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Why Exploring Your Feelings Is Good for Your Health

The concept of “alexithymia” has a long but little-recognized history.

Key points

  • Alexithymia is a personality trait that captures how well people can explore and express their feelings.
  • People high in alexithymia can be at risk for chronic physical, stress-related symptoms.
  • Measuring alexithymia can provide a first step toward achieving better physical and mental health.
MediaProdaction/Shutterstock
Source: MediaProdaction/Shutterstock

How in touch would you say you are with your emotions? Do you enjoy digging down deep into your emotional life just for the sake of doing so? Or would you prefer to focus on what’s going on around you rather than within you at any given moment? A concept in psychology with the perhaps mystifying name of “alexithymia” was introduced several decades ago as a means of capturing the fundamental tendency within personality towards being open to your inner life.

What Is Alexithymia and Why Should You Care About It?

Empirical evidence for the impact of alexithymia on health comes from a wide range of sources. According to the University of Toronto’s Michael Carnovale and colleagues (2021), this research includes “genetics, neuroimaging, attachment and trauma, emotion processing, taxometric investigations, epidemiological studies, and investigations of the influence of alexithymia on treatment outcomes.” Clinical psychologist John Nemiah and colleagues first coined the term, based on the Greek words a (lack), lexis (words), and thymos (emotions). In what you might consider a classic psychoanalytic situation, patients who couldn’t put their feelings into words instead showed up with medical problems having a psychosomatic component.

If you push your feelings aside, according to this view, they’re not going to disappear but will instead wreak potential havoc on your body. Perhaps you have occasional physical symptoms such as an upset stomach or difficulty breathing, or perhaps you have a chronic medical condition that is worsened when you’re under stress. By not “giving words” to your feelings of being under duress, sad, or anxious, your body registers an alarm that something is wrong.

The concept of alexithymia raises fascinating mind-body issues but it also has great practical value, as suggested by the increasing number of studies that support its validity. The issue addressed by the authors is whether, from a statistical standpoint, alexithymia is a unitary trait within personality or whether instead it is better understood as breaking down into separate components. The original concept incorporates four basic factors, but unlike other researchers who used subscale scores, Carnovale and his associates maintain that to understand alexithymia, the proper approach is to measure it as a unitary score.

How to Gauge Your Own Levels of Alexithymia

Before getting to the methods that the researchers used, it’s worth getting an in-depth view of what constitutes this important trait. As the authors note, the four “distinct but interrelated facets” include:

  1. Difficulty identifying feelings (DIF): Not being able to know where your feelings come from while also being unable to distinguish emotions from the bodily arousal that accompanies them. This might happen when you become nervous just before you’re supposed to speak publicly but you’re only aware that your heart is racing.
  2. Difficulty describing feelings (DDF): Not being able to articulate the feelings you’re having. You might try to share those public speaking jitters with your partner later that day but find yourself unable to communicate clearly enough for your partner to understand your distress.
  3. Limited fantasy and other imaginal activity: As the phrase implies, you don’t really enjoy playing around with ideas just for the sake of it, so are somewhat stuck in the here-and-now of what you’re doing rather than what you’re feeling.
  4. Concrete, externally oriented style of thinking (EOT): This is a component of the trait that Nemiah referred to as “operational thinking” or pensée opératoire. You might prefer to solve problems by actually tackling them rather than planning your approach ahead of time in your mind.

The Toronto Alexithymia Scale, although developed with these four components as the starting point, actually includes the three facets of DIF, DDF, and EOT. The limited fantasy component didn’t survive the rigorous statistical tests that would have maintained its independence. You might have even thought of this yourself as you read the above descriptions, but it was important to point out their slightly different qualities to give you an appreciation of what the TAS is attempting to gauge.

Turning now to the individual items, here are examples of each of the three subscales as they appear within the full test:

DIF:

  • I am often puzzled by the sensations in my body.
  • When I’m upset, I don’t know if I’m sad, frightened, or angry.

DDF:

  • I’m able to describe my feelings easily.
  • I find it hard to describe how I feel about people.

EOT:

  • Daydreaming is a waste of time.
  • Knowing the answers to problems is more important than knowing the reasons for the answers.

Looking at the scoring of these items, which test-takers rate on a 1 (strongly disagree) to 5 (strongly agree) scale, the average per item is approximately 2.3 (i.e. along the midpoint) with most people scoring between about a 1.8 and 2.8. The sample in the Carnovale et al. study included 1,903 adults living in Canada, averaging 36 years old (18-81), roughly 60 percent women, and 88 percent identifying as White. This particular study was aimed at testing the TAS structure (i.e. 1 vs. 3 factors) but previous investigations have used translated versions of the TAS into as many as 29 languages. One key advantage of this study was that the sample was older than the typical age range in previous studies, many of which included undergraduate participants only.

How Can Knowing Your Alexithymia Score Help You?

As the authors predicted, the overall TAS scores held up more robustly to statistical testing than did the three subscales. Indeed, the authors caution on this basis that previous reports in which only one subscale proved to relate statistically to other outcomes or psychological qualities therefore can’t be trusted. Picking apart one of those scales from the totality of the instrument could capitalize on chance factors that sometimes lead to apparent significance but that aren’t justified.

One key outcome that you can gain in knowing about your own TAS score relates to what strategy might work for you if you were to seek psychotherapy. You might benefit from learning to deconstruct a negative feeling state as you try to overcome feelings of depression or anxiety. Indeed, should you have certain physical symptoms that are triggered when things are going wrong, you could benefit from help that focuses on the DIF and DDF components of alexithymia. Previous clinicians have described alexithymic patients as “boring” because they don’t want to talk about their feelings, but behaviorally oriented therapy can work with their tendency to think concretely.

Although the main value of this study can be considered its methodological contribution, you can also use the findings to achieve greater insight from your own emotional states. Thinking back on times when you had those unpleasant sensations of anxiety or a sad mood but don’t want to spend time exploring them, you can now see the value in trying to pick them apart. If you have a chronic health condition that a medical professional says may be related to stress, don’t dismiss the advice. Break down situations that make you feel most stressed and try to understand (either on your own or with help) what those feelings are and where they come from.

At the same time, enjoying the “play” of your inner life can also help you develop greater psychological depth. You may think that daydreaming is a waste of time, but on those occasions when you’ve tried it, how many times did you notice yourself coming up with novel and effective solutions to your problems?

To sum up, knowing rather than hiding from your feelings is a key psychological attribute. Those feelings may not be all that pleasant, but exploring them can help lead you to greater mental and physical health.

LinkedIn/Facebook image: MediaProdaction/Shutterstock

References

Carnovale, M., Taylor, G. J., Parker, J. D. A., Sanches, M., & Bagby, R. M. (2021). A bifactor analysis of the 20-item Toronto Alexithymia Scale: Further support for a general alexithymia factor. Psychological Assessment, 33(7), 619–628. doi: 10.1037/pas0001000

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