Alexithymia Worksheet for Couples Therapy
A guide for couples navigating emotional processing differences
What Is Alexithymia?
Alexithymia means difficulty identifying, describing, and expressing emotions. It's not that you don't have emotions—it's that recognizing and naming them is challenging.
Common experiences with alexithymia:
- Knowing something feels "off" but not knowing what emotion you're experiencing
- Difficulty finding words to describe your feelings
- Confusion between physical sensations and emotions
- Tendency to focus on external events rather than internal feelings
- Difficulty recognizing emotions in others
- Preference for discussing facts over feelings
Important to know: Alexithymia is common in autistic individuals (~50%), can occur with ADHD, anxiety, depression, and trauma. It's a trait on a spectrum, not a disorder.
Part 1: Self-Assessment
Rate yourself on the following statements (1 = Never, 5 = Always)
| Statement | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| I have difficulty identifying what I'm feeling | |||||
| I find it hard to describe my feelings to others | |||||
| I'm confused about what's happening in my body | |||||
| Other people tell me I should share my feelings more | |||||
| I prefer to talk about events and facts rather than emotions | |||||
| I have difficulty knowing what emotions others are experiencing | |||||
| When upset, I notice physical symptoms before emotions | |||||
| I find emotional conversations draining or confusing | |||||
| I need time to figure out what I'm feeling | |||||
| I'm better at expressing emotions through writing than speaking |
Rate yourself on the following statements (1 = Never, 5 = Always)
| Statement | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| I have difficulty identifying what I'm feeling | |||||
| I find it hard to describe my feelings to others | |||||
| I'm confused about what's happening in my body | |||||
| Other people tell me I should share my feelings more | |||||
| I prefer to talk about events and facts rather than emotions | |||||
| I have difficulty knowing what emotions others are experiencing | |||||
| When upset, I notice physical symptoms before emotions | |||||
| I find emotional conversations draining or confusing | |||||
| I need time to figure out what I'm feeling | |||||
| I'm better at expressing emotions through writing than speaking |
Part 2: Understanding Each Other's Emotional Processing
When I'm having a feeling, the first thing I usually notice is:
The time it takes me to identify what I'm feeling is:
When I'm experiencing an emotion, I'm better at:
What helps me identify my emotions (check all that apply):
When I'm having a feeling, the first thing I usually notice is:
The time it takes me to identify what I'm feeling is:
When I'm experiencing an emotion, I'm better at:
What helps me identify my emotions (check all that apply):
Part 3: Emotion Identification Tools
Use this reference when trying to identify emotions:
MAD
- Angry
- Frustrated
- Irritated
- Annoyed
- Resentful
SAD
- Hurt
- Disappointed
- Lonely
- Vulnerable
- Guilty
GLAD
- Happy
- Peaceful
- Proud
- Content
- Excited
SCARED
- Anxious
- Worried
- Insecure
- Overwhelmed
- Uncertain
DISGUST
- Aversion
- Repulsion
- Disapproval
SURPRISE
- Shocked
- Confused
- Amazed
- Startled
Emotions often show up in the body first. Notice where you feel sensations:
Anger/Frustration
Common sensations: Heat in face/chest, tension in jaw/fists, increased heart rate
Where I feel it:
Sadness
Common sensations: Heaviness in chest, lump in throat, low energy, tears
Where I feel it:
Anxiety/Fear
Common sensations: Butterflies in stomach, racing heart, shallow breathing, muscle tension
Where I feel it:
Happiness/Joy
Common sensations: Lightness, warmth, relaxation, energy, smiling
Where I feel it:
Overwhelm
Common sensations: Pressure in head, difficulty breathing, numbness, fatigue
Where I feel it:
Part 4: Communication Strategies for Couples
- "I know I'm feeling something, but I can't identify it yet."
- "I need time to process this. Can we talk about it in [timeframe]?"
- "I'm noticing tension in my shoulders. I think that means I'm stressed."
- It's okay to ask for multiple choice questions instead of open-ended ones
- It's okay to use writing, texting, or email to express emotions
- Ask "Are you feeling mad, sad, scared, or glad?" instead of "How do you feel?"
- Notice and name: "I notice you're clenching your fists. I wonder if you might be feeling frustrated?"
- Give processing time - don't expect immediate emotional responses
- Offer options: "Would it help to write about this instead of talking?"
- Validate physical sensations: "Your headache might be telling you something"
- Remember: Lack of emotional expression doesn't mean lack of feelings or caring
Part 5: Practice Exercise - Recent Situation
Situation Description (Just the facts):
Physical sensations I noticed:
Thoughts I had:
Actions I wanted to take:
Using the feelings wheel, the emotion might have been:
How long it took me to identify it:
Physical sensations I noticed:
Thoughts I had:
Actions I wanted to take:
Using the feelings wheel, the emotion might have been:
How long it took me to identify it:
Discussion Questions:
How were our experiences similar?
How were they different?
What did Partner A need in that moment?
What did Partner B need in that moment?
Part 6: Building Your Communication System
When I need processing time, I will:
Partner A:
Partner B:
When I'm experiencing something but can't name it, I will:
Partner A:
Partner B:
When I need help identifying my emotions, I will:
Partner A:
Partner B:
The timeframe I typically need to process emotions is:
Partner A:
Partner B:
For difficult emotional conversations, we agree to:
Questions that help us identify emotions:
Worksheet created by Sagebrush Counseling © 2026
Important Disclaimer: This worksheet is designed as a therapeutic tool to be used collaboratively in therapy sessions and at home between sessions. It is not intended to be a substitute for professional couples therapy or individual therapy. This worksheet does not constitute medical or mental health advice, diagnosis, or treatment. Use of this worksheet is at your own risk, and Sagebrush Counseling makes no warranties regarding its completeness, accuracy, or suitability for any particular purpose.
Professional Support Recommended: If you are experiencing significant relationship distress, mental health concerns, or emotional difficulties, please seek professional help from a licensed mental health provider. This worksheet is meant to supplement, not replace, professional therapeutic intervention.
Crisis Resources: If you or your partner are experiencing a mental health crisis, please call 988 (Suicide and Crisis Lifeline) or 1-888-568-1112 (Maine Crisis Line) immediately, or go to your nearest emergency room.