Alexithymia and Mr. Spock

If I had Mr Spock in my practice, he would have been easily recognizable as having Alexithymia.  His perplexity with emotions was very well-played by the puzzling expression he had whenever confronted with human emotions.

Alexithymia comes from the Greek meaning  (a),without , lexis (word), and  thymos, (emotions).   In a nutshell it means that an Alexithymic does not have the capacity to identify, nor describe emotions  within themselves, nor do they have the capacity to identify them in others.

You will not find it classified as  a mental disorder in the DSM IV, because it is considered a personality  trait.  It was first coined by a psychotherapist named Peter Sinfeos in 1973.

It is said to be found in less than 10% of the population.  Males seem to be more afflicted with this than females, which from a biological context is logical due to females being biologically wired to be more expressive emotionally.  By the way women also have a greater capacity to recognise emotional states and cues in others too.

Since Alexithymia is a trait,  it can be  associated with other neurological or mental illnesses.  Most commonly seen in those who are autistic or somewhere on the autistic spectrum, such as Aspergers syndrome.

Alexithymia has various degrees of severity, so someone could be on the low-end or high-end of the alexithymic spectrum.  If it is a personality trait, then it is called primary and is fixed and will be unyielding to any treatment.

If it occurs as a result of a mental illness, then it is said to be secondary, such as in PTSD, eating disorders, and major depressive disorder.  In that case, psychotherapy could be helpful in reducing the severity.

Although the “Vulcans” might take pride in being without emotions, this does not fly well in ordinary human society as you can imagine.  The major complications of lacking emotional awareness and expression are in interpersonal relations and in attachment.

If you can not identify, nor describe your own emotions, you are not going to be able to pick them up in others either and that in and of itself is a major obstacle in forming social and intimate relationships.

Conversations with those afflicted with alexithymia are not only emotionally devoid, but tend to be  more monologues with rather long detailed explanations relating to finite logical reasoning and minutiae.   They can come across as being fixated on their rational trivia.

Because they lack the capacity to pick up your emotional cues or responses, they can come across as aloof, uncaring or even cold, because they lack emotional reciprocity.  Empathy is not really possible, because they can not identify with sadness in themselves , nor others.  This lack of empathy is not the same as seen in narcissistic or sociopathic individuals.

Their cognition is strictly literal and very concrete without being able to abstract or be metaphorical. They do not have the capacity to fantasize, but can formulate and describe detailed plans or blueprints of technological concepts.

As you can imagine, they are drawn to and are found in professions that are notoriously left brained, such as engineering and computer sciences.  That does not mean that all engineers and geeks are full spectrum alexithymics!

True, left hemispherical oriented individuals can have a tendency to comes across as inbred thinking only types and can be awkward in dealing with emotional terminology, but they can if pushed, to recognise and describe feelings.  It just takes them longer to process.

Not surprisingly then, the physically oriented hypothesis to the neurological causes have to deal with brain circuitry.  Some studies have demonstrated a problem in the right brain, which deals with emotions relaying  data to the left brain language centers via the corpus callosum, or the divide between the left and right brain hemispheres.

Then there is data also showing  circuitry problems conveying data to the amygdala, which is part of the limbic system and the primary site of emotions, which I have addressed in several posts.

Psychological  and developmental contributions are there too and seen in families of origin. For an example; a family where emotions are never talked about, avoided, neglected or minimised is going to impact the personality of a child.

A child growing up in those circumstances will have a high chance of being emotionally avoidant and suppressed too.  Those who inherited neurological tendencies and grows up in a family like described above, will probably fall into the alexithymic spectrum.

Some patients who suffer from eating disorders can have alexithymia because of  difficulty in dealing with underlying emotions and use calorie restriction, binging or purging as an adaptive measure  of coping, however maladaptive!

Secondary alexithymia resulting from PTSD comes from the overwhelming numbing out after being exposed to any trauma, especially combat.  In major depressive disorder, where there is neuro vegetative symptoms, there can be a flatness of emotions and poverty of thought.  These by the way are treatable by medication and psychotherapy.

So, however cute the character of Mr Spock is, only another Vulcan would be happy in having a relationship with him.  Most alexithymics go through life being unable to form intimate relationships to any real dept, unless they find another alexithymic or a very compassionate, patient and understanding partner.

Social integration of all varieties require emotional recognition and reciprocity, especial in forming intimate relationships, so alexithymics are going to be more visibly handicapped in this arena.  Helping the alexithymic recognise emotional cues in others and reacting with appropriate words, even if they can’t understand them, is helpful.

The old adage that; if you can’t feel, you can’t heal unfortunately holds true.  Intelligence based on logic and reasoning is recreatable, aka programmed robots. Emotional awareness and intelligence has too many subtleties and nuances and now is only really being looked into as a higher form of human expression.

With that in mind, perhaps that is why Mr. Spock said “I have never understood the female capacity to avoid a direct answer to any question”