What Is Alexithymia? Understanding Emotional Challenges in Autism
- Kaitlyn Boudreault
- Jun 27
- 5 min read
Updated: Jun 28
Have you ever felt something deeply, but you weren't sure how to express what you were feeling or why you felt that way?
This is a sign of alexithymia, which is experienced in about 1 in 10 individuals.
If you are experiencing alexithymia, you may find it difficult to find the words for your emotions, recognize emotional cues in others, or distinguish between a feeling and a physical sensation.
The experience of alexithymia often overlaps with autism and can impact your communication skills, relationships, and emotional well-being.
You might go silent when asked how you feel, experience mood swings, or feel emotionally disconnected, without knowing why. A neurodiversity-affirming therapist or coach could support you.
In this blog, we’ll explore what alexithymia is, how it affects autistic individuals, common signs, practical coping tools, and guidance for loved ones.
What is Alexithymia?
Alexithymia is usually seen as a secondary condition or diagnosis because it commonly co-occurs with pre-existing neurotypes and mental health challenges, such as depression or autism.
People with alexithymia may struggle with recognizing, processing, and verbalizing emotions that are deemed socially acceptable, such as happiness. The term has Greek origins and means “no words for emotions.”
This doesn’t mean you don’t feel emotions or that you have apathy (lack of feeling, emotion, interest, or concern about something). Instead, it means that it’s hard to find the words to describe what you feel.
People with alexithymia might struggle with:
Identifying the difference between bodily sensations and emotions
Recognizing nuanced emotional experiences
Describing their emotions to others
Understanding emotional responses in social situations
If you have alexithymia, you are not broken or emotionally cold. You simply relate to emotions differently. With the right tools, patience, and alternative strategies, you’ll be able to express how you feel.
Causes of Alexithymia
There is no clear-cut known cause for alexithymia.
However, some research suggests that alexithymia could be the result of genetics or brain differences.
One such brain difference may involve damage to the insula, or part of the brain involved in social skills, empathy, and emotions.
There may also be a connection between alexithymia and various mental health and neurological conditions, including:
Alexithymia and Autism Connection
There are many traits of autism, and some autism misconceptions suggest that autistic individuals lack empathy, which has largely been debunked.
But there is also research by Bird & Cook (2013) that found that approximately 50% of autistic individuals show clinically significant alexithymia. They described this combination in their paper titled “Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism.”
This overlap may explain why some autistic people may be described as detached or unemotional. This is not because this is true, but because of the alexithymia and the difficulty with naming emotions.
Why Does It Matter?
When you can’t name your feelings, it can make everyday life harder. This affects communication, relationships, and self-care. As a result, it may be
Hard to express emotions clearly: You might say “I don’t know” or stay silent when asked how you feel.
Challenging to establish social connections: Friends or partners may misread you as cold or distant.
Challenging to regulate your emotions: You may not notice yourself becoming overwhelmed by emotions until you experience a meltdown, shutdown, or physical symptoms, such as heart palpitations.
Signs You Might Have Alexithymia
Because alexithymia involves an inability to describe or express feelings, someone may see a person with alexithymia as apathetic from the outside.
However, a person with alexithymia does feel things. They have a difficult time expressing it to you.
Alexithymia may show up differently in different people, but autistic people may show the following signs if they have alexithymia:
Feel numb or disconnected from your emotions
Confuse physical sensations with feelings, such as mistaking anxiety for stomach pain.
Can’t explain how you feel. You may use generic words like “fine,” “weird,” or “bad.”
Don’t recognize anger, sadness, or joy because your emotions feel vague.
Struggle to describe feelings to others: You may feel something intensely, but have no idea how to talk about it.
In social contexts, you may experience anger, confusion, increased heart rate, or panic.
How It Shows Up Daily
Daily life can feel confusing when emotions aren’t easy to recognize or label. You might:
Take longer to process your emotions.
Avoid conversations about feelings, as conversations about emotions may feel draining or uncomfortable.
Feel overwhelmed but not know why.
Experience unexplained mood changes with no clear emotional understanding behind them.
Diagnosing Alexithymia
There is no set diagnostic test for alexithymia.
Since alexithymia is not an officially recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it may be diagnosed using other tools.
Your healthcare provider may use a questionnaire with emotion-based questions, or an MRI may be performed by a neurologist.
This MRI will provide images of the insula in the brain to see if you have the differences commonly associated with alexithymia.
Tips to Cope With Alexithymia
If you’re experiencing alexithymia, there are some strategies to help you identify and express how you feel, including:
Keeping a body map or journal of physical sensations: Regularly track signs like tension, temperature changes, or stomach discomfort. With these, you can explore what emotions might be linked to these signs.
Use a feelings wheel with simple, descriptive words: Start with broad emotions like “happy,” “sad,” or “angry,” and work your way toward more nuanced words.
Try drawing what you're feeling inside: Use colors, shapes, or imagery.
Practice naming your emotions during low-stress moments: Reflect on how you felt in past situations and what physical cues you noticed.
Use pre-written responses or emotion cards: These may be helpful for situations where you know you’re expected to understand emotions but aren’t sure how.
Work with a neurodiversity-affirming therapist: A trained therapist can help you build emotional awareness and vocabulary without shame or pressure.
Communication Tips for Supporters
If you’re supporting someone with alexithymia, the following tips can make a big difference:
Be patient: Try to understand that processing and expressing emotions may take longer for those with alexithymia.
Use clear, concrete language. Instead of asking, “How do you feel about that?” Try “Did that make you feel upset, worried, or something else?”
Avoid vague or abstract questions. Be specific and provide examples.
Encourage expressing feelings in different ways: Not everyone does well with verbal expression. Being neurodiversity-affirming means encouraging the method of expression that works best for each individual. Writing, art, physical cues, or emoji-based responses can all help.
Give extra time to respond: Try not to get annoyed with silence. This is often used to help with processing the information.
Accept non-verbal cues: Body language, facial expressions, or behavior changes can communicate just as clearly as words.
At the end of the day, the most important aspect of support is having compassion, rather than pressuring someone to express and verbalize their emotions at the rate that someone without alexithymia does.
Creating a safe, non-judgmental space can help someone develop emotional awareness in a way that works for them and their needs.
Book a Free Consultation
Do you or someone you love struggle to identify or express emotions? Blue Sky Learning has neurodiversity-affirming therapists and coaches who understand the connection between autism and alexithymia.
Our team can help you build emotional awareness, develop practical tools, and improve communication at a pace that feels safe for you.
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