Alexithymia, psychosomatosis, and psychosis

A discussion of "Alexithymia and the Effectiveness of Psychoanalytic Treatment" by Henry Krystal, M.D. Following a critical appraisal of Krystal's work on alexithymia, the author proposes that alexithymic symptoms may also reveal themselves to be a massive defense against psychotic anxieties. In both psychotic and alexithymic-psychosomatic states there is an attack on mental functioning and perception. However, while the psychotic creates a neo-reality to protect himself from psychic pain, the grave alexithymic drains external reality and relationships of their meaning, leaving a devitalized relationship of a "pseudo-normal" kind with the world.