What is lack of emotion

Causes and Treatment for Emotional Numbness

Feeling emotionally numb or feeling no emotions can be a symptom of several different medical conditions. It may also occur as a side effect of some medications.

Emotional numbness creates a sense of emptiness, isolation, or emotional disconnect from the rest of the world. The numbness can be unbearable for many people who experience it.

Find out what it’s like, why it happens, and how to manage and prevent it.

Emotional numbness, also sometimes called emotional blunting, can be difficult to imagine if you have not experienced it.

Some people describe it as feeling emptiness or despondency, while others report feeling isolated. Some feel as though they have no future or that there is no hope for the numbness to ever fade.

“Often I feel invisible, like I’m a ghost. I watch my family engaging with each other, but feel like there’s an invisible barrier that keeps me from joining them,” describes Amy H., who has experienced emotional numbness from depression. “I’m like a submarine drifting undetected, picking up on other people’s emotions like sonar. However, if you were to ask me what my own feelings are, I wouldn’t be able to tell you.”

Rebecca C.* has a similar experience with numbness caused by depression: “The world around me often seems slightly superficial, [like] I am simply going through the motions and can’t connect to my environment,” she explains. “It makes me feel as if there were analog TV static in my brain. I am unable to communicate or think deeply.”

Some people describe emotional numbness as feeling unfocused or ungrounded.

“It basically feels like when you zone out before you go to sleep,” Amanda D. said. “Feels like being unfocused. And sometimes, especially right when you are going through it, it’s really hard to understand how the world keeps moving when it should have stopped.”

*Some names have been changed at the request of interviewees.

There are a number of different things that can cause emotional numbness to occur. While depression and anxiety are the most common causes, others include the following:

Stress and stress hormones: Elevated cortisol levels can lead to emotional numbness in some people.
PTSD: Post-traumatic stress disorder (PTSD), which may change your stress hormone levels, can be tied to depression, anxiety, and symptoms like emotional numbness.
Medication: Some medications used to treat anxiety and depression affect how the brain processes mood and emotion. Selective serotonin reuptake inhibitors (SSRIs) affect serotonin levels in your brain, which could also alter dopamine levels. Most evidence is anecdotal, but a 2021 review of research suggests this could explain medication-induced emotional numbing.
Depersonalization-derealization disorder: People with depersonalization-derealization disorder may experience numbness in their minds or bodies.
Fatigue: Experiencing physical fatigue and burnout could lead some people to have emotional blunting.

Despite how it may feel, emotional numbness is not permanent. Treatment is available to provide both immediate relief and long-term remission.

The first step in treating emotional numbness is to identify and treat the underlying cause. A healthcare professional can help with this, or they may refer you to a mental health professional.

You’ll be asked what medications you take and what other symptoms you have. If your doctor thinks one of your medications is to blame, they may substitute it with something else.

If you do not already have a mental health professional, the FindCare tool can help you locate one in your area.

Immediate relief options

To start getting more immediate relief from emotional numbness, you can also try several treatment options:

Make an appointment with a mental health professional

A mental health professional can offer coping techniques to help you regain your feelings. Some professionals, like psychiatrists, can prescribe different medications.

While antidepressants typically take up to 6 weeks to start working, your doctor may prescribe anti-anxiety medication like benzodiazepines or beta-blockers for you to take while the other drug builds in your system.

Rely on your support system

Even if you’re having trouble connecting, reach out to the people who love you. They may be able to help you connect, and you may find relief in telling them what you’re going through.

Exercise

When you’re feeling numb, the last thing you may want to do is get up and move, but it’s one of the best things you can do.

Running, swimming, yoga, and kickboxing classes are all great for stress relief, but even just taking a walk around the neighborhood can help flood your brain with endorphins. To get the best results, exercise daily.

Get plenty of sleep

Getting 7 to 9 hours of quality sleep every night could help improve your mood.

