Alexithymia & Emotional Regulation: When Feelings Are Hard to Name.

Dr Miriam Mavia-Zając
Mar 26
4 min read

The Skewed Internal GPS of Emotion

Imagine your emotions are like destinations on a map. For most people, their internal GPS reliably guides them ,pointing out where they are emotionally, where they need to go, and what route will get them there.

Now imagine that GPS is skewed. Instead of clear labels like "sad," "frustrated," or "excited," your emotional landscape is an unmapped terrain with vague, shifting coordinates. The turn-by-turn directions are missing, and when people ask “How are you feeling?”, it’s like being expected to describe your location without a map, road signs, or even a clear sense of where you are.

This is alexithymia, a condition that makes identifying, expressing, and processing emotions incredibly difficult. It’s not a lack of emotion—far from it. It’s the experience of having emotions but struggling to navigate them, like trying to decode a foreign language without a translation guide.

For many autistic and ADHD individuals, alexithymia isn’t just a minor difficulty—it’s a fundamental challenge in emotional regulation, shaping how they experience stress, relationships, and even self-identity.

So, what’s actually happening in the brain? And if the internal GPS is off, how do we recalibrate it?

The Neuroscience of Alexithymia: Why Emotions Feel Vague or Unreachable

1. The Disrupted Connection Between the Limbic System & Prefrontal Cortex

Emotions originate in the limbic system, specifically in the amygdala, which processes emotional intensity. For most people, the prefrontal cortex then helps interpret and label these emotions, providing meaning and allowing for regulation.

In alexithymia, this communication pathway is disrupted. The amygdala sends emotional signals, but the prefrontal cortex struggles to translate them into recognisable feelings. Instead of knowing “I’m anxious because I’m overwhelmed,” the experience is more like “Something feels off, but I don’t know why.”
This disconnect leads to emotional blunting (a sense of detachment from feelings) or emotional flooding (feeling overwhelmed without knowing what emotion is present).

2. Interoception: When Your Body’s Signals Don’t Make Sense

Interoception is the ability to sense internal body states—things like hunger, fatigue, and yes, emotions. It’s your brain’s ability to read physical signals and translate them into feelings.

In people with alexithymia, interoceptive processing is often impaired. This means:
- Physical sensations aren’t always linked to emotions → A racing heart may not register as anxiety.
- Internal states feel vague or disconnected → Instead of sadness, there’s just an overall sense of “off-ness.”
- Emotions don’t always trigger appropriate responses → Instead of reacting with frustration, a person might react with shutdown or blankness.
Why this matters: If you can’t recognise an emotion, it’s nearly impossible to regulate it effectively.

3. Emotional Regulation Without Emotional Recognition

Emotional regulation relies on identifying a feeling first—but what happens when you can’t?

In ADHD, dopamine imbalances affect emotional intensity, leading to quick, intense emotional spikes that are hard to name before they spiral.
In autism, sensory and cognitive overload contribute to emotional dysregulation, making it difficult to process feelings in real-time.

Without a clear internal GPS, emotional regulation becomes a guessing game—trying random coping strategies without knowing if they match the actual feeling.

How Alexithymia Affects Everyday Life

Social Interactions & Relationships

People with alexithymia often struggle with:

Recognising emotional cues in others → Facial expressions and tone may not register as emotions.
Expressing their own emotions → Responses may seem “flat” or overly logical.
Connecting feelings to events → An argument may feel distressing, but they may not connect it to “anger” or “hurt.”

Impact? They are often perceived as uncaring, distant, or emotionally detached—when in reality, they feel just as deeply but lack the words to express it.

Mental Health & Emotional Burnout

When emotions go unrecognised, they don’t disappear—they accumulate. This leads to:

Emotional bottlenecking → Emotions build up until they explode in unexpected ways.
Shutdowns & dissociation → When emotions become too overwhelming, withdrawal becomes the default.
Physical manifestations of stress → Unprocessed emotions often show up as headaches, digestive issues, or chronic fatigue.

Impact? Many people with alexithymia seek help for physical health issues without realising the root cause is emotional suppression.

Recalibrating the Internal GPS: How to Navigate Emotions Without a Clear Map

1. Externalise Emotions First, Label Later

If you can’t recognise feelings internally, start with external cues:
- Use body check-ins → “Is my breathing shallow? Is my jaw tense?” (These might indicate anxiety.)
- Describe sensations instead of feelings → Instead of “I’m sad,” try “I feel heavy and sluggish.”
- Track patterns → If certain events repeatedly cause distress, they may be tied to specific emotions.

2. Build an Emotional Lexicon (Without Relying on Words)

Since words may not come naturally, try alternative methods:
- Use visuals → Mood colour charts or emotion wheels.
- Use metaphors → Instead of “I’m stressed,” describe weather patterns (“It feels like a storm is coming”).
- Rate emotions on a scale → Even if you don’t know what you’re feeling, ask how strong it is (1-10).

3. Regulate First, Identify Later

If identifying the feeling is too hard, focus on regulation first:
- Sensory grounding → Use texture, temperature, or sound to reconnect with your body.
- Change movement patterns → If frozen, try pacing. If overstimulated, try slow, rhythmic breathing.
- Use “if-then” strategies → If I feel restless, then I will take a short walk.

Emotion doesn’t have to be named to be processed. Sometimes, just responding to your body's signals is enough.

4. Practice “Emotion Proxies” Through Creative Expression

If direct emotional processing is difficult, engage with emotions indirectly:
- Music selection → Notice what songs resonate with you emotionally.
- Art or journaling → Let emotions express themselves in shapes, colours, or free writing.
- Storytelling → Relate emotions to characters in books or films to create a reference point.

These practices help build a bridge between abstract feelings and tangible understanding.