oaq

Taking the Alexithymia Questionnaire

This week for Take-a-Test Tuesday we’re taking the online alexithymia questionnaire.

Alexithymia refers to people who have difficulty identifying and describing emotions as well as differentiating between physical and emotional sensations. It’s not a formal diagnosis, but a way of describing a common set of experiences related to emotional dysfunction.

Some descriptions of alexithymia also include impoverished imagination and a tendency toward externally oriented (concrete) thinking. I found it interesting that both studies I cite below omitted these last two characteristics. Many of you who commented on the emotional dysfunction post last week questioned the inclusion of impoverished imagination, saying that you personally felt the opposite was true. I have to agree with this. My imagination is, if anything, overactive. Perhaps there is an autistic subtype of alexithymia?

Alexithymia is extremely common in autistic individuals. About 50% of people diagnosed with ASD have severe alexithymia, however nearly all people on the spectrum experience it to some degree. Among the general population, about 10% fit the alexithymia profile and parents of autistic children are more likely to be alexithymic than parents of nonautistic children.

When it comes to social communication, the line between autistic traits and alexithymic traits is blurry. Two recent studies (Bird et al, 2010 and Silani et al, 2008) suggest that alexithymia, not ASD, is responsible for impaired affective empathy.

The 2008 study looked at brain activity in autistic and nonautistic people with and without alexithymia. It found a correlation between a person’s level of alexithymia, brain activity in one of the regions believed to be responsible for identifying one’s own emotions, and scores on an empathy questionnaire. This was true of both the autistic and nonautistic participants, suggesting that impaired processing of emotion, not autism, is the source of impaired affective empathy.

The brain uses the same neural pathways for perceiving and interpreting our own  emotions as well as the emotions of others, so it makes sense that if we cannot process our emotions easily, we’ll also struggle to process emotions demonstrated by others..

One question that remains unanswered is why autism and alexithymia occur together so frequently.

Many commenters on last week’s post recognized themselves in my description of my own emotional dysfunction, so I thought it would be interesting to take the Online Alexithymia Questionnaire. While not a clinically recognized measure of alexithymia, it is based on commonly used clinical screening questionnaires.

Pros and Cons of the Online Alexithymia Questionnaire

Pros

  • Self-scoring
  • Provides subscale scores with cutoffs
  • Overall score is presented on a simple visual “severity” scale
  • Includes questions phrased as self-observation (I feel . . .) and other observation (People tell me . . .)

Cons

  • Not clinically tested or validated
  • Unclear how cutoffs were derived
  • Includes questions on topics that are not a part of generally accepted alexithymia definition

Taking the Test

The alexithymia questionnaires used in clinical research (TAS-20, BVAQ) aren’t available online, so I took the Online Alexithymia Questionnaire (OAQ-G2).

Take the test here. There are 37 questions. You have to answer at least 20 to get a result, meaning you can skip any you find overly invasive. The answers for each question become “grayed out” once you make a selection but you can go back and change your answer if you want to.

Scoring the Test

When you’re satisfied with your answers, click the “Evaluate Test” button and you’ll be given an overall score as well as 7 subscale scores. Here are mine:

Test Results: 141 Points.
Alexithymia: You show high alexithymic traits.

The yellow area indicates "some alexithymic traits" and the orange area indicates "high alexithymic traits"
The yellow area indicates “some alexithymic traits” and the orange area indicates “high alexithymic traits”

Difficulty Identifying Feelings: 23 Points <15 – 18> high alexithymic traits

Difficulty Describing Feelings: 17 Points <10 – 12> high alexithymic traits

Vicarious Interpretation of Feelings: 13 Points <8 – 9> high alexithymic traits

Externally-Oriented Thinking: 29 Points <18 – 21> high alexithymic traits

Restricted Imaginative Processes: 19 Points <18 – 21> some alexithymic traits

Problematic Interpersonal Relationships: 29 Points <15 – 18> high alexithymic traits

Sexual Difficulties and Disinterest: 11 Points <10 – 12> some alexithymic traits

The subscale scores in parentheses appear to be equivalent to the yellow area on the slider bar, meaning “some alexithymic traits.” A score below the range in parentheses indicates the absence of alexithymic traits (green area) and a score above indicates high alexithymic traits (orange area).

Keep in mind that the last two subscales, problematic interpersonal relationships and sexual difficulties/disinterest, aren’t specifically part of the formal definition of alexithymia. It’s possible that the sexual difficulties subscale could be impacted by whether a person is in a long-term relationship and feels comfortable with their partner.  Also, externally-oriented thinking and restricted imaginative processes are not always included in clinical definitions of alexithymia. The first three subscales are the best gauge of the core deficits of alexithymia.

