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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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The Loneliness of Alexithymia

Allan Schwartz, LCSW, Ph.D. Updated: Dec 11th 2012

The Loneliness of Alexithymia"She was a thirty year old married woman who had lost her job for no reason she could understand. In fact, while still working other people shunned her, never inviting her to lunch or other social events connected with the office. She never understood the reasons for this but was aware of feeling lonely. She did want to belong. Things at home were much the same. She had a loveless and sexless marriage primarily because she had no interest in sex. In therapy she seemed flat, uninterested, silent and spoke in a way that was monotonous. She reported having nothing to talk about and nothing to say. Ultimately, the therapist started to engage her in casual conversation about very mundane and concrete things. For example, how was her dog, did she walk him today, did she speak to her mother, did she see her younger sister? The question about walking her dog stemmed from the fact that she avoided leaving the house as much as possible. She did not want to see people and felt very uncomfortable around them. She was depressed and was able to acknowledge that fact but only if asked."

This patient was a good example of someone with Alexithymia.

What is Alexithymia?

Alexithymia is a personality characteristic in which the individual is unable to identify and describe their emotions. The main feature of Alexithymia is an emotional unawareness, lack of social attachment, and poor interpersonal relating. Furthermore, those suffering from Alexithymia have difficulty recognizing and understanding the emotions of others.

Alexithymia means there is:

1.Difficulty identifying feelings and distinguishing between feelings and the bodily sensations.

2.Difficulty describing feelings to other people.

3.Limited imagination and, therefore, little or no fantasies and limited dreams.

4.An unawareness of what is happening in their own mind and a very concrete way of thinking.

To illustrate these types of problems, this patient would occasionally report dreams but have no interest in them other than that. In a way, she illustrated the saying that, "a cigar is just a cigar," which was what was said of Freud's interpretation of the meaning of dreams. To her, there was no meaning to her dreams. In another example, I suggested she do I role play in which she imagine she was speaking to her father in an empty chair next to her. The idea was that she have the opportunity to tell him more about herself. She thought the entire idea was ridiculous and would not give it any more thought. She also had many somatic problems. At one time it was thought that she have Fibromyalgia because of all of her complaints about being in pain and of being chronically tired. Chronic Fatigue Syndrome was under consideration but that would not account for her pains. All of her medical tests were negative. Asked if she thought there might be a connection between her depression, social isolation, and lack of sex that could cause her to feel ill, she rejected the question as being ridiculous. Her body was shouting at her but she could not hear the message.

Ultimately, her husband left her and sued for divorce. She was completely shocked. Yet, she could never grasp the notion that her husband could be sexually frustrated. She seemingly had no understanding of  him at all. In point of fact there were many things that frustrated him. In addition to the lack of sex there was the inability to go out to dinner, the movies, have friends over the house for entertainment or do any of the things couples do to enjoy married life. In coping with losing him she had no insight into any of these things.

There are some suggestions that Alexithymia is connected to the Autism. It's an interesting theory because her father fell on the autism spectrum. Coming to many of the family sessions that were conducted, he was unable to maintain eye contact. He was a successful man whose career had been in physics and engineering. He described his ability to concentrate on his work in college. He was able to focus his mind completely on his studying and block out any noise around him. He did the same during his examinations, being free of distractions of other students, noises, movements or the environment. Unfortunately, this ability to focus did not help him in raising his daughter. He was an absentee father, always at work and away from the family. However, his success was probably due to the fact that, on the autism spectrum, he suffered with Asperger's Disorder. Socially, he did not function well but his keen intellect and brilliant understandings of the most difficult concepts in physics made him an invaluable member of any engineering team.

This patient began to make slow progress after she was referred to an intensive program that set about teaching her how to relate socially and how to think about her physical sensations and  how they are different from her emotions.

Those with Alexithymia have a sad and lonely existence. It is as though, in a world of multiple and beautiful colors, they can only see black and while. As psychiatry begins to make progress on learning about and treating this disorder, new treatment methods are being developed to help these people.

While they are able to marry, most end up in divorce situations because of their inability to interact with their partner.

Do you know someone who might have Alexithymia?Does this sound familiar?  Help them reach out for help.

Your questions and comments are encouraged.

