autism spectrumcouples counselingpsychology

Alexithymia: “Does He Even Have Feelings?”

Some people come in to therapy stating that their partners seem to have no empathy at all.  They act self-centered and seem entirely unaware of their partner’s deeper feelings.  When a conversation involving emotions is initiated, the partner seems bored or distant.  This has the effect of making these people feel lonely, disconnected, and desperate for some genuine closeness.The partners of these “robots” feel drawn to act out in ways that seem “crazy,” like crying, not letting the partner end discussions (which the partner calls “fights that you start”), and fantasizing about infidelity (particularly emotional affairs) or leaving the relationship entirely.

what if nothing is there?

what if nothing’s there?

In my last post, I discussed how Asperger’s and narcissism can both make people seem very unempathic and self-absorbed, but for different reasons.  Many people with Asperger’s also have a seeming lack of feelings, or inability to express their feelings, which is called alexithymia.

Alexithymia is the inability to express emotions or to understand others’ emotions.  It is present in about 10% of people, and some studies find that it is twice as common in males, while others find more equal rates across gender. Alexithymics can feel emotions, although not a wide range, but they do not know how to to verbalize them.  Usually, they are unaware that certain sensations are actually emotions.  For example, a person with alexithymia will appear angry, but when asked if he is angry, will deny it.  Similarly, their eyes may fill with tears and they will assume they are tired or have a blocked tear duct.  This can obviously be very frustrating for partners, who assume that the person is purposely or passive aggressively hiding or lying about his emotions for some deeper reasons.  The idea that the person could be unable to notice or express them is usually not even considered.

Alexythymia is linked with poor marital quality and higher rates of divorce. It is also implicated in can lead to “Affective Deprivation Disorder,” which is “crazy” behavior in the partner of the alexithymic. It is also the dynamic I explained in Mr. Perfect and His Crazy Wife, or when I described attachment panic.  People become angry, frustrated, sad, lonely, and desperate when continually denied emotional validation and support from a partner.  The difference with alexithymics is that they are usually not being passive aggressive.  They genuinely cannot imagine their partner’s experience and feel no emotions themselves, so they are not “hiding” or “deflecting,” but are angry and confused because they literally have no idea what a partner means by “emotional support” and truly believe that the partner is the one with the problem, and is emotionally unstable and irrational.

Alexithymics often have a range of canned responses to normal social situations in which empathy is required.  They can mimic others’ responses and assemble a repetoire of phrases like, “That must be so hard” and “Awww,” with the correct, imitated, tone.  Only an intimate partner will notice that the same responses recur over and over and the pseudo-emotion that is exhibited dissipates instantly.  This is why other people often think that an alexithymic is normative, and that the partner is the one with the issue.

Alexithymia is really a disorder of imagination.  In order to empathize, you need to imagine yourself in someone else’s shoes.  Alexithymics therefore seem to have no imagination, little spontaneity, and a constricted fantasy life.  Their dreams are usually of everyday occurrences, and are boring for them to recount and for others to hear.  They are not artistic or creative.  They can succeed at work in occupations where order and predictability are prized, but they cannot think outside the box or predict others’ social or political maneuvers, so they will only advance until a certain point before they plateau.  (However, they are very stable and even keel, so they will never make impulsive decisions that jeopardize their jobs.)

Conversations with alexithymics can feel monotonous and frustrating.  In Emotionally Dumb: An Overview of Alexithymia, the author writes, “The alexithymic communication style is object-tied and logical, with a striking absence of poetic undertone which might reveal deeper resonances of psychic life.” The alexithymic does not often lead with opinions or reflections.  Rather, he discusses factual happenings in his day, or details about his activities, without offering observations or feelings about them that would draw others into his story.  It seems to others that the alexithymic is intentionally shutting down deeper communication, but he just does not understand how or why people would continuously discuss feelings or hypotheticals.  Alexithymics are very literal.  They usually don’t enjoy novels, or shows or movies that focus on emotions, but if they come into contact with them, they may learn ways of talking or relating from them, just as they mimic others in their social circle.

