Alexithymia. Test for alexithymia. Causes and treatment of alexithymia

Causes of alexithymia

Modern experts distinguish two forms of violation: primary and secondary. Primary alexithymia is congenital and is associated with deficits in certain areas of the brain; secondary alexithymia is considered acquired. The causes of the disorder will depend on its form.

The following causes are identified for primary alexithymia:

congenital malformations of the fetus, in particular of the brain;
birth injuries;
infectious processes suffered during pregnancy;
the hereditary nature of alexithymia, that is, similar traits can be observed in close relatives.

Causes of secondary (or acquired) alexithymia:

mental illness (ASD, schizophrenia);
neuroses, hidden depression;
stress, constant nervous tension;
suffered psychological trauma;
brain injuries, central nervous system;
severe infectious diseases that affect the functioning of the brain and central nervous system.

Alexithymia, according to many researchers, can also arise as a result of improper upbringing: over- or under-custody, inattention to the child’s feelings. Researchers also note the influence of stereotypes accepted in society. This includes “men don’t cry” and “it’s indecent to express your feelings in public.”

Doctor of Psychological Sciences, Professor of Moscow State University. M.V. Lomonosova V.V. Nikolaeva

On the psychological nature of alexithymia // Human corporeality: interdisciplinary research. M., 1993. pp. 84-93.

In the history of the development of psychosomatic research, one of the central directions is represented by the search for a special mental quality - psychosomatic specificity, which is a factor predisposing to the occurrence of psychosomatic pathology, influencing the course and treatment of diseases. The latest attempt of this kind is to isolate and describe the phenomenon of alexithymia (14, 15). Alexithymia is considered as a certain set of signs that characterize the mental makeup of individuals, predisposing them to diseases of psychosomatic specificity. It should be noted that in recent years it has been associated with an increasingly wide range of nosological forms (for example, depression, secondary psychosomatic disorders in chronic diseases, etc.) and is characterized in this case as a phenomenon of secondary alexithymia . Thus, the prognostic significance of this phenomenon is thereby significantly leveled. At the same time, the question of the possibility of qualifying the degree of severity of this phenomenon or even creating a typology of alexithymia is becoming increasingly relevant. What is the essence of this phenomenon?

According to descriptions available in the literature, individuals with alexithymia are characterized by a special combination of emotional, cognitive and personality manifestations. The emotional sphere of these patients is poorly differentiated. They exhibit an inability to recognize and accurately describe their own emotional states and the emotional states of others. The cognitive sphere of persons with alexithymia is characterized by a lack of imagination, a predominance of visual-effective thinking over abstract-logical thinking, and a weakness in the function of symbolization and categorization in thinking. The personal profile of these patients is characterized by a certain primitiveness of life orientation, infantility and, what is especially significant, a lack of reflection function. The combination of these qualities leads to excessive pragmatism, the impossibility of a holistic view of one’s own life, a lack of creative attitude towards it, as well as difficulties and conflicts in interpersonal relationships. The latter is aggravated by the fact that, against the background of low emotional differentiation, in a number of situations they easily experience short-term, but extremely pronounced affective breakdowns in behavior, the causes of which are poorly understood by the patients. Limited ability to understand oneself, associated with a lack of reflection, becomes a significant obstacle in psychotherapeutic work with these patients. In the literature, there are still discussions about the nature of this phenomenon, and one of the most widespread in this regard is the hypothesis about changes in the interactions of the cerebral hemispheres with insufficiency of the function of the right hemisphere (see, for example, the article by I.S. Korostelova and V.S. Rotenberg). Without denying the legitimacy of putting forward such hypotheses, we note that the attempt to physiologically explain the nature of alexithymia is clearly insufficient and not only does not exclude, but also presupposes the need for a meaningful psychological analysis of this phenomenon, i.e. research into the question of its psychological nature and mechanisms. The scientific relevance of such an analysis, as we believe, is that it will allow us to understand some hitherto hidden psychological mechanisms of the emergence of psychosomatic phenomena, in particular, the role of psychological self-regulation processes in their genesis. Knowledge of these mechanisms can open the way to a scientifically based search for ways of psychological correction and psychotherapy.

