Demystifying alexithymia: An empirical approach and roadmap for remediation

Abstract

Alexithymia is a problematic psychological characteristic that limits one’s ability to identify and describe internal emotional states. Heightened levels of alexithymia are ubiquitous among many mental and physical health disorders, and yet, much is unknown about how it alters emotional processing and how to improve it. Experiment one presents a novel, laboratory-based paradigm that facilitates collection of a wide range of emotional processes, including subjective and implicit measures of emotion, as well as aspects of emotional complexity. Results highlight reduced subjective arousal, increased response time to questions about emotional experiences, and reduced emotional dialecticism and granularity as the most important predictors of alexithymia, each of which differentially predicts components of alexithymia. Experiment two considers the role of interoceptive awareness for predicting alexithymia and performance on the tasks developed in experiment one. Interoceptive awareness refers to awareness of internal bodily states; though interoception is critical to the generation of subjective feelings states and many suspect it is involved in alexithymia, little is known about the relationship between the two. The present results suggest interoception plays a critical role in all components of alexithymia, supporting theories it is key to alexithymia. Interestingly, two subtypes of heightened alexithymia emerged from this work: one characterized by low interoceptive awareness and another characterized by high. Both likely interfere with daily function via different pathways. Experiment two also examines whether atypical aspects of emotional processing identified in experiment one improve in response to brief a mindfulness meditation or relaxation script. Results suggest that simple interventions may be successful in improving certain deficits associated with alexithymia, including interoceptive accuracy, normative labeling of emotional experiences, negative dialecticism and positive granularity, particularly among individuals with low interoceptive awareness at baseline. Findings have implications for treatment design and clarifying diagnostic patterns within alexithymia. These are discussed and many avenues for future research proposed.