Alexithymia is a psychosomatic disorder in which a person is unable to express feelings in words. Alexithymia should not be classified as a mental pathology; this is not true. The symptom is considered as a feature of the human nervous system. Mental development does not affect the formation of alexithymia; people with this diagnosis often have a high IQ level.
- Forms of alexithymia
- Symptoms
- Association with psychosomatic illnesses
- Treatment of alexithymia
Various studies say that between five and twenty-five percent of all people have some form of alexithymia. Various methods are used for research, and there is no clear scale that determines the levels of the ability to express emotions.
Causes of alexithymia
Modern experts distinguish two forms of violation: primary and secondary. Primary alexithymia is congenital and is associated with deficits in certain areas of the brain; secondary alexithymia is considered acquired. The causes of the disorder will depend on its form.
The following causes are identified for primary alexithymia:
- congenital malformations of the fetus, in particular of the brain;
- birth injuries;
- infectious processes suffered during pregnancy;
- the hereditary nature of alexithymia, that is, similar traits can be observed in close relatives.
Causes of secondary (or acquired) alexithymia:
- mental illness (ASD, schizophrenia);
- neuroses, hidden depression;
- stress, constant nervous tension;
- suffered psychological trauma;
- brain injuries, central nervous system;
- severe infectious diseases that affect the functioning of the brain and central nervous system.
Alexithymia, according to many researchers, can also arise as a result of improper upbringing: over- or under-custody, inattention to the child’s feelings. Researchers also note the influence of stereotypes accepted in society. This includes “men don’t cry” and “it’s indecent to express your feelings in public.”
Treatment
The very first step is to accurately diagnose what form of alexithymia the patient has and how severe it is. To do this, the Toronto School of Alexithymia test mentioned above is used. Further treatment is complex. It is based on psychotherapy; additional medications can be prescribed to increase the effectiveness of treatment and consolidate the results.
The therapist's job is to teach the client how to correctly interpret their feelings and manage their emotions. This reduces the psychosomatic effect and reduces the risk of various diseases that it can cause. Quite often, to relieve internal tension, a person simply needs to learn to cry or get angry, releasing emotions, rather than holding them back.
Main signs of alexithymia
The main signs of a violation include:
- Difficulties in understanding and verbalizing one’s own feelings;
- Tendency to loneliness. It may not appear in people with alexithymia immediately, but after some time;
- Limited imagination;
- Denial of the concept of intuition;
- Lack of bright, colorful dreams;
- Logical thinking, penchant for analysis.
However, a person with alexithymia does not necessarily have to have all of the above symptoms.
Doctor of Psychological Sciences, Professor of Moscow State University. M.V. Lomonosova V.V. Nikolaeva
On the psychological nature of alexithymia // Human corporeality: interdisciplinary research. M., 1993. pp. 84-93.
In the history of the development of psychosomatic research, one of the central directions is represented by the search for a special mental quality - psychosomatic specificity, which is a factor predisposing to the occurrence of psychosomatic pathology, influencing the course and treatment of diseases. The latest attempt of this kind is to isolate and describe the phenomenon of alexithymia (14, 15). Alexithymia is considered as a certain set of signs that characterize the mental makeup of individuals, predisposing them to diseases of psychosomatic specificity. It should be noted that in recent years it has been associated with an increasingly wide range of nosological forms (for example, depression, secondary psychosomatic disorders in chronic diseases, etc.) and is characterized in this case as a phenomenon of secondary alexithymia . Thus, the prognostic significance of this phenomenon is thereby significantly leveled. At the same time, the question of the possibility of qualifying the degree of severity of this phenomenon or even creating a typology of alexithymia is becoming increasingly relevant. What is the essence of this phenomenon?
