Alexithymia. Now that’s quite the word. Derived from the Ancient Greek, it means “without words for emotions,” and identifies difficulties with recognizing and naming feelings. Since emotions are central for understanding oneself and others, not being able to discern what you feel can cause distress, agitation, and anxiety — along with rocky, unsatisfying relationships. (Honestly, I think I might love you, but I’m not sure if what I am feeling is irritation, elation, or just fear.) While alexithymia can reach the level of a disorder, becoming an obstacle to finalizing decisions (What do I really want?) and making commitments (Do I really love him?), alexithymia also seems like an increasingly common response to the conditions of late modern capitalism. (I’ll get to the latter point shortly.)
Attributes of people who show signs of alexithymia include:
- Difficulty identifying feelings
- Difficulty finding the correct words to describe what they are feeling
- Difficulty distinguishing feelings from their associated body sensations
- Restricted imagination–having few fantasies and very realistic dreams
- Focused mostly on the external world and factual information
- Highly logical thinking
- Low levels of empathy
Alexithymia is most often considered a personality trait. However, it has also been identified as a precursor to Posttraumatic Stress Disorder (PTSD) and Affective Disorders, and is associated with traumatic events in childhood such as physical and sexual abuse. It also co-occurs with Asperger syndrome.
Research conducted by Sabine Aust and her colleagues in Berlin (2012, citation below) showed alexithymia might also originate with early emotional neglect that is too mild to cause psychological disorders, nevertheless is enough to strain the flow and interpretation of feelings. In their study, Aust and her colleagues examined the role of early attachment and emotional regulation for developing alexithymia. Using questionnaires, they assessed for early life stress, emotional functioning, as well as alexithymia. They excluded from their study people who scored high on these scales, but also showed evidence of a psychological disorder. And they found themselves left with a relatively intelligent bunch of people.
Aust & colleagues saw greatest impairment when emotional neglect had occurred in childhood. But their study also showed some with alexithymia lack histories of emotional neglect. Furthermore, they confirmed alexithymic people with histories of emotional neglect could also be psychologically and physically healthy.
What to make of these findings? They certainly suggest possible genetic precursors to alexithymia and the likelihood of it being a relatively isolated trait with limited impact. In contrast, alexithymia might also be described as the outcome of environmental conditions in a culture that habitually devalues emotional connections.
At birth, the human brain is 25% developed (compared to 45% for chimpanzees). The genes that program the developmental trajectory of the human brain wait for cues from the outside world for how to proceed. Like the responsive dance partner sensing a subtle shift from ball to toe, neural networks and synaptic connections are laid down and pruned back in response to even the most muted nuances of culture, relationships, and sensory data. In a perfect world, genes and environment find the ideal rhythm, their synchronicity mesmerizing.
But as neuroscientist David Linden pointed out in his book, The Accidental Mind, “in the extreme case of environmental deprivation…the effects of environment become much greater and largely overcome the effects of genes.” As an example, Linden relayed what happens when a patch covering an injured infant’s eye is left on too long: “If a baby has an eye closed with a bandage (to treat an infection, for example) and the bandage stays on for a long time, then that baby can be blinded in that eye for life.” According to Linden, “The reason for the blindness is not that the eye has ceased to function…but rather that the information from that eye was not present to help retain the appropriate connections in the brain during the critical period for vision.”
A similar case could be made for the impact of emotionally neglectful caregivers and cultures. When emotional neglect occurs in childhood, emotional regulation and communication atrophy. Yet as Aust and her colleagues showed, emotional neglect is not a necessary precursor for later difficulties with feelings. More ‘low-level’ disturbances in attachment must also cause reduced emotional capacities.
One likely culprit is the Western style of child rearing. Few things are as unnatural and engineered as child rearing in Western cultures where the need for highly individualistic people dictates what “successfully” raising a child looks like.
To understand the impact of Western child rearing practices on emotional development, it helps to look at how other cultures raise children. Jean Liedloff conducted ethnographic work with the Yequana Indians of the Amazon Rainforest and wrote about their parenting practices in her book, The Continuum Concept. Liedloff developed the continuum concept to describe “natural” ways of raising children that evolved over millions of years of humans living as hunter-gatherers. According to Liedloff, the Yequana’s child rearing practices respond to innate expectations for the kind of social environment humans evolved to inhabit.
Liedloff identified one Yequana parenting practice that differed significantly from child rearing in the United States: The Yequana caregivers continually held their infants until they developed the need to roam freely.