Long-term care

For long-term methods of treatment and prevention of emotional numbness, you may want to follow these tactics:

Eat a healthful diet: By eating nutrient-dense foods, you fuel your body to work at its best. Specifically, fish, fresh fruit and vegetables, and other antioxidant-rich foods can improve mood regulation.

Minimize stress: Minimizing stress or improving how you manage it can positively affect your body, reduce stress hormones, and help you regain emotional feeling. Reduce the stressors in your life, and practice stress-busting techniques like meditation or mindfulness to better manage stress.

Learn to identify and express emotions: For those who have been emotionally numb for an extended time, it can be difficult to identify or process different emotions. A mental health professional can help with this. Make an appointment with a professional in your area who can help you tap into your emotions.

If you’re experiencing emotional numbness, know that no matter how you feel, you aren’t alone, and it won’t last forever.

Reach out to the people you love and make an appointment with a mental health professional. They can help you bridge the gap and bring you one step closer to feeling your feelings.

Emotion-Focused Coping: 7 Techniques to Try

When a challenge comes up for you, you probably have a handful of go-to strategies to help you deal with it. Even if your approach varies slightly from problem to problem, you probably manage most difficulties in similar ways.

You might, for example, be a problem solver. When navigating a challenge or stressful event, you go straight to the source and work at it until you’ve either fixed what’s wrong or brought your stress down to a more manageable level.

What if taking immediate action isn’t your strong point? Maybe you try to hack your emotions by considering the situation from a different perspective or leaning on loved ones for support.

These two approaches represent two distinct coping strategies:

Problem-focused coping involves handling stress by facing it head-on and taking action to resolve the underlying cause.
Emotion-focused coping involves regulating your feelings and emotional response to the problem instead of addressing the problem.

Both strategies can have benefits, but emotion-focused coping may be particularly useful in certain situations.

Emotion-focused coping skills help you process and work through unwanted or painful emotions and reactions. In other words, this approach helps you manage your emotions rather than outside circumstances.

This approach won’t help you solve a problem directly, but it’s a great tool to have for dealing with stressful situations you can’t change or control.

When you can manage your emotional response to a given situation more effectively, you may feel somewhat better about what’s happening — or at least more equipped to handle it.

Research from 2015 suggests people who tend to use emotion-focused coping strategies may be more resilient to stress and enjoy greater overall wellness.

Meditation helps you learn to acknowledge and sit with all of your thoughts and experiences, even the difficult ones.

The key goal of meditation? Mindfulness: to recognize thoughts as they come up, accept them, and let them go without stewing over them or judging yourself for having them.

You can practice mindfulness anytime, anywhere, and it won’t cost you anything. It may feel a little awkward, even unhelpful, at first, and it can take some time before it feels natural. If you stick with it, you’ll generally begin seeing some benefits before long.

If you’re new to meditation, get started by learning more about different types or trying this easy body scan exercise.

Journaling is a great way to sort through and come to terms with challenging emotions.

When something goes wrong, you might experience a lot of complicated, conflicting feelings. They might feel jumbled up inside you, making the thought of sorting them out exhausting. Or, maybe you’re not even sure how to name what you’re feeling with words.

Exhaustion and confusion are valid feelings and can be a good starting point for putting pen to paper.

Sometimes, writing down your feelings — no matter how messy or complex they are — is the first step in working through them. You might eventually find that journaling offers a type of emotional catharsis, as you purge them from your mind and into your journal.

To get the most out of journaling, try:

writing every day, even if you only have 5 minutes
writing whatever comes to mind — don’t worry about editing or censoring yourself
keeping track of any mood or emotional changes you experience and any factors that might be contributing to the pattern, whether that’s your exercise routine, certain foods, or particular relationships

Optimism won’t solve problems alone, but it can certainly boost your emotional wellness.

It’s important to understand that optimistic or positive thinking does not involve ignoring your problems. It’s about giving challenges a positive spin and finding pockets of joy to help you get through them.