Allan N. Schwartz, PhD


Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Lost the love of my life - - Mar 12th 2015

I think my boyfriend has this. Before we started dating he told me he had a hard time connecting emotionally,and was never able to keep relationships. Everyone kept breaking up with him. We could not have sex, it did not interest him and made him incredibly uncomfortable when I'd attempt anything. He recently got a job that is high stress. He's already an incredibly anxious person, and one day he told me he wasn't at the same level I was emotionally. I couldn't get him to understand that it was okay and I loved all the same. But when I looked at him all the life was gone from his eyes. I thought it was just normal anxiety but this makes more sense. I wish I could reach him. 

Partner with alexithymia? - Jenny - Mar 11th 2015

Thank you for your article. I have just come across the term alexithymia tonight and think it may apply to my partner. I don't know whether to be relieved or to cry. It would explain so much of our relationship. I just hope there is effective treatment for this because I love him and don't want to leave him but don't know how I can live in such an emotionless relationship.

Living with a hubby with Alexithymia - Mary - Mar 10th 2015

Thank you for your article, above. My husband was diagnosed in 2003. I thought that he was ADHD or just hyperactive.

Brilliant man, whom I'm extremely proud of. No emotional empathy though with me or family. All head knowledge but no heart feeling. When I (now his carer), carefront him, he acknowledges his problem - over eating, OCDing, acting like Mrs Doubtfire! etc. but no desire to actually do any cognitive in helping himself improve. Very frustrating. I've had to pick up and follow through on everything. 

Much more I could say, but, we're firm friends; have a good sexual relationship (although he's oversexed!!) and he's wonderful with our 5 grandkids, albeit 'fun, fun, fun'. That's his excape. Yes, it's hard for me.......he's hurt me; I've learnt & am still learning to live 'above' his mess. If I left him our children would never speak to me again - so not an option.

Fortunately, I have trusted friends & get out and about when I've time. My advise to anyone in this situation is to continually listen to your head and not your heart - have a mentor & councillor - be strong and decisive & let much go over your head and just get on with living and enjoying normal company as much as possible.

Divorce is not an option for me, due reasons above, as I actually love this sick man of mine. Over time, one becomes stronger and has to laugh at him but encourage him also as he has a brilliant mind. A pilot, writer, lecturer wow....

These people need us to lean on, believe it or not, as they generally cannot survive on their own - can't follow through or see the full picture etc. Many have changed with therapy. I'm still looking forward to that day (after 44 years of marriage).

Good luck everyone who has a partner with this condition. I empathise fully :)



It helps to know - Dani - Dec 7th 2014

I have recently left my fiancé and now understand and can put a name to my former partners condition. It goes towards helping me heal, knowing that I wasn't crazy for having feelings. I spent years trying to be seen and heard. The feeling of being alone with your partner sitting right beside you is heartbreaking. I still love my Man but I know I can't live a life less than I deserve. This article helps towards my healing. Thank you. I can best describe my former life as lonely and frustrating trying to get him to realize to share equally in a deep relationship. I know now that wasn't possible for him to give in a way I needed. I left so that I may one day have a whole experience with a healthy man. Sad but true, connection is most important to the majority of people. 

Need help for my partner - AM - Nov 25th 2014

I have spent 11 years trying to make my marriage work. Through all kinds of circumstances we have stood by each other but through everything I have been very lonely and emotionally alone. My husband cannot understand me emotionally and has no clue about how it is destroying and depressing me. WE have almost always had zero emotional intimacy and now since our first child was born (about 3 years ago) the physical intimacy is also nil. He's a very nice guy to everyone else and a good father but with me he's forever cribbing and complaining. No loving gestures, appreciation or a kind word.I dont know how to deal with this any longer. I feel like I need help for my sanity now. Please help.

comorbid with BPD? - wewa - Aug 17th 2013

Thank you for this enlightening article.

Family member with BPD.

help for getting help - Caleb Carlin - Dec 23rd 2012

I have alexithymia and have been fortunate enough to be able to have a name for why I am different from most people.  I have scoured the internet, libraries, and even met with a therapist for several months but have found little beyond descriptions of the condition and references to treatments (as in this article).  What I haven't found is a name for the treatments that have been shown to work, so I can ask for it directly.  Any advice on how to get viable treatment?

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