According to descriptions available in the literature, individuals with alexithymia are characterized by a special combination of emotional, cognitive and personality manifestations. The emotional sphere of these patients is poorly differentiated. They exhibit an inability to recognize and accurately describe their own emotional states and the emotional states of others. The cognitive sphere of persons with alexithymia is characterized by a lack of imagination, a predominance of visual-effective thinking over abstract-logical thinking, and a weakness in the function of symbolization and categorization in thinking. The personal profile of these patients is characterized by a certain primitiveness of life orientation, infantility and, what is especially significant, a lack of reflection function. The combination of these qualities leads to excessive pragmatism, the impossibility of a holistic view of one’s own life, a lack of creative attitude towards it, as well as difficulties and conflicts in interpersonal relationships. The latter is aggravated by the fact that, against the background of low emotional differentiation, in a number of situations they easily experience short-term, but extremely pronounced affective breakdowns in behavior, the causes of which are poorly understood by the patients. Limited ability to understand oneself, associated with a lack of reflection, becomes a significant obstacle in psychotherapeutic work with these patients. In the literature, there are still discussions about the nature of this phenomenon, and one of the most widespread in this regard is the hypothesis about changes in the interactions of the cerebral hemispheres with insufficiency of the function of the right hemisphere (see, for example, the article by I.S. Korostelova and V.S. Rotenberg). Without denying the legitimacy of putting forward such hypotheses, we note that the attempt to physiologically explain the nature of alexithymia is clearly insufficient and not only does not exclude, but also presupposes the need for a meaningful psychological analysis of this phenomenon, i.e. research into the question of its psychological nature and mechanisms. The scientific relevance of such an analysis, as we believe, is that it will allow us to understand some hitherto hidden psychological mechanisms of the emergence of psychosomatic phenomena, in particular, the role of psychological self-regulation processes in their genesis. Knowledge of these mechanisms can open the way to a scientifically based search for ways of psychological correction and psychotherapy.
Of course, psychological research into the phenomenon of alexithymia requires special theoretical study and rigorous (as far as possible, given the complexity of the phenomenon) experimental research. In this article, we intended to dwell only on some aspects of this problem, namely, to consider the connection between the phenomenon of alexithymia and the characteristics of psychological self-regulation. For this purpose, let us turn to some provisions of Russian psychology related to the problem of self-regulation. The concept of “self-regulation” is interdisciplinary in nature. Self-regulation is a systemic process that ensures variability and plasticity of the subject’s life activity at any of its levels that is adequate to the conditions. The works of many authors contain an attempt to isolate the actual psychological aspect of self-regulation. At the same time, the level of mental self-regulation (1) is highlighted, which helps maintain optimal mental activity necessary for human activity. Another – operational-technical – level of self-regulation ensures the conscious organization and correction of the subject’s actions (10). The personal-motivational level of self-regulation (3, 4, 5, 7, 8) ensures awareness of the motives of one’s own activities, management of the motivational-need sphere; creates the opportunity to be the master, the creator of your own life. Thanks to the functioning of this level of self-regulation, “a person’s internal reserves are revealed, giving him freedom from circumstances, ensuring the possibility of self-actualization even in the most difficult conditions (8, p. 122).
The ability to voluntarily control one’s own motivational sphere is considered by many researchers as one of the most important characteristics of a person, as an indicator of the harmony and maturity of the individual (7, 8). The motivational and personal level of self-regulation is a process mediated by social norms and values, as well as a system of internal requirements, a special “life philosophy” that turns a person into an active subject of life. L.S. Vygotsky associated a specifically human method of regulation with the creation and use of symbolic psychological tools and saw it in the phenomenon of mastering one’s own behavior. He understood signs as artificial stimulus-means, consciously introduced into a psychological situation and performing the function of autostimulation (6). S.L. Rubinstein associated a high level of self-regulation with the emergence of worldview feelings, i.e. a person’s conscious holistic relationship to the world, other people, and himself” (12, p. 370). A.N. Leontiev’s concept laid the foundation for the study of a “coherent system of personal meanings” (2, p. 218), intermotivational relationships that characterize the structure of personality. Emphasizing the regulatory function of systems of personal meanings, A.N. Leontyev noted that “you can understand and own the meaning, know the meaning, but it will not be sufficient to regulate and manage life processes: the strongest regulator is what I denote by the term “personal meaning” ( 2, p.239). Consequently, the processes of self-regulation do not lie in consciousness; consciousness does not produce them, but mediates them. Self-regulation in this understanding is a special activity, “inner work” or “internal movement of mental forces” (9), aimed at connecting systems of personal meanings.
The ideas of L.S. Vygotsky, S.L. Rubinstein, A.N. Leontiev were further concretized in the concept of semantic formations of personality (2, 3, 4). Semantic formations are considered as “an integral dynamic system, reflecting the relationships within a bundle of motives that realize one or another attitude towards the world” (4, p.48). The regulating role of semantic formations is especially clearly revealed when they are realized and accepted as values (5). F.E. Vasilyuk, emphasizing the regulating role of semantic formations, identifies a special activity for the production of meaning “in critical situations of the impossibility of realizing the internal needs of one’s life” (5, pp. 25-27). This special activity (experience), having arisen in critical life situations, can become, according to the author, an independent functional organ, i.e. “one of the usual means of solving life problems and is used by the subject even in the absence of a situation of impossibility” (ibid., p. 75). Those. experience as a special activity of meaning generation can perform a regulatory function in situations of everyday life. In the literature we find a successful attempt to differentiate this type of self-regulation and volitional behavior (8). The latter arises, in particular, in conditions of motivational conflict; it is not focused on harmonizing the motivational sphere, but only on eliminating this conflict (“affective self-regulation ensures “the achievement of harmony in the sphere of motivations” (ibid., p. 123). As mechanisms, personally -motivational level of self-regulation, reflection and semantic connection are considered (8). Reflection provides a person with the opportunity to look at himself “from the outside”, it is aimed at realizing the meaning of his own life and activities. It allows a person to embrace his own life in a broad time perspective, to correlate the present with the past and the future, thereby creating “integrity, continuity of life” (9), allowing the subject to maintain or restore internal harmony, to necessary rebuild his inner world and not be completely at the mercy of the situation.