To add more positive thinking to your life, try:

building yourself up with positive self-talk instead of talking down to yourself
recognizing your successes instead of focusing on “failures”
laughing off mistakes
reminding yourself you can always try again

All these things are easier said than done, but with a bit of practice, they’ll start to feel more natural.

It’s easy to focus on feelings of injustice or unfairness when someone wrongs you or does something unkind.

Most of the time, though, you can’t do anything to change the hurt you’ve sustained. In other words, the damage is done, and there’s nothing to do but let go and move forward.

Forgiveness can help you let go of hurt and begin healing from it. Of course, forgiveness doesn’t always happen easily. It can take some time to come to terms with your pain before you feel able to forgive.

Practicing forgiveness can benefit your emotional wellness in a number of ways. You might notice:

reduced stress and anger
increased compassion
greater empathy
stronger interpersonal relationships

Looking for tips on practicing forgiveness? Check out our guide to letting go of the past.

When you reframe a situation, you look at it from another perspective. This can help you consider the bigger picture instead of getting stuck on little details, as difficult or unpleasant as those details sometimes are.

Say, for example, your relationship has been struggling over the past few months, primarily because you and your partner haven’t had much time to do things together or communicate about problems.

Suddenly, you lose your job and find that you’re now spending plenty of time at home.

Not working isn’t ideal, of course, but for the moment there’s nothing you can do to change that situation. Instead of letting frustration and boredom build up, you can look at the bright side of the situation: You now have plenty of time to reconnect with your partner and strengthen your relationship.

Burying or pushing away negative emotions usually doesn’t do much to improve them.

You might not actively notice these unwanted emotions if you work very hard at keeping them hidden, but they do eventually tend to resurface.

In the meantime, they can trickle out in the form of:

mood changes
emotional distress
physical symptoms like muscle tension or head pain

It’s generally a good idea to talk about your feelings to any others involved in the situation. They may not even realize they had an impact on you unless you tell them.

Communicating your difficulties won’t always resolve them, but if an approach to resolution does exist, you’re more likely to discover it together.

Talking about your emotions to a trusted loved one can also help you feel better, especially when there’s no good solution to your problem. Friends and family can provide social and emotional support by listening with empathy and validating your feelings.

Some serious concerns can cause a lot of distress, especially when you can’t do anything to improve your situation.

Maybe you’re going through a breakup, facing a life-threatening health concern, or dealing with grief.

There’s not much you can do to change these circumstances and dealing with the painful emotions that come up on your own can be hard. But there’s no need to go it alone.

A trusted mental health professional can help you manage emotional distress by offering guidance on any of the emotion-focused coping strategies above. They can also provide support that’s more specifically tailored to your situation.

Our guide to affordable therapy can help you get started.

In an ideal world, you’d be able to face all your problems head-on and solve them right away. In reality, though, many challenges are beyond our control. Emotion-focused coping can help you weather these challenges and build resilience.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Alexithymia: an emotional gap hiding under the mask of normality

Alexithymia is a psychological state of a person in which a person, having lost the ability to determine and display his own emotions, is forced to try to look normal in the eyes of others. The psychiatrist Saito Satoru talks about this disorder using examples from his own practice, as well as the example of the heroes of the novel "Man of the convenience store" ( Kombini ningen , by Murata Sayaka), awarded the Akutagawa Prize for 2016.

In psychiatry there is a term "alexithymia". It consists of the negative prefix "ἀ" and two stems: "λέξις" (word) and "θυμός" (feelings, emotions). This term describes a psychological state where a person is unable to evaluate and describe their own emotions. In order to have a holistic view of one's own life, the individual must be aware of and distinguish what he feels. However, there are people who are incapable of this - they do not understand in what situations this or that emotion arises in them. Features of alexithymia appear in such people in those moments when they are overcome by anger, sadness, or any other strong feeling that they are not able to define and express.

In fact, with the exception of babies, there are practically no people in modern society who would cry or scream, completely without restraint. It is understood that an adult member of society should control himself and not show such primitive emotions outwardly. And if he is not able to restrain himself, then he needs treatment.

