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Trauma

Struggling to Identify Your Feelings? It Could Be Trauma

The condition known as alexithymia can follow trauma.

Key points

  • Comprehending and identifying one's own emotional state is essential for various aspects of life.
  • A person who has difficulty identifying and expressing feelings may have a condition called alexithymia.
  • Addressing alexithymia can lead to more effective emotional expression and better overall well-being.
Source: RobinHiggins & Artwork by Denise Robertson/Pixabay
Source: RobinHiggins & Artwork by Denise Robertson/Pixabay

When someone asks, “How are you feeling?” are you genuinely not sure? Maybe you come across as socially awkward. Or perhaps people have accused you of “withholding” your emotions.

Any of those examples might indicate something called “alexithymia.” It’s a legitimate condition (with a fancy title). And about 13 percent of the population experiences it (Ditzer, 2023). Characteristics of alexithymia include difficulties in identifying and describing one’s own emotional state.

Of course, there are times in any of our lives when we can’t find the words to express what’s going on inside the body and mind at a particular moment. But that doesn’t necessarily mean we have the condition. Alexithymia is a more persistent state than the occasional “at a loss for words.” It’s an emotional unawareness. With alexithymia, the person can’t (or struggles to) attach symbols (words) to label or share what’s happening emotionally for them.

Six reasons why emotional awareness matters

If we don’t understand what we’re emotionally experiencing:

  • It’s difficult—even unfair—to expect a partner to fulfill or meet our needs. It sets up a cycle of discomfort or frustration.
  • Body sensations and emotions can confuse instead of inform us (for example, if someone says something cruel to you, your body could react with a sensation, but you don’t know what it means or what information it’s providing).
  • Treatment for psychiatric disorders can be tricky (Frederica and colleagues, 2020).
  • We can’t typically care for and nurture feelings in healthy, adaptive ways. We may develop inappropriate maladaptive strategies—such as disordered eating, substance use, impulse buying, unhealthy attempts at self-regulation, etc.
  • We may be unable to read others’ emotional or social cues because we can’t read our own emotions. Then what happens? Boundary crossings, misunderstandings, unstable relationships, etc.
  • We can’t fully know or understand ourselves.

Why do people experience alexithymia?

So far, research hasn’t been able to answer that conclusively. Some possibilities have included but are not limited to experiencing the following: a traumatic brain injury, distressing life events (AKA “trauma”), or childhood maltreatment.

Traumatic Brain Injury

Certainly, when our head endures physical injury, behavioral, cognitive, and emotional changes can happen depending on the impact and severity. Experiencing alexithymia after a traumatic brain injury is common (Wood and Doughty, 2013).

Trauma

Then, there’s a different kind of trauma. When we go through something incredibly distressing, our response to it can overwhelm our ability to deal with it. We often have trauma responses that can distance us from our emotions.

That phenomenon helps us to survive and press forward. Still, it may also contribute to the development of (or strengthening of existing [Ogłodek, 2022]) alexithymia. Research shows that alexithymic traits commonly appear alongside post-traumatic stress disorder (Edwards, 2023).

Childhood maltreatment

A recent review by Ditzer (2023) concludes that childhood maltreatment—particularly emotional abuse, emotional neglect, and physical neglect—is linked to adult alexithymia. And that makes sense when you think about how people, especially young ones, get through emotional or physical unsafety.

Children often disconnect or dissociate from their feelings and the distressing situations happening to them. The brain mercifully does that when something is too painful or inexplicable to hold. Thus, as they develop, being unable to match their emotions to experiences appropriately may carry forth.

Further, with childhood neglect, how is the child supposed to learn emotional regulation without it being taught? Interactions help us to understand our emotions. That can’t happen when being neglected.

Little-t trauma or non-trauma

Without having gone through any aforementioned traumas, any one of us might still experience alexithymia. Here are four reasons that could explain it.

First, our culture sucks at teaching people to recognize, tolerate, and normalize our emotions. In fact, messaging often aligns with suppressing emotional awareness. For example:

  • “Don’t be so dramatic.”
  • “Suck it up.”
  • “You’re oversensitive.”
  • “Don’t be a crybaby.”

