Alexithymia: When Emotions Feel Like Puzzles
"How are you feeling right now?" It should be a simple question, but if you're one of the many autistic people who also experience alexithymia, it might as well be asked in a foreign language. You know something is happening inside you—there's a sensation, an internal shift, maybe physical discomfort—but putting words to it? That's where things get complicated.
Maybe you've been told you're "emotionally unavailable" or "not in touch with your feelings." Perhaps you've felt frustrated watching others seem to effortlessly navigate the emotional landscape while you're still trying to figure out if what you're experiencing is sadness, anxiety, or just hunger.
If this sounds familiar, you're not broken or deficient. You may be experiencing alexithymia—a condition that affects up to 85% of autistic people and makes the emotional world feel like a puzzle with missing pieces.
Alexithymia: More Than Just "No Words for Emotions"
Alexithymia, which literally means "no words for emotions" in Greek, is far more complex than just vocabulary issues. It's a difference in how your brain processes emotional information, affecting your ability to identify, understand, and express feelings—both your own and others'.
Research shows that alexithymia involves:
Difficulty identifying emotions - You know you're feeling something, but can't name what it is
Trouble distinguishing emotions from physical sensations - Is that tightness in your chest anxiety, excitement, or just tight muscles?
Challenges describing feelings to others - Even when you recognize an emotion, finding words to communicate it feels impossible
Reduced emotional awareness - Emotions might not register consciously until they become overwhelming
Different processing of emotional facial expressions and vocal tones - Missing emotional cues that others pick up automatically
What's crucial to understand: New research suggests that many emotional processing difficulties previously attributed to autism may actually be due to co-occurring alexithymia. This means alexithymia isn't a core feature of being autistic—it's a separate condition that happens to occur frequently alongside autism.
The Alexithymia-Autism Connection
As we discussed in our recent post on Knowing Your Autistic Needs, many autistic people struggle with interoception and identifying internal states. Alexithymia adds another layer to this challenge, specifically affecting emotional awareness and processing.
Why is alexithymia so common in autistic people?
Research suggests several possibilities:
Shared neurological pathways - Both conditions involve differences in brain areas like the amygdala, insula, and prefrontal cortex that process emotions
Developmental factors - Early differences in social communication may affect how emotional vocabulary and awareness develop
Sensory processing differences - When you're managing sensory overload, emotional signals might get lost in the noise
Masking effects - Years of suppressing authentic responses may disconnect you from your internal emotional experiences
Importantly: Not all autistic people have alexithymia, and not all people with alexithymia are autistic. Understanding whether you experience both can be crucial for developing effective strategies for emotional wellness.
What Alexithymia Actually Feels Like
Alexithymia isn't just about lacking emotional vocabulary—it affects your entire relationship with your internal world:
The Physical-Emotional Confusion
You might experience emotions primarily as physical sensations:
Feeling "sick" when you're actually anxious
Headaches when you're overwhelmed or frustrated
Fatigue when you're sad or disappointed
Physical restlessness when you're excited or happy
The Delayed Recognition
Emotions might not register until hours or even days later:
Realizing you were angry about yesterday's meeting only after you've snapped at someone else
Discovering you're grieving a loss weeks after it happened
Not knowing you're stressed until you're having physical symptoms
The All-or-Nothing Experience
Emotions might feel either completely absent or completely overwhelming:
Going from feeling "fine" to having a complete meltdown with no middle ground
Experiencing emotions so intensely they feel dangerous or uncontrollable
Feeling emotionally "numb" even during significant life events
The Social Confusion
Difficulty reading your own emotions makes it hard to understand others':
Not knowing if someone is joking or serious
Missing when others are upset or uncomfortable
Feeling confused by social situations that seem emotionally charged
Practical Strategies for Navigating Alexithymia
Living with alexithymia doesn't mean you're doomed to emotional confusion forever. Here are research-backed strategies that can help:
1. Build Your Emotion-Body Connection Map
Since emotions often register as physical sensations first, create a personal map:
Track patterns:
What does anxiety feel like in your body? (Racing heart, tight chest, stomach issues?)