Young people striving to conform to the notions of "normality" learn from the older generation to suppress the expression of emotions. Over time, some of them lose the ability to recognize their own feelings. Suppressed anger, sadness become the cause of psychosomatic diseases and hypochondriacal disorders. Hypochondriacs are characterized by a clear manifestation of somatic symptoms in the absence of any significant pathological abnormalities. As a result of an anxious set and constant concern about health, the functions of the heart, gastrointestinal tract and other autonomically innervated systems can be disturbed. And this, in turn, leads to the development of arterial hypertension, peptic ulcer, etc. That is why hypochondria is considered a psychosomatic disease.

However, with alexithymia, not only negative emotions are blurred, but also positive ones - a person is not able to experience such feelings as joy or inspiration. The loss of the ability to experience pleasure is called anhedonia. This disorder is characterized by a loss of motivation for activities that the individual enjoyed in the past. The development of anhedonia is an important indicator in the diagnosis of pathological depression.

Under the guise of normality

I have my own psychiatric practice in Tokyo, and I encounter people suffering from depression and hypochondria on a daily basis at work. During the first meeting, most of them show no signs of suffering or despair. And I have to pull off their mask of normality, under which they hide their illness, which needs treatment.

Cover of "Convenience Store Man" (illustration courtesy of Bungei Shunju)

I thought about this when I read the novel "Convenience Store Man" for which Murata Sayaka recently won the Akutagawa Prize. Indeed, in this story we are talking about a person suffering from alexithymia. The heroine, a woman named Kokura Keiko, worked for 18 years as a saleswoman in the same minimarket ( combi) - it is on her behalf that the story is being told. She made it a rule never to show her feelings or express judgment. Instead, she has created a "patchwork personality" by copying the behavior and adopting the habits and mannerisms of the women around her (mostly work colleagues), whom she considers correct and admires for their style. This effective and convenient strategy allows it to adapt to its own environment. The moment she arrives at work shortly before the start of her shift and changes into her work uniform, Keiko becomes a function, a convenience store man. Now all that is required of her is to perform the prescribed duties for the appointed time, using the skills she has learned and the judgments she has borrowed appropriate to the occasion. The school years of the heroine passed under the endless complaints of parents who were dissatisfied with their individualistic daughter, and constant pressure from school teachers. As an adult, she is grateful for the opportunity to hide her identity under a faceless uniform.

However, when Keiko suddenly realizes that those around her feel sorry for her - a single woman who worked as a saleswoman in a minimarket for 18 consecutive years - she becomes extremely worried. At this moment, she meets a new minimarket employee, a man who is the complete opposite of her. He is convinced that society has turned its back on him and that everyone is hounding and persecuting him. So he doesn't even try to appear normal, and very soon he is fired from the convenience store. Keiko invites him to stay with her. At first glance, it seems that they are a very harmonious couple, but their relationship is built on a cold calculation. For a workaholic Keiko, this is an opportunity to create the appearance of a romantic relationship; for a lazy man, life with Keiko is an excellent hiding place from the injustice of a cruel world. But their life together upsets the fragile mental balance that Keiko has maintained and strengthened in herself throughout all these eighteen years.

The caustic remarks of her roommate expose her spiritual emptiness, the gaping emptiness of her personal space, which Keiko had refused to notice for so many years. Refusal, denial is a primitive psychological defense mechanism, a subconscious attempt to ignore the problem, the existence of which is obvious to any outside observer. And the one who denies the obvious looks infantile and eccentric in the eyes of others.

Realizing the hopelessness of his situation, Keiko quits his job and ceases to be a "man of the convenience store". She has no choice but to lie all day under the covers, on the futon, which she spread out inside the closet. I call this phase "bed addiction" and I believe that it is the starting point for the development of other types of addiction: from drug or alcohol addiction to sexual addiction. In fact, both addictive behavior and "show normality" are desperate attempts to get out of the quicksands of the emotional vacuum.

