Alexithymia: Toward an Experimental, Processual Affective Science with Effective Interventions

Alexithymia is a multi-dimensional personality trait involving difficulty identifying feelings, difficulty describing feelings, and an externally oriented thinking style. Poor fantasy life is debated as another facet. For over 50 years, the alexithymia literature has examined how alexithymia-related disturbances in perceiving and expressing feelings contribute to mental and physical disorders. We review the current understanding of alexithymia—including its definition, etiology, measurement, and vulnerabilities for both mental and physical illness—and its treatment. We emphasize the importance of further experimental and processual affective science research that (a) emphasizes facet-level analysis toward an understanding of the nuanced bases of alexithymia effects on neural, cognitive, and behavioral processes; (b) distinguishes between emotion deficits and emotion over-responding, including when over-responding is functional; and (c) clarifies when and how impairments occur for neutral and positively valenced information or contexts. Taken as a whole, a clarification of these issues will provide clear directions for effective and tailored alexithymia interventions.