Alexithymia — The Empathy Blog

By John Ford

Emotions shape our thoughts, behaviors, and relationships, yet many of us struggle at times to identify and express them. This challenge exists on a continuum of emotional literacy, where some navigate their inner world with ease, while others feel lost in a sea of unrecognized emotions. For those with alexithymia, this difficulty is more pronounced, making emotional processing a complex and often frustrating experience.

However, understanding emotions is not an ability that one either possesses or lacks—it’s a skill that can be developed. By exploring alexithymia and the neuroscience behind emotional awareness, we can build greater empathy for those who struggle and cultivate tools to strengthen our own emotional literacy.

What is Alexithymia?

The term "alexithymia" comes from the Greek words meaning "no words for emotions." It refers to a personality trait in which individuals:

Struggle to identify their emotions – They may feel physical sensations (e.g., a tight chest, a racing heart) but be unable to recognize whether they are experiencing anxiety, excitement, or something else.
Have difficulty verbalizing feelings – Without a clear emotional vocabulary, they may find it hard to communicate their emotions to others.
Confuse emotions with physical sensations – Hunger, fatigue, or bodily discomfort may be misinterpreted as an emotional state or vice versa.

Though approximately 10% of the general population exhibits alexithymic traits, it is even more common among neurodivergent individuals, particularly those with autism and ADHD. Research suggests that many of the emotional difficulties often attributed to autism may, in fact, stem from alexithymia itself (Bird & Cook, 2013).

Why Does Emotional Awareness Vary?

While some people naturally connect emotions to words, others experience weaker interoception—the ability to sense internal bodily states. Interoception helps us recognize when a fluttering stomach means nervousness or when tight shoulders signal stress. Individuals with alexithymia often have impaired interoceptive processing, making it difficult to link bodily sensations to emotions (Cook et al., 2013).

The Neuroscience of Emotional Literacy

Emotional processing relies on several key brain regions, including the:

Anterior Insula – Responsible for interoception and emotional self-awareness. Lower activity in this region is associated with alexithymia.
Amygdala – Plays a role in recognizing emotional cues, especially in others.
Prefrontal Cortex – Helps regulate and interpret emotions, linking feelings to decision-making and social interactions.

Studies have found that alexithymia, rather than autism, is the primary predictor of difficulty recognizing emotional expressions in others (Cook et al., 2013). This suggests that alexithymia affects not just self-awareness but also the ability to engage emotionally with those around us.

Developing Emotional Awareness

While alexithymia presents real challenges, emotional literacy is a skill that can be strengthened over time. Whether you experience mild difficulties identifying emotions or deeply struggle with them, there are steps you can take to improve self-awareness and connection.

Practical Strategies to Build Emotional Literacy

· Expand Your Emotional Vocabulary – Using tools like The Empathy Set (feelings and needs cards), you can practice naming and differentiating emotions. Research suggests that people who use a wider range of emotion words tend to have better emotional regulation.

· Engage in Mindfulness & Body Awareness – Practices like meditation and breathwork help improve interoception, strengthening the connection between bodily sensations and emotions.

· Practice Self-Reflection and Keep an Emotion Journal – Reflecting on your day and identifying what you felt (even if you’re unsure at first) can build a habit of emotional self-awareness. Ask: “What am I feeling right now?”

· Use Visual & Kinesthetic Cues – If words feel inaccessible, try mapping emotions through colors, music, or movement, which can serve as alternative forms of emotional expression.

· Talk About Feelings – Sharing emotions in conversations—even if it’s just saying, “I feel something, but I’m not sure what”—can be a step toward greater clarity.

A Shared Human Experience

While alexithymia exists as a distinct trait, we all experience moments of emotional uncertainty. Whether due to stress, cultural conditioning, or personal challenges, there are times when emotions feel confusing or inaccessible.

Instead of seeing this as a flaw, we can view it as a normal part of the human experience—one that can be met with curiosity, compassion, and intentional growth.

By expanding our emotional literacy, we not only gain deeper self-awareness but also build more empathetic and connected relationships with those around us.

Navigating the Ocean of Emotions: Understanding Alexithymia and Emotional Literacy