Introducing alexithymia: a concept within the psychosomatic process

Alexithymia (Greek, a = lack, lexis = word, thymos = emotion) is a new concept which, whilst being based upon longstanding clinical observation, remains unproven clinically. The lack of definite criteria for inclusion, and the absence of reliable and valid assessment tools, ensures that past data collection has been flawed and that no real inter-study comparisons can be made. However, the theoretical concept employed at clinical level provides a personality trait that is of great interest to the therapist. Alexithymic individuals lack the ability to transfer the emotional (biological) arousal of experience into feelings and fantasy that symbolize and express the emotion. Literally, they have no words for feeling, and express their arousal in physical (somatic) ways. This paper reviews the clinical components of this trait and the somatic symptomatology associated with it. It also reviews the present 'tools' for 'measuring' alexithymia, and relates these to suggested aetiology. It recommends that all rehabilitation personnel should be aware of this phenomenon, as the somatized symptom may be the presenting complaint of a client. It also encourages therapists to begin screening for alexithymia so that more comprehensive epidemiology information can be gathered, particularly relating to the influences on treatment and physical manifestation.