Alexithymia - A Pill For Fear?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Alexithymia - a pill for fear?

The article was written based on the book by D. McDougall "Theater of the Soul"

Alexithymia is a psychological phenomenon in which an individual has difficulty in describing his emotions, experiences, feelings

All psychological symptoms are attempts at self-healing and alexithymia is no exception. Parents, for the most part, teach their children to be obedient, careful, cowardly, silent, over-adaptive, which often leads to alexithymic symptoms. To deal with such a phenomenon as alexithymia, we need to find out from what imaginary dangers children who have become adults unconsciously protect themselves, continuing to maintain a lifeless relationship with the world. One of the key points of this understanding is the knowledge that giving up sensitivity prevents a return to a state of psychological trauma.

Alexithymia is a protective ability of the psyche not to feel when feeling is too dangerous, too scary

This mechanism for turning off feelings is unconscious, and therefore uncontrollable. It is automatically transferred to all spheres of life and to all relationships: with oneself, with one's neighbor, with the World. But in order to live, we need to feel, because this is one of the signs of a living organism. It is through the senses that we receive information about the surrounding reality. And this vital ability is transferred to the Other. As a rule, first it is one of the parents, then members of their own family.

“Tell me how I feel”, “Feel for me”, “Live my pain for me, because I cannot do it, and being alone with her is unbearably scary” - this is how unconscious messages from a spouse sound like always remains unperturbed, often laughs it off with direct questions, shows his indifference to all "emotional waves" in the family. The spouse, of course, is chosen by him rather emotional. He plays his feelings on her as an instrument. (An example is given in a pair where a man is alexithymic, but, less often, an alexithymic woman can be paired with an emotional man).

We should remember that conflict with the environment (unsatisfying relationships with people), as a rule, is a reflection of internal conflicts in the unconscious of a person.

“Neurotic conflicts refer to the adult's right to love life and sexual pleasure, as well as pleasure from work and competition. When these rights are questioned by the inner child, neurotic symptoms and difficulties arise as a compromise. On the other hand, psychotic anxiety is addressed to the right to exist as well as to have a separate identity without fear of attack or harm from others. A deep lack of confidence in one's otherness and the right or the ability to preserve private ownership of one's thoughts and feelings is, on the one hand, fear of invasion from the outside, fear of the destructive impact of invasion or mastery of another, and on the other hand, fear of exploding from within, fear of losing control over borders. your own body, your actions and your sense of your own identity.”*

In order to make existence bearable, alexithymia helps to keep archaic horror within limits. When communicating, this happens as follows: instead of experiencing feelings, a person thinks about them. He uses thought instead of feeling.

How is your relationship with alexithymic ** going?

The operational form of the relationship

Such communication looks like a dry transfer of information, saturated with verbs without expressing one's attitude to what has been said. (I remembered the school, literature lessons and a prerequisite for the teacher when reading aloud - “read with expression”!)

Emotionality is not allowed not only in relations with the Other, but also in the psychic of our "hero - alexithymic". And any relationship without an emotional component runs the risk of becoming meaningless.

The lack of a necessary component of any effective communication, namely the exchange of feelings, emotions and experiences in the process of communication, leads to a feeling of boredom and detachment. Have you ever had the feeling in a conversation that your thoughts are flying away somewhere, it is difficult for you to concentrate on what your interlocutor is saying? This is one of the markers that you are talking to a person with alexithymic symptoms.

“Here is a typical portrait of an alexithymic individual: often expressionless sandwiched wooden ones and making almost no gestures during a conversation. This rigid demeanor, combined with the lack of emotional coloring in speech, preoccupation with the smallest details of everyday life, makes many of them annoying and boring for the interviewer. Such a reaction is not a criticism, but rather should serve as a diagnostic criterion for the presence of alexithymic symptoms”*.

Alexithymia and projective identification

What is projective identification? This is a mechanism of primitive psychic defense, in which unacceptable personality traits or intolerable experiences are split off by the personality and transferred to the Other, in order to act out and control them. The individual unconsciously tries to establish contact with his split-off, lost part in order to recreate his integrity, for healing. In this case, the split off part is perceived as an integral attribute of the Other.

Sometimes this is how dysfunctional couples form. Projective identification manifests itself most often in conflicts, in the dissatisfaction of one spouse with another.

Among my clients there are quite a few examples when one of the spouses (in my practice they are more often men) experience real torment while being with emotional wives, but at the same time cannot leave the relationship. And they are also in no hurry to change these relations. The portrait of such a man is described in article on male trauma … Projective identification, in my opinion, partly explains this phenomenon. An alexithymic man who does not allow himself to show emotions, to be aware of them, vitally needs an emotional woman. He himself often provokes these attacks of female rage, tears, accusations - these are the affects that he does not allow into his consciousness. These are the affects that once, in early childhood, were not allowed to manifest, they were not allowed in relationships with parents. And now they are actualized by some events of adult life, remotely reminiscent of childhood traumatic experiences for the purpose of living and healing. For such a union, the concept of "my soul mate" is very appropriate. Breaking relationships or changing them without realizing the foundation on which this form of relationship originated does not provide an opportunity to heal them.

Alexithymic patients, unable to find words to describe their feelings in order to cope with them, use the Other. The individual himself is afraid that he will be flooded with violent affective experiences, and he will not be able to cope with them.

There are two main types of interaction - distancing and the formation of a false "I"

Each alexithymic needs the Other, and at the same time, has difficulty in being with someone in a close relationship. The feeling of awkwardness, numbness, "frostbite", the desire to distance themselves leads to misunderstandings and conflicts.