I was surprised by my score on externally oriented thinking. This item refers to a tendency to think in concrete, nonintrospective terms. I don’t view concrete and nonintrospective as synonymous, but that could be my autistic brain.

I think in concrete terms, but I also spend a lot of time examining my thoughts and feelings. I might spend more time on the latter because I have to consciously “check-in” with my feelings to identify them. However, neurotypical people may be spending more time considering their feelings as part of decision making or social interaction. My introspection usually tends toward “what the heck is going on?”

The Bottom Line

The Online Alexithymia Questionnaire is the only freely available alexithymia  test. Although not scientifically validated, it appears to be a reasonable “amatuer” measure of alexithymic traits and a useful starting point for better understanding how you process emotions.

77 thoughts on “Taking the Alexithymia Questionnaire”

  1. I’ve been aware for some time that I have serious difficulties identifying and especially expressing my emotions – it does cause problems in relating to my wife. I often have to consciously work out my emotional state from my physical reactions. As for my test scores…

    Overall: 160 points – You show high alexithymic traits.
    Breakdown:
    Category: Difficulty Identifying Feelings: 27 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 19 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 8 Points
    In this category you show some alexithymic traits.

    Category: Externally-Oriented Thinking: 31 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 31 Points
    In this category you show high alexithymic traits.

    Category: Problematic Interpersonal Relationships: 29 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 15 Points
    In this category you show high alexithymic traits.

  2. My score was 162.

    Category: Difficulty Identifying Feelings: 30 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 20 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 14 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 31 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 22 Points
    In this category you show high alexithymic traits.

    Category: Problematic Interpersonal Relationships: 30 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 15 Points
    In this category you show high alexithymic traits.

    I was in no way surprised by the results because I expected to be high on the scale. I hear all the time that I’m like a robot and I’m sitting with a blank face or I’m not responding to people’s emotional needs.

    My general response is confusion and a regular helpless feeling because I try to understand. I try to behave in an expected manner when I have a basic understanding of how I’m expected to react but most of the time I don’t respond the way others want me to. Even when I’m trying they can generally tell it’s forced behavior. I’m definitely described as more in my head than my heart.

    1. I know what you mean about trying to understand and then feeling helpless. Years and years of this can really wear on you. Perhaps, if you’re comfortable doing so, you could share some information about alexithymia with people close to you? It might help them understand more about how you work.

  3. Test Results: 144 Points
    Alexithymia: You show high alexithymic traits.

    Category: Difficulty Identifying Feelings: 22 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 16 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 8 Points
    In this category you show some alexithymic traits.

    Category: Externally-Oriented Thinking: 33 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 19 Points
    In this category you show some alexithymic traits.

    Category: Problematic Interpersonal Relationships: 26 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 20 Points
    In this category you show high alexithymic traits.

    Well, that’s totally not shocking…

  4. My results are outright bizarre

    Test Results: 91 Points
    Non-alexithymia: You show few to no alexithymic traits. If you are interested in Alexithymia we would be happy to have you as a regular visitor on our pages.

    Category: Difficulty Identifying Feelings: 18 Points
    In this category you show some alexithymic traits.

    Category: Difficulty Describing Feelings: 9 Points
    In this category you show no alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 10 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 11 Points
    In this category you show no alexithymic traits.

    Category: Restricted Imaginative Processes: 11 Points
    In this category you show no alexithymic traits.

    Category: Problematic Interpersonal Relationships: 20 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 12 Points
    In this category you show some alexithymic traits.

    1. I’m not sure if that’s bizarre. Vicarious interpretation is social imagination and interpersonal relationships is social interaction, both overlap with social communication, so can be explained fully by the autistic triad of impairments. The results imply that you’re aware of your own emotions but have difficulty relating to other people in non-concrete (literal) terms. I’d think that this would be what would be expected of someone who’s on the autistic spectrum but doesn’t have alexithymia to a significant degree.

    2. Quarries and Corridors’s interpretation feels right on to me. I’m curious to see if anyone else who is on the spectrum but has low alexithymic traits comes up with a similar profile of scores.

  5. Well, I scored 131.
    I liked the dreaming question. I rarely ever have dreams, and the ones I have are pretty boring. Once I dreamed I was buying sheets at Sears. Why even have a dream if it’s going to be stupid like that?
    Also, I think I have more trouble with negative emotions. I always characterise them as “mad” unless there’s obvious sobbing (sometimes even then, because I’ll cry when I’m mad sometimes). But the subtleties, embarassment, defensiveness, whatever other flavours – I don’t know.

