Erroneous Definitions of Alexithymia

Erroneous definitions

These definitions represent misunderstandings by people outside the field.

Alexithymia as a communication disorder

In Mapping the Mind, a remarkably well illustrated and accessible popular book on cognitive neuropsychology, Rita Carter confuses alexithymia with the inability to express emotions that are fully perceived and understood. This phenomenon is seen in some stroke victims and others who have lost emotional control over the motor functions of the face (affective prosoplegia) or voice (aprosodia). They know what they feel, but they just can't express it naturally.

Carter, 1998.

It is quite common for people to be able to feel emotion but to be quite unable to express it. These people, whose condition is known as alexithymia, are in a different situation to those like Elliott [a patient of Antonio Damasio, described in Descartes' Error, 1994], who cannot express emotion because they do not feel it to start with. The inability to express felt emotion probably arises when there is some disruption in the neural connections between the cortical (conscious) emotional processing areas and the brain regions that control facial expression, speech and the other physical means by which emotions are displayed.

Alexithymia strips those who have it of an important social tool — the ability to convey, swiftly and economically, how they feel. It is an unfortunate affliction for anyone, and can be disastrous in those who seek to influence people on a large scale.

Mapping the Mind, p.132

This confusion with the inability to express emotion is quite widespread. For example,

This need is also evident in the occurrence of alexithymia, a relatively widespread communication disorder. The patient presents with difficulty expressing his emotions in words.

so-called "alexithymia" (the inability to speak about feelings)

Gillberg, 1992

The confusion seems to arise from taking the etymology of alexithymia—"the lack of words for feelings"—too literally.

Alexithymia as psychopathy

The conflation of alexithymia with psychopathy has regrettably reached a very wide audience: it featured in episode 24 of the popular X-rated TV series The Sopranos.

The Sopranos

There's a psychological condition known as alexithymia, common in certain personalities. The individual craves almost ceaseless action, which enables them to avoid acknowledging the abhorrent things they do. Abhorrent? What certain personalities? Antisocial personalities.

script of episode 24

WB points to an emotional defect shared by all criminals, he says, whether they're Italian-American from Jersey or cracker-American from East Jesus, Arkansas. It stems, he says, from a psychological condition called "alexithymia." Thought up in 1972, alexithymia means "the inability to express or verbalize one's emotions." Every crook worth his salt has it, says WB. None of them know their own feelings. It could be out of some childhood terror or maybe just the lack of parental training. I mean, most crooks didn't have Alan Alda as a dad.

An alexithymic has no internal life so he focuses all of his attention on external events. To avoid the emptiness of his own existence, he looks for constant high-grade stimulation. He needs one rush after another - beating a guy over the head, robbing a truck, gambling at the track, screwing a hooker. In other words, the gangster's life. He's got to keep moving, got to keep one step ahead of the Feds, got to keep coming up with new thrills, new scams.

Wernick Report 8, Feb 7th 2002, on HBO website

The scriptwriters have conflated alexithymia with antisocial personality disorder, on the basis that some people have both traits. Yet the traits are distinct. Nothing in the alexithymia construct implies the thrill-seeking or Macchiavellian behaviour characteristic of sociopathy. As explained in the FAQ, many alexithymics (Type II) have exactly the opposite disposition.

Alexithymia as a desirable pathology

Rowles, 2001

'Alexithymia' refers to that pathology which prevents the afflicted from expressing their 'feelings'.

[...] So I beg you, be a carrier of the dread disease Alexithymia. Sneeze your repulsion of indulgence when you see it. Cough your logic in the face of irrationality and counterfeit 'feelings'.

Prescription for America: An epidemic of alexithymia

Rowles's misunderstanding, on which he bases an entire web article, appears both as a slightly skewed definition (it isn't just a problem with expression) and in an ill-conceived proposal. He points to the massive public wallowing in grief that occurred with the death of Diana, Princess of Wales, and the events of Sept 11, and recommends that the public at large would benefit from being alexithymic. However, studies have shown that (certain subtypes of) alexithymia correlate with lower quality of life and higher levels of stress, so it would seem to be a rather high price to pay.

Alexithymia as a mental disorder:


Alexithymia is Greek for "no word for emotions." This is a mental disorder in which a person has extreme difficulty in verbally expressing feelings and fantasies. Alexithymia is thought to contribute to psychosomatic illness, alcoholism and drug addiction, post-traumatic stress disorder, and sociopathic personality. And this difficulty is present to a great or lesser degree in many people who are healthy as well as ill. I think that most women consider it a pretty normal male condition…

This isn't completely wide of the mark, but it is a little sloppy. Alexithymia is not strictly a "mental disorder" - it is a complex symptom bundle or personality trait; it doesn't "contribute" to post-traumatic stress disorder, because it is neither a cause nor a component of the PTSD syndrome - instead, it is a common symptom; it is independent of "sociopathy", and it is not a "pretty normal male condition" because the stereotypical male is full-blooded and passionate, even if he is often inarticulate about describing his emotions. The passage may well be tongue-in-cheek but it could mislead uninitiated readers.

So you see there are a lot of misleading ideas out there. Hopefully this page will help to counter some of the misinformation.

Back to Definitions

Return to: