What is Alexithymia and How Can Expressive Arts Help?
Have you ever felt like your emotions are locked away in a box - completely inaccessible to you? Maybe they all feel the same, like a weight on your chest or a bubble in your stomach. Trying to tease out how you are feeling and what each emotion actually is seems like something other people do, but not you. Putting words to those experiences - even harder.
If you struggle to identify and express your feelings, you might be experiencing Alexithymia. It can make trying to navigate feelings seem like reading a book in a foreign language. It’s also a really common experience for autistic people.
Interoception, Alexithymia, & Autism - How They Are Connected
It’s hard to describe the autistic experience of alexithymia without addressing the impact of interoception.
Interoception is the ability to perceive, identify, and understand our internal signals. This includes experiences like feeling your heartbeat or sensing hunger, pain, or bathroom cues. Since emotions are strong, energetic shifts in our bodies that include mental reactions and physical sensations, being able to tap into these sensations and make sense of them is important for processing our emotional experiences. If you have trouble connecting with these internal experiences, it can be incredibly difficult to name, describe, and/or process emotions - an experience known as alexithymia.
What is Alexithymia?
Alexithymia is characterized by difficulty identifying, naming, describing, and processing emotions. It’s not a diagnosable condition - but instead a framework for understanding how many people, including 50-60% of Autistics, experience the world. It’s so common to the Autistic experience that some researchers hypothesize that many of the behaviors and experiences often attributable to Autism are, in fact, due to alexithymia, and as a result, the diagnostic criteria for Autism should be changed.
People with alexithymia may not be able to realize they are angry, sad, or anxious until the feelings become completely overwhelming. It can also be difficult for them to find words to express their feelings and figure out what’s lurking under their primary emotions. To other people, this can look like being “unemotional” or “detached,” reinforcing stereotypes that Autistic people lack emotional and empathetic capacity. In reality, autistic individuals often feel their own emotions and the emotions of others quite deeply but struggle to recognize or articulate them.
Characteristics of Alexithymia
Difficulty identifying feelings
Difficulty distinguishing between feelings and body sensations of emotional arousal
Difficulty describing feelings to other people
Difficulty identifying facial expressions
Difficulty identifying/remembering facings
Difficulty fantasizing
A thinking style focused on external events (often ignoring internal events)
How Alexithymia Affects Daily Life
Alexithymia can make it difficult to cope with the normal emotional challenges of day-to-day life. When we don’t identify and process our emotions, they build up and bubble over - eventually leading to stress, anxiety, and overwhelm. For some of us, we can even experience this as physical symptoms - chronic headaches, GI upsets, and pain or full-on physical and emotional meltdowns. Alexithymia can also impact social relationships. As others may confuse alexithymia as a lack of empathy, it can lead to misunderstandings, emotional disconnect, or challenges in forming deep connections.
While it can bring challenges, alexithymia may also be protective and add to our resilience. It’s more common in trauma survivors and may serve as a way to dampen down our experiences to a manageable level, especially in developmental and complex trauma. Alexithymia may also make it easier to focus on logic and problem-solving and detach and compartmentalize in high-stress situations.
I have alexithymia, and it often means my first response to a question about my emotional experience is “I don’t know” (or if I’m masking - what I think would be a normal appropriate response given the circumstances). Now that I understand my alexithymia, I can give myself the space I need to process and figure things out instead of beating myself up for “not getting it" or feeling overwhelmed. If I take time to sit with my emotions and connect to my “felt sense” experience of my body, I can eventually figure out what it is that I’m experiencing. For me and many of my clients, art, sensory-based activity, and non-verbal expression are a big part of this process.
Strategies for Coping with Alexithymia
Therapy & Coaching: Working with a provider knowledgeable in alexithymia can help you find unique ways to tap into and express emotions.
Mindfulness: Practices that encourage embodied experiences and mindfulness can help to enhance self-awareness and interoception.
Psychoeducation: Learning about emotions, their physiological signals, and how they manifest, along with common experiences of alexithymia, can help bridge the gap between your experience and understanding of your emotions.
External Aids: Tools like emotion-sensation wheels, tracking apps, and arts activities can help to label and identify feelings.
Support Networks: Leaning into supportive relationships where we are free to experience and explore our full selves can help us better identify and process our emotions in a validating and nonjudgmental way.
How the Expressive Arts Can Help Alexithymia
Bilateral Stimulation Drawing of Emotional Experience
Expressive arts therapy was a lifeline for learning to navigate my alexithymia. It gave me a non-verbal way to explore and express my emotions, bypassing the need for words. On days when I can not put the words together to describe my experience, I can make marks, doodles, sounds, or body movements that help me identify and process my emotions. The more I tap into these creative processes, the easier it’s been for me to ‘reverse engineer’ and identify my emotions by the colors, marks, and images that come up.
1. Visual Arts
By exploring colors, shapes, textures, and various visual mediums, emotions can be externalized and explored. The act of creating can help bring subconscious feelings to the surface, making them easier to tease out and understand.
2. Music & Sound
Music is universal, speaking across languages to convey what words cannot. Playing an instrument, singing, listening to music, or even just making non-musical sounds (like screams, grunts, groans) can help people with alexithymia tap into their emotional state. Rhythm and harmonies can evoke feelings that are hard to articulate, providing a pathway to emotional processing.
3. Dance and Movement
Movement-based activities help connect the mind and body, encouraging an embodied emotional experience. Dance and movement can help release pent-up emotions, transforming the intangible into the tangible and turning abstract feelings into concrete experiences. In expressive arts therapy, movement might resemble traditional dance or expressing yourself through simple hand or body gestures. For example, I might ask you, “If that experience was a body posture or hand movement, what would it look like?”
4. Drama and Role-Play
Drama and role-play can be incredibly helpful for alexithymia as they create a safe and playful way to explore emotions and social dynamics. By stepping into a character or situation, you can practice identifying, expressing, and understanding feelings without the pressure of "getting it right." It's like trying on emotions in a low-stakes, creative way that builds confidence and emotional awareness over time.
5. Poetry and Writing
Writing stories, journaling, and/or poetry can be a gentle and creative way to put words to our emotional experiences without fully understanding them. Instead of forcing words into rigid definitions, you can use abstract language, imagery, or metaphors that feel authentic to you. This creative freedom can make it easier to process and share your inner world without the pressure of finding “the right words.”
6. Sensory Connection
At the root of all expressive arts therapy is the sensory experience—art engages all of our senses. Participating in creative activities while focusing on textures, colors, smells, sounds, and other senses fosters a deeper connection to your interoceptive experiences. This makes space for self-expression, authenticity, and identifying and interpreting your emotions in a safe and grounding way.
Living with alexithymia can be overwhelming, like floating along in a sea of uncharted emotions with a life jacket. The expressive arts provide a way to navigate those waters and find new ways of understanding and expressing your feelings, leading to a richer and more connected life.
Online Alexithymia Assessment and Support
Online Alexithymia Questionnaire
Further Reading Alexithymia
If you’re ready to explore how expressive arts, neurodivergent affirming therapy, or coaching can help, reach out today to get scheduled for a free 15-minute consult call or initial intake session.
References
https://pmc.ncbi.nlm.nih.gov/articles/PMC5098957/
https://pmc.ncbi.nlm.nih.gov/articles/PMC2859151/
https://pubmed.ncbi.nlm.nih.gov/8465889/
https://pubmed.ncbi.nlm.nih.gov/9018679/