The Linear Relationship Between Visual Imagery and Alexithymia Breaks When Imagery Is Absent: Complete Aphantasics Are No More Alexithymic Than Typical Imagers

Several studies have suggested a link between aphantasia (reduced or absent visual mental imagery) and alexithymia (difficulty identifying and describing one's feelings, together with an externally oriented thinking style), but results and interpretations differ across studies, and no consensus has emerged. We pooled data from five independent studies (N = 1478: 147 complete aphantasics, 141 hypophantasics, 1115 typical imagers, 75 hyperphantasics) who completed the Vividness of Visual Imagery Questionnaire and the twenty-item Toronto Alexithymia Scale, and compared six candidate models, from linear and categorical baselines to several non-linear alternatives (GAM, Segmented and Floor-group models), to determine the shape of the relationship between visual imagery vividness and alexithymia, rather than assuming it in advance. The best fitting and most interpretable model (floor-group) showed that among all participants capable of some degree of visual imagery (from hypo- to hyperphantasics), alexithymia declined as visual imagery vividness increased, consistent across all three TAS-20 sub-scales. Complete aphantasics broke this linear relationship entirely: rather than showing the highest level of alexithymia, as the linear relationship would predict, their scores were lower than that of hypophantasics and did not meaningfully differ from those of typical imagers. This discontinuity, specific to the total absence of visual imagery, was corroborated by an equally well-fitting segmented model, held up across all five studies individually, and is inconsistent with prior work treating any degree of reduced imagery as equivalent. Our results support the idea that some components of alexithymia are related to the level of visual imagery vividness in people that experience visual imagery. However, in people with complete aphantasia, alexithymia levels may depend on other processes. In other words, having no visual imagery at all does not seem to be associated with increased alexithymia levels, while having very weak visual imagery does.