When Miguel was eight years old, he began asking his mother several times a day if she was mad at him. Technically, he meant “angry” rather than "insane," but she never corrected him.

He misinterpreted her actions as anger: when she hurried him out of the car for school as people queued behind them, when she expressed frustration after repeatedly asking him to do something he hadn't done yet, and when she was mildly irritated about having to rearrange her day due to running low on his medicine. In reality, "mad" wasn't what his mother felt. Yet, in Miguel's perception, he spent every day believing others were angry with him.

At that time, Miguel could only discern two emotions: happiness and anger, limiting his ability to understand the emotions of others. This misconception saddened his mother deeply, likely contributing to Miguel's anxiety. Unknown to his mother, Miguel was grappling with alexithymia, a term derived from Greek meaning "without words for emotions," introduced by Peter Sifneos in 1973 to describe difficulties in understanding, processing, or describing emotions.

Recent research has suggested a potential link between autism and alexithymia, indicating that this personality trait, marked by challenges in identifying and expressing emotions, may be notably prevalent in autistic individuals.

This blog post will explore the connection between autism and alexithymia, highlighting how these overlapping yet distinct conditions can affect the lives of autistic individuals.

Introduced by psychotherapist Peter Sifneos in 1973, alexithymia is a personality construct characterizing difficulties in identifying, describing, and expressing emotions. Those with alexithymia often struggle to differentiate between emotions and bodily sensations and may find it challenging to comprehend others' emotions. While not recognized as a mental disorder in the DSM-5, alexithymia frequently accompanies other psychological conditions.

Particularly prevalent among individuals with autism, studies suggest that a significant portion of autistic people experience alexithymia, far exceeding the occurrence rate in the general population. This disparity has propelled further research into the connection between autism and alexithymia, highlighting potential implications for social communication and emotional recognition in autism.

The Autism-Alexithymia Connection

The notable overlap between autism and alexithymia has garnered scientific interest, with some research indicating that alexithymia may contribute to the social communication challenges commonly associated with autism. For example, difficulties in interpreting why someone might be crying can be attributed to alexithymia rather than autism per se, suggesting that some emotional recognition issues might be more closely linked to alexithymia.

It's crucial to acknowledge, however, that not all autistic individuals have alexithymia, and not all those with alexithymia are autistic, indicating that while related, they are distinct entities.

Impact of Alexithymia on Individuals with Autism

Alexithymia can significantly affect autistic individuals, presenting unique challenges as well as opportunities for understanding and growth. The condition can amplify difficulties in emotional understanding, making it hard for those affected to identify their feelings or articulate them. This can complicate social interactions and empathy, as understanding and responding to the emotions of others is a critical aspect of social communication.

Furthermore, alexithymia may lead to "expressive incoherence," where there's a mismatch between internal emotions and external expressions, potentially resulting in misunderstandings in social contexts. Managing emotions can also be more challenging, potentially heightening stress and anxiety. Physical sensations might be misinterpreted as emotions, adding to the confusion.

The story of Miguel, who benefited from real-life explanations of emotions from his mother, exemplifies the practical approaches that can aid individuals with alexithymia and autism. Such interventions highlight the importance of tailored support and the potential for improved emotional understanding and regulation. Understanding the intersection of autism and alexithymia is essential for developing effective interventions and accommodations. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) tailored to the needs of those with both conditions can offer significant benefits.

Final Thoughts

The relationship between autism and alexithymia is an area ripe for research, offering insights that could enhance the emotional lives of autistic individuals. Recognizing the unique challenges and needs of those experiencing both conditions is crucial for providing meaningful support and fostering improved quality of life.

More Information

Alexithymia and Autistic Traits: Associations With Social and Emotional Challenges Among College Students, Vaiouli and Panayiotou, 2021.

Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism, Bird and Cook, 2013.