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From Body Signals to Emotions: 3 Ways Interoception Helps Us Understand Alexithymia

Hey everyone, Kelly Mahler, occupational therapist. I want to take the time to talk about alexithymia and interoception. Yes, this is a topic that we’ve discussed before, and it is a very common question. We hear lots of people curious about alexithymia and interoception, so I wanted to take time to talk about three things or ideas that aren’t typically part of the conversation about alexithymia. Because we are all so different in our inner experiences, it is hard to generalize conversations about interoception and/or alexithymia, but the following 3 ideas might help us to understand alexithymia a bit more for some people. 

What is Alexithymia?

First, in case this term is new to you: what is alexithymia? It is defined as difficulty identifying and describing the way you feel. Recent research has shed light on the underlying mechanism that might be contributing to alexithymia: interoception, which is that sense within our bodies that lets us know how we are feeling. We might experience a wide variety of sensations, and it’s different for each person. Maybe you notice your heart racing, or your muscles are tight, or you feel a zappy sensation throughout your body. We experience these sensations because of interoception. These sensations are really important in helping us identify and describe how we feel.

So, let’s dive into three things that are typically not part of this discussion when we talk about alexithymia and interoception, but these 3 ideas might be important in moving our understanding forward.

#1: Some Are Labeled as Alexithymic Simply Because They Express Their Emotions in a Way Society Doesn’t Celebrate

As I mentioned, alexithymia involves difficulty identifying how you feel. While this can certainly be a true experience for someone with alexithymia, there are also people who might be labeled as alexithymic but truly understand how they feel. It’s just that their experience doesn’t match the one-size-fits-all approach to emotions that is commonly used. Many times, we—or our society—tend to discuss how emotions should feel. What we’re learning from interoception science is that there is no single footprint of emotion. For example, the way anxiety feels in your body is likely different from how it feels in mine. Similarly, hunger likely feels different in your body compared to mine.

When we teach, for instance, that hunger is signaled by a growling stomach, if that growling stomach doesn’t happen for you, that might not be your body’s signal to indicate hunger, you might not come to realize you are hungry. I have many clients who are waiting for that growling stomach, and if it doesn’t happen, they think they can’t identify hunger. However, when we do a lot of individualized interoceptive exploration, we find that they do have a body signal letting them know when they’re hungry; it’s just different from what society might traditionally discuss. For example, I have a client who experiences zappy feelings all over her skin, which we’ve discovered is her sign for hunger. No one helped her learn when she was young that a zappy feeling in her skin means hunger. She was victim to the one-size-fits-all, emotions ‘should’ feel a certain way approach.

We really need to take a step back and consider how we talk about emotions and how they feel, embracing the notion that emotions are different for each of us and can feel differently for each individual. That’s the beauty of interoception work; it helps us explore our body signals, find patterns in those signals, and give meaning to those patterns in an individualized manner.

#2: Describing How You Feel Can Be Way More Than Just Emotion Words

Number two addresses the second part of the alexithymia definition: describing how you feel. Many individuals with alexithymia truly have difficulty putting words or descriptions to their internal experiences. However, many of my clients report that they do know how they feel and can describe it to someone else. The issue is that their instinct might not be to describe it with a traditional emotion word. Over time, they’ve received the accidental message that they must translate their inner experiences through emotion words and if they can’t they are labeled as ‘unable to describe how they feel’.

Often, emotion words can fall short for various reasons. Maybe one word isn’t enough to describe the extensive inner experience someone has. Perhaps those emotion words lack meaning to a person’s neurology or way of viewing their inner world. Some individuals might describe their inner world better through songs, drawings, or other types of art, or even through noises, GIFs, or video clips. They might even express how they think about their inner experiences rather than how they feel.

We really need to expand our understanding of how someone might describe their inner experience. Traditional emotion words might not be meaningful for everyone, so just because someone can’t label their felt experience via an emotion word does not mean they are necessarily alexithymic.

#3: Alexithymia Can Be Changeable Through Interoception Work

Number three addresses a common question: Is alexithymia changeable? Can you improve your ability to identify and describe how you feel? If that’s a meaningful goal for you, the answer is yes. Is it easy work? Not always! But it is possible.

We are learning from many people through research and lived experiences that an interoception-based approach and improve alexithymia. People can become clearer about how they feel and how to describe it. And this needs to circle back to points one and two above, this interoception work needs to embrace the inner differences in both how emotions feel in our bodies and how we describe those feelings. If we can embrace differences, many times the experience of alexithymia can be enhanced, especially when coupled with a lot of interoception work and connection to the body, especially when we feel safe enough to notice and explore how our body is feeling.

Until next time.

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