Alexithymia: When You Cannot Find Words for What You Feel

There is a particular kind of suffering that rarely gets named. It is not depression exactly, though it often accompanies it. It is not anxiety, though tension is never far away. It is something quieter and more disorienting: the experience of feeling — of knowing that something emotional is happening inside you — while being completely unable to identify, describe, or make sense of what it is.

This is alexithymia. And if you have ever found yourself staring blankly when someone asks how you feel, or realising with a shock that you have been clenching your jaw or holding your breath for hours without knowing why, it is worth understanding what this condition is, where it comes from, and what can be done about it.

What Alexithymia Actually Means

The term was coined in the early 1970s by psychiatrist Peter Sifneos, drawing from Greek roots: a (without), lexis (word), thymos (emotion). Literally: without words for emotion.

Contemporary research, including a major 2025 review by Luminet and Nielson in the Annual Review of Psychology, defines alexithymia as a multi-dimensional personality trait characterised by three core difficulties: difficulty identifying feelings, difficulty describing feelings to others, and an externally oriented thinking style — a tendency to focus attention outward on concrete facts and events rather than on inner emotional experience.

A fourth dimension — a restricted fantasy life, a limited capacity for daydreaming or imaginative elaboration — is debated in the literature, though clinically it is frequently present.

Alexithymia is not a psychiatric diagnosis. It is a trait, meaning it exists on a continuum. Estimates suggest it affects approximately 10% of the general population, rising to around 25% among psychiatric patients (Luminet & Nielson, 2025; MDPI systematic review, 2024). It is associated with a wide range of difficulties: depression, anxiety, eating disorders, addiction, chronic pain, and somatic complaints that resist straightforward medical explanation.

What It Feels Like From the Inside

People with high alexithymia often describe a puzzling inner blankness. When something upsetting happens, they may feel a vague bodily discomfort — a tightening in the chest, heaviness in the limbs, sudden fatigue — but cannot locate a corresponding emotional name for it. Asked “how do you feel about that?”, they find the question baffling. They may answer with a description of what happened, rather than how they experienced it.

This is not indifference. It is not that nothing is happening emotionally. Something is — the body registers it — but the cognitive and linguistic systems that would normally translate physiological arousal into a recognised emotional state have not been reliably developed, or have been suppressed.

The consequences in daily life are significant. Relationships are often difficult, not because the person does not care, but because emotional attunement — the mutual recognition of feeling states that creates intimacy — is genuinely hard. Partners may feel shut out. The person with alexithymia may feel chronically misunderstood, or find themselves watching others’ emotional responses as though from behind glass.

In the body, the cost can be considerable. Research consistently links alexithymia to elevated somatic symptoms — headaches, gastrointestinal problems, chronic pain — as well as to disrupted sleep. The hypothesis, with growing empirical support, is that unexpressed and unprocessed emotion does not disappear: it finds expression through the body.

Origins: Where Alexithymia Comes From

Alexithymia is not something people choose. The research points to several interlocking pathways.

Early relational experience plays a central role. Children learn to identify and name their emotional states primarily through interaction with emotionally attuned caregivers. Where that attunement is absent — where parents are themselves emotionally unavailable, dismissive of emotion, or frightening — the child’s emotional vocabulary simply does not develop in the normal way. This is consistent with attachment theory and with the neuroscience of early development: the right hemisphere, which processes emotional information, develops in direct response to early relational experience.

Trauma, particularly early and repeated trauma, is strongly associated with alexithymia. A 2023 neurobiological review (Arancibia et al., Neuroscience Insights) found structural and functional differences in the hippocampus and insular cortex in individuals with alexithymia and disorganised attachment — areas centrally involved in interoception, the capacity to sense and interpret internal bodily states. Where trauma has overwhelmed these systems, the ability to read one’s own emotional signals may be profoundly disrupted.

There is also evidence for a genetic component, though the research here remains in early stages.