    1. I think I would much rather dream about buying sheets at Sears than some of the bizarre stuff my brain comes up with. :-)

      Things like embarrassment and defensiveness are complex emotions so I think most people on the spectrum struggle more with them than the basics. I tend to be able to recognize emotions in others and then get stuck on reasoning out why they’re occurring. I routinely ask people to explain why they’re mad, sad, etc. *sigh*

      1. People can feel the same emotion for so many reasons that it’s quite easy to recognize an emotion and not be entirely sure how to interpret it. If Ickes’ empathic accuracy studies are right, NTs also have a problem with this, but they make both their correct and incorrect assumptions unconsciously and don’t usually have the opportunity to find out when they’re wrong, so they don’t realize it.

        To make this more concrete: I knew someone (non-autistic, to the best of my knowledge) who, whenever I seemed upset or in a bad mood, asked if I was mad at them. (Hey, it could be worse–they could have simply assumed I was!). This person had a traumatic past that made it automatic to suspect others might be mad at them. However, I was almost *never* angry at them. If we can get something as basic as the *target* of an emotion wrong, imagine how many other places we might get stuck!

        Since things don’t always come across clearly in text, I intend this comment not to diminish your difficulties or deny that you have them but simply to suggest you’re not alone in having them, and that there are good reasons to have them. :)

  6. Thanks for another excellent post! I think your analysis of the questionnaire is spot on. Our overall scores were similar:

    Test Results: 140 Points
    Alexithymia: You show high alexithymic traits.

    Category: Difficulty Identifying Feelings: 26 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 17 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 12 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 25 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 20 Points
    In this category you show some alexithymic traits.

    Category: Problematic Interpersonal Relationships: 25 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 15 Points
    In this category you show high alexithymic traits.

    I found it difficult to answer some of the questions about discussing emotions with others. My friends are in the majority on the autistic spectrum and we spend a lot of time discussing our experiences and feelings in a very analytical, concrete and strategic way. I have neutrotypical friends who really value my ability to be objective about emotional issues and willingness to discuss the reasons behind their emotions in a productive way. This made it hard to answer questions that seems to put the two factors as opposites. I think though, on reflection, that most neurotypical people would probably find the way I discuss emotions to be ‘cold and uncaring’ which is probably what I should answer ‘in the spirit of’ the questions. I actually mostly wrote ‘undecided’.

    Additionally, I’m asexual, so I didn’t find the sexual questions all that easy to answer and could only do so in terms of past romantic relationships I’d had with sexual people. It’s not surprising I scored as ‘high’ given this!

    On a related note, I happened to read this article about the physical symptoms of depression today and, I think, confirmed my suspicions that the chronic joint pain illness that disabled me for 18 months in my early 20s was actually depression: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/
    This is why awareness of alexithymia and the other ways that depression (both situational and chemical) can manifest is so important.

    It’s funny how the more I learn, the more seemingly unrelated life experiences suddenly make enormous sense!

    1. I think you’re right about the analysis or dissection of emotions probably not being what they’re talking about on the introspection questions. I had a few undecided answers to because I just couldn’t come to a conclusion in either direction. But I suspect the undecided answer is probably worth 3 points because not knowing how to answer could in itself indicate dysfunction.

      The issue you ran into with the sexual questions is another reason I find it hard to justify including them. I think the questionnaire author is making invalid assumptions about the relationship between sexuality and emotion/intimacy/social relatedness. I’m off to read the article you linked to!

  7. Ted: Test Results: 129 Points
    Alexithymia: You show high alexithymic traits.

    Category: Difficulty Identifying Feelings: 15 Points
    In this category you show no alexithymic traits.

    Category: Difficulty Describing Feelings: 13 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 7 Points
    In this category you show no alexithymic traits.

    Category: Externally-Oriented Thinking: 32 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 24 Points
    In this category you show high alexithymic traits.

    Category: Problematic Interpersonal Relationships: 24 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 14 Points
    In this category you show high alexithymic traits.

    FYI – Me: 72 Silly ole emotional indentifying and describing me! :-)

    1. Well, you do have the lowest score so far. Not sure that’s saying much tough. ;-) It’s interesting that Ted scored so low on the identifying/interpreting scales. Makes me wonder how much of this is nurture and how much is nature.

      Data study?! What are you thinking? I need details. :-)

      1. Ted is wonderfully astute, seriously, do you think that contributed to his low scores? Now, regarding the data study, I was totally seeing YOUR brain light up with ideas. Get your data points collected and have some stat fun!!! :-)

        1. I wonder if he’s developed a skill for reading others, perhaps guided by some astute parenting. :-)

          Oh, I’m doing the data study! Well then, I was thinking it would be interesting to see how the EQ scores correlate with these scores. Not sure I have a enough common commenters on both but I’ll check in a day or two.