Where do you feel sadness? (Heavy limbs, tired eyes, hollow feeling?)
How does anger show up? (Hot face, clenched jaw, tense shoulders?)
What about excitement or joy? (Light feeling, energy, restlessness?)
Create your personal emotion dictionary: Instead of traditional emotion words, use descriptions that make sense to you:
"Heavy and slow" instead of sad
"Buzzy and scattered" instead of anxious
"Hot and tight" instead of angry
"Sparkly and bouncy" instead of excited
2. Use External Emotion Tracking Tools
Since internal awareness can be challenging, external tools can provide helpful scaffolding:
Emotion tracking apps: Set reminders to check in with yourself several times a day Visual scales: Use 1-10 scales for different feeling categories (energy, comfort, stress, social battery) Photo journals: Take pictures of your face throughout the day—sometimes emotions are visible externally before you feel them internally Voice memos: Record quick voice notes about your state—hearing your own tone can provide clues
3. The Alexithymia-Friendly Feeling Check
Instead of "How do you feel?" try this structured approach:
Physical scan: What's happening in my body right now? Energy assessment: Am I feeling high energy, low energy, or somewhere in between? Comfort rating: On a scale of 1-10, how comfortable/uncomfortable am I? Recent events: What's happened today that might be affecting me? Needs assessment: What do I need right now? (Rest, food, movement, quiet, connection?)
4. Develop Emotional Processing Rituals
Create structured ways to process emotions when you do recognize them:
Write it out: Even if you can't name the emotion, describe the physical sensations and circumstances Movement processing: Dance, walk, or exercise to help move stuck emotional energy through your body Creative expression: Draw, paint, or create music that matches your internal state Body-based release: Use progressive muscle relaxation, self-massage, or somatic techniques to address physical tension
5. Build Emotional Safety Nets
Since emotion recognition can be delayed, create systems to support you:
Trusted person check-ins: Ask close friends or family to help you notice when you seem off Environmental supports: Create calming spaces you can retreat to when something feels wrong but you're not sure what Routine maintenance: Keep consistent sleep, eating, and self-care routines to support overall emotional regulation Professional support: Work with therapists who understand alexithymia and can help you develop personalized strategies
Social Side of Alexithymia
Alexithymia doesn't just affect your relationship with your own emotions—it impacts how you connect with others:
In Relationships:
Let partners know you might not immediately recognize or express emotions but that doesn't mean you don't care
Ask for direct communication rather than expecting you to read emotional subtext
Create systems for checking in about relationship satisfaction and addressing issues before they become overwhelming
At Work:
Request clear feedback rather than assuming you'll pick up on subtle cues about performance or relationships
Use structured check-ins with supervisors to ensure you're meeting both task and interpersonal expectations
Advocate for written communication when possible, as it gives you time to process emotional content
When Counseling Support Can Help
According to research from Autistica, alexithymia can make anxiety feel worse for autistic people because they may struggle to sense physical symptoms of anxiety such as changes in heart rate or rushes of adrenaline. Professional support can be particularly valuable if:
You're experiencing frequent physical symptoms that might be emotional in origin
Relationships are suffering due to communication difficulties around emotions
You want to develop better interoceptive awareness and emotional vocabulary
Past trauma or invalidating experiences have complicated your relationship with emotions
You're interested in exploring how alexithymia affects your specific autistic experience
Your Emotional Experience is Valid
Here's something important: having alexithymia doesn't mean you don't have emotions or that they don't matter. Your emotions are just as real and valid as anyone else's—you just process and express them differently.
You're not "emotionally stunted," "cold," or "robotic." You're not missing some essential part of the human experience. Your brain processes emotional information in a unique way that requires different strategies and supports, just like any other neurological difference.
