What is Alexithymia? Understanding When Emotions Feel Out of Reach

Julie N
May 27, 2025
5 min read

What is Alexithymia?

Do you ever find yourself saying, "I don't know how I feel"? Perhaps you notice a tight chest, a knot in your stomach or a sense that something isn't quite right, but you struggle to put your experience into words. If so, you may be experiencing alexithymia.

Alexithymia is a term used to describe difficulty recognising, understanding and expressing emotions. It doesn't mean you don't have emotions or that you lack empathy. Many people with alexithymia experience emotions very deeply. The difficulty lies in recognising, making sense of and expressing those emotions.

Alexithymia is not a mental health condition in itself. However, it is commonly associated with ADHD, autism, AuDHD, trauma, anxiety and depression. It can affect relationships, self-awareness and emotional wellbeing, often leaving people feeling confused, disconnected or misunderstood.

In this article, we'll explore what alexithymia is, what it can feel like, why it's common in neurodivergent people and those who have experienced trauma, and how therapy can help you develop a deeper understanding of your emotional world.

What Does Alexithymia Feel Like in Everyday Life?

People with alexithymia might:

Struggle to name or describe what they are feeling.
Have physical sensations (such as tightness in the chest or stomach discomfort) but not recognise them as emotions.
Experience emotions in a vague or confusing way, such as feeling "off" but not knowing why.
Find it hard to differentiate between different emotions, like anger and frustration or sadness and exhaustion.
Feel disconnected from their own emotional experiences or those of others.

It’s important to note that alexithymia does not mean a person lacks emotions—rather, they have difficulty recognising and expressing them. Many people with alexithymia describe noticing physical sensations long before they are able to recognise an emotion. They may become aware of a racing heart, tightness in their chest or a knot in their stomach, yet struggle to understand what these sensations are communicating. This can make emotions feel vague, confusing or difficult to put into words.

Could I Have Alexithymia?

Many people only come across the term alexithymia after years of feeling that something about their emotional experience is different. You might recognise yourself in some of the descriptions above without ever having had the words to explain it.

You may relate to alexithymia if you often:

Know something feels wrong but struggle to identify exactly what you're feeling.
Notice physical sensations, such as a racing heart, tight shoulders or a knot in your stomach, without realising they may be connected to emotions.
Find it easier to describe facts or events than your emotional experience.
Feel overwhelmed by emotions without understanding where they have come from.
Struggle to explain your feelings to other people, even when you want to.
Need more time than others to understand what you're feeling after a difficult experience.

Recognising yourself in these experiences doesn't necessarily mean you have alexithymia. Difficulties identifying or expressing emotions can arise for many different reasons, including neurodivergence, trauma, anxiety or periods of chronic stress. Rather than viewing alexithymia as a label to fit into, it can be helpful to see it as one way of understanding your unique emotional experience.

Alexithymia and Neurodivergence

Alexithymia is common in neurodivergent people, particularly those with autism, ADHD and AuDHD. While everyone's experience is different, many neurodivergent people describe finding it difficult to recognise what they are feeling until emotions become intense or overwhelming. For autistic people, sensory overload and social communication differences can contribute to difficulties processing emotions. For people with ADHD, fast-changing emotions and executive function challenges can make it hard to pause and reflect on what they’re feeling. Alexithymia can also develop in response to trauma. If someone has repeatedly experienced distressing emotions without support or understanding, they may have learned to disconnect from their feelings as a protective mechanism.

A Gestalt Perspective on Alexithymia

While alexithymia is often described as a difficulty identifying or expressing emotions, Gestalt psychotherapy offers another way of understanding this experience. From a Gestalt perspective, emotions are not separate from the body. We first experience them through sensations, movement, breathing, tension and other bodily experiences before they become part of our conscious awareness. For some people, the connection between these bodily sensations and emotional awareness may become interrupted.

Gestalt therapist Joseph Zinker (1977) described awareness as a creative process through which sensations gradually become meaningful experiences. When this process is interrupted, physical sensations may still be present, but recognising and making sense of them as emotions can become much more difficult. Although Zinker was not writing specifically about alexithymia, his description of awareness offers a helpful way of understanding why emotions may sometimes feel difficult to recognise or articulate.

Rather than viewing alexithymia simply as a deficit, Gestalt invites us to understand it as a meaningful adaptation. For some people, particularly those who have experienced trauma, chronic stress or environments where emotions felt unsafe, losing contact with emotional awareness may once have served a protective function. What was once a creative way of coping can later make emotional awareness feel less accessible.

How Can Alexithymia Affect Everyday Life?

Alexithymia can influence many areas of life, including:

Relationships

Difficulty communicating feelings can lead to misunderstandings with friends, family, or partners.
Others may misinterpret emotional detachment as indifference or coldness.
It can be hard to offer emotional support to others when their feelings are difficult to interpret.

Mental Health

Struggling to process emotions can lead to anxiety, depression, or stress-related symptoms.
Emotions may build up over time, leading to sudden emotional outbursts or shutdowns.
Difficulty recognising emotions can make self-care and emotional regulation challenging.

Decision-Making

Many decisions involve emotional input—when this is missing, choices can feel overwhelming or uncertain.
People with alexithymia may rely on logic alone to make decisions, sometimes overlooking personal needs or values.

Can Therapy Help with Alexithymia?

While alexithymia itself is not something that needs to be "fixed", therapy can help people develop a deeper awareness of their emotional experience in ways that feel safe and manageable.

As a Gestalt psychotherapist, I don't believe emotional awareness begins with finding the "right" words. Instead, we begin with curiosity. Together we might notice bodily sensations, breathing, movement, images or metaphors before trying to name an emotion.

By gently bringing awareness to what is happening in the present moment, many people gradually begin to reconnect with emotions that previously felt distant, confusing or inaccessible. Rather than forcing emotional insight, Gestalt therapy allows awareness to emerge naturally through experience.

Some ways therapy can help include:

Exploring bodily sensations to recognise emotional signals.
Bringing awareness to present-moment experiences to deepen emotional understanding.
Using creative and experiential techniques (such as role-play or guided imagery) to access emotions in non-verbal ways.
Supporting alternative communication styles, including using metaphors, sensory descriptions, or movement instead of traditional emotional language.

If you recognise yourself in this article., it’s important to remember that there is no right or wrong way to experience emotions. With understanding and the right support, it is possible to develop a stronger connection to emotions in a way that feels natural and accessible. Developing emotional awareness is not about becoming a different person. It is about gradually rebuilding a connection with parts of yourself that may have felt difficult to access or that you may have learned to disown, always at a pace that feels safe and manageable.

Source:

Zinker, J. (1977). Creative Process in Gestalt Therapy. New York: Vintage Books.