Some people feel emotions but cannot find words for them
Alexithymia, sometimes called emotional blindness, is not an absence of feeling. People with it may know they feel bad, yet struggle to tell sadness from anger, or an emotion from a knotted stomach. Around 5 per cent of people have it, and in autism the figure rises to about half.
Psychotherapists John Nemiah and Peter Sifneos introduced the term in 1970, building it from Greek roots meaning no words for feelings, on the model of dyslexia. Even earlier, in 1967, Sifneos noticed that such patients did mention anxiety or depression but could go no further than a few blunt words like happy or unhappy. The core problem is poorly differentiated emotion, which makes feelings hard to separate from one another and from bodily sensations. As of 2025 neither the DSM-5 nor the ICD-11 counts it as a symptom or a disorder.
The leading cognitive model breaks it into three parts: trouble identifying feelings, trouble describing them, and a habit of thinking outward about concrete events rather than inward about emotions. A psychoanalytic version adds sparse daydreaming, but that trait does not track the others, so most modern questionnaires leave it out. The Perth Alexithymia Questionnaire is now widely seen as the strongest measure and is the only one validated for autistic people. Psychologist Michael Bagby and psychiatrist Graeme Taylor argue there is strong evidence it is a stable trait rather than just a side effect of distress.
Men may score somewhat higher, apparently because of difficulty describing feelings rather than identifying them; a subclinical pattern called normative male alexithymia has been linked to masculine norms such as treating sadness as feminine. Beyond autism, it is common in post-traumatic stress disorder, at about 42 per cent, and has been tied to conditions from irritable bowel syndrome to hypertension. Henry Krystal observed that in therapy such patients often recount daily events in flat, chronological detail.
It matters for well-being: alexithymia is linked to lower life satisfaction even after depression is accounted for, and people with it may release tension through impulsive behaviour such as binge eating. Many also find positive emotions muted. Recent studies continue to probe its role among patients with pelvic floor disorders and breast cancer.
Source: Alexithymia