Liedloff believed the Yequana’s habit of honoring their children’s innate timeline for developing independence contributed to the general sense of well being seen not only in children, but also in adult members of the Yequana tribe. Liedloff argued the Western emphasis on children gaining independence at the earliest possible moment contradicts innate developmental needs, which for millions of years centered on fostering healthy attachment, and not preternatural independence. Liedloff believed the emphasis on independence in the West leads to emotional suffering for both mother and infant: “The violent tearing apart of the mother-child continuum, so strongly established during the phases that took place in the womb, may understandably result in depression for the mother, as well as agony for her infant.”
If reducing opportunities for physical closeness has such dire consequences, what is the impact of denying or ignoring emotional needs? According to Liedloff, “There are neuroses and insanities to protect the deprived from the brunt of unmeetable reality. There is a numbness that overtakes pain beyond bearing.” And this numbness may very well be what the term alexithymia describes.
What happens when children must behave as individuals too soon? For one thing, the parent may speak harshly to the naturally curious child courting danger (e.g., reaching for a hot stove). Alternatively, even a “good” parent risks being permissive to the point of neglect, letting the child do what she pleases as long as she stays out of trouble (e.g., hours plopped in front of the TV) and excels as an individual (e.g., picks up her toys). There’s a double risk here, one obvious and the other imperceptible. Obviously, children’s interests do not necessarily lead to optimal development. However, when the caregiver continually holds her young child, the child sees and feels the rhythms of the type of life she will eventually live, and thus her experiences will be meaningful and engaging, since they relate directly to her future.
In contrast, the critical voice of the well-meaning parent, although intended to protect and guide, is potentially pernicious in its invisible influence on the developing child. To keep herself safe and on track, the child internalizes the critical voice of her caregiver. Depending on the child, the caregiver, and the nature of the criticism, the internalized voice can reduce self-empathy, which could limit internal emotional communication, impacting the corpus callosum–the “superhighway” connecting the right and left hemispheres of the brain. The corpus callosum transfers emotional information from the right hemisphere to the left hemisphere, where associations between language and feelings then occur. Reductions in the volume of the corpus callosum have been found in people who suffered severe childhood abuse. Studies also associate a smaller corpus callosum with alexithymia. Like the eye patch that inhibits the child’s vision, limited opportunities for developing safe, internal emotional communication through supportive, external attachments might make the corpus callosum more of a goat path than a major thoroughfare.
Capitalism needs winners and losers to keep the system going. It’s also a fear-based system, one that promises great rewards to those who master the game, and abject poverty to those who don’t. Individualism is a key trait of capitalism’s winners, in part because being highly individualistic seems to dampen the fear capitalism instills. According to psychologist Hazel Markus, in middle class communities (the supposed winners), people more likely see the world as welcoming and seek opportunities to express their individualism, whereas working class people more often perceive the world as uncertain, and protect themselves by fitting in. Markus also claims that, for members of the middle class, individual achievement is the prized experience, whereas for lower class people, being interdependent and part of the community is the greater goal. (Of important note, these observations ignore the role of oppression for both socioeconomic status and comfort with individualistic expression.)
Capitalism rewards people whose brains and relationships change to meet its demands, but it also expects them to pay the price of success. And the cost for some may be the sliver of grey matter connecting the two halves of the brain. Another potential drawback is increased anxiety, since without the ability to identify and name feelings, intense emotions can be overwhelming and indiscriminate, just as the meaning of alexithymia suggests. To protect from the onslaught, people with alexithymia often build walls around their hearts, damping down feelings, and in the process, limiting opportunities for emotional connection with others.
How is capitalism “cured”? Probably the same way alexithymia is cured, or at least alleviated: by increased opportunities for playing, loving, and just being.
I believe that in the well-armored heart of every alexithymic person–as well as every industrious, over-focused individualist–is a longing for tenderness and connection. And the good news is our brains are forever growing, continually redefining “normal,” changing the person, but also potentially changing society as well.
Citation: Aust, S., Alkan Härtwig, E., Heuser, I. & Bajbouj, M. (2012). The role of early emotional neglect in alexithymia. Psychological Trauma: Theory, Research, Practice, and Policy. DOI: 10.1037/a0027314.
© 2012 Laura K Kerr, PhD. All rights reserved.
Laura K. Kerr, PhD, IMFT is a mental health scholar and registered marriage & family therapist intern in the San Francisco Bay Area. For more information, visit her website.