And when you think of social conditioning like “Man up,” it’s no surprise that males seem to demonstrate higher levels of alexithymia than women (Levant et al., 2019).

Second, a quote from a 2014 paper still likely holds true today: “Low social support may promote the emergence of alexithymia” (Karukivi and Saarijärvi, 2014). That said, many things can pull us away from our social support systems—the need to work multiple jobs to survive, technology, disorders that increase isolation, etc.

Finally, much of the research categorizes alexithymia as a personality trait (Barańczuk, 2019)—a tendency or characteristic we are born with or that develops as our genetics mix with our environments. And that could be true. However, the conceptualization seems counterproductive to the treatment of it.

Personality traits are mostly stable—like, if you’re extroverted, you’ll likely be social and outgoing throughout your lifetime. And it’s probably true that for some with alexithymia, their condition may be steady. But for others, it can change. As a therapist, I’ve witnessed massive improvements—people moving from levels of emotional numbness and lack of words to emotional engagement and fluid expressiveness.

Three ideas that might help if you have some degree of alexithymia

  1. Look up a list of “feeling words” or “emotions” online. (There’s also a handy tool called a “feeling wheel.") Practice wondering what others are feeling while watching them on your television or device. Reality shows might be especially helpful here. They often spotlight emotions and offer labels and interpretations of the feelings via commentaries and gossip.
  2. Listen to songs and musicians known for their storytelling and expressiveness. Good lyrics may help us to identify, understand, and normalize our feelings. (My last post addresses that.)
  3. Try exploring labeling and talking to someone safe about your experiences of your emotions—even if you don’t know what they are. Maybe that’s a friend, family member, pastor, etc. If you have access to a therapist, that can offer an especially safe, skilled space to work on expanding your feeling identification, tolerance, and expression. Learn to nurture them (and you) in healthy ways.

Final thoughts

For the most part, we (humans) can’t not have feelings and emotional reactions. They happen whether we can identify them or not. When we can learn about them, we can often figure out how to care for them—in healthy ways.

If you might struggle with alexithymia, you are not alone.

This piece is for informational purposes only and does not provide therapy or professional advice.

To find a therapist near you, visit the Psychology Today Therapy Directory.

References

Barańczuk, U. (2019). The five factor model of personality and alexithymia: A meta-analysis. Journal of Research in Personality, 78, 227-248. https://doi.org/10.1016/j.jrp.2018.12.005

Ditzer, J., Wong, E. Y., Modi, R. N., Behnke, M., Gross, J. J., & Talmon, A. (2023). Child maltreatment and alexithymia: A meta-analytic review. Psychological Bulletin, 149(5-6), 311–329. https://doi.org/10.1037/bul0000391

Edwards, E. R. (2022). Posttraumatic stress and alexithymia: A meta-analysis of presentation and severity. Psychological Trauma, 7, 1192-1200. doi:10.1037/tra0000539

Federica, P., Mirko, M., Pasquale, P., & Bernardo, C. (2020). The impact of alexithymia on treatment response in psychiatric disorders: A systematic review. Frontiers in Psychiatry, 11. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00311

Karukivi, M., & Saarijärvi, S. (2014). Development of alexithymic personality features. World Journal of Psychiatry, 4(4), 91–102. https://doi.org/10.5498/wjp.v4.i4.91

Levant, R. F., Hall, R. J., Williams, C. M., & Hasan, N. T. (2009). Gender differences in alexithymia. Psychology of Men & Masculinity, 10(3), 190–203. https://doi.org/10.1037/a0015652

Ogłodek E. A. (2022). Alexithymia and emotional deficits related to posttraumatic stress disorder: An investigation of content and process disturbances. Case Reports in Psychiatry. doi: 10.1155/2022/7760988

Wood R. L., & Doughty C. (2013). Alexithymia and avoidance coping following traumatic brain injury. Journal of Head Trauma Rehabilitation, 2, 98-105. doi: 10.1097/HTR.0b013e3182426029

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