What Is Alexithymia?

Written by Keri Wiginton
Medically Reviewed by Smitha Bhandari, MD on July 27, 2025
7 min read

Alexithymia is when you have trouble identifying, understanding, or naming your emotions. The word comes from the Greek language and literally means "lacking words for feelings." It's not a mental illness, but it can affect your mental health and quality of life.  

Emotional awareness is more than just putting feelings into words. It's a skill that helps you make better decisions, respond to stress, and adapt to change. Without it, daily life and relationships may feel confusing or disconnected.

According to Jordan Grafman, PhD, a cognitive neuroscientist at the Shirley Ryan AbilityLab and professor at Northwestern University in Chicago, our brains assign value to things. That sense of value helps you remember what to seek out – and what to avoid.  

But for people with alexithymia, that value system can break down. If you can't consciously tap into your emotions, you may have a hard time understanding people or making choices.   

"You know the saying, 'Go with your gut,'" Grafman says. "Alexithymics have trouble doing that." 

How common is alexithymia?

About 1 in 10 people may have alexithymia. It seems to happen more often in men than women and may be more common in people with lower income or education levels. But those numbers may not tell the full story. 

Grafman says many people go through life with mild forms and never get diagnosed. Unless a psychiatrist or psychologist is trained to look for it, the signs might get missed or folded into a broader diagnosis like depression or autism.  

Here's how alexithymia might show up in your everyday life: 

Emotional awareness

  • You have a hard time naming or describing your feelings.
  • You may feel good or bad and not know why. 
  • You might not see how feelings affect your thoughts and actions. 
  • You may not think about your inner feelings much. 

How you relate to others 

  • You might not pick up on other people's emotions. 
  • You might hurt people's feelings by accident.
  • You may not know how to comfort someone. 
  • Others might describe you as cold, even if you care deeply.  
  • You may find it hard or pointless to imagine how others feel.

How emotions affect your body 

  • You may have unexplained headaches, belly pain, or fatigue.
  • You may feel restless or tense and not know it's tied to your emotions. 
  • Emotions may show up as physical symptoms instead of mood issues. 

Symptoms of alexithymia aren't always easy to recognize on your own. But there are screening tools and interviews that can help a mental health professional spot the signs. 

There's no single cause. But experts think alexithymia is linked to differences in the brain, early life experiences, and certain mental health or brain conditions. 

Studies show that alexithymia is tied to areas of the brain and nervous system that help regulate stress and emotions, especially the: 

Anterior insula. Makes emotional sense of physical signals like a racing heart
Amygdala. Recognizes emotional cues, especially fear and threat
Frontal lobes. Helps regulate and label emotions

These brain regions work together to shape emotional awareness. Because they're closely connected, dysfunction in one can affect the others, Grafman says. Some people lose emotional awareness as a coping mechanism, especially when emotions feel unsafe or overwhelming. This may happen with: 

  • Childhood trauma, including physical and emotional neglect or abuse
  • Major life stress, like living through a war 

Certain mood disorders are linked to alexithymia, such as: 

  • Depression or anxiety 
  • Eating disorders
  • Psychosomatic disorders (physical symptoms caused by emotional stress)
  • Posttraumatic stress disorder (PTSD) 
  • Borderline personality disorder (BPD)

What's the link between alexithymia and autism?

Research shows that up to half of autistic people may also have alexithymia. But it's a separate trait, meaning you can have one without the other or both. Scientists think the link may stem from shared genetic pathways or differences in brain wiring. 

What is acquired alexithymia?

Most research has focused on people who are born with alexithymia or develop it early in life, such as those with autism or early trauma. But scientists are now paying more attention to acquired alexithymia. That's a loss of emotional awareness that happens after a traumatic brain injury (TBI) or neurological condition, like Parkinson's disease.

While we still don't have strong studies that track changes in emotional awareness before and after these conditions, experts believe that brain changes – not just personality – are likely what cause this type of alexithymia.

