Alexithymia

The term was coined by the psychiatrist Peter Sifneos in 1973 to describe patients who experienced emotional arousal — racing heart, tightness, agitation — but could not put words to what they were feeling. Alexithymia is now understood as a dimensional trait: most people have some access to emotional language, while a subset have markedly reduced access. The standard measure is the Toronto Alexithymia Scale (TAS-20), developed by Bagby, Parker, and Taylor in 1994.

It is not a clinical disorder in itself; it does not appear as a standalone entry in the DSM-5 or the ICD-11. Estimated prevalence in the general population is around ten percent. Rates are higher in some neurodivergent and trauma-affected populations: studies suggest that up to half of autistic adults score in the alexithymic range on the TAS-20, and elevated rates are also reported in people with PTSD or histories of complex trauma.

Recent research has begun to document overlap between alexithymia and aphantasia. A 2024 study by Monzel and colleagues in Biomarkers in Neuropsychiatry reported that aphantasic adults score higher on alexithymia measures on average than typical-imagery controls, and proposed that mental imagery facilitates emotion recognition in self and others. The overlap is far from total, and many people with aphantasia have unimpaired emotional awareness; but the cluster is real enough that any account of one trait is incomplete without acknowledging the others nearby.