Exploring Alexithymia

Understanding Alexithymia By Michelle Morand, MA, RCC Now bear with me here. I’m going to take you on a bit of a journey, in order to explain a very important part of your recovery process. If you were sitting in my office, I’d be leaning over and beginning to draw a diagram on my white board to illustrate this piece of information, and you’d be laughing at my poor artistic ability. But since we’re not face to face right now, and the computer won’t draw what I’d like it to, I’m going to do my best to explain the connection of your childhood experiences against eating disorders and understanding alexithymia, hence I ask for your patience. A study was conducted by psychologists about 5 years ago that looked at childhood experiences of trauma, (physical abuse, sexual abuse, emotional and verbal abuse, and neglect), and the later development of disordered eating behaviours. What they were looking at was to uncover what the mediating factors were that lead someone with childhood trauma experience to later develop an eating disorder. And what they discovered was that it was a condition called Alexithymia that came hand in hand with depression, and the two supported the development of disordered eating on any level. Alexithymia is characterized by: (a) difficulty in identifying and describing feelings in self or other, (b) difficulty in distinguishing between feelings and the bodily sensations associated with emotional arousal, (c) restricted imaginative processes (few positive dreams or fantasies – can have frequent intrusive ideation*), and (d) thinking that is concrete and reality based. [Hendryx, Haviland, & Shaw, 1991; Taylor, Bagby, Ryan, & Parker, 1990] In other words, Alexithymia makes it really hard for us to know what we are feeling, or even if we are having a feeling. It makes it difficult for us to tell whether the sensation we think we’re having is physical or emotional. It makes it difficult for us to dream or imagine positive, fun things. And we get stuck in very concrete “logical” thinking, which can make us rigid, most often with ourselves. The good news is that you can learn to distinguish what you’re feeling, and move through that feeling very quickly, that is why it is important in understanding Alexithymia. Even better news is that in order to be able to let go of what you’re feeling, you don’t even have to know where the feeling came from. Since you’ve very likely been distanced from awareness of your feelings since childhood, you may feel some resistance to connecting with them again. You may believe that there will be a great big back log of feelings that will sweep in and overpower you if you were to open the door. That’s just your drill sergeant, (otherwise known as your ego), trying to maintain the status quo. He knows that if you begin to connect with your authentic feelings in the moment, and learn how to effectively release them, you’re going to become more powerful and competent at taking care of yourself than he’s ever been. Now, again, if you’ve lived your life disconnected from your feelings for the most part, you are very likely wondering what the value of being connected to them would be – in fact your drill sgt. may be saying something like: feelings make you weak; other people won’t respect you if you let your feelings show; I’m just a cry baby if I can’t control my feelings; etc. Check in with yourself for a moment and ask yourself where in the past may you have either heard those very words spoken or witnessed significant people in your life modeling the behaviour of stuffing and discounting or denying their feelings? The experience of understanding Alexithymia is what leads us to discount and deny our life experience now. Have you ever had the experience of suddenly feeling totally overwhelmed? You are certain you’re overreacting, and in addition to feeling emotional, you’re judging and berating yourself for feeling emotional? You’re certain there is nothing going on in your life to justify you reacting so strongly in that moment. Does that experience sound familiar? I assure you that if you were sitting in my office, recounting a recent experience like that, we would be able to put our finger on the underlying trigger(s) within moments – and it wouldn’t be me spoon feeding or forcing those thoughts on you – you would be able to list for me quite clearly all the things that are going on in your life right now, issues with work, home, relationship with others, food and body image would of course be right up there on the list, issues with money, and others, would all appear from within you, and be highlighted for you to see up on my fabulous white board. At which point you would look at me and say, wow, I guess I do have a lot going on, no wonder why I feel so overwhelmed right now. At which point I, (having brilliantly left enough space at the side and at the bottom of my white board), begin to draw the following. Okay, bear with me, I’m drawing a mountain. Just trust me on that. So, you’re looking at your list of things that are going on in your life and you’re also seeing a mountain off to the right. This is what I call your “mountain of unfinished business.” It’s all the past experiences that feel unresolved, all the feelings that have been left unexpressed, all the stored trauma and pain of your life to whatever extent it exists is there. At the beginning of the recovery process most people, (unless they’ve done a fair amount of therapy or self-work already), have a pretty big mountain of unfinished business. Then down at the bottom of the page I draw this:   1———————————– 5 ————————— 10 I call this your stress threshold scale. Now let’s say you’re a lucky guy or gal, and you experienced minimal trauma as a child, you were taught to have clear and strong boundaries, good self-esteem, and you deal with things in the moment as they arise, and you have little or no unfinished business in your life, (I think there are 5 people like that on the planet.) If this is you, you wake up every morning, and your stress level from every day demands and life events is at about a 2, (probably higher in our society but let’s think the best). So, if 10 is the point on the stress scale where you get pushed into harming yourself with some unhelpful