    1. Some of the questions are hard to interpret without more context and a few seemed overly broad, like the one that includes a range of feelings from awkward to physically ill. How is that a valid question?! :-)

  8. Ok, I think I just discovered another aspect of alexithymia that was not addressed in this questionnaire. I guess I can come off as cold and unfeeling. My daughter just stubbed her toe and was crying uncontrollably. I started feeling extremely frustrated and my overwhelming feeling was that I just wanted her to stop crying. How terrible is that?? I’m a horrible mom! This is not the first time that I’ve felt frustrated when especially someone I care about is either in pain or upset. I think the frustration comes from not being able to do anything to help.

    1. Oh, I know what you mean by this. You’re not a horrible mom! You just need less uncontrollable crying. It’s so hard to have to stand by helplessly when others are hurting. :-( I hope her toe is feeling better.

        1. I live on the opposite side of the “coin”. My empathy and “real-time” emotional dialogue with everyone around me makes me wish sometimes that I could turn it down/off. Don’t worry about “doing” for your daughter, just try to “be” there (sit with her). It is the unconscious communications that mean the most!

  9. 131 points overall.
    Breakdown:
    Category: Difficulty Identifying Feelings: 21 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 15 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 14 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 22 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 22 Points
    In this category you show high alexithymic traits.

    Category: Problematic Interpersonal Relationships: 27 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 10 Points
    In this category you show no alexithymic traits.

    High alexithymic traits in all categories but one, in which I have no traits at all? Odd. :/

  10. Yay! Tuesday Quiz!
    Test Results: 148 Points
    Detailed Results

    Category: Difficulty Identifying Feelings: 28 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 17 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 11 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 35 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 21 Points
    In this category you show some alexithymic traits.

    Category: Problematic Interpersonal Relationships: 23 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 13 Points
    In this category you show high alexithymic traits.

    As I took this quiz, I had one thought–I do not surround myself with emotional people. My friends and family are all very no-nonsense, just the facts please people. More emotional people distress and confuse me. I think that this might be why I feel so attracted to art. I can *show* feelings and emotions without having to name or discuss them.

    I enjoy your quizzes and discussion! Thank you! :)

    1. Your art is a fantastic representation of emotions. :-)

      It must be kind of nice to be surrounded by logical people. I have a very emotionally in touch with himself husband and a daughter who can model either one of us, depending on who she’s talking to, which is really interesting.

  11. I got 117, just into the “high alexithymic traits” traits section. I didn’t expect to get a high result here. I tend to think of my issues with emotion as existing at the interface between myself and others, rather than something more internal. Probably shouldn’t be surprised though. Just because I have a lot of feels (sorry, too much time on tumblr) doesn’t mean I’m any good at sorting them out into type and cause. In fact, I spent part of this evening properly crying and I’m still not entirely sure why.

    1. Sorry you were having a cry all evening. I hope you’re feeling better today.

      The more I learn about alexithymia, the stranger I find it that people spend so much time talking about how autistic individuals “don’t have feelings” and very little talking about how hard it is to express the feelings we have, which are often many and quite strong.

  12. …also, this may explain why it took me so long to realise that I am bisexual and kinky. Weird physical sensations to decipher alongside complicated emotional and social stuff. Sorry if that’s too much information. :#

  13. I got 121. I answered “undecided” to most questions.

    Category: Difficulty Identifying Feelings: 22 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 14 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 12 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 17 Points
    In this category you show no alexithymic traits.

    Category: Restricted Imaginative Processes: 19 Points
    In this category you show some alexithymic traits.

    Category: Problematic Interpersonal Relationships: 23 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 14 Points
    In this category you show high alexithymic traits.

    I have synaesthesia, and it’s easier for me to identify feelings through colour or sound, so for a long time I would make a binary tree with colours. Do I feel more like this colour or that one? And I’d discard the ones I felt less like until I was left with the colour I felt most like. I learned how to translate the colours into feeling words as a teenager. I do something similar with music because music is more nuanced and can have many different colours at once, which means that the song that has all the right colours for how I’m feeling right now gives a more detailed picture of what I’m feeling than a crayon or coloured pencil would.

    But of course sometimes the song that fits now the most might just be a song that has pleasing movement or colours and may not have bearing on my emotional state. But I can generally tell the difference. As I’ve gotten older, it has gotten easier to say “I am feeling annoyed” without having to listen to lots of different songs or colour with lots of different colours to find the right one, but the colours and sounds are my native language for feeling stuff.

    1. Well, now you’ve answer the question for us about how undecided answers are scored. Clearly they’re getting assigned enough points to count as alexithymic-leaning answers.

      It sounds like synaesthesia might be somewhat helpful in identifying emotions by giving them concrete associations? It’s really interesting that you found an intersection between music and emotion and color!

