recognise, make sense of, or put words to what they’re feeling.

For example, a person might have autism (a condition which can increase the likelihood of alexithymia) and cry or get angry, yet have no idea what set them off or how to explain it to someone else. It’s this inability to look inwards and understand or describe the emotion that defines alexithymia.

Common Signs and Experiences of Alexithymia

Alexithymia is said to affect around 1 in 10 people in the general population and 1 in 5 in the autistic community. People experiencing alexithymia may have trouble with the following:

• Reflecting on personal feelings
• Determining the difference between bodily sensations and associated emotions
• Identifying and explaining emotions to others
• Interpreting other people’s emotions or body language
• Engaging in imaginative or fantastical thinking 

A person can have alexithymia and not identify with every point on this list. Experiences vary from person to person, and the intensity of these traits can change over time or in different environments.

What Causes Alexithymia?

It’s only natural to wonder why people experience alexithymia, but the truth is, there isn’t a clear-cut cause. Experts believe it may be linked to a combination of the following:

Genes: Some research suggests alexithymia may run in families, indicating a possible genetic component that affects how the brain processes and regulates emotions.

Early trauma: It’s thought that childhood experiences like neglect, abuse, or emotional invalidation may lead some people to disconnect from their feelings as a protective mechanism that persists into adulthood.

Poor mental health: Alexithymia commonly co-occurs with conditions like depression, anxiety, PTSD, and eating disorders, though it’s unclear whether these conditions cause alexithymia or share common underlying factors.

Neurological differences: Some people may acquire alexithymia due to an injury in a part of the brain known as the anterior insula. This brain region helps you to become consciously aware of your emotions by interpreting signals from your body.

Alexithymia and Autism

As we’ve mentioned, it’s not uncommon for people with autism to experience alexithymia. However, many experts agree that alexithymia is best understood through the lens of interoception. This is our ability to perceive internal body signals like heartbeat, hunger, pain, and emotions. 

Because some autistic individuals have reduced interoceptive awareness, they may find it harder to notice subtle emotional changes in their bodies, leading to alexithymia as a secondary effect. With that said, not all autistic people experience alexithymia, and it isn’t a defining autistic trait.

Alexithymia and Mental Health

Although it’s unclear whether alexithymia is caused by mental health issues like PTSD and other trauma-related disorders, research shows that it can heighten emotional difficulties over time. A 2025 alexithymia study following a group of teenagers for several months found that those who struggled to identify and describe their emotions at the start were more likely to develop problems regulating both positive and negative emotions later on. This was linked to increased stress, anxiety, and depression, suggesting that alexithymia doesn’t just co-occur with mental health challenges; it may also make them worse.

For individuals who are neurodivergent, alexithymia can be even more complicated. Since sensory overload and high emotional intensity may already contribute to overwhelm, alexithymia can make it harder for neurodivergent people to notice the early bodily signs that something is building. This might mean that an autistic meltdown or shutdown feels particularly tough to manage, and can make standard therapies less effective unless clinicians have alexithymia awareness.

Ways to Support Employees With Alexithymia

If you’re an employer, you can support staff with alexithymia by learning more about the phenomenon. Here are some helpful dos and don’ts. 

Do:

• Do start with calm curiosity: It’s important not to force emotional language. Instead of asking your staff member to name feelings, ask them: “What helps you to do your job?” This prevents them from having to describe emotions and opens a practical conversation. 
• Do encourage alternative communication methods: Rather than forcing someone to think on their feet or produce words that don’t come naturally, invite them to write down what they do or don’t notice. This can help them to map bodily sensations to words at their own pace.
• Do offer predictable routines and small sensory adjustments: If someone is sensitive to their environment or prefers routine, make sure you’re meeting their needs. Offer quiet spaces, scheduled breaks, and advanced notice when changes are likely to occur. These steps can make internal signals, like a racing heart or tight stomach, easier to notice and label.

Don’t:

• Don’t pressure them to “find” or vocalise emotions: Pressuring someone to tell you how they feel often increases anxiety and shuts down communication. This is because alexithymia is about naming feelings, not about feeling less. Try to support them without expecting anything in return.
• Don’t assume silence means indifference: Someone may not use emotional words, but this doesn’t mean they don’t feel strongly about a task or project. Avoid assuming they’re not engaged, as this can lead to unfair judgments and missed chances to help.
• Don’t mistake physical complaints for avoidance: Research shows that people with alexithymia often experience and report emotional distress through physical symptoms like headaches, fatigue, muscle tension, or digestive issues. Rather than dismissing these as excuses, recognise that this may be how emotional overload manifests for them.

FAQs

Can alexithymia be treated or cured?

Although alexithymia isn’t something that can be treated with a drug, a person with alexithymia can gradually change their relationship with emotions using certain techniques and practices. This might include developing simple body checks like noticing the breath, heartbeat, or where tension occurs, building an emotion vocabulary in the form of a wheel or a list, or using expressive outlets such as journalling or drawing. Working with a therapist can be a helpful way to find the right approach.

Is alexithymia linked to ADHD?

Yes, but there isn’t a causal link. Alexithymia is slightly more common in people with ADHD than in the general population, but it is a separate trait, not a core part of ADHD. Many people with ADHD do not have alexithymia, and many people with alexithymia do not have ADHD. They often overlap, especially where emotion‑regulation problems are present.

Is there a test for alexithymia?

Yes, there are standard tests for alexithymia, most commonly the 20‑item Toronto Alexithymia Scale (TAS‑20). Other tools (like the Bermond–Vorst Alexithymia Questionnaire) and clinical interviews can be used, but no single test alone makes a diagnosis. It’s best to ask a GP or clinician about assessment and interpretation.