coping strategy, some pretty big events would have to happen all on the same day to max you out. And because of your self-esteem you would have the self-care skills to be able to attend to yourself before you got to that place anyway, barring major ecological disaster. But let’s say you’re you. And you’ve got a mountain of unfinished biz. That means you start the day, before you’ve even got out of bed, (here’s where that permeating level of anxiety comes from), at a stress level of 5, (and I’m being generous here – for some of you it may be more realistic to say you’re starting the day at an 8). And you know what your self-esteem is like, and how quickly you rush to take responsibility for everything, including other people’s needs and feelings. Just stepping out your front door is a big deal some days when you’re feeling focused on your body in a negative way, and certainly a sideways glance, whether truly directed at you or not, is enough to add a few more points to your stress level. An issue or two with the kids, or with work, or the car, or money, or your partner, or friend, or parent, and where are you? You’re at about a 25 on the scale of 1 – 10. And you didn’t even realize that you were feeling anything until you suddenly break down crying, or you develop a killer migraine, or you begin to get very short and tense with everyone, or you find that you’ve just eaten an entire box of cookies, or all of the above. Even then, the Alexithymia would make it hard for you to appreciate that you had any “good” reason for doing what you’ve done. Your drill sergeant will go to town on you, adding to your stress level, and before you know it you’re eating again, or having terrible thoughts about your body. Now you’ve hopefully had some experience with the list of stressors tool, and you know how, even when you don’t think there’s any good reason for what you’re doing, there’s always a good reason. If you haven’t tried it yet, try it – even once will be enough to prove to your drill sergeant that you’re not a wimp, a baby, a weakling who can’t cut it when everyone else can. Honey, I assure you, you are a super woman, and when you allow yourself to see in writing all the crap that’s on your plate, (figuratively), you’ll have no choice but to cut yourself some slack. So, the unfinished business, plus the disconnect from your feelings that comes from Alexithymia, sets you up for overload day after day. Until you begin to acknowledge and validate how much you’ve got going on, and begin to develop some strategies for lightening your load, (past and present), you will continue to need food to cope, in whatever way you use it currently it will remain, because it’s the only way you get release. You may have already noticed in the past few weeks a lessening of your use of food as you have begun to appreciate some of your underlying stressors and triggers and attend to them more effectively. I could go on for hours here because there is so much to say about this point – wait for the book! Two things I want to add:
  • if you read this and said: I wasn’t “abused”; or what happened to me wasn’t that bad; or my parents did the best they could, I just have to get over it. Yes, your parents did the best they could, and I’m not about blaming them – for me assigning responsibility to parents or caregivers for the appropriate and healthy care of a child is not blame. And the only reason I attend to that time in your life is not to blame ma and pa, but to support your awareness that there is a reason for why you are the way you are, and for why you do what you do – so your drill sergeant will ease up on you, which you deserve. About the abuse part, the study I mentioned above discovered that the form of abuse that impacted children the most wasn’t physical or sexual – although they had a profound impact on one’s locus of control and self-esteem – it was actually the emotional abuse and neglect that had the most dramatic and lingering impact. This is stuff like “the silent treatment” or withdrawal of love and affection as punishment (torture to a child – nasty). In the section on healthy vs. unhealthy relationships you’ll get more information on this.
  • Intrusive Ideation is a thought pattern – borne out of trauma and a key component of post traumatic stress disorder. It is a situation where you receive a message that your partner is going fishing and before you know it you’re imagining him falling out of the boat, drowning. You feel the sensations of pain and suffering, his panic, your loss and grief, you imagine calling his family to notify them – who first and how to tell them, the funeral, the bills, how you’ll feel, what you’ll wear and say and do, and ultimately, how you’ll cope. Now your partner has just gone fishing and he’s having a great time – but  you’re traumatized and feeling anxiety – you’ve just lived his death very vividly. And   depending on where you’re at, you may have these experiences countless times a  day – where really everything is just fine, but you’re taking yourself on a journey to hell with these intrusive fantasies about death and abuse and suffering. The worst case scenario of every event you and your loved ones experience gets played out before you and you feel it, you live it – and that adds to your stress level for sure. This pattern comes from a misdirected attempt at being in control and prepared for any eventuality, often borne from a time in our lives when we needed to be on the ball and have many contingency plans to keep ourselves safe. What really happens is that we take ourselves out of the present moment where we are truly safe and in control and re-create that feeling of panic, trauma and powerlessness.
I’m always open to further discussion on this or any issue and I’ll be preparing something more detailed about the intrusive ideation. If you are impacted by this pattern just know that the most effective solution is just to catch yourself when you’re doing it and ask yourself “what am I doing?” – believe it or not that’s enough to snap you out of it for then. The other pieces you’re working on during this class will be very helpful with the need for control that the intrusive ideation is seeking to meet.  

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