Alexithymia can cause issues with communication and intimacy in a relationship. We look at some tips to strengthen your bond.

Alexithymia refers to an inability to express or identify emotions. People with alexithymia feel the usual range of emotions, but they are less aware of their own emotions and the emotions of others.

If your partner has alexithymia, there’s a good chance they’re unaware of their condition. Alexithymia is not well-known, and it’s not listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) — though estimates suggest it affects about 10% of the population.

Trouble with emotional awareness can get in the way of your relationships, but there are several ways you can try to improve your communication and well-being.

Alexithymia can affect how you communicate, which is a major part of most relationships. People who live with alexithymia are less likely to infer or sense the emotions of others, so unless you state your feelings explicitly, your partner might seem to ignore them.

You might realize your partner could have alexithymia before they do. Signs of alexithymia include:

  • difficulty naming their own emotions
  • difficulty connecting with other people’s emotions
  • general discomfort
  • seeming apathetic about people, objects, or situations
  • low tolerance for stress
  • irritability or anger
  • emotional distance, sometimes perceived as coldness
  • limited communication skills
  • low responsiveness to the emotions of others

How alexithymia can affect relationships

These characteristics can be frustrating in a relationship. It may feel like your partner doesn’t acknowledge your feelings or seems irritated when you feel emotional. It can lead to:

  • a lack of intimacy
  • feeling unsupported by your partner
  • feeling like you aren’t being seen in your relationship

Alexithymia can also affect the way your partner reacts to situations that call for emotional empathy. A 2020 study found evidence to support the widely-held belief that people with alexithymia lack emotional empathy, or the ability to feel concerned for and share the emotions of others.

Research from 2021 has linked alexithymia with fear of intimacy. If your partner lives with this fear, they may:

  • sabotage their relationships
  • fear rejection
  • avoid physical contact
  • exhibit sensitivity to criticism
  • have trouble regulating their emotions
  • lack trust
  • isolate themselves socially
  • avoid discussing feelings or emotions

Commitment, romance, and satisfaction are also affected when alexithymia is part of a relationship, according to a 2015 study involving college students.

All of this can have a profound effect on the non-alexithymic spouse. You may experience loneliness and emotional deprivation, leading to physical illnesses like heart disease and high blood pressure.

Other signs of alexithymia

A 2016 study found that alexithymia might be a condition involving reduced levels of interoception, or the awareness of internal states. In the study, people with higher levels of alexithymia had a harder time telling the difference between emotions and physical sensations like fatigue and hunger.

You might notice that your partner has some traits of an interoception difference, such as:

  • forgetting to eat
  • feeling temperature differently than other people
  • being unaware they’re stressed until someone else tells them
  • being unsure how hard to hug people
  • appearing clumsy or uncoordinated
  • an inability to tell when their muscles are tight or sore
  • eating until the point of discomfort

If your partner lives with alexithymia, it’s likely that emotions are genuinely confusing for them.

When tensions rise, it can help to remember that your partner is not acting this way on purpose. Instead, their brain works a little differently — and may be structured differently, too.

According to a 2018 meta-analysis, people with alexithymia have less gray matter volume in various brain regions, including the amygdala, with is often thought to be the center of emotions.

The causes of alexithymia are beyond a person’s control and can include:

  • a mental health condition
  • neurological differences
  • a brain injury or stroke
  • genetics
  • past trauma

Though they aren’t withholding emotions intentionally, the symptoms of alexithymia can still impact your relationship.

People with alexithymia can feel love when it’s strong enough. They just can’t describe or express it in a way that provides others with emotional validation.

Instead, they may express their love through action, rather than words or affection. Examples include working hard to provide financial support or offering to help with an issue that they understand.

Alexithymia also means your partner may miss cues that indicate what you’re feeling. Because they miss these cues, they can’t decipher your emotions and don’t react to them.

When your partner doesn’t express their feelings and doesn’t seem to notice yours, it can feel like you’re in a loveless relationship, even when you’re not.

It can be difficult having an alexithymic partner. Relationships are likely also stressful for them as they navigate a world full of people who communicate with non-verbal cues they don’t understand.

There are, however, many things you can do to improve the situation.

1. Clear communication

Expecting your partner to figure out what you’re feeling based on cues or context may leave you frustrated and hurt. Instead, try telling them how you feel directly. This reduces the chance of miscommunication.

It helps to be clear and refer directly to your feelings or needs.

For example, if your partner repeatedly interrupts you while you work or study, relying on non-verbal cues to dissuade them may not work. Instead, use clear language to explain that now isn’t a good time to talk.

“I have to study right now for my exam tomorrow, but I’ll have time to talk tomorrow after school.”

The bottom line is that it’s best to be direct and communicate with words rather than non-verbal cues.

2. Labeling feelings

Your partner may have a feeling they can’t identify or describe. You may be able to read their cues and tell them what you see, for example:

  • “You look angry.”
  • “You seem tired.”
  • “You appear to be frustrated.”

Your comment might give them the clarification they’ve been looking for. With your support, they may learn to independently identify some of what they’re feeling.

3. Interoceptive support

Physical states like sleep deprivation can affect mood.

Since alexithymia can interfere with interoception, your partner might be irritable because of hunger or fatigue but unable to recognize this.

If you’re aware, you can help them. You might prompt them to get the food or rest that they need.

4. Couples therapy

Couples therapy may help your alexithymic partner learn to identify their feelings. It can also teach you more effective ways to communicate.

It’s important to make your partner feel safe enough to try expressing their emotions.

Emotionally focused couples therapy (EFCT) may help reduce the effects of alexithymia on relationships.

All relationships come with challenges, including when one person has alexithymia.

It can help to remember that it’s not your fault. You’ve done nothing wrong, and you have every right to feel loved and cared for. Meanwhile, your partner may not be purposefully trying to be difficult. They may be living with a condition they didn’t choose and might not even know about.

There are ways you can help your partner. Clear communication and couples therapy are two examples.

Psych Central’s How to Find Mental Health Support page can point you in the right direction if you want to try therapy and are looking for a therapist.

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