Word of the week: alexithymia

What are you feeling right now? How do you know? Where do you feel it? How strongly or subtly do you feel it? How do you know what to call it to explain it to me?

If you’ve ever been in some kind of therapy, and possibly at no other time in your life, you’ve probably been asked some version of these kinds of questions. They’re those bizarre questions that only therapists ask, right? The absolute counselling cliché clunker, “How do you feel about that?” is ridiculed all over the English-speaking world; yet sometimes I find myself asking exactly that. Why do I ask it? And why is it so often awkward and weird?

If you have a spare 10 minutes, I commend to you this short documentary from BBC Northern Ireland, where a journalist interviews primary school children about their emotions (email registration required), and listen to the way the kids describe their feelings.

“I feel like, you know a volcano where it just comes slowly up, the lava comes up and then bursts out like that!”

“I get a kind of sick in the stomach, my blood boils up and I clench my fists, and I look at them in the eyes like this, then I run after them”

“Guilt… feels as if you’re sort of sweating and you’re burning up inside like a fire… and then if you tell someone about it, it cools down again”

“It’s a very bad feeling, you feel sad and you feel sick”

These kids have awareness of their feelings, and vivid, embodied ways of describing them.

Feelings are fundamentally physical experiences: things happening in our bodies, in response to things happening in our environment. That claim might come as a bit of a surprise to some people, as it once did to me, because the culture I grew up in (white working class Britain in the 70s) gave me to understand that feelings were a lot less concrete, more ambiguous, than that. I’d go so far as to say they were less real than that: they were an entirely subjective, interior experience, with no real-world, observable existence.

Or perhaps it just seemed that way to me; because to be honest, I wasn’t very competent in recognising and expressing my feelings. There’s a word for that: alexithymia.

There can be many reasons someone might grow up not knowing much about their own feelings – or not sure how to communicate what they do know to another person.

For starters, in many places there are strong cultural prohibitions on showing you have feelings, unless you’re a very small child, or a crazy person. The British “stiff upper lip” is a classic articulation of this, not only discouraging the expression of emotion, but selling it as a virtue. “Boys don’t cry” is another favourite. Mockery of the perceived over-emotionality of cultural others, such as those from “Latin cultures”. Criticism, ridicule and medicalisation of the relative emotionality of women (take a look at the histories of the lobotomy procedure, or tranquilizer medications, if you want to be outraged).

The culture might proscribe showing feelings in public, but still tolerate it in our personal relationships. Even then, we might grow up in an emotionally illiterate family, where there is limited capacity for receiving and containing our emotions by carers when we’re young.

Parents or carers receiving our emotions teaches us that they are real and valuable, and nothing to be ashamed of (i.e. acceptable to others). Having them contained teaches us that they’re survivable and nothing to be afraid of.

If our carers instead silence our emotions, or ignore them, or mock or punish us for them, then we tend to learn to do the same for ourselves. And we grow up to become people who are numb to, or dismissive of, how we really feel; and threatened by the expression of feeling by others. So we pass this attitude on to our own children.

How are you doing as you’re reading this? Is anything stirring in you? Any interesting sensations? Or anything gone numb or silent that usually would be clamouring for attention?

You don’t have to be able to put an emotional label on it; just be curious about anything you notice and describe it to yourself.

I notice I feel a kind of tension around my outer eye muscles that I associate with sadness, and a sensation I can’t quite put a word to just below my breastbone, a kind of slight breathlessness, even though I’m breathing deeply down into my belly.

Having more than a passing acquaintance with our feelings is not only essential for good mental health, it’s also vital to experiencing our quality of life; setting and managing our boundaries; and motivating us to take steps to make changes when things aren’t going well. Living our lives without good access to our feelings is like living without access to our senses: it’s certainly possible to live without them; but much valuable information is missed, and the workarounds we generate to manage instead are costly in terms of time and energy.

For the majority of us, if we stick our hand in a flame it hurts, yes? And we quickly pull our hand back, and remember to avoid that in future if we can? Emotional information is the same. Not analogous. If I get a call from some pushy salesperson who won’t shut up or listen to my perspective, my heart beats faster, my skin flushes, my facial muscles tense up (a combination of physiological changes we’d probably call anger) and I hang up the call and block their number.

If I tell myself the flame didn’t do that much damage, just a little light singeing, and some moisturiser will soon mend the skin; or if I tell myself the salesguy’s just doing his job, and sure he was annoying, but it was an overreaction to hang up and I should have been polite and listened – I’m ignoring vital information about how I’m doing as an individual; I’m minimising my own real experience; and I’m losing the opportunity to develop beneficial strategies for situations in the future.

This is why counsellors and therapists ask those bizarre, intrusive, uncomfortable questions. Not because we’re nosy (though we are) or abusive (hopefully we’re not); but to encourage our clients to take an interest in their feelings and start to treat them as a source of valuable information about the current state of play for them.

So the next time someone asks you “How do you feel about that?,” maybe take a moment to check in with yourself - by which I mean your physical, bodily self - and see what there is to be found. Are your eyes scrunching, your jaw setting, and your top lip twisting into a sneer? Maybe the question irritates you? That’s great emotional information! Go with it!