There's no lab test or scan to confirm alexithymia. But screening tools and interviews can help identify it. Commonly, that includes the Toronto Alexithymia Scale (TAS-20). 

The TAS-20 is a short quiz that measures three main things: 

  • How hard it is to recognize your own feelings
  • How hard it is to talk about those feelings
  • Whether you tend to focus more on facts than emotions

Experts use your score to group you into one of three categories: 

  • 61 or higher – likely alexithymia
  • 51 to 60 – borderline
  • 50 or below – unlikely to have alexithymia 

Mental health professionals may also use clinical interviews or questionnaires to get a clearer picture of how you process emotions. That's different from regular talk therapy, which often doesn't pick up on alexithymia. 

Treatment depends on the cause and how much alexithymia affects your daily life. There's no one-size-fits-all approach, but many people benefit from: 

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • Mindfulness-based interventions (MBIs)

Working with a therapist trained in emotional processing can help you: 

  • Build your emotional vocabulary 
  • Notice how your body reacts to different feelings
  • Learn to link physical symptoms to emotions or stress
  • Practice empathy and improve your relationships

Some therapists take a gender and culturally sensitive approach, especially when alexithymia stems from rigid social norms that discourage emotional expression.

Others use creative or compensatory tools to help you name and make sense of your emotions. For example, you might: 

  • Start by describing shades of colors (light blue vs. dark blue). 
  • Focus on one emotion that feels especially confusing.
  • Use 1-to-10 rating scales to gauge how much you like or dislike certain experiences. 

These structured methods can help retrain your brain to recognize emotional cues, even if those feelings don't come naturally at first. Progress often starts small. Over time, these strategies may build a stronger link between your body, brain, and emotions. 

Start with patience and realistic expectations. While people with alexithymia have emotions, they may have trouble showing or naming what they feel. Try not to take it personally if they don't respond the exact way you want them to emotionally. 

Instead, focus on building trust and familiarity over time. "You want to be a person that the person [with alexithymia] prefers," Grafman says. "That makes it more likely they're going to listen to you." 

Here are some ways you can help: 

Be consistent. Familiarity builds comfort and trust.
Ask simple questions. "Did you like that?" instead of "How did that feel?"
Model emotional language. Share how you feel in everyday moments.
Offer support. Help them find a therapist or support group.

Helping someone with alexithymia is less about fixing and more about understanding. Even if they have trouble connecting with you in the way that you're used to, that doesn't mean the relationship can't work. You may just have to be more thoughtful in your approach. 

Alexithymia is a trait that makes it hard to recognize, name, or describe emotions. It's not a mental illness, but it can affect relationships, therapy outcomes, and emotional well-being. 

People with alexithymia may feel physical signs of stress without knowing the emotional cause. It often shows up with conditions like autism, PTSD, depression, or after a brain injury. 

Therapy, mindfulness, and emotional skills training may help build awareness over time. 

Is alexithymia a disorder?

It can be a disorder in the sense that it makes your life harder, but it's considered a trait. But it often shows up alongside mental health disorders like depression, PTSD, borderline personality disorder, or autism spectrum disorder. 

Can alexithymia be cured?

That's not really how doctors approach it. But people with milder forms may improve emotional awareness with therapy. In cases caused by a brain injury or neurodevelopmental conditions, treatment may focus more on rebuilding emotional skills. 

Can people with alexithymia feel love?

Yes. People with alexithymia can form close bonds. But emotional expressions may look different. 

Are you born with alexithymia?

Maybe. Some people are likely born with brain differences that make it harder to process emotions. Others may develop it later in life due to childhood trauma, mental health conditions, a brain injury, or neurological conditions.  

Can people with alexithymia feel pain?

Yes. Doctors first noticed alexithymia in people who came in for physical symptoms like pain or fatigue. They were clearly in distress, but they couldn't clearly explain how they felt emotionally.