This story has a somewhat happy ending - Keiko starts working at the convenience store again. But I do not think that this will make many readers laugh too much, as they notice the connection between excessive obsession with work and the meaninglessness of the heroine's personal space.

Refusal to feel

"Bed addiction" is essentially a regression to the so-called "primal sleep" - a dream-like state characteristic of infants. This is exactly the state that heroin addicts so passionately desire to achieve. A similar process of regression is also experienced by recluses.0003 hikikomori . Every day this quagmire sucks in hikikomori more and more, and getting them out of it is not an easy task.

Here it is important to pay attention to one point. A baby who falls asleep while nursing and wakes up to find that he has been taken from his mother's breast will feel restless, angry, flushed and crying.

Older babies (between a year and a half) also live in a world of basic emotions such as anger, anxiety, depression, or sadness. But adults hikikomori are deaf to these emotions. At first they themselves refuse to feel anything, and then they simply lose this ability and fall into a state of alexithymia.

Break free from the spell of "normality"

Such people sometimes come to my clinic for help, mistaking their condition for depression. For example, a housewife came to me who told me that after graduating from university she got a job at a firm right away, but worked for only a year, because office work seemed boring to her. She then found a part-time job at a sadomasochistic (SM) club, a place she liked so much that she worked there for four years. Shortly before she turned thirty, she resigned from the club, judging that sooner or later she would have to do it anyway. Some time later, after an active search for a suitable party ( konkatsu ) she got married, had a baby, and began to lead a "normal" life as a housewife. And then she suddenly found that she spends most of the day in bed or in close proximity to it.

Her husband - a typical sissy, who also suffers from atopic dermatitis - quickly realized that his wife would not take care of him to the same extent as his mother did, and divorced her. At the time of her visit to me, about a month had passed since the divorce.

I think some of my colleagues would have diagnosed this patient with depression or adjustment disorder and would have given her antidepressants. But I noticed how strong her desire to be, or at least seem normal. It was it that made her suppress her individuality and doom herself to life in a world that causes nothing but boredom in her.

Everyday work in the SM club was fraught with danger, but at the same time excited her – the idea that she was working in a “non-standard”, “abnormal” job served as a strong source of emotional excitement. Thus, "normality" is just an illusion, an ideal that can be different for different people.

My patient says that she is already thirty-five, the figure is no longer the same, and that "what was in the past cannot be returned." I do not dispute this point of view. But whether she returns to work at the SM club or not, I think she needs to remember and rethink the strong, exciting feelings she experienced while working at the job she loved. My task is to return to this woman the ability to feel strong emotions, restoring her connection with her own eroticism. I have to convince her that she doesn't need to hide behind a mask of normality.

Title picture: Design Pics/AFLO

(Japanese article published November 18, 2016)

What is alexithymia and how to understand your feelings in which a person is not able to describe and understand his feelings and emotions.

It leads not only to problems in interpersonal relationships, but can also cause psychosomatic illnesses. We talked to people living with alexithymia and learned from experts how to deal with it.

"It's like not being able to taste and smell"

Tatyana, 21 years old

I have schizoaffective disorder, obsessive-compulsive disorder and Asperger's syndrome - the first signs were in adolescence, diagnosed several years ago. As a child, for the first time, I realized that it was difficult for me to define emotions and feelings. I could cry and didn't realize why. Because of the pain or because I'm sad.

When I realize that I feel something, I try to pay attention to the sensations in my body. If heaviness appears in the chest, most likely, these are negative emotions - sadness, sadness, resentment. If warmth is felt in the body and limbs, then it must be positive.

For a long time I did not understand what love and sympathy are and whether I can experience them. I was able to distinguish them from other feelings when I met my boyfriend at the age of eighteen. This is a completely different level of feelings that I felt physically : my heart beat faster when I thought about him, I wanted to be near him, when talking it became hot, my palms sweated, there was a feeling of intoxication in my head. And somehow I realized that this is something new and that I can love someone.