      1. Synaesthesia certainly was helpful to me. I always knew how a certain colour felt, long before I had words to describe the feeling. I knew all about purple long before I could verbalise feeling lonely. It’s like the synaesthesia created a bridge between the stuff I couldn’t verbalise and the words. Sometimes, though, it felt like I was a character in a novel with heavy colour symbolism, because I’d be wearing a yellow shirt and nobody around me would know what it meant or that it had any significance at all, and so you just had to hope that there was a reader some place who was highlighting colour references with a pen and piecing it together…

        I did eventually figure out that I wasn’t a character in a novel.

        But this is largely why I had to keep putting undecided. I do understand feeling stuff with relative ease these days and can use my words in a way that an average person would understand, but it feels more like “I have an algorithm for that” than “this comes easily and naturally to me and it didn’t take any effort to get to where I am now.” + i learned how to do a lot of this considerably later than my peers.”

        To me, undecided meant “yes, but I don’t think I’m getting here the same way everyone else is” or “yes, but not historically.”

        I guess it makes sense that the undecideds were scored as alexithymic-leaning, because it seems to me it’s a very alexithymic answer. “how are you feeling?” “undecided.” “how do you feel about talking about your feelings?” “undecided.” “how easy is it for you to talk about your feelings?” “I DONT KNOW”

        1. Oh my gosh, that’s so interesting that you wanted to communicate with others via the color of your clothing.

          Your reasons for seeing the undecided answers as alexithymic are exactly what I was thinking. If you can’t answer the question, it suggestions a certain level of difficulty right there. :-)

      2. Also, my elaborate colour sorting thing that I used to do was misdiagnosed as OCD, because to the people around me it looked like I was spending a lot of time lining things up and then sorting them in a bizarre way, and so my therapists made it a goal to get me to stop doing it. If they’d only understood, and I didn’t feel safe explaining it back then, they would hopefully (if they were better therapists than they were) encouraged the behaviour.

        1. I get so rage-y when I hear this kind of thing. All I keep thinking is “nonfunctional for WHOM?” because there are things we do that serve a very real purpose for us, no matter what it looks like to others.

  14. Interesting post! I particularly appreciate that you talk about the limitations of the test. It’s also fascinating seeing how commenters experience emotions, especially the Anonymous right above me. Wow!

    I just took the test myself out of curiosity and got no alexithymia symptoms in all categories except describing emotions, where I had a high score (15). Interestingly, I find emotions hard to describe for perhaps all the reasons I’m *not* alexithymic: I’m highly aware of immense complexity and intensity of my emotions, but they’re an entirely nonverbal experience, so how can I possibly convey all that in words? They just seem so inadequate. I have no problem telling people I trust “I feel happy/sad/embarrassed/annoyed/stressed/depressed because x” but going beyond this usually requires metaphor, and lots of thought. Another complication: worrying whether my emotions will be acceptable to others also interferes with communicating them in most situations. I wonder if fears like this, or social anxiety, would raise this part of the alexithymia score for others, too.

    Do you think it’s possible that *either* end of the alexithymia continuum could lead to difficulty describing emotions?

    1. That’s an interesting question. If you experience emotions in a primarily nonverbal way (which makes perfect sense to me) then describing then sounds not only difficult but perhaps unnecessary? I mean, if you know what you’re feeling and can put a general word to the feelings, that should probably be enough for others? Though I can see where it might not be, especially in close relationships.

      I’m leaning toward thinking that you’re a predominantly nonverbal thinker and that’s where the difficulty lies, rather than being an emotional dysfunction issue. Do you have trouble describing other conceptual ideas in words?

  15. Test Score: 128
    Category: Difficulty Identifying Feelings: 21 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 16 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 12 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 22 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 15 Points
    In this category you show no alexithymic traits.

    Category: Problematic Interpersonal Relationships: 24 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 18 Points
    In this category you show high alexithymic traits.

    I get really upset sometimes when I get stuck emotionally in a grey area and can’t decide if I feel positive or negative about something, so I can’t figure out what to do. So frustrating! And trying to explain it to someone else is even worse when you spend half of the conversation grasping at words.

  16. I’ve been a bit of a lurker here. This test was interesting because I was pretty convinced that I didn’t have alexithymia.

    Ho hum.

    Score: 136

    Category: Difficulty Identifying Feelings: 25 Points
    In this category you show high alexithymic traits.

    Category: Difficulty Describing Feelings: 17 Points
    In this category you show high alexithymic traits.

    Category: Vicarious Interpretation of Feelings: 13 Points
    In this category you show high alexithymic traits.

    Category: Externally-Oriented Thinking: 26 Points
    In this category you show high alexithymic traits.

    Category: Restricted Imaginative Processes: 14 Points
    In this category you show no alexithymic traits.

    Category: Problematic Interpersonal Relationships: 25 Points
    In this category you show high alexithymic traits.

