Alexithymia Symptoms: Is Emotional Blindness A Thing?

Autism commonly presents itself along with other co-occurring conditions such as anxiety, depression, ADHD, obsessive behaviors, apraxia, and others, which sometimes makes it more difficult to receive a correct and full diagnosis.  Experts have also taken a closer look at the connection between autism and lesser-known alexithymia symptoms.  

Alexithymia can co-occur with autism, and is sometimes called emotional blindness.Alexithymia symptoms are characterized by difficulty identifying and describing one’s own emotions. While not officially classified as a disorder, alexithymia involves core challenges in processing emotion that can significantly impact mental health and interpersonal relationships.

Studies have found high rates of alexithymia symptoms among those with autism. Research shows that they both are considered as conditions characterized by widely overlapping traits that are related to social awkwardness and challenges and deficits in emotional competence.

However, it’s not just limited to individuals on the spectrum. Some research says that up to 13 percent of the population in general experiences alexithymia symptoms. This striking overlap suggests shared mechanisms may underlie both conditions. Understanding the co-existence of autism and alexithymia symptoms is key to better supporting those who struggle with aspects of both.

Defining Alexithymia Symptoms

The term “alexithymia” comes from Greek roots meaning “a lack of words for emotions.” Specifically, “a” means lack, “lexis” means word, and “thymos” means emotion. Essentially, alexithymia involves difficulty understanding and verbalizing emotions.

As with the condition called flat affect, alexithymia symptoms are sometimes referred to as “emotional blindness.” However, alexithymia and flat affect are not the same, although both relate to emotions.

Flat affect is a lack of emotional expression in response to events such as lack of facial expression or verbal response and you can read more about it here.

Key characteristics of alexithymia include:

  • Impaired ability to identify and distinguish between different emotions. Those with alexithymia often cannot pinpoint or name the emotion they are feeling.
  • Difficulty describing feelings to others. Even when a feeling is identified, conveying it in words may be a struggle.
  • A thinking style focused on external events rather than inner experiences. People with alexithymia symptoms tend to avoid introspection.
  • Challenges with cognitive processing and regulation of emotions. Alexithymia is associated with less ability to cope with emotional states.
  • A lessened fantasy life and dream recall. People with alexithymia symptoms report fewer imaginative fantasies and dreams.
  • Difficulty appreciating others’ emotions. Perspective-taking and empathy may also be impaired.

Alexithymia exists on a spectrum, and those with mild forms may develop adequate coping strategies. However, more severe alexithymia can disrupt emotional life and relationships. People rely on communicating feelings to form intimate connections. The inability to express emotions can lead to loneliness, anxiety, depression, and poorer well-being.

Alexithymia in Autism Spectrum Disorder

Many studies over the past two decades have uncovered high rates of alexithymia among those with autism. Estimates vary greatly, but one estimate is that alexithymia symptoms presents in the autistic population between 33 and 64 percent.

The challenges of autism overlap with the characteristics of alexithymia in several key ways, according to experts:

Difficulty Identifying Own Emotions

  • A core trait of autism is diminished ability to understand emotional states in oneself and others. This mirrors the struggle to identify feelings seen in alexithymia.
  • Autistic individuals may know they feel bad, but cannot pinpoint if they are anxious, angry, sad, etc. The nuances between emotions are lost.

Challenges Describing and Communicating Feelings

  • Verbal and nonverbal communication impairments are hallmarks of autism. conveying subtle emotions through words or expressions does not come naturally.
  • Even when feelings are identified, putting them into language is limited. Autistics may have a sense of so-called “emotional illiteracy.”

Externally Focused Cognitive Style

  • Individuals with autism often focus attention on details, objects, schedules and facts more than internal reflection. There is a preference for concrete over abstract thinking.
  • Drawing connections between physical events and emotional reactions is difficult. Understanding causality of feelings is limited.

Sensory and Emotional Regulation Issues 

  • Autistic individuals struggle to modulate emotional responses. Meltdowns, shutdowns, and outbursts reflect extreme reactions to emotional inputs.
  • Alexithymia symptoms also correlate with difficulties regulating emotions. The inability to process feelings likely contributes to deregulation.

Theory of Mind and Empathy Deficits

  • Perspective taking and inferring others’ mental/emotional states is impaired in autism. Empathizing with feelings is challenging.
  • The limited ability to imagine and appreciate emotions hinders cognitive and affective empathy in alexithymia symptoms as well.

Autism Symptom Severity

  • Multiple studies show a positive correlation between autism severity and degree of alexithymia symptoms. More severe spectrum traits are associated with greater emotional processing impairments.
  • The ability to identify and describe emotions decreases as social-communication deficits worsen.

Potential Shared Origins with Autism and Alexithymia Symptoms

The considerable clinical overlap between autism and alexithymia suggests common neurological underpinnings may be at play.

