Emotional Expression, Emotional Communication, and Alexithymia.
Hypo-expression or hyper-expression can produce alexithymia.
Posted June 7, 2010
Previous posts in this series have considered emotional education and emotional competence, how they are based upon emotional communication during development, and how miscommunication can undermine a child's understanding of feelings contributing to alexithymia: a lack of effective vocabulary for recognizing and labeling feelings and desires. Communication is inherently dyadic, requiring both a sender's display and a receiver's perception/judgment of the display. To measure emotional communication, we use a slide-viewing technique. A sender is shown a series of emotionally-loaded color slides in several categories-Familiar People, Scenic, Unpleasant, and Unusual-and rates the emotions each slide evoked. Receivers viewing the sender silently over television judge what kind of slide a sender views on each trial and how she feels about the slide. To measure emotional display activity, we use a segmentation technique. Viewers are asked to press a button at meaningful points in the stream of the sender's expression, with the definition of what is "meaningful" left to the viewer. Despite the lack of specificity, viewers tend to agree on which points are meaningful and which are not, and Darren Newtson at the University of Virginia showed that the points consensually defined as meaningful constitute "high information points" in the stream of expressive behavior.
Using the slide-viewing technique, judges are able to correctly judge the expressions and feelings of most healthy college age senders with significant accuracy, although women are significantly better senders than men and extroverts are better senders than introverts. Also, good senders show smaller physiological responses to the slides (skin conductance deflections, heart rate acceleration, blood pressure rise), leading to a distinction between externalizing and internalizing modes of expression that parallels extraversion-introversion. In clinical groups--behaviorally-disordered children and schizophrenia patients--communication is severely disrupted even though the emotional responses to the slides themselves seem not greatly affected by the clinical disorder. Indeed, some schizophrenia patients show more emotional activity than healthy comparison persons on the segmentation measures. Thus, they seem to have considerable facial/gestural activity to the slides, and more consensually-defined high-information points, but this does not translate into their being able to communicate their feelings to others. But, if there is more information, should there not be more communication?
To understand this, it is useful to consider the dyadic and developmental context of emotional communication. In healthy samples, there is a strong positive correlation between emotional display activity (measured by segmentation) and communication accuracy: introverts show an internalizing pattern of low display activity and low communication, while extraverts are higher in display activity and have high communication accuracy. However, in clinical samples, the relationship between display activity and communication accuracy can break down, with more display activity actually leading to less communication accuracy at times. For example, one slide category very effective for healthy samples is a Familiar picture of the sender him/herself, unexpectedly included among the slides. This typically produces a strongly positive emotion response with a broad smile and laugh that the receiver can correctly judge to be based upon a familiar slide. However, when shown a picture of himself one behaviorally-disordered child (aged about 10) showed surprise but also a strong, distinct, and unmistakable expression of disgust. He then went on to rate the picture of himself as very positive. A receiver viewing this expression would very likely assume it reflected a negative slide which evoked negative emotions in the child, so that emotional communication as defined by the slide-viewing technique would be low.
Previous posts showed that emotional education and competence are based upon social biofeedback resulting from accurate emotional communication, and that there are a number of ways in which such communication can go awry, including biases in responses of receivers (inhibiting anger in girls more than boys for example). Another source of miscommunication rests with the sender: the display may be inhibited, either because of an introverted temperament or because of direct inhibition from punitive social learning. In this case, even a perceptive and sympathetic receiver may be hard put to discern what emotion a child is actually feeling, so that social biofeedback allowing the child to label, understand, and develop a vocabulary of feelings and desires is disrupted. Thus, emotional inhibition is associated with increased physiological arousal and decreased expressive display activity, with less social biofeedback leading to deficits in emotional education and competence. The result might be termed "hypoexpressive alexithymia," or alexithymia due to a lack of expressive display activity on the part of the sender.
However, interpersonal emotional communication also can be impeded by insufficient inhibition/control of expression, because of an externalizing temperament involving extreme extraversion or laissez-faire social learning. Low inhibition can lead to decreased autonomic responding and active but incoherent expressive display. Again, even a perceptive receiver may be hard put to discern what a child is actually feeling, and social biofeedback is disrupted. Thus, emotional disinhibition is associated with decreased physiological arousal and increased but incoherent expressive display activity, with less social biofeedback and corresponding deficits in emotional education and competence. The result might be termed "hyperexpressive alexithymia," or alexithymia due to a surfeit of expressive activity on the part of the sender.
The accompanying figure illustrates the relationships between emotional display activity and emotional communication. When levels of emotional display activity are either too low or too high, emotional communication tends to be disrupted with consequent alexithymia due to deficits in social biofeedback; leading to deficits in emotional education and emotional competence. As a result, emotional communication actually tends to be optimal at moderate levels of emotional display activity.