    Category: Sexual Difficulties and Disinterest: 16 Points
    In this category you show high alexithymic traits.

    I’m a writer, so imagination isn’t a problem for me. One thing that did occur to me though, was that because I’ve had a lifetime of people invalidating my feelings, and punishing me for showing anger, anxiety or distress, I’ve spent a lot of time stamping on my emotions because I wasn’t allowed to have them. I wondered if this was common for autistic people and could it contribute to alexithymia?

    1. I’m so glad you decided to comment!

      I think that being told “negative” emotions are wrong or being punished for displaying certain emotions can contribute to how alexithymia manifests, but I lean toward thinking that autistic alexithymia is rooted in our wiring (not sure if you’re on the spectrum, so disregard the inclusiveness of my statement if appropriate). Another regular commenter here (@quarridors) had the opposite experience of my own growing up. Mine was more like yours while quarridors’s was one of encouragement to express emotions openly and we had nearly identical overall scores on this test. But the way we experience alexithymia is somewhat different and appears to be influenced by how we were taught to experience and display emotions.

      So my thinking is that the fundamental dysfunction exists, but how it “looks” in us as adults might be heavily influenced by our upbringing. Certainly what you describe is a negative contributor to anyone’s emotional health and something that takes a long time to try to heal from. I’m really sorry you’ve experienced that because I know how hard it is to cope with and how much impact it has on a person’s wellbeing.

      1. Yes, I am autistic!
        Blog: http://autistwriter.wordpress.com

        You make a good point; I think this is one of the big issues for the divide between autistic people over 35 and those younger. It’s not an absolute rule, but in general the parenting styles the two groups experienced are very different; many older auties had their autistic behaviours beaten out of them, because that was what you did back then if your child was ‘bad’. So now we have people saying that there are no adult autistics, or very few, because we have been trained to suppress who we are.

        And what is probably worse, many of us have internalised this. Which is why I need a questionnaire to point out the ways I differ from ‘normal’, because (for example) when someone asks me if I’m happy, my response is to decide whether or not I am in a situation where I would be expected to be happy, and base my reply on that, without questioning whether this is how most people respond. The concept of actually interrogating my own feelings is alien – I gave up on it years ago, because the wrong (but honest) answer would usually bring the sky down on my head.

  17. Well, I have to admit I took the test and scored 113 which still puts me as having “high alexithymic traits”. I didn’t comment right after I took the test because I wanted to take it again “more honestly”. But I haven’t had time, so I’m just going to admit to it and put my score here. I thought for sure I would score much, much lower, because though, whenever I read about alexithymia I can relate, I didn’t believe I actually had it! Hence my solution – retake the test! Also I couldn’t answer a lot of the questions, because, as with most multiple choice, they aren’t nuanced or specific enough for me to be able to answer “honestly” and that always trips me up.

    1. I don’t think the test is very conclusive, but more of a starting point for thinking about how we process emotions. Also, you’re right about some of the questions being poorly worded or too broad. I feel like some of these tests are written in a vacuum. The researchers need to field test them on actual people to see how the questions are being interpreted. Or in some cases how impossible they are to interpret!

  18. This is such an interesting new look on myself all of a sudden, so first of all : thank you for pointing this out! I have been diagnosed on the autism spectrum last year (I’m 34 now), so I’m still learning about a lot.
    This alexithymia is something that I am noticing is a major problem in trying to get the right help. How can you get help, if you can’t indicate what your problem is? I figured it was autism + being raised with a manic-psychotic mom (so I have also learned to suppress everything about me), but this alexithymia makes a lot of sense.
    So, this is extremely helpful, reading your experiences and analyses.

    My test result:
    I initially filled this in pretty conservatively, and I ended up with 126. Today it’s 135.

    Difficulty Identifying Feelings: 25 Points high
    Difficulty Describing Feelings: 17 Points high
    Vicarious Interpretation of Feelings: 12 Points high
    Externally-Oriented Thinking: 20 Points some
    Restricted Imaginative Processes: 24 Points high
    Problematic Interpersonal Relationships: 21 Points high
    Sexual Difficulties and Disinterest: 16 Points high

    I was realizing something as I was doing the test for the second time: I am in doubt about many questions, as I am in doubt about whether or not I have difficulty distinguishing and describing my feelings. Because I think : « but I had this conversation with a friend yesterday, and we spoke about my feelings ». So apparently I can, and do talk about my feelings, and I am not that uncomfortable, apart from the eye contact during all this (though she accepts my looking away, I still have to get used to that possibility).

    But, I thought just now. Big but : It took a long time for me to get to this point, much haptotherapy and other therapy, in order to finally be capable of speaking about my feelings with this particular friend, after I have thought about it for a long time. So there.

