Quick summary: Alexithymia affects roughly 10% of people and describes a genuine difficulty in recognising, naming, and managing emotions, rather than an absence of feeling. It can strain close relationships and complicate everyday communication, since partners and family members often misread the condition as coldness or disinterest rather than a real barrier to expressing empathy. For mental health practice, recognising alexithymia matters because approaches such as cognitive behavioural therapy and somatic based work can help people build a clearer link between physical sensation and emotional meaning, improving both well being and the quality of their relationships.

Has anyone ever asked how you’re feeling, and you genuinely couldn’t answer? You know something is happening inside you. Maybe it’s a tightness in your chest, a heavy feeling in your stomach, or a sudden flush of warmth. But you can’t work out what it is. Sadness? Anger? Fear? Or is it just something you ate?

For roughly 10% of people, this isn’t an occasional blank moment brought on by stress. It’s a fairly constant feature of how they experience emotion. Psychiatrists call this alexithymia.

The term was coined in the 1970s by psychiatrist Peter Sifneos, drawn from the Greek for “no words for feelings”. It isn’t classed as a mental disorder or a standalone diagnosis. Rather, it’s a personality trait, or a subclinical pattern, marked by real difficulty in recognising, naming, and managing one’s own emotions.

What it looks like

People with alexithymia aren’t short on emotion. Their bodies register the full physical weight of it. What’s missing is the bridge between those bodily signals and a clear mental label for what they mean. Common features include:

• Difficulty recognising emotions: Struggling to tell the difference between an emotional state and the physical sensation that comes with it
• A limited emotional vocabulary: Trouble describing how they feel to others, often falling back on vague words like “bad” or “OK”
• Externally oriented thinking: A mindset geared towards outside events, concrete facts, and practical details rather than inner experience, daydreaming, or reflection
• Reduced imaginative capacity: A preference for realistic, literal accounts of things over abstract or metaphorical ones

Where it comes from

Psychologists generally split alexithymia into two types: primary and secondary. Primary alexithymia appears to be a structural trait that’s simply part of how someone’s brain is wired from early on. It’s commonly seen alongside conditions such as Autism Spectrum Disorder, where the neural connections linking bodily sensation to emotional awareness work differently by default. Secondary alexithymia, on the other hand, is learned. It tends to develop after something difficult, such as abuse or prolonged, extreme stress.

How it plays out in relationships

Alexithymia can make everyday life, and particularly close relationships, harder to navigate. Because it affects a person’s capacity to express empathy in ways their partner can recognise, misunderstandings creep in easily. A partner might start to feel unloved or shut out, while the person with alexithymia may feel they simply can’t meet expectations they don’t fully understand. On top of this, unexplained physical symptoms, aches, tension, palpitations, are common and can be unsettling precisely because there’s no obvious way to control them.

Finding a way through

Alexithymia isn’t easy to live with, but it responds to the right kind of support. Mindfulness practice and psychotherapy can help someone build a clearer connection between bodily sensation and emotional meaning. Cognitive behavioural therapy and somatic based approaches, in particular, have shown promise.

Many people with alexithymia describe their emotions almost entirely in physical terms, a racing heart, pressure in the chest, and struggle to translate that into words others can understand. Recognising this pattern, both in oneself and in someone close to you, can ease some of the frustration that builds up around it, and make it a little easier to stay connected to those who experience the world this way.

Dina G. Relojo is a social media manager at Psychreg. She is a high school teacher from the Philippines.