Alexithymia – Wikipedia
Thealexithymia is a difficulty in identifying, differentiating and expressing one’s emotions, or sometimes those of others. This personality trait is commonly seen among patients with autism spectrum disorders and psychosomatic symptoms. [réf. souhaitée].
The term (taken from the Greek at- : private prefix, lexis meaning « word » and thymos meaning « mood ») was introduced in 1970 by John Nemiah and Peter Sifneos[1].
According to the observations of Nemiah and Sifneos[1], psychosomatic patients have in common a marked difficulty in describing their feelings, an absence or reduction of phantasmal life, and the manifestation of operative thought.
The psychoanalyst Jean Bergeret tries to locate the psychosomatic characteristics often associated with alexithymic behavior: “a weakening of the functioning of the thought in favor of a mode of expression passing essentially through the body. « [2]
The analysis of emotional dysfunctions in the clinical field is relatively untapped. Operative thinking and alexithymia are an exemplary illustration of the role of language behavior and verbal representations in the development of an emotional experience. We must point out the important difference between a neurotic individual and an alexithymic subject. The former manage to repress or defend themselves against feelings and fantasies associated with the psychological conflict, while the latter seem to have a gap in their possibilities to have control over their inner feelings.[réf. souhaitée]
In short, the clinical criteria for alexithymia are presented as follows:
- tireless description of physical symptoms;
- difficulty in verbally communicating emotions;
- repetitive speech;
- poor phantasmal and dreamlike production;
- interpersonal relationships marked by strong dependence, generally manifested by distancing.
About 15% of the population presents this pathology which results from a deficient connection between the cerebral centers of emotion, and those where it is represented in a conscious way.[3].
Alexithymia could therefore be linked to the presence of certain psychosomatic disorders. This is indeed what the majority of studies have shown. Noel and Rime (1998)[source insuffisante] thus indicate that 80% of the studies which compared a group of psychosomatic subjects with a control group observed significantly higher alexithymia scores in the first group. This could show how disturbances in the expression of emotions have an effect on the individual’s adaptation to his environment. For the past ten years or so, studies on alexithymia have multiplied, and tend to better define the personality of psychosomatic patients by offering a certain number of explanations. Here are some examples allowing to refine the general definition of alexithymia, and to expose the main etiological hypotheses.
Montreuil and Lyon-Caen (1993)[source insuffisante] showed the alexithymic nature of patients with multiple sclerosis. For them, the concept of alexithymia helps to understand the importance of the links between physiological experiences, physical sensations perceived very early in life and mental representations such as feelings, thoughts, and also indicates the need for their expression by the through the verbalization of emotions. They have made it possible to identify certain neuropsychological data on alexithymia: patients with rebellious epilepsy who have undergone a section of the corpus callosum and the anterior commissure present a functioning reminiscent of alexithymia. According to Bertagne (1992)[source insuffisante], alexithymia would correspond to a functional or structural dysconnection of the cerebral hemispheres. Their research also allowed the objectification of emotional poverty, mental inertia, mimic, gestural, sensorimotor and pain manifestations in alexithymic subjects.
Fukunishi, in 1994[source insuffisante], found that alexithymia was negatively correlated with social desirability and narcissistic personality scores, and positively correlated with scores on the MMPI Hostility Scale. As a result of this research, Rubino is testing 181 people with asthma, psoriasis and eczema, with the Toronto Alexithymia Scale (Taylor, Ryan, & Bagby, 1985), SAD, which measures aggression, and MMPI Panic-Fear Personality scale (MMPI-PF). The results indicate that alexithymia is positively correlated (.35) with the fear-panic personality (with p <.01), but has little or no correlation with aggression (.11) (Rubino, 1995).[source insuffisante].
Rad et al. (1977)[source insuffisante] highlighted differences in the lexicon used by alexithymics and neurotics to describe certain affects. These authors concluded that the deficit would relate more to the communication function than to a lack of verbalization. Tenhouten, in 1986[source insuffisante], studied patients presenting with a commissurotomy to highlight this inability to pass from thing to word, by proposing « a model of functional commissurotomy », thus posing the hypothesis of a dissociation between verbal and non-verbal representations. In a 1989 research, Pedinielli[source insuffisante] wanted to highlight the differences in the spontaneous verbal productions of psychosomatic patients presenting the same respiratory disorders, but different by the degree of alexithymia (an alexithymic group and a non-alexithymic group). He characterized the verbal productions of psychosomatic patients concerning their illness from a lexical point of view and from the general organization of the story.
