“How are you feeling?” For most people, it’s a simple question. For some, it’s one of the hardest questions there is.
You might know something is going on inside. Your chest feels tight, your stomach feels heavy, or you just feel “off”. But when you try to put a name to it, nothing comes. If that sounds familiar, you may be experiencing something called alexithymia, and you’re far from alone.
At a glance
- Alexithymia means finding it hard to identify and describe your own emotions. It’s a trait on a spectrum, not a mental illness.
- It’s common, and especially common in autistic people. About half of autistic people have high levels of alexithymia.
- Emotional awareness can grow with practice. Three small steps help: notice, name, share.
What is alexithymia?
The word comes from Greek and roughly means “no words for feelings”. It was first described by psychiatrist Peter Sifneos in the 1970s.[1] Today it’s usually understood as three connected traits:[2]
- Difficulty identifying feelings, and telling emotions apart from body sensations.
- Difficulty describing feelings to other people.
- An outward focus, preferring facts, events and practical details over inner experience.
Alexithymia isn’t a mental illness or a personality disorder, and it isn’t a diagnosis. It’s a trait that sits on a spectrum, from mild to more pronounced. It doesn’t mean you don’t have feelings. Many people with alexithymia feel things strongly. The feelings just arrive without a label.
People often describe:
- Feeling emotions but not being able to name them or work out why they’re happening
- Reaching for vague words, like “I just feel off” rather than “I feel anxious”
- Noticing body sensations, such as a tight chest or heavy stomach, before noticing an emotion
- Feeling distant from others, or finding it hard to feel close
Who it affects
Alexithymia is more common than many people realise. In one large Finnish study, about 13% of adults had high levels of alexithymia.[3] It often shows up alongside depression, anxiety, PTSD and chronic pain, but it can also exist on its own.
Autism and alexithymia
A 2019 review found about 50% of autistic people had high alexithymia, compared with about 5% of non-autistic people.[4] It’s common in autism, but not universal.
Not the same thing
Research suggests some emotion difficulties often linked to autism are better explained by co-occurring alexithymia than by autism itself.[5]
There’s also a strong link with interoception: how well we notice signals from inside the body, like heartbeat, hunger or tension. Research suggests people with higher alexithymia often find these signals harder to read too.[6] That’s why body-based strategies can help so much. Read more about the senses, including interoception, in our sensory differences guide.
Notice, name, share
Building emotional awareness usually happens in three steps. Here’s how they work.
Three small steps that can help: notice, name, share.
Scan from head to toe. What do you feel, and where?
A rough guess is better than skipping it.
Change is slow, but it is possible. We’re here to help.
Use the Pause button to stop the animation at any time.
Why it matters
Emotions work like a signal system. They tell us when something matters, when we’re safe or unsafe, and when a need is being met or missed. When those signals are hard to read, everyday life gets harder too. It can be more difficult to:
- Tell others what you need
- Soothe difficult feelings
- Build close relationships
- Make decisions that feel right
Over time, this can leave people feeling disconnected, flat or overwhelmed, even when life is otherwise going well.
What helps?
There’s no single “alexithymia therapy”. A 2024 review of 18 trials found most psychological treatments reduced alexithymia, with approaches based on cognitive behavioural therapy (CBT), including acceptance and commitment therapy (ACT), studied most often. The authors noted the evidence is still limited and more high-quality research is needed.[7]
Helpful approaches tend to share four ingredients:
Learning about it
Understanding what alexithymia is, and that it’s a common trait rather than a personal failing.
Emotion skills
Practising how to notice, name and sit with emotions, one small step at a time.
Body-focused work
Tuning in to physical sensations and linking them to feelings, including mindfulness-based practices.
A safe relationship
A therapy space where emotional language is modelled and there’s room to practise without pressure.
Five strategies you can try at home
Small, regular practice tends to help more than big efforts. Pick one to start with.