Of course, psychological research into the phenomenon of alexithymia requires special theoretical study and rigorous (as far as possible, given the complexity of the phenomenon) experimental research. In this article, we intended to dwell only on some aspects of this problem, namely, to consider the connection between the phenomenon of alexithymia and the characteristics of psychological self-regulation. For this purpose, let us turn to some provisions of Russian psychology related to the problem of self-regulation. The concept of “self-regulation” is interdisciplinary in nature. Self-regulation is a systemic process that ensures variability and plasticity of the subject’s life activity at any of its levels that is adequate to the conditions. The works of many authors contain an attempt to isolate the actual psychological aspect of self-regulation. At the same time, the level of mental self-regulation (1) is highlighted, which helps maintain optimal mental activity necessary for human activity. Another – operational-technical – level of self-regulation ensures the conscious organization and correction of the subject’s actions (10). The personal-motivational level of self-regulation (3, 4, 5, 7, 8) ensures awareness of the motives of one’s own activities, management of the motivational-need sphere; creates the opportunity to be the master, the creator of your own life. Thanks to the functioning of this level of self-regulation, “a person’s internal reserves are revealed, giving him freedom from circumstances, ensuring the possibility of self-actualization even in the most difficult conditions (8, p. 122).

The ability to voluntarily control one’s own motivational sphere is considered by many researchers as one of the most important characteristics of a person, as an indicator of the harmony and maturity of the individual (7, 8). The motivational and personal level of self-regulation is a process mediated by social norms and values, as well as a system of internal requirements, a special “life philosophy” that turns a person into an active subject of life. L.S. Vygotsky associated a specifically human method of regulation with the creation and use of symbolic psychological tools and saw it in the phenomenon of mastering one’s own behavior. He understood signs as artificial stimulus-means, consciously introduced into a psychological situation and performing the function of autostimulation (6). S.L. Rubinstein associated a high level of self-regulation with the emergence of worldview feelings, i.e. a person’s conscious holistic relationship to the world, other people, and himself” (12, p. 370). A.N. Leontiev’s concept laid the foundation for the study of a “coherent system of personal meanings” (2, p. 218), intermotivational relationships that characterize the structure of personality. Emphasizing the regulatory function of systems of personal meanings, A.N. Leontyev noted that “you can understand and own the meaning, know the meaning, but it will not be sufficient to regulate and manage life processes: the strongest regulator is what I denote by the term “personal meaning” ( 2, p.239). Consequently, the processes of self-regulation do not lie in consciousness; consciousness does not produce them, but mediates them. Self-regulation in this understanding is a special activity, “inner work” or “internal movement of mental forces” (9), aimed at connecting systems of personal meanings.

The ideas of L.S. Vygotsky, S.L. Rubinstein, A.N. Leontiev were further concretized in the concept of semantic formations of personality (2, 3, 4). Semantic formations are considered as “an integral dynamic system, reflecting the relationships within a bundle of motives that realize one or another attitude towards the world” (4, p.48). The regulating role of semantic formations is especially clearly revealed when they are realized and accepted as values (5). F.E. Vasilyuk, emphasizing the regulating role of semantic formations, identifies a special activity for the production of meaning “in critical situations of the impossibility of realizing the internal needs of one’s life” (5, pp. 25-27). This special activity (experience), having arisen in critical life situations, can become, according to the author, an independent functional organ, i.e. “one of the usual means of solving life problems and is used by the subject even in the absence of a situation of impossibility” (ibid., p. 75). Those. experience as a special activity of meaning generation can perform a regulatory function in situations of everyday life. In the literature we find a successful attempt to differentiate this type of self-regulation and volitional behavior (8). The latter arises, in particular, in conditions of motivational conflict; it is not focused on harmonizing the motivational sphere, but only on eliminating this conflict (“affective self-regulation ensures “the achievement of harmony in the sphere of motivations” (ibid., p. 123). As mechanisms, personally -motivational level of self-regulation, reflection and semantic connection are considered (8). Reflection provides a person with the opportunity to look at himself “from the outside”, it is aimed at realizing the meaning of his own life and activities. It allows a person to embrace his own life in a broad time perspective, to correlate the present with the past and the future, thereby creating “integrity, continuity of life” (9), allowing the subject to maintain or restore internal harmony, to necessary rebuild his inner world and not be completely at the mercy of the situation.

