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  • Writer's pictureJulie Morris, Ph.D.

"But, I don't know how I feel!"

When asked how they feel, some people simply do not know. They have difficulty

describing what emotion(s) they are feeling. For these people, this inability to know how they feel happens frequently and across various situations and contexts. Research suggests that approximately 8% of males and 2% of females experience it.


So, what is it exactly?


It is called Alexithymia.


Alexithymia is a trait (Nemiah et al., 1976) that makes it hard to find words for thoughts and feelings. Alexithymia is experienced by people of all ages and sexes and can be mild, moderate or severe. Because of the nature of the trait -- an inability to know what oneself is thinking or feeling -- many with Alexithymia are often unaware that they struggle with it.


However, Alexithymia is not a diagnosis in and of itself. You will not find it in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it can be something that one struggles with in the absence of a formally diagnosed mental illness as well as a trait associated with particular psychological diagnoses such as autism, depression, and others.



Therapy can help.


Evidence-based psychotherapy such as Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Cognitive Behavioral Therapy (CBT) will teach you how to be mindful of internal emotional states and how to identify these same states in others. Therapy may include both group work and homework, or action plans:


  • Group work: Group psychotherapy may also be helpful as it assists in learning how to deepen connection to others.


  • Homework/ Action Plans: This is the work clients do on their own between their scheduled sessions. Action plans are not optional. They are carefully created and thoughtfully assigned. Momentum to change doesn't just happen during the therapy hour...it happens during the other 23 hours of the day, too. Action plans help clients continue the work "outside of session" and achieve gains sooner in their treatment process. These assignments will help clients continue to improve their level of functioning.

Homework to cultivate a deeper sense of emotional awareness:


-Expressive writing: Begin by journaling every day. Start with what you did that day and then let your writing expand to include more of your internal dialogue. Be patient with yourself as this won't come naturally, at first. You may want to try a journal with prompts on each page.


-Reading novels: Reading novels/fiction literally means reading words that describe the thoughts and feelings of others. By reading such stories, you will be expanding what researchers call Theory of Mind (ToM; Kidd & Castano, 2013). Theory of Mind is the ability to think about mental states (including beliefs, feelings, thoughts, desires, knowledge) -- both your own and those of others. Theory of Mind is a critical socio-cognitive skill.


-Artistic expression: Take an art class, dance class, or learn to play a musical instrument. The creative arts are very much about how colors, methods, movements, and sounds

make one feel. When you express yourself artistically it helps you strengthen your ability to interpret and communicate these feelings.

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