What the hell is alexithymia?

Alexithymia means not being able to sense and communicate what is going on with you.  The word literally means "no words for emotion". But what causes it?

Alexithymia and dissociation all involve the brain structures that enable us to focus, know what we feel, and take action to protect ourselves.  When these essential structures are subjected to inescapable shock (like childhood trauma), the result may be confusion and agitation, or it may be emotional detachment, often accompanied by out-of-body experiences - where you feel like you are watching yourself from far away.

Trauma interferes with the proper functioning of brain areas that manage and interpret experience.  A robust sense of self - one that allows a person to state confidently, "This is what I feel and think" and "This is what is going on with me" - depends on a healthy and dynamic interplay between these areas. Having no story to tell almost certainly implies an impaired identity: Who we know ourselves to be depends heavily on the story we tell ourselves about who we are. The inability to express emotions verbally implies a deficient interior life. Inevitably, those who cannot match words to feelings will live out that deficit in their contacts with others as well. To have no words for one's inner experience is to not live fully.

Almost every brain-imaging study of trauma patients finds abnormal activation of the insula. This part of the brain integrates and interprets the input from the internal organs to generate the sense of being embodied.  The insula can transmit signals to the amygdala that trigger the flight/fight response - which are powerful feelings generated deep inside the brain that cannot be eliminated by reason or understanding.

Language is essential: our sense of Self depends on being able to organize our memories into a coherent whole.  This requires well-functioning connections between the conscious brain and the self system of the body: the full story can on be told after those structures are repaired and after foundations have been laid.

What is key is this: only by getting in touch with your body, by connecting viscerally with yourself, can you regain a sense of who you are, what your priorities are and what your values are. Embodiment/presence is the offering given by many modalities: whether it be martial arts, meditation, massage, craniosacral therapy or many others.

Includes excerpts from "The Body Keeps the Score by Bessel Van Der Kolk"