Fear also manifests itself more physically: lack of air, headache, severe tinnitus, spasm in the intestines, muscle stiffness, coldness in the body, trembling. It looks like the beginning of a cold - I would say so that it was more understandable.

The most difficult thing for me is to tell my relatives how I feel if they ask me about it or wait in a conversation for me to say something about emotions. I just feel like I can't find the words for this, it's like there aren't any, and I don't know what to say. At such moments, people think that I do not feel anything, and my silence confuses them.

Sometimes relatives get angry - apparently, they are waiting for an emotional return in the course of a conversation, and I often don’t know what to do, what emotion to show, squeeze out of myself. But I think that they are not angry on purpose. Once I talked with my mother about further education, I explained where and for whom I want to study, to which she replied that I was speaking without interest and emotions, as if I didn’t care.

You seem to be deprived of the opportunity to fully experience emotions. It’s like they don’t exist, and you don’t know what they are, because anger and joy feel equally insipid. For me, it's like living with a constant runny nose and not feeling the taste and smell.

I didn't tell my parents about alexithymia and Asperger's syndrome. They are of the old school, all people with autism for them are those who cannot speak and are kept in boarding schools. Also, we are not very close, and I don’t even know how to gently talk about my states. I tried to explain my mental disorder to my mother, but for her it’s “you can’t control yourself”, so all my stories and articles shown on this topic are useless. I have a physical disability - my parents treat me the way they treat people with disabilities in Russia: they consider me weak and unable to work. They are aware that I am mentally ill, but if you also tell them about problems with emotions and Asperger's syndrome, they will treat me with even more pity and think that I am not like normal children, and that this is their punishment from God. But my young man is aware of my problems, and after he found out about them, we began to understand each other better.

I am in therapy and it is very difficult for me to talk about how I feel, about my emotions. But the more time passes, the more I learn to describe my emotions in images. For example, sadness is a dark and cloudy cloud . It's a strange experience, but I like it.

"I was considered a callous and unsociable person"

White, 35 years old

I have bipolar II disorder. I am currently in remission and continue medication. I have long felt that it is difficult for me to describe emotions and feelings, but for the first time I realized this about ten years ago. Then we often played word games in the company, and several times I got questions of the format “what do you feel about ... (a person, phenomenon, event, and so on)?” Such questions plunged me into a stupor, and at the same time I noticed that other people had no problems with answers. I tried to understand how they find words so quickly, for a while I even suspected that they were making them up on the go. Later, I accidentally stumbled upon an article on alexithymia on the Internet and recognized the familiar symptoms.

In my case, alexithymia does not affect creativity and professional tasks: I love fiction based on the problems of human relationships, sometimes I write prose, poetry, songs myself. Feelings are easier to formulate on behalf of a lyrical hero, besides, this is verbalization training.

But in my personal life and communication with friends, alexithymia leads to problems: relatives often noticed that I had difficulty expressing emotions - before, they were mostly angry and took the position “why can’t I immediately say normal.” For a long time I was considered a callous and unsociable person, because I did not understand how to express various kinds of empathy. Several times I quarreled with my girlfriend almost to the point of breaking up, because my reaction was “wrong”: it did not correspond to the situation and incorrectly displayed my own emotions.

After I started to warn about my problem, there were fewer conflicts, we started talking more about feelings with loved ones.

I also have problems with decision-making because of the inability to understand what feeling guides the opinion, but this is rather good: you have to learn to look at things from a rational position, fixing the pros and cons, instead of succumbing to emotions.

“My feelings are a mystery to myself”

Anton, 30 years old

Until recently, I did not know about such a problem as alexithymia, but I began to notice that I did not understand my emotions and feelings in my youth. I could not understand how to react to the actions of classmates and friends - when to laugh, get angry and upset. I still can't tell a joke from an insult if it's not obvious. For example, I can be offended to tears if they say “fool” to me in a friendly way, and laugh when I hear a mate addressed to me.