As a private mechanism of the personal-motivational (or semantic) level of self-regulation, reflection is a powerful source of stability, freedom and self-development of the individual (8, 9). These contain its fundamental difference from unconscious forms of semantic regulation (psychological defenses), functioning at the level of learned mental automatisms. Thus, summarizing the views available in the literature on the essence of the personal-motivational level of self-regulation, we note that it represents a special form of internal activity. It can be considered as a special activity, the motives and goals of which are to preserve internal harmony and self-identity, ensuring the success of self-actualization. Particular goals of such activity may be situationally determined, but their content in the context of this activity always consists of conscious human values, rules, and an established system of internal requirements formed during life. The nature of these requirements is reflected in the content and structure of self-esteem and the level of aspirations (in particular, in the ratio of real and ideal self-esteem, 3). Let us turn again to the phenomenon of alexithymia. Let us recall that one of the important signs of alexithymia is a deficit of reflection, i.e. awareness of one’s own human essence, needs and motives for activity and, consequently, the inability to control one’s motives, flexibly rearrange them in accordance with the requirements of the situation, changing, if necessary, the “life plan” as a whole or finding new internal means to preserve the old. Internal constraint, the lack of internal means of harmonizing life or the inability to adequately choose them is what makes such a patient like (in the figurative expression of one of the researchers” (quoted from 14) “something like a taut rope.”
Continuation of the article by Nikolaeva V.V. about alexithymia
Psychologists who effectively work with alexithymia
Associated problems with alexithymia
Complications with alexithymia are very diverse. First of all, we are talking about the improper production of hormones responsible for emotions and psychosomatic diseases. These include various manifestations of allergies, gastrointestinal problems, atherosclerosis, migraines and a whole list of diseases.
Often with alexithymia, a person begins to experience problems with excess weight. Many people with this disorder become addicted to alcohol or drugs, which can easily develop into a severe addiction.
Due to the inability to understand the feelings of other people, problems of a social nature often arise: conflicts, problems at work and in personal life.
Prevention
Now that we have found out what alexithymia is and how dangerous it is, we can confidently say that it is advisable to avoid this condition. The best prevention in this case is competent education, and this is an additional responsibility that falls on parents.
From an early age, a child must understand how important it is to correctly interpret his emotions, without suppressing them, but using them as an important tool of self-control. There should be no prohibitions on feelings. If you raise a child under such pressure, then in adulthood it will be very difficult for him to get rid of the habit of suppressing his own emotions.
Another important preventive measure is the development of imagination and creative thinking. This must be done both in childhood and in adulthood. Parents should encourage their children to express their feelings in every possible way, as this is the inalienable right of every person. Of course, we are not talking about teaching a child to violate discipline by demonstrating his individuality.
Refusal to feel
“Bed addiction” is essentially a regression to the so-called “primary sleep” - a sleep-like state characteristic of infants. This is exactly the state that heroin addicts so passionately desire to achieve. Hermit hikikomori also experience a similar process of regression. Every day this quagmire sucks in hikikomori more and more, and getting them out of it is not an easy task.
It is important to pay attention to one point here. A baby who falls asleep during feeding and wakes up to find that he has been weaned from his mother's breast will feel anxious, angry, flushed and cry.
Older babies (one to one and a half years old) also live in a world of basic emotions, such as anger, anxiety, depression or sadness. But adult hikikomori are deaf to these emotions. At first, they themselves refuse to feel anything, and then they simply lose this ability and fall into a state of alexithymia.
Research and Testing
The problem of alexithymia was studied in the USA. In 1985, a psychological test was developed in Toronto to determine the level of alexithymia. The term was coined by Peter Sifneos, a Harvard psychiatrist.
Also in 1985, the test began to be used in Russia with minor modifications. The Bekhterev Psychoneurological Institute has finalized the testing and remade it to suit Russian realities and domestic psychology. In 2010, at the Moscow Research Institute of Psychiatry, the test was adapted and revised again.