Several theories from experts exist on the origins of this connection:

  • Early developmental issues in connecting words to emotions may lead to both conditions. The ability to label feelings promotes emotional awareness.
  • Mirror neuron system dysfunction could underlie both autism and alexithymia. These neurons allow us to internally replicate and understand others’ experiences.
  • Poor interoceptive awareness is common to both conditions. Interoception involves reading internal bodily signals, which provide clues to our emotional states.
  • Impaired connectivity between brain regions involved in emotions and language could cause both autism and alexithymia symptoms. These regions cannot coordinate properly to process feelings into words.

While autism and alexithymia appear highly interrelated, there are still unanswered questions about the two conditions:

Alexithymia is sometimes referred to as "emotional blindness."

  • Are they separate disorders, or different expressions of shared neurocognitive deficits? More research on overlapping traits is being conducted.
  • Is alexithymia a distinct feature of autism, or simply a consequence of social-communication impairments inherent to ASD?
  • Could addressing core autism deficits have a positive effect on alexithymia symptoms as well? Improving emotional literacy may help treat both.
  • What interventions can benefit individuals affected by both autism and alexithymia? Tailored therapies may need to target self-awareness, empathy, and communication skills specifically.

Alexithymia is not a formal diagnosis on the autism spectrum. However, assessing where an autistic person falls on the alexithymia symptoms continuum can inform treatment priorities. Understanding emotions is crucial for building connections and improving quality of life.

The Complex Relationship Between Autism and Alexithymia

A complex relationship exists between autism and alexithymia. While more research is still needed, current evidence shows substantial overlap between the two conditions.

Shared deficits in identifying emotions, communicating feelings, cognitive style, sensory/regulation issues, and theory of mind underlie both autism and alexithymia. The combination and severity of these traits influence how deeply alexithymia impacts any given autistic individual.

Supporting Those with Autism and Alexithymia

Given the intertwined nature of autism and alexithymia, approaches that address both conditions together may have the greatest positive impact. However, this requires understanding the full profile and needs of each individual.

For autistic people with significant alexithymia traits, experts say the following types of support may help:

Learning Emotion Vocabulary and Literacy

  • Building a vocabulary for different emotions and their nuances is essential for communication. Apps, books, games, and therapies can teach how to name feelings.
  • Journaling and discussing emotions, even through text if easier, helps put feelings into words. Creative arts like painting or music are additional outlets.
  • Learning how emotions manifest physically in the body aids identification. Meditation and mindfulness practices bring internal awareness.

Developing Coping Strategies

  • Emotional regulation skills help avoid being overwhelmed. Techniques like deep breathing, counting, and breaks can manage intense feelings.
  • Creating “if-then” plans for upsets and having comforting items available helps minimize outbursts.
  • Finding healthy emotional releases like exercise, destruction of objects, or compression aids modulate reactions.

Building Cognitive Empathy

  • Exercises in imagining others’ perspectives and inferring emotional states from cues can enhance theory of mind.
  • Watching shows or reading fiction flexes empathy muscles needed in real relationships.
  • Role playing social scenarios and effective responses provides practice interacting.

Fostering Supportive Relationships 

  • Finding communities, either online or in-person, connects autistic individuals who understand each other’s challenges.
  • Therapy focused on building self-insight, communication skills, and emotional intelligence provides guided growth.
  • Educating friends and family about alexithymia symptoms helps them have realistic expectations and compassion.

The core of emotional awareness is realizing no feeling lasts forever, even intense ones. For autistic people with alexithymia symptoms, learning to ride the ups and downs by identifying and verbalizing feelings – as well as receiving support from others – can greatly enhance wellbeing and connections. With improved balance and coping skills, those with both conditions can still thrive.

About My Autism Journey

I don’t have alexithymia symptoms myself, but I did have some trouble identifying my emotions growing up like many kids with autism. This is a fairly typical thing everyone has to figure out when they’re growing up regardless if they are neurodiverse or neurotypical, so don’t feel bad if you’re having trouble with this.

Identifying and understanding your own emotions is crucial for self-acceptance and acceptance of others, as it’s an important life skill.

If you were diagnosed with alexithymia of told you display some alexithymia symptoms, you have to do best to understand your emotions and bodily sensations.  Maybe you won’t be the best at it but with age and therapy, if needed, you may improve these skills well enough to have a good life.

Other Common Autistic Behaviors

There are many behaviors associated with having autism. Keep in mind that everyone presents differently, which is why it is caused a spectrum disorder. However, there are common autism behaviors. Learn more about them. 

Picture of Connor McClure

Connor McClure

I'm a young adult navigating life with autism. By sharing my experiences and views, I hope to create a better awareness, understanding, and compassion for those on the spectrum. Let's connect!
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