Alexithymia and Autism: Inability to describe emotions verbally

Jun 5, 2020

By Dr Michelle S Garnett, Clinical Psychologist, Author & Autism Consultant

The term “alexithymia” is coming up more and more in the research literature on autism. You may have wondered about alexithymia and austim: what it alexithymia and how is it is relevant to autism spectrum disorder?

Alexithymia describes someone who has difficulties both sensing and describing their own emotions. Whilst alexithymia occurs in the neurotypical population at a rate of about 10%, it is far more common in the autism spectrum disorder population, with estimates at around 50% from studies so far.

Alexithymia also commonly co-occurs in certain mental health conditions, including depression, anxiety, schizophrenia, pain disorders and eating disorders.

Researchers have studied the relevance of alexithymia to the development of mental health conditions. This research is highly relevant for individuals with autism also, given their high rates of both alexithymia and mental health conditions. From this research we know that having alexithymia increases the likelihood of having clinical levels of anxiety and depression, but the mechanisms of this association are still being explored.

From my own clinical experience, I have found that, as humans, we manage our emotions best when we can both notice and label them. For example, noticing when we are feeling anxious gives us a chance to do something about it.  Noticing and labelling defines the emotion as being separate from ourselves, giving us the opportunity to decide what to about it. If we do not notice and label anxiety, we tend not to do anything differently. We stay fused with a state of feeling tense and worried, which is tiring, gives rise to pessimism, and if it goes on long enough, leads to depression and insomnia.

The implication is that two things we can do to assist people with autism who have significant difficulties with anxiety, pain (from sensory experience), addiction, eating issues, or depression, is to increase their recognition of their own feelings in their bodies (increase interoception), and to label these feelings (decrease alexithymia).

Tips to start the process: alexithymia and autism

  • Start a mind/body practice – which means tuning in to your body whilst doing something, e.g. while walking, gardening, meditating, doing yoga, washing up, cooking, working or practising a martial art. Start with 3 minutes a day. Lasting benefits come with a daily mindfulness practise of 10 minutes. If you have difficulty with scheduling things, you could try doing it whenever you think of it. You can place strategic reminders in your various environments.
  • With kids – ask them about what is happening in their bodies. Talk out loud about what is happening in your own body during times of strong emotions. Incorporate mind/body practices into their day. When they need to cry let them cry, teach them safe ways to express their anger. Afterwards help them label their feelings and describe what happened in their bodies whilst they felt that way.
  • Pause between activities – whenever you complete one activity, before you start another, pause and notice the sensations in your body, including the rhythm of your breath.
  • Use an App for mindfulness – eg Headspace, Smiling Mind, Calm or Breath. Play around with them until you find the best one for you. This may change over time.
  • Research the topic of mindfulness or meditation or polyvagal theory.
  • Practise with one of our free audio-recordings, Bringing the Body into Awareness or Bringing the 5 Senses into Awareness

At Minds & Hearts we encourage individuals and parents to seek further, specific  information and advice about the interplay between alexithymia and autism by speaking to an appropriate professional.