The imagination deficit in alexithymia impedes romantic and sexual functioning.  Empathy and imagination are necessary for responsive sexual behavior.  For fulfilling sex, people usually need to be able to pick up on non-verbal communication and to know what a partner is alluding to or hinting at.  Sex with alexithymics can feel very mechanical and awkward. Alexithymics can learn sexual techniques, and will then repeat them by rote after they received a positive response once or twice, but there is limited variety or spontaneity during the act.  Some alexithymics feel physically uncomfortable during sex and don’t enjoy it, because sex arouses emotions that then make them feel overwhelmed or even physically sick.  Others are addicted to sex as a rote way to feel physical pleasure.  In neither case does sex feel like “lovemaking” to a partner.

Alexithymia does not only occur in people with Asperger’s.  It can also affect individuals with depression, PTSD, or those with emotionally neglectful childhoods (which you can read about in Running on Empty: Overcome Your Childhood Emotional Neglect, and probably means the person likely had an unempathic, narcissistic, or alexithymic parent himself).  In the Asperger’s case, though, it is more often trait (or innate, permanent) alexithymia, and in the other cases, it is more often state alexithymia, which can be helped with therapy.

State alexithymia is thought to develop from having your feelings constantly ignored and/or invalidated, or via observing parents who don’t express emotions normally.  When parents “mirror” a baby or child, they notice the child’s emotion and label it and respond in kind, such as when a baby looks surprised, the mother says, “Oh! That was a surprise!”  When parents are not capable of empathic responding, a child does not learn about his own emotions or what they mean.  Therapy that is geared toward helping a client recognize and identify his emotions can therefore be helpful, and can change a relationship dynamic.  Sometimes, insight oriented therapy can help a client uncover repressed anger and sadness about his childhood, and can be cathartic and lead to emotional change and the expression of dormant imagination and creativity.

Trait alexithymia may be more organic and biologically based, as is Asperger’s and autism spectrum diorders as a whole. In therapy, clients can learn to express more empathy and possibly to identify their and others’ emotions by rote.  It is unlikely that this will lead dramatic change, and partners will find themselves in a marriage where people finish one another’s sentences and call each other during the day just to tell each other something exciting or upsetting.  However, just having a therapist explain to an alexithymic that a partner’s emotions are not abnormal or irrational can be marriage-changing (if, of course, the alexithymic is open-minded enough to identify as alexithymic and own this aspect of his identity).

Till we meet again, I remain, The Blogapist Who Would Also Like a Guest Post On This Topic If You or Your Partner is Alexithymic (So Take The Test).

Order Dr. Rodman’s newest book, 52 Emails to Transform Your Marriage and order her first book: How to Talk to Your Kids about Your Divorce: Healthy, Effective Communication Techniques for Your Changing Family

This blog is not intended as medical advice or diagnosis and should in no way replace consultation with a medical professional. If you try this advice and it does not work for you, you cannot sue me. This is only my opinion, based on my background, training, and experience as a therapist and person

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  1. Anon
    April 5, 2017 at 5:24 am — Reply

    I just found this article via the Huffington Post. I am almost certain my husband is alexithymic, though it has not been diagnosed by a doctor as we learnt about in the UK as it’s not really recognised in the English NHS – most of the research seems to be from the US. A marriage counsellor made us aware of it and he did undertake the online test and scored highly. Of course, when I answered on how I perceive his behaviour, he scored even higher.

    We have a happy if somewhat empty marriage. We’ve been together for 16yrs (married for almost 10) yet no children. It takes two to tango, but very hard when one partner displays almost no affection (we hold hands in a now comfortable way) and has no interest in sex, not emotional intimacy anyway. It’s now becoming an issue as we are in our late 30s and it’s dawning on me that I will probably never have children. Emotionally, I am now worn out, the dreams of babies have dissipated and I’m not sure I could also handle a child with alexithemia. He says he wants kids but has no understanding of why it is an issue because he cannot think in terms of the future (or the past), despite most of our friends now having families. We even tried having a dog which he cares about, but hasn’t really instigated any emotion/desire for a family. He never did the intimacy exercise the counsellor suggested, nor other tips, probably because he won’t admit he is ‘different.’ (Half the problem).

    Aside from having no emotions, he is a very kind good man who genuinely means well. He is highly successful and we have a very comfortable life, now living in Asia (second stint away from home). He is very intelligent and has unusually ended up in a lucrative career that he is not even academically qualified for, as he is highly intelligent. He is also very sporting though I note he trains alone and gets very fixated on high performance (marathons etc) and that becomes his life. So as he ages, ‘his world’ is becoming his career and training, whilst the dog and I are merely becoming accessories to a highly focused goal/task-orientated world.

