Alexithymia

Alexithymia is difficulty identifying, naming, and describing one's own emotions — the person feels something but has trouble recognizing which emotion it is, or distinguishing it from physical sensations. "I have a stomachache" may be the only perceptible sign of what is, in reality, anxiety or sadness.

Alexithymia is far more common in autistic people (roughly 50%) than in the general population (~10%). It isn't an absence of emotion — it's difficulty accessing emotions consciously and putting a name to them. People with alexithymia often experience intense emotions but have little verbal access to them.

Alexithymia has implications for treatment: therapeutic approaches that rely heavily on identifying and naming emotions (such as traditional CBT) may need to be adapted. Using emotion wheels, linking emotions to specific physical sensations, and working with nonverbal expression (art, music, movement) are useful adaptations.