Trying to socialize, I repeated after other people, but it looked awkward, I did not catch the norms. I was bullied at school, but I didn’t know how to react: I was silent on insults, and for a slight irony I could get into a fight, then I was ashamed and apologized.

When I started working, I could not settle down in the team, because I did not read other people's attitude towards me and, accordingly, did not know how I should treat people. Many said that I was being arrogant, which surprised and upset me, because I was just silent all the time. My unsociableness leads to the fact that, despite high professional performance, career growth and a leadership position do not shine for me. In the humanitarian field in which I work, relationships with people, the ability to understand and read the emotions of others, are extremely important, especially if you want to manage a team.

Relations with friends and close people do not develop for the same reason - mutual misunderstanding, which even strong romantic or friendly affection could not overcome. I felt the difference in the direction of these attachments only by the presence of sexual desire, which manifests itself in a standard human way. However, his absence did not stop me from rash acts: I confessed my romantic love to my girlfriends and even friends, although I did not think about sexual relations with them, I was simply drawn to them and in their presence it became physically warm and comfortable. People, to put it mildly, were surprised in response to my proposal to meet, and the guys expressed dislike. Relations with many wonderful people were ruined once and for all, even an apology did not help restore friendship.

And after the breakup, I didn't understand what I was feeling - sometimes I was sad, sometimes I was happy, and it drove me crazy. When the ex-girlfriend moved out from me, my breath often took hold in an empty apartment, my pulse quickened, especially when I recalled our life. The reasons are not clear, because there is nothing to be offended and angry at, because we parted on my initiative. And somehow a friend posted a photo from the party, and everything boiled inside me, my breath also caught (it seems that this is my standard reaction to anything), but I did not understand what was happening inside me. I called him and asked why he went there, which sounded very stupid - he did not understand this question, and I no longer understood why I was asking it, and even in a breaking voice. My friends know that I am not a party lover in principle, and I know this about myself, so I did not hold any claims in my mind, but some emotions were overwhelmed, judging by the physical manifestations. I would call them meaningless, phantom.

Trying to explain to people that I have problems with emotions does not help: even those closest to me are sure that this is a whim and I just don't want to control myself and "try to understand others."

When I first went to a psychiatrist, he said that problems with emotions are a neurosis. I was treated with various drugs for a long time, but the situation did not get better, until now my feelings are a mystery to myself. Psychotherapy is weak, but it helps: the doctor taught to determine how feelings differ from emotions, but it is still difficult to recognize them. I learned that emotion is a small, short-term acute sensation, like a flash, lightning, you don’t have time to think about anything. And a feeling is a long-term state accompanied by a bunch of thoughts. For example, I hit a chair and screamed, my hands clenched, instinctively hit the chair in response - it means that the emotion of anger arose. But I had a colleague at a former job who set me up, and if we went on the same shift, then I felt muscle tension, heart palpitations and often thought about how he could be such a lousy person.

The hardest thing for me is to tell the doctors what I'm experiencing: no matter what words I choose, everything seems like a lie or a fantasy. This applies to both mental and physical sensations. As soon as I go into the office of a gastroenterologist or a therapist and start complaining, I listen to myself more carefully and start thinking that I dreamed the sensations. It’s the same with a psychotherapist and a psychiatrist: it seems that I’m actually a healthy dreamer, because I can’t convey exactly how I feel, and specialists are not telepaths and cannot understand.

"I can't put my feelings into human language"

Kristina, 28 years old

I went to a psychologist with borderline and depression issues, one day he asked me to describe myself and I felt confused because I didn't know Who am I. I told him that I consist of layers: on the outside there is a polite shell, under it is an evil gopnik, and under it is a kind soul that saves everyone, and it is she who is protected by the gopnik. Then again something dark that I do not understand and am afraid to analyze, and so on ad infinitum. Later, these layers emerged into some subpersonalities, and their emotions were perceived as alien, which I cannot understand or control. I gave them names, and they speak in my head like separate parts of me: kind, aggressive, overly emotional, my ordinary.