- Build an emotional vocabulary. Keep a simple feelings wheel on your phone or fridge. Start with six core emotions: happy, sad, angry, afraid, disgusted and surprised. Over time, add more specific words like frustrated, lonely, content, hopeful or ashamed.
- Track emotions through your body. Twice a day, do a two-minute body scan. Notice your breathing, heart, jaw, shoulders, stomach and throat, and write down one word: tight, heavy, fluttery, empty or buzzing. Over time, patterns appear, like “a tight stomach often comes with not wanting to talk”.
- Name it to tame it. When something happens, fill in the gaps: “When ___ happened, I felt ___ in my ___.” A rough guess is better than skipping it. Research suggests that putting feelings into words can help calm the brain’s emotional response.[8]
- Switch your attention. Spend about 30 seconds looking around the room, 30 seconds noticing your breath, and 30 seconds noticing what your mind is saying. Moving between the outside world, your body and your thoughts builds flexibility.
- Journal facts first. Each day, write down three things that happened, then what your body was doing at the time. Later, look back and see whether an emotion word fits. Starting with facts takes the pressure off.
Building connection with others
Alexithymia can make relationships feel like a foreign language. A few small steps can help close the gap.
- Share your pattern. Try telling people you trust: “I find it hard to name feelings, so I might say ‘I don’t know’ a lot. Please be patient, and ask me what I noticed in my body instead.”
- Practise checking in. Ask a housemate or family member one small question a day, like “What’s one thing that went well today?”
- Start with shared interests. Friendships often grow around activities rather than deep conversations. A class, a club or a sports team is a gentle way in.
- Set small goals. One short conversation a day, one text to someone a week, and one activity around other people each fortnight.
For more ideas, read Making and Keeping Friends When You’re Autistic, ADHD or AuDHD.
What to expect
Change is slow, but it is possible. Progress usually follows the same order as the animation: first noticing sensations, then naming feelings, and later sharing them with others.
You don’t need to become a highly emotional person. The goal is simply enough emotional awareness to communicate, connect and look after yourself.
Common questions
Is alexithymia the same as autism?
No. Alexithymia is more common in autistic people, but many autistic people don’t have it, and many people with alexithymia aren’t autistic. They’re separate, though they often overlap.
Can you be diagnosed with alexithymia?
Alexithymia isn’t a formal diagnosis. A psychologist can use questionnaires, such as the Toronto Alexithymia Scale, alongside conversation to understand your emotional awareness and what might help.
Do people with alexithymia have less empathy?
Not necessarily. Many people with alexithymia care deeply about others. They may just find it harder to put feelings, theirs or other people’s, into words.
Can children have alexithymia?
Yes. Children can find it hard to name feelings too. Feelings charts, body maps and naming feelings out loud together can help. Our children and teens team can support families.
Keep reading
Ready to put words to your feelings?
If this sounds like you, a psychologist can help you slow down and put words to what’s happening inside, at a pace that feels right. We offer neuro-affirming therapy in Wahroonga and by telehealth. Book online, call us, or start with a free 15-minute chat.
(02) 9037 3509Suite 4 & 5, 5 Redleaf Avenue, Wahroonga NSW 2076. Telehealth Australia-wide. Psychcare is not an emergency service. If you or someone you know is in immediate danger, call 000 or contact Lifeline on 13 11 14.
Sources
- Sifneos, P. E. (1973). The prevalence of “alexithymic” characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2–6), 255–262.
- Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32.
- Salminen, J. K., Saarijärvi, S., Äärelä, E., Toikka, T., & Kauhanen, J. (1999). Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland. Journal of Psychosomatic Research, 46(1), 75–82.
- Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry, 55, 80–89.
- Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3, e285.
- Brewer, R., Cook, R., & Bird, G. (2016). Alexithymia: A general deficit of interoception. Royal Society Open Science, 3, 150664.
- Tsubaki, K., & Shimizu, E. (2024). Psychological treatments for alexithymia: A systematic review. Behavioral Sciences, 14(12), 1173.
- Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words: Affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18(5), 421–428.
This article is general information, not personal clinical advice.