As a private mechanism of the personal-motivational (or semantic) level of self-regulation, reflection is a powerful source of stability, freedom and self-development of the individual (8, 9). These contain its fundamental difference from unconscious forms of semantic regulation (psychological defenses), functioning at the level of learned mental automatisms. Thus, summarizing the views available in the literature on the essence of the personal-motivational level of self-regulation, we note that it represents a special form of internal activity. It can be considered as a special activity, the motives and goals of which are to preserve internal harmony and self-identity, ensuring the success of self-actualization. Particular goals of such activity may be situationally determined, but their content in the context of this activity always consists of conscious human values, rules, and an established system of internal requirements formed during life. The nature of these requirements is reflected in the content and structure of self-esteem and the level of aspirations (in particular, in the ratio of real and ideal self-esteem, 3). Let us turn again to the phenomenon of alexithymia. Let us recall that one of the important signs of alexithymia is a deficit of reflection, i.e. awareness of one’s own human essence, needs and motives for activity and, consequently, the inability to control one’s motives, flexibly rearrange them in accordance with the requirements of the situation, changing, if necessary, the “life plan” as a whole or finding new internal means to preserve the old. Internal constraint, the lack of internal means of harmonizing life or the inability to adequately choose them is what makes such a patient like (in the figurative expression of one of the researchers” (quoted from 14) “something like a taut rope.”

Continuation of the article by Nikolaeva V.V. about alexithymia

Psychologists who effectively work with alexithymia

Main signs of alexithymia

The main signs of a violation include:

Difficulties in understanding and verbalizing one’s own feelings;
Tendency to loneliness. It may not appear in people with alexithymia immediately, but after some time;
Limited imagination;
Denial of the concept of intuition;
Lack of bright, colorful dreams;
Logical thinking, penchant for analysis.

However, a person with alexithymia does not necessarily have to have all of the above symptoms.

Impact on the body and quality of life

Having highlighted the signs that the concept of alexithymia includes, the negative impact of this phenomenon on a person’s life becomes obvious. If there is no processing of emotions (and in this disorder there is none), then it is appropriate to talk about chronic stress.

The impact of the disease on a person and his quality of life manifests itself in many aspects.

Constant muscle tension, leading to distortion of posture and changes in the functioning of internal organs.
Changes in hormonal levels. The endocrine system continues to respond to events in the surrounding reality by releasing certain hormones into the blood, regardless of whether a person is aware of his emotional state or not. The concentration of the hormone in the blood during a stressful situation increases, but there is no reaction from the brain - the nervous system is depleted, the body does not rest.
Mental abnormalities. The disease often leads to anorexia or bulimia, insomnia, depression and increased personal anxiety, schizophrenia and psychopathy, and addictive behavior.
Pathology interferes with effective communication and the formation of healthy interpersonal relationships. Social contacts of a person with this disorder become scarce and short-lived. Communication partners get the impression of such people as cold, indifferent, and distant.

The life of an individual with such a diagnosis is darkened by the fact that he is aware of the imperfection of his psyche, he wants to experience emotions, express feelings, but he cannot do this. This often becomes the reason for the development of personal complexes.

Associated problems with alexithymia

Complications with alexithymia are very diverse. First of all, we are talking about the improper production of hormones responsible for emotions and psychosomatic diseases. These include various manifestations of allergies, gastrointestinal problems, atherosclerosis, migraines and a whole list of diseases.

Often with alexithymia, a person begins to experience problems with excess weight. Many people with this disorder become addicted to alcohol or drugs, which can easily develop into a severe addiction.

Due to the inability to understand the feelings of other people, problems of a social nature often arise: conflicts, problems at work and in personal life.

Emotion training

But, whatever the cause of alexithymia, you can live with this deficiency. Moreover, you can try to correct the situation by pumping up your emotions. Writing in a journal can help us understand why we are irritated. If you write down events, you can better understand yourself and expand the range of emotions. Psychologists recommend writing down the events of every day. Moreover, you should not limit yourself to just listing events. For example, you can monitor the state of your pulse or breathing. Over time, analysis of situations will reveal which readings correspond to anger or fear.

Reading fiction also trains you to understand and express emotions. Books help develop empathy. After all, novels often describe the thoughts, feelings, and experiences of the characters. Also, any kind of creativity: music, dancing, acting lessons help to recognize and practice feelings. Emotion training can help a person lead a more vibrant, emotion-filled life. And if there are alexithymics in your environment, then do not rush to label them. Ask them more questions about their feelings and emotions. In this way, you will help them to open up better, and yourself to better understand these people.