I can describe my feelings with the help of a table of feelings, in psychotherapy pairs (I studied as a doctor) we were offered to use it to tell others about our feelings. But sometimes I experience things that are not in this table or there is no name for these feelings.

I have developed empathy, I easily understand others, but inside of me is either a mixture [of feelings], or nothing at all. This does not affect my hobby: I draw the necessary emotions for my characters, sometimes the drawing helps me figure out what I feel, or others begin to understand it - sometimes they are horrified. Due to alexithymia, I do not communicate with people much, because I cannot respond with the emotional reactions they need.

For example, if a person raised their voice at me, I may cry, even if I just feel like I'm being pressured, or I get too angry and yell. There is no average response to pressure. If they regret it, I roar.

The most difficult thing is to tell those who expect warmth from me that I experience this warmth, but do not show it, because I do not know how. This feeling is blurred, it is impossible to concretize it in words. Also, I can’t tell people what specifically offended me, because words get stuck or I can’t put feelings into human language. It's hard to be locked up and not understand how I really feel . I ignore my feelings more often than I track.

Alexithymia often leads to psychosomatic manifestations: when I am nervous, the temperature rises to 37–37.5 degrees, pains in the abdomen, heart, head, teeth ache, allergies begin (I itch, I break out in a rash), breathing problems (I can’t do breath or I don’t feel oxygen in the air), anything can hurt at all, regardless of the absence of physical pathology.

Why does alexithymia occur and how to deal with it?

Alexithymia is most characteristic of autism spectrum disorders, but can accompany any mental disorder (depression, personality disorders, etc.). It is associated with the mechanism of formation and maintenance of a psychosomatic symptom, but not the only reason for its occurrence. Clients with alexithymia, as a rule, first of all turn to somatic doctors with physical discomfort.

According to the results of some studies, difficulties with the expression of emotions are more common in men than in women, alexithymia is practically not studied in people of a different gender identity. However, the quality of most research on alexithymia is quite low.

The exact causes of this condition have not yet been identified. There is evidence that mirror neurons are involved in the occurrence of alexithymia, structures such as the amygdala, insula and cerebellum are involved. Violation of dopaminergic metabolism in these structures is associated with manifestations of alexithymia.

Nevertheless, the environment plays a significant role in the development of difficulties with understanding one's emotions: whether the child sees the expression of emotions, hears their names, whether they tell him what emotions are, how they manifest themselves.

Alexithymia can lead to difficulties in building or maintaining interpersonal relationships - in these cases, I would recommend contacting a specialist. If you notice that it is difficult for you to interact with people, there is a feeling that no one understands your goals, motives, and it is often difficult for you to understand people when they talk about their emotions, you can independently study materials about emotions, gradually learn to notice them from yourself and other people, observe them and express.

By itself, this problem does not require medical treatment. A psychotherapist works with alexithymia at the beginning of any psychotherapy, since it is important for a specialist to understand how the client feels in problem situations.

Relatives can help a person by talking about their emotions and thereby showing the experience of living them, and also by asking about the person's experiences, thereby drawing his attention to the emotional sphere.

Alexithymia is indeed common among my clients and makes interaction in the first meetings much more difficult. At the beginning of the work, the specialist collects information about what is happening with the client (about his behavior, thinking, emotions), of course, alexithymia hinders this process. In such cases, we dedicate several meetings to the client to find out what emotions are, how they manifest themselves, how they feel, learn to notice them in themselves, name them, observe them. The most difficult for me case of alexithymia in a client required eight meetings of work on the identification, observation, description and expression of emotions.

How does alexithymia affect physical health?

Alexithymia can lead to the occurrence of psychosomatic symptoms - pain, squeezing, bursting, tingling, and others, but at the same time, according to tests and studies, doctors do not find anything.

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