    @sexual difficulties and disinterest: It makes sense to think that those difficulties (and perhaps therefor some disinterest) stems from the difficulty with the feelings. I think you’re right that the presence of a longterm relationship really matters in this.

    1. I’m so glad it’s provided with you with an additional explanation. A late diagnosis along with the things that linger from childhood can make it so complicated to get a handle on ourselves. It sounds like you’ve made a lot of progress in how you process your feelings. It’s great that you have someone you can share with and who understands what is comfortable for you. My husband is the same way – he knows that if I’m looking away it’s because I need to, not because I’m ignoring him or being rude. :-)

  19. I decided to try this test, as I think it has some relevance, and here I can compare with others’ test results (which is fun). I had 123 points, which is a little bit in the orange overall, but with ‘no alexithymic traits’ at all for 3 out of the 7 areas.

    Category: Difficulty Identifying Feelings: 30 Points
    In this category you show high alexithymic traits.
    Category: Difficulty Describing Feelings: 15 Points
    In this category you show high alexithymic traits.
    Category: Vicarious Interpretation of Feelings: 7 Points
    In this category you show no alexithymic traits.
    Category: Externally-Oriented Thinking: 25 Points
    In this category you show high alexithymic traits.
    Category: Restricted Imaginative Processes: 14 Points
    In this category you show no alexithymic traits.
    Category: Problematic Interpersonal Relationships: 22 Points
    In this category you show high alexithymic traits.
    Category: Sexual Difficulties and Disinterest: 10 Points
    In this category you show no alexithymic traits.

    My feedback on the test: I think it is pretty OK. Only a few of the questions were confusing. I am surprised about result category no. 2 and 4 based on what I answered.

    1. I still don’t for sure understand the externally oriented thinking category. I scored high in it as well.

      It’s interesting that you got “no traits” on interpretation of feelings but “high” on interpersonal relationships. I think that in part points to the interpersonal questions measuring something other than alexithymic qualities.

      1. That might be the case…

        Anyway, the result seems largely right: difficulty defining feelings is the one alexithymic trait I thought I have, and I guess that when you have difficulty defining your feelings then it can be hard to describe them. I think I am really good at describing feelings once they are clearly defined though, but the test didn’t really ask in a way so I could say that.

  20. Yeah, 150.
    I got stuck on the sex questions because I obviously feel I enjoy sex. It did stir up some thoughts about how I experience sexuality and what is so-called ‘sexy’.
    The imagination questions confused my because I do have an imaginative, creative streak. But it made me realize this remains a detached quality, not one that specifically helps me in my well-being of what I achieve in life.

    1. I think the sexuality and imagination questions were an unnecessary distraction, especially given their lack of a direct relationship to the core traits of alexithymia. Still, the test overall seems to be pretty accurate based on what everyone here has said.

    1. Nevermind, retook it. Scored higher this time:

      Overall score: 134

      Category: Difficulty Identifying Feelings: 28 Points
      In this category you show high alexithymic traits.

      Category: Difficulty Describing Feelings: 19 Points
      In this category you show high alexithymic traits.

      Category: Vicarious Interpretation of Feelings: 15 Points
      In this category you show high alexithymic traits.

      Category: Externally-Oriented Thinking: 19 Points
      In this category you show some alexithymic traits.

      Category: Restricted Imaginative Processes: 12 Points
      In this category you show no alexithymic traits.

      Category: Problematic Interpersonal Relationships: 20 Points
      In this category you show high alexithymic traits.

      Category: Sexual Difficulties and Disinterest: 18 Points
      In this category you show high alexithymic traits.

      To my credit, though, I’m only sixteen, so while I DO identify as Asexual, I don’t know if this will hold true in the future. (Though I’m fairly sure that it will…)~

      1. I don’t think you should be “penalized” on this quiz for identifying as Asexual. That doesn’t make sense. Another reason that the sexual difficulties section has no place here. I have no idea what the future holds for you, but I can confirm that my sexual identity at 16 was much the same as it is now. :-)

  21. After meeting at my Asperger Service on Tuesday to work on strategies for improving emotional self-awareness, I found this paper’s abstract saying that autistic people show much less brain activity for emotional self-reflection regardless of how much emotional awareness they self-reported on the Alexithymia questionnaire:

    http://www.tandfonline.com/doi/abs/10.1080/17470910701577020?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&

    Shame the full paper’s behind a paywall.

    This similar paper on how we use the part of our brain NT people use only for understanding other people on ourselves is fully available though:

    http://www.academia.edu/984892/Atypical_neural_self-representation_in_autism

  22. I scored 121: high alexithymic traits

    Difficulty Identifying Feelings: 19
    -high alexithymic traits.

    Difficulty Describing Feelings: 14
    -high alexithymic traits.