    Why I have spent 16yrs? I always knew he was different but really had no idea about aspergers or autism. He would always get upset when I got upset that he was ‘so cold’ remote and robot-like. He was affectionate and sexual when we were dating though that faded as we got older, got married, bought our first home (with unused nursery) etc. His ‘odd’ parents probably exacerbate things as only after learning about alexithemia I realised his father is probably aspergers. His mother, well she is just an extremely cold woman (though okay with me). So he thinks his behaviour is normal according to how he was nurtured, though it isn’t. He is English (yes reserved!) and I am from an ethnic heritage (very animated culture). Hence, we are becoming emotionally polarised as we get older, and of course only one of us experiences emotions like grief and sadness (whilst the other just looks away).

    I don’t really know what to do because approaching 40, I’m unlikely to ever meet anyone else to have a family. My life isn’t at all terrible (ie. he doesn’t beat me or try to control me etc) but I do feel incredibly lonely. I have told him that I had i knew, I would never have married him and I am no longer in love with him. He said nothing, so what do I do?

    • April 5, 2017 at 7:09 am — Reply

      Do you want me to answer via blog?

    • Lynne
      May 3, 2017 at 12:29 pm — Reply

      I have just read your comment and thought to myself that I could have written this. My life is as yours is, with a man that I describe as a robot. I had dreams of a child when we got married, but that never happened for reasons consistent with this illness, and I had to have a hysterectomy eventually (medical issues). Now I am 47 years old, with no family of my own, in a foreign county (I am British and now live in the US), with a man I cannot communicate well with, and who is emotionally absent. I too have told my husband if I had known how our life was going to turn out that I would never have married him and that I no longer love him and he too says nothing. I think being British we just kind of “soldier on.” I wish I had left years ago, and now with a house and so many possessions together the thought of leaving is such a daunting task, so instead of leaving I just muddle on in this desperately lonely situation. To answer your question on what should you do, I wish I knew because I would be a hypocrite to tell you to leave, when I have not done so myself. I hope you manage to make better choices than I did, because you will live to regret it. Best of luck.

  2. Onze
    September 11, 2018 at 1:57 am — Reply

    I just learned about Alexithymia and wow does it explain a lot. I have been married for 17+years (together for almost 20) and have constantly felt lonely and continually tried to pull any kind of emotion or connection out of my husband. I asked him to read Running on Empty (both books) and he said he would but never finished. He tends to tell me what I want to hear with no intention of actually doing anything, but I didn’t realize that until we were already married. Every conversation leaves me feeling stupid and like I shouldn’t have shared with him. I hate it.
    I took the test (no Alexithymia traits) and actually got him to take it and he has HIGH Alexithymia traits. No wonder I’m so lonely.
    We’ve done counseling a few times and I’ve done it alone, which was very helpful, but he’s the one who really needs more and he just ignores my pleas and hopes it will go away.
    We have 4 kids and I just went back to work after being a sahm for 15 yrs, so we have a whole bunch of debt to pay off before I could leave, if it came to that. I feel so stuck 🙁
    I’d love to guest blog on this topic as I feel like I’m an expert on dealing with an Alexithymic spouse! The only problem is that I’m still up to my neck in tears and silence because of it, so it won’t have a happy ending.

  3. William
    November 17, 2019 at 6:26 pm — Reply

    Lately my therapist has been suggesting that I might have alexithymia. I’ve been trying to learn about it, but for all the reading I’ve done, I haven’t found much more information than you provide here in this blog post (which was very thorough).

    I was wondering if you could elaborate on what you mean by having little imagination, or a constricted fantasy life. Let me tell you where I’m coming from with this…

    I’m trying to learn how to write fiction. I can do all the mechanical tasks well. I can tell you all sorts of things about plot and story structure. I can pick up other writers’ work and make it better. But when the time comes to write my own stuff, I draw a blank. I can see the people and places and events, but I can’t see how they relate to each other. This is more than simple writer’s block; it’s been going on for years. I also find best-selling novelists intensely boring, and they tend to focus on emotion at the expense of aesthetic quality.

    Is this the kind of thing that’s meant by constricted fantasy? Is there a certain way that fantasy is impaired by alexithymia? Is there any hope of building a better ability to fantasize? What if the person has Aspergers’?

    • November 17, 2019 at 8:05 pm — Reply

      Yes what you describe is a great example of what I’m talking about.

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