Treatment

The first step is diagnosing alexithymia. Treatment of alexithymia should begin with determining its type. As a diagnostic tool, psychologists use a short TAS test with closed-ended questions, developed by the Toronto School of Alexithymia.

Quantitative processing of test results makes it possible to fairly accurately judge the presence or absence of a given mental disorder in a client. This method for diagnosing alexitia has a simplified version for children.

Therapy for emotional deafness requires an integrated approach. To consolidate the effect of psychocorrectional classes, a maintenance course of drug therapy is necessary. The goal of a psychologist is to teach the client to process emotions and manage their feelings. This reduces the likelihood of psychosomatic consequences. In some cases, a person manages to get rid of alexithymia as soon as he allows himself to be angry, cry and say: “No.”

When a psychologist or psychotherapist thinks about how to treat alexithymia, they consider, first of all, the age of the patient. Methods of working with alexithymia in children are art therapy and sand therapy. Hypnosis and Gestalt therapy can be used when working with adults. The effectiveness of treatment depends on the ratio of hormones in the body, so hormonal drugs are additionally prescribed.

Boring, unempathetic robots

Alexithymics find it difficult not only to identify sensations in their body, but also to understand the experiences of others. Research by Professor Geoff Bird has shown that such people can distinguish between a smile and a frown in a photo. However, some have no idea what these facial expressions mean.

Alexey recognizes the joy and sadness of his friends, but cannot truly empathize with them, since he does not experience such emotions.

“Some people suffer after a breakup, others are worried about the lack of money. I can tell them: “It must be hard for you right now” or “I’m happy for you.” But in reality I have no idea what all this means. I don't have such problems. That is, I also had breakups and difficulties with finances, but I didn’t care. I didn’t kill myself, but prescribed an action plan or told myself that there was nothing wrong with it,” explains the guy.

Vera also has no sympathy:

“I try to evaluate the person and the situation. There are those for whom it is enough to hear “Everything will be fine.” There are people who are only enraged by such words. Then I try to express understanding, say something positive, wish something, share advice.”

In addition, thanks to her peculiarity, it is easier for Vera to survive difficult situations.

Problems with empathy are not the only thing alexithymics have to put up with. Candidate of Biological Sciences Anna Iskusnykh writes that they also have a reduced ability to imagine and create, and their thinking is concrete and mechanistic. Jason Thompson, author of Emotionally Mute: An Overview of Alexithymia, describes their communication style as coherent and logical, but "without any poetic undertones."

It may seem that alexithymics are boring and will discuss Excel files and plans for tomorrow with you. But that's not true. Alexey is a rather erudite man. He can talk about DNA and RNA in such a way that you will immediately understand the essence, even if someone erased all your knowledge of biology. Or retell in detail the biography of serial killer Ted Bundy so vividly that you will dream about all the horrors of his bloody crimes. Plus he jokes a lot. But if you think it's not comme il faut to trump other people's stand-up jokes, you won't like his humor.

But Alexey’s profession seems to confirm Anna Iskusnykh’s description: he works as a financial analyst in a large IT company. There is not much creativity in profit reports, but Sviridov is sure that finding cause-and-effect relationships is real creativity.

This love of reporting, as well as the psychological stability and resilience where others become stressed and panicked, makes him a valuable asset.

Vera, on the contrary, is a very creative person. She is an artist, draws comics and illustrations for fairy tales:

“Alexithymia is not a disease with a strict set of symptoms. I have no problems with fantasy. On the contrary, imaginative thinking sometimes helps me describe a feeling that I cannot identify and call in one word.”

Prevention

Now that we have found out what alexithymia is and how dangerous it is, we can confidently say that it is advisable to avoid this condition. The best prevention in this case is competent education, and this is an additional responsibility that falls on parents.

From an early age, a child must understand how important it is to correctly interpret his emotions, without suppressing them, but using them as an important tool of self-control. There should be no prohibitions on feelings. If you raise a child under such pressure, then in adulthood it will be very difficult for him to get rid of the habit of suppressing his own emotions.

Another important preventive measure is the development of imagination and creative thinking. This must be done both in childhood and in adulthood. Parents should encourage their children to express their feelings in every possible way, as this is the inalienable right of every person. Of course, we are not talking about teaching a child to violate discipline by demonstrating his individuality.