Alexithymia/uh-LEK-si-THY-mee-uh/
The inability to identify and describe your own emotions. You feel things intensely but can't name them—like having a complex emotional storm inside but only being able to say "I feel bad." Affects 50-85% of autistic people.
Andy says:
Your emotions are color-blind. Everyone asks "Are you sad? Angry? Anxious?" and you're like "I don't know, I just feel... bad? Wrong? Something?" It's like your feelings forgot to come with labels. Your therapist says "How does that make you feel?" and your brain returns ERROR 404: EMOTION NOT FOUND. You're not emotionless—you're drowning in unnamed feelings. Your body screams signals but they're in a language you never learned. Someone asks why you're crying and honestly, you have no idea. Could be sadness, could be overwhelm, could be because you saw a nice dog three hours ago. The emotions are real and intense; the words for them just aren't there.
Detailed Explanation
Alexithymia means "without words for emotions" (Greek: a=without, lexis=words, thymos=emotions). It's not lacking emotions—it's lacking the language to describe them.
What happens in alexithymia:
- Emotions exist and are often intense
- Brain can't translate feelings into words
- Body signals don't connect to emotion labels
- Physical sensations remain mysterious
The interoception link: When you can't feel your heartbeat, muscle tension, or gut sensations clearly (poor interoception), you can't recognize that racing heart = anxiety or tight chest = sadness. The body-emotion dictionary is missing pages.
How it shows up:
- Therapist: "How do you feel?" You: "...Bad?"
- Doctor: "Describe your symptoms." You: "Wrong. Just wrong."
- Partner: "What do you need?" You: "I don't know."
- Friend: "Why are you crying?" You: "No idea."
You're not broken or cold—your emotional operating system just speaks a different language.
Everyday Life Examples
The therapy struggle: "How does that make you feel?" asks the therapist. Maria stares blankly. She knows something is happening inside—her chest is tight, stomach churning—but feel? The question might as well be in ancient Sumerian. She says "upset" because that's safe, but it could be grief, rage, or indigestion.
The relationship confusion: Tom's partner asks "What's wrong?" He genuinely doesn't know. His body is screaming distress signals but they're unlabeled packages. Is he angry about work? Sad about his dad? Hungry? All he can say is "I feel bad" while his partner grows frustrated with his "emotional unavailability."
The meltdown mystery: Sarah finds herself sobbing uncontrollably. Someone asks why. She literally has no idea. Could be the documentary about penguins, could be cumulative stress, could be that weird interaction from Tuesday. The tears are real; the reason is encrypted.
Practical Strategies
Building an emotion vocabulary:
- Start with body sensations: tight, heavy, light, buzzy
- Use emotion wheels and charts
- Rate intensity (1-10) before naming
- Accept "I don't know" as valid
- Try metaphors: "feels like storms" or "like static"
The HALT+ check: Hungry? Angry? Lonely? Tired? +Overwhelmed? Overstimulated? Under-stimulated?
Communication helpers:
- "I'm having feelings but can't name them"
- "My body feels wrong but I don't know why"
- "I need time to figure out what this is"
- Color or number systems instead of words
- Pointing to emotion charts
Quick Tips
- Today: Start a sensation journal—just describe physical feelings
- This week: Learn five new emotion words
- This month: Practice connecting body sensations to situations
- Long-term: Build your personal emotion-body dictionary
Community Context
The neurodivergent community has developed extensive supports:
Prevalence:
- 50-85% of autistic people
- 30-50% of ADHD people
- Higher in those who mask heavily
- Can develop after trauma
Community wisdom:
- "Emotions are there, words are missing"
- "Not knowing is valid"
- "Your uncertainty isn't resistance"
- Reducing masking improves awareness
Do / Don't
Do's
- Offer emotion word choices: "Frustrated, overwhelmed, or something else?"
- Use visual aids (emotion wheels, color codes)
- Validate "I don't know" as legitimate
- Ask about body sensations first
- Focus on needs, not labels
Don'ts
- Don't equate flat expression with no feelings
- Don't pressure for emotion words
- Don't assume lack of empathy
- Don't dismiss physical symptoms
- Don't use abstract emotional language
For Families and Caregivers
Your loved one isn't emotionally unavailable or cold:
- They have intense feelings but no words
- "I don't know" means literally that, not resistance
- Physical symptoms often ARE the emotions
- They care deeply but can't always express it
Support through:
- Regular check-ins with body sensations
- Emotion charts and visual aids
- Accepting uncertainty without pressure
- Noticing patterns in behavior
- Creating judgment-free spaces
For Schools and Workplaces
Educators: Students with alexithymia need:
- Emotion vocabulary teaching
- Multiple expression methods (art, movement, writing)
- Concrete rather than abstract language
- Regular emotional check-ins
- Validation that "not knowing" is okay
Employers: Support workplace needs:
- Clear, direct communication
- Focus on tasks not emotional expression
- Allow processing time
- Written rather than verbal emotional discussions
- Understand apparent "coldness" isn't lack of care
Intersectionality & Variation
- Autism: 50-85% prevalence, often with poor interoception
- ADHD: 30-50% prevalence, emotions lost in hyperactivity
- Trauma: Can develop secondary alexithymia
- Culture: Some cultures have richer emotion vocabularies
- Gender: Women often forced to mask more, worsening alexithymia
Related Terms
- Interoception - Sensing internal body signals
- Emotional dysregulation - Difficulty managing emotion intensity
- Flat affect - Reduced emotional expression (different from alexithymia)
- Masking - Hiding neurodivergent traits, worsens alexithymia
- Emotional suppression - Consciously hiding emotions (different)
Related Terms
Interoception
Your internal body sense—the ability to feel hunger, thirst, heartbeat, temperature, pain, and other signals from inside your body. Many neurodivergent people experience this "eighth sense" differently, making basic needs harder to recognize.
Emotional Dysregulation
Neurological differences in how emotions are experienced, processed, and expressed. Characterized by intense feelings that may seem disproportionate to triggers and difficulty returning to emotional baseline—not a character flaw, but brain-based variation.
Autistic Burnout
Complete physical, mental, and sensory collapse from the cumulative cost of existing in a neurotypical world. Skills disappear, speech vanishes, and previously automatic tasks become impossible—not tiredness but neurological system failure.
Masking
Hiding or suppressing neurodivergent traits to appear more neurotypical. A survival strategy that involves mimicking social behaviors, suppressing stims, and performing neurotypicality at significant personal cost.
Community Contributions
Your contributions help make definitions more accurate and accessible.