Living with alexithymia: When you can’t put a name to what you’re feeling
Imagine living through these times saddled with a condition that keeps you from identifying or expressing the emotions felt by yourself or others
Imagine living through these times saddled with a condition that keeps you from identifying or expressing the emotions felt by yourself or others. Alexithymia is classified as a subclinical / neurobiological condition (not a psychological disorder). “People with alexithymia can’t put words to feelings,” says Dr Rajesh Sagar, professor of psychiatry at the All India Institute of Medical Sciences (AIIMS), New Delhi. “They cannot distinguish between fear, guilt, dread or the range of other emotions that we go through in life.”
Alexithymia is best understood in combination with other conditions, adds Dr Srinivas Rajkumar, formerly with AIIMS and now a consultant psychiatrist at the Malout De-addiction Centre in Punjab. “Data suggests that exposure to traumatic events can result in symptoms of anxiety, depression or post-traumatic stress disorder, which can be accompanied by alexithymia.”
In a world that wears its heart on its sleeve, the condition tends to create fissures between the person with it and those close to them.
“One of my patients, a 19-year-old, had difficulty expressing her emotions. She would use blanket statements to express herself, but couldn’t go beyond that,” says Vandana Choudhary, a clinical psychologist at AIIMS. “Her expressions could speak volumes. She was deeply troubled and wanted to get it out but wasn’t able to.”
Choudhary’s patient was often sidelined as a result. “People would dismiss her as introverted,” Choudhary says. Choudhary engaged her in psychotherapy, recommended that she maintain an experiential diary where she was encouraged to engage in expressive writing, starting with describing in detail experiences ranging from the neutral to the distressing.
“What I have found effective is group therapy,” says Arati Kedia, and intermodal therapeutic practitioner based in Mumbai. “I take it a step further with dance therapy and the use of metaphors. One of the exercises is to act out the navrasa, or the journey of the nine emotions through dance.”
Kedia has found that when a person is not able to verbalise something, letting their body make the connections has been an effective exercise, but a slow process.
Choudhary too used the navrasas of dance to help her patient. “We would watch Kathak dancers on mute and she would guess what emotions they were trying to express.” They then moved on to emotional literacy, where the patient understood how to interpret what her body was telling her.
From differentiation to regulation of emotions to being able to identify those emotions in others, Choudhary says the patient began to be aware of nuances of feeling. She began to express herself better, instead of describing most feelings with the generic word “problem” that made things immediately easier, Choudhary says.
Six months in, the patient had learnt not to turn her back on “bad feelings” and instead stand her ground and dissect them. “Finally, she worked on building relationships with people around her, always being mindful of the emotions at play, not pushing them away. She achieved emotional competency.”
Therapy makes life easier for both the person with alexithymia and those around them. “New onset alexithymia which is comorbid with other conditions is responsive to treatment. In select individuals it may continue to persist as an enduring trait,” says Dr Srinivas.