The goal isn't to become neurotypical in your emotional processing—it's to understand your unique patterns and develop tools that help you navigate the emotional world more skillfully.
Many people with alexithymia develop rich emotional lives once they understand how their brains work. You might express love through actions rather than words, show caring through problem-solving rather than emotional support, or connect through shared interests rather than emotional sharing. These are all valid and valuable ways of being human.
Understanding alexithymia can be incredibly liberating. Instead of feeling like you're failing at emotions, you can start working with your brain's natural patterns to build the emotional awareness and communication skills that support your relationships and well-being.
Your emotional journey might look different from others', but it's no less meaningful, important, or worthy of support and understanding.
Build Emotional Awareness with Alexithymia-Informed Support
Living with alexithymia alongside autism can feel isolating and confusing, especially when the emotional world seems to operate by rules that no one ever explained to you. Understanding that your emotional processing differences are neurological—not personal failings—can be the first step toward building a more connected and satisfying life.
At Sagebrush Counseling, we recognize that alexithymia affects how you experience and express emotions, but it doesn't make you less capable of meaningful relationships, personal growth, or emotional wellness. Our therapists understand the complex intersection of autism and alexithymia and can help you develop personalized strategies for emotional awareness, communication, and regulation.
Individual therapy can help you:
Develop better interoceptive awareness and learn to recognize emotions through body sensations
Build a personalized emotional vocabulary that makes sense for your unique processing style
Process experiences of feeling misunderstood or invalidated because of your emotional expression differences
Learn practical strategies for managing delayed emotional recognition and overwhelming emotional experiences
Explore how alexithymia affects your relationships, work, and daily functioning
Develop communication skills for explaining your emotional needs to others
Navigate the intersection of alexithymia with other aspects of your autistic experience
Couples therapy can support relationships affected by alexithymia by:
Helping partners understand how alexithymia affects emotional expression and recognition
Teaching both partners alternative ways to share and receive emotional support
Developing communication strategies that work with alexithymic processing rather than against it
Addressing misunderstandings that arise when emotional needs are expressed differently
Building intimacy through understanding and accommodating neurological differences
For more insights on autism, emotional processing, and neurodivergent-affirming approaches to mental health, explore our blog where we regularly share research-based information and practical strategies for living authentically with neurological differences.
Alexithymia-Friendly Online Therapy Throughout Texas
We understand that traditional therapy can feel overwhelming when you have difficulty processing emotions in real-time. That's why we offer comprehensive online therapy throughout Texas, allowing you to access specialized support from your own comfortable environment where you can take the time you need to process and respond.
Virtual sessions can be particularly helpful for people with alexithymia because they eliminate the pressure of immediate face-to-face emotional processing while still providing the connection and support you need. You can use chat functions, take breaks to process, and access your personal regulation tools during sessions.
Learn more about how our online therapy works and why many clients with alexithymia find virtual sessions more accessible and effective.
Connect With Alexithymia-Informed Support Across Texas
Austin area: Individual therapy specializing in autism, alexithymia, and emotional processing differences Houston area: Affordable couples counseling with sliding scale options for neurodiverse couples navigating emotional communication differences El Paso area: Flexible virtual therapy with approaches that honor different emotional processing styles Corpus Christi area: Couples therapy that understands how alexithymia affects relationships
We serve clients throughout Texas with flexible, patient-centered approaches that honor your unique emotional processing style. View our complete services and rates including individual therapy, couples counseling, and intensive options designed to accommodate different communication and processing needs.
Ready to build a better relationship with your emotional world? Contact us today or call (512) 790-0019 to begin developing the emotional awareness and communication skills that will enhance your relationships and well-being.
Your emotions matter, even if you process them differently than others. You deserve support that understands how your brain works and helps you build on your natural strengths while developing new skills. Alexithymia isn't a limitation—it's just different wiring that requires different strategies. Let's work together to help you navigate the emotional world with greater confidence and connection.