The results clearly show the existence of different verbal productions in patients with alexithymia. However, these differences are more striking in the case of language production linked to current symptoms, and less with the historical narrative of the disease. This leads the authors to say that alexithymia must be interpreted in terms of a cognitive style varying according to the context, and not in terms of a stable dimension of the personality.
A study by Dan Bollinger and Robert S. Van Howe[4] believes that circumcision significantly increases the likelihood of suffering from alexithymia.
In psychoanalysis[modifier | modifier le code]
Most psychoanalytic studies on alexithymia aim to explain its appearance in its relation to the unconscious: fixation, regression, impossibility of constituting a transitional object, predominance of denial and isolation, arrest of affective development (Pedinielli , 1989). Thus, Wise, Mann, and Epstein (1991), showed that alexithymia is strongly associated with immature defensive styles, such as inhibition or projection.
According to Joyce McDougall, alexithymia is an ego defense mechanism which, by foreclosure, rejects affect. This mechanism can sometimes facilitate adaptation, especially in people who have had to undergo painful ordeals.
Overall alexithymia remains a concept making it possible to describe the psychosomatic patient, and not to explain the onset of the disease. Alexithymia is an impossibility for the affected subject to suffer or experience the suffering of the other. The result is a total failure to take into account the reality of emotional, affective and psychological life in its entirety if not through violent expression, addiction, denial. It is a structural defense linked to one or more traumas and which, through the performance of traumatic acts, tries out an expression, an exteriorization of his traumas. The subject is not aware of the traumatic acts he performs and of his internal reality. He is totally devoid of emotional life and cannot understand its nature. This often comes from an unstable and poor childhood in affection.
Noel and Rime (1988) listed the work that examined the possible association between alexithymia and certain natural variables:
Only three studies[Lesquelles ?] out of eight showed significant differences in the degree of alexithymia by sex. One was in the direction of stronger alexithymia in women, the other two indicated higher alexithymia in men. The other five did not show any differences. Out of seven studies[Lesquelles ?] concerning the relations between age and alexithymia, it emerges a non-negligible correlation of r = .40 with p <.01 in the sense of an increase in alexithymia with age. These studies suggest the accentuation of the anchoring in the immediate reality and the reduction of the spontaneous expression as the individual advances in age. Five studies wanted to show a relationship between the level of education and alexithymia, thus attempting to explain the difficulties of verbalizing affects by a poor level of education. None showed a significant correlation. Finally, three out of four studies indicate higher alexithymia in low socioeconomic backgrounds.
In short, alexithymia appears to be more common in older individuals as well as in those from less advantaged social backgrounds. On the other hand, it seems independent of gender and level of education. The examination of these various works by Noel and Rime has, it seems[Qui ?], was preceded by a verification of the methodological rigor of these studies.
Recently, a study showed that adults with high functioning autism appear to have a range of response to music similar to that of neurotypical individuals, including the deliberate use of music for mood management. The clinical treatment of alexithymia could involve the use of a simple associative learning process between musically induced emotions and their cognitive correlates.[5].
Based on most studies[Lesquelles ?], the psychosomatic patient appears more often in alexithymic individuals than in healthy individuals. Loas (1995) specifies that alexithymia has been described above all in psychosomatic conditions, but also in addictive disorders (bulimia, alcoholism, drug addiction, etc.).
- ↑ a and bNemiah, Sifneos, Affect and fantasy in patients with psychosomatic disorders, in OW Hill, (ed.), Modern Trends in Psychosomatic Medicine, Boston, Butterworth, 1970, p. 126.
- ↑ (Medico-surgical encyclopedia, 1980).
- ↑ Sylvie Berthoz, “The alexithymia or the silence of the emotions”, on Cerveau & Psycho, August 2004 (consulted January 18, 2018).
- ^ Dan Bollinger and Robert S. Van Howe, « Alexithymia and Circumcision Trauma: A Preliminary Investigation », International Journal of Men’s Health, 2011.
- ↑ Allen. – ‘Autism, music, and the therapeutic potential of music in alexithymia’ in Music Perception (2010) p. 251.
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