Alexithymia — When Feelings Have No Words

Alexithymia — from the Greek for “without words for feelings” — is the difficulty identifying what one is feeling, distinguishing between emotions and bodily sensations, and putting emotional experience into words. It is not the absence of feeling. It is the absence of access to feeling.

The person with alexithymia is not cold or unfeeling. They are often intensely affected by their emotional world. What they lack is the capacity to locate, name, and communicate what is happening inside them.

Why it matters clinically

Alexithymia is found at significantly elevated rates in people with eating disorders, addiction, and a range of psychosomatic presentations. This is not coincidental. When feelings cannot be identified and metabolised, they tend to be managed through behaviour — restriction, substance use, compulsive exercise. The symptom is doing the work that the emotional vocabulary cannot.

“I see a great deal of alexithymia in my work — particularly with men, and particularly with eating disorders and addiction. The question I ask is not ‘how do you feel?’ It is: ‘what happens in your body?’ That is often where we can begin.” — Philippe Jacquet

Alexithymia and men

Philippe Jacquet’s doctoral research on male eating disorders identified emotional language as a specific area of difficulty. Men are frequently socialised away from emotional vocabulary from early childhood. Alexithymia in men with eating disorders is common, under-recognised, and clinically significant.

In therapy

Developing emotional vocabulary is itself a clinical task. Therapy — and in particular the consistent experience of having emotional states named, reflected, and tolerated within a relationship — can build this capacity over time.

Book a consultation with Philippe Jacquet — psychotherapist and eating disorder specialist, London.