Withdrawal is a way to prevent the painful intrusion of the Other into the carefully guarded inner world - a symptom also inherent in the schizoid personality dynamics.

Others, for better interaction with the environment, develop a false "I". This is where projective identification is most clearly manifested. At the same time, the Other experiences the strongest emotions, feeling the inexplicable influence of his interlocutor.

The following is an excerpt from an interview with an alexithymic patient:

Counselors try to ask the patient what thoughts they have when they are angry.

Patient: - I have bad thoughts.

Therapist: - For example?

Patient: - I am very angry, very indignant.

Therapist: - What thoughts come to your mind when you are angry?

Patient: - Thoughts? I'm just really angry. Well, I'm angry … very unpleasant. Trying to understand what you mean by asking for thoughts.

Therapist: - How do you know that you are angry?

Patient: - I know, because people around them are upset because of me …

Our hero wrote a whole script in which he intellectualizes. Dodging - an attempt to gain time to protect oneself from affective experiences, leads to frustration of the interlocutor. He does not feel, but thinks about what he is feeling, while the interlocutor begins to experience at least irritation, at the most - rage, reflecting as a mirror what the alexithymic simply calls “angry”.

“Undoubtedly, this way of causing the affect of others is the way of communication that the patient learned in early childhood. Perhaps, then, it was the only available channel for the transmission of his experiences. *

During the session, the analyst feels the patient's unrecognized, discarded feelings - helplessness and internal paralysis, numbness.

In communication, we experience what our patients were accustomed to in early childhood. A mother who cannot stand her child's temperament, his spontaneous manifestations of anger or excessive mobility, will find a way to tell her child what behavior she considers acceptable. In turn, the infant, eager to control the sources of pleasure and safety (feeding, body warmth, affectionate gaze and calm voice of the mother), learns to restrain his movements and reactions - ways of expressing spontaneous feelings.

In therapy, the patient and I relive together his traumatic infantile experience, communicating, experiencing feelings of helplessness and hopelessness, connecting them with early childhood fantasies of abandonment, in which existence itself is felt threatened.

Alexithymia and splitting of the soul and body (psyche and soma)

Thus, we see that alexithymia is an unusually effective defense against inner feelings. Affects are connecting links between the instinctive center of life (impulses) and consciousness, which is able to organize and control emotions. Affects carry messages from the outside world (through sensations in the body) to the world of awareness. In the case of such a phenomenon as alexithymia, affects are paralyzed and the body begins to talk to us with the symptoms of the disease.

Alexithymia is like a fortress around the patient's fragile emotional world, and the more sensitive the subject, the thicker the protective wall of this emotional collapse. Such a personal structure is formed, as mentioned above, at the earliest stages of communication and is created out of necessity. Although it costs its creator very dearly (psychosomatic illnesses, lack of warm emotional relationships, depression, etc.), the patient fiercely defends himself against any intrusion into his emotional world. In this article, I appeal to both parties (both therapists and patients). To solve the problem, a working alliance between the therapist and the patient is needed, and here, in my opinion, awareness of what is happening in therapy will help both sides.

For readers who have seen alexithymic symptoms in themselves, I suggest to be patient, to set aside more time for therapy than if these were other problems. We must not forget that the problem “I don’t feel anything” itself is rarely addressed, as a rule it is disguised as “loss of motivation”, dysfunctional relationships in the family, I don’t want anything, apathy, depression.“I don't feel anything” - opens in the course of therapy.

And also we, therapists, psychologists, consultants, cannot force the patient's emotional reactions. It should be remembered that the premature opening of the affective flow can destroy the patient or further strengthen his psychological defenses, further alienating him from healing.

“We must first make sure that such a patient is firmly convinced of his intention to learn more about himself. Even then, caution is needed. A lot of preliminary work may be required before such a patient can see the nature of his protective prison and the measure of his ability to desire and express affect. Without an inner insight about these serious symptoms, the unexpectedly released prisoner, perhaps, will not be able to collect scattered words, choose, use hitherto strangled emotions without pain and fear, which may seem destructive to psychic economy”*.

Preliminary work involves the creation of a safe, "embracing" space, which is achieved by adhering to the setting, minimizing interpretations and patiently "containing" the patient's experiences and emotions. The therapist will be filled with the latter.

What do we need to do in therapy to help the alexithymic patient?

Experiencing emotions, experiencing feelings is the most typical human trait. Contact with feelings is one of the main differences between humans and animals. Not an impulsive response with affects, but the use of symbolic speech to communicate their needs, expectations, hopes. The verbalization of feelings in therapy, their expression through metaphors, symbols, drawings, movements, facial expressions helps us to establish a connection with the patient's inner center, his identity, self.

“Without words, we can neither think, nor think, nor ponder what we feel…. In such a situation, others must think for us. Or our body will think instead of us … Children early learn to be afraid of the emotional dynamite that words carry in themselves. Like adults, they tremble at the threat of humiliation or the threat of being abandoned … afraid of words that express the possibility of losing love. They quickly learn to use words as a weapon, a defense against others”*.

In the course of therapy, the patient learns to trust himself, his feelings, gains a new experience that it is possible to be himself and next to the Other.

* Joyce McDougall “Theater of the Soul. Illusion and Truth on the Psychoanalytic Stage”

** I apologize to the reader for the term "alexithymic" - perhaps its use is not entirely correct, but this way, it will be easier for me to convey my thoughts and knowledge on this topic.