Alexithymia and the Jungian Perspective

From a Jungian standpoint, alexithymia represents an almost complete disconnection from the inner world of feeling — what Jung called the Feeling function, one of the four primary psychological functions through which we orient to experience. Where the Feeling function is underdeveloped, the person is left navigating life primarily through Thinking or Sensation, without access to the evaluative emotional intelligence that would normally guide relational decisions and self-understanding.

Jung’s concept of the Shadow is also relevant here. Emotional states that cannot be consciously identified do not simply evaporate — they accumulate in the unconscious, often projecting outward in ways the individual cannot fully understand or account for: disproportionate reactions to apparently minor events, inexplicable episodes of rage or grief, somatic symptoms without clear medical explanation.

Depth psychotherapy offers particular resources here precisely because it attends to what is beneath the surface — the dreams, the body’s signals, the charged atmospheres that surround certain memories — rather than asking for direct verbal articulation of feeling states that, by definition, the alexithymic person cannot easily access.

What Therapy Can Do

The good news — and this is important — is that alexithymia is not fixed. A 2024 systematic review published in Behavioural Sciences (MDPI) examined randomised controlled trials of psychological treatments and found meaningful reductions in alexithymia scores across multiple modalities, including cognitive behavioural therapy, schema therapy, and compassion-focused therapy. A 2025 longitudinal study (Sayar et al., Frontiers in Psychiatry) found significant improvement in alexithymia scores among patients treated in group psychotherapy settings for personality difficulties.

Equally importantly, earlier beliefs that alexithymia was a stable and immovable trait — a permanent ceiling on therapeutic progress — have not been supported by the evidence. Changes in depressive symptoms correlate with changes in alexithymia, suggesting that the two influence each other, and that effective therapy for depression or anxiety also tends to improve emotional awareness.

In practice, working therapeutically with alexithymia means going slowly. It means creating conditions of safety in which the person can begin to tolerate internal experience rather than deflecting from it. Body-based awareness — noticing physical sensations, locating them, describing them without immediately demanding that they be named as emotions — can be a useful starting point. So can attention to dreams, to images, to what arises in the relational space of the therapeutic encounter itself.

Importantly, therapy also needs to address the relational context in which alexithymia developed. If the inability to identify and communicate feelings emerged from an early environment in which such communication was unsafe or useless, the therapeutic relationship itself becomes the primary site of learning: a place where feelings can gradually be recognised, named, and — for perhaps the first time — met with interest and care rather than dismissal.

This is slow work. It is also deeply worthwhile.

When to Seek Help

If you recognise yourself in this account — if emotional blankness, somatic symptoms without clear explanation, or persistent difficulty in close relationships feels familiar — it is worth speaking to a therapist experienced in working with emotional processing difficulties.

Alexithymia is not a life sentence. It is a description of where you are now, not where you have to remain. Many people who have lived much of their adult lives behind a kind of emotional glass discover, with the right support, that there was always far more feeling available to them than they knew.

Further reading:

• Disorganised attachment style
• Male depression: what it actually looks like
• Inner child healing: a Jungian perspective
• Psychotherapy at Harley Street

Dr Philippe Jacquet is a Jungian analyst and integrative psychotherapist with over 25 years of clinical experience, specialising in trauma, addiction, and eating disorders. He practises at Harley Street, London W1, and works with clients internationally online.

References

• Luminet, O., & Nielson, K.A. (2025). Alexithymia: Toward an Experimental, Processual Affective Science with Effective Interventions. Annual Review of Psychology, 76, 741–769.
• Betts, S. (2025). Exploring Alexithymia: Reviewing at Risk Populations and Treatment Pathways. Doctoral thesis, Staffordshire University.
• Systematic review of psychological treatments for alexithymia. Behavioural Sciences (MDPI), December 2024.
• Arancibia, M. et al. (2023). Neurobiology of Disorganized Attachment. Neuroscience Insights.
• Sayar, G. et al. (2025). Improvement of alexithymia in patients treated in mental health services. Frontiers in Psychiatry.