    Vicarious Interpretation of Feelings: 9
    -some alexithymic traits.

    Externally-Oriented Thinking: 25
    -high alexithymic traits

    Restricted Imaginative Processes: 18
    -some alexithymic traits.

    Problematic Interpersonal Relationships: 26
    -high alexithymic traits.

    Sexual Difficulties and Disinterest: 10
    -no alexithymic traits.

    Now I understand why so many arguments with my parents used to involve long periods of me staring at the floor unable to express myself when my parents expected an answer about how I felt or how someone else felt. I would say I didn’t know, then my dad would say something to the effect that he hated that I said “I don’t know” so often, that it was a pathetic evasion and that I was a smart kid, so I couldn’t actually not know how I felt. I always hated that, so then I’d tell them that now I felt frustrated and angry, which usually got them offended, so I wouldn’t say anything, and this cycle would repeat ad neaseum.

  23. Something strange: I tried a few different emotional intelligence/EQ tests, and I kept getting average to well above average scores. I wonder if this could be because most people who take the tests tend to have lower than normal emotional intelligence? The questions focused a lot on interpretation of expressions, or on how you would handle your feelings and those of others in various emotionally tricky situations. I seem be considerate and careful of other people’s feelings, good at recognizing facial expressions and body language, and good at knowing how I should proceed in emotionally charged situations. However, I’m also bad at analyzing and communicating my own emotions and frequently unaware of how people feel when they aren’t being obvious about it, or why they feel the way they do. Well-intentioned, considerate, but clueless. Rats.

    1. It definitely could be that the scores are skewed downward, though on a well made test, the scoring rubric would account for that. But I’m suspect of a lot of the “averages” on internet quizzes for exactly the reason you mention. They definitely appeal to people who suspect they may fit a certain profile.

      And like you, I fall into the well-intentioned but clueless category. :-)

  24. Hello, I’m a first timer on this page and newly acquainted with the term Alexithymia. After learning about it and taking the test (138) I finally know what is “wrong” with me or however I should call it. I can’t say that it has been much of a struggle up until the past 2 years or so because I met a person that can read me and knows how to handle me in most situations.

    Throughout my life I have been living in a world where my actions and my face towards other people have been copied straight from todays very open society. You watch movies, you can see what is going on, you can see how they react and your brain goes like “Ahaa, so this is what I’m feeling in this situation” if it’s scared, sad, happy, in love, angry, annoyed etc. That worked great for me for a very long time, until it just didn’t anymore and everything came crashing down on me.

    I don’t want people to know that I have no clue what I’m feeling, I am an extremely private person. I don’t like to be touched by people I don’t know, even handshakes makes me terribly uncomfortable. However at the same time, I have no problem doing my job, I take care of elderly people both at a nursing home and in their own homes. I talk to them, give them medication and show sympathy and empathy wherever I need to, even though I can’t be sure if I actually feel it or not. It is usually pretty straight forward though, if someone is crying you know they are sad, if they are crying and smiling you know it’s tears of joy etc etc, things you learn from watching a bunch of movies and tv series rather than interperate your own gut feeling.

    Despite the struggles that comes with this emotion confusion in the real world (not my personal copied version), I actually am a very lively person, I have an insane sense of humor and I laugh a lot but it is getting more and more difficult. Reading about Alexithymia has helped me understand what is going on but I don’t know how to deal with it anymore. I try to compare what I read about other peoples stories and my own but that just doesn’t work, we are all different.

    How do you deal with this without lying to every single person in your life including yourself?

    1. Welcome. I’m glad you felt comfortable enough to share your thoughts and experiences here. It sounds like you’ve learned how to play certain roles in your life through intuiting various rules and cues, which I can really relate to. It’s hard to realize that you’ve basically been “faking it” for so long and suddenly that isn’t working so well any more.

      While I haven’t told anyone other than my husband that I’m alexithymic, I also don’t think I can hide the traits of my alexithymia. I’d venture to say that everyone I know is well aware of it, so I guess that’s how I deal with it, but not having any other option.

      What I’m sensing from what you shared is that you feel like you’ve found ways to mask your traits and that feels to you like you’re lying to people. I can relate to that in the sense that I’ve spent my whole life trying to mask my autistic traits and now I find myself straddling two worlds essentially – the world where I still have to “pass” because certain people are unaware of my diagnosis and the world where I can be myself because the people in that world are aware of it. And that’s becoming harder and harder to cope with.

      If you can, I’d suggest trying to share what you’ve shared here with the person you feel would be most open to understanding your experience. That might be a person who is closest to you or maybe someone who you think has had similar experiences. Just getting a positive response from one person, even if it takes some convincing at first, can make a huge difference. I remember how scary it was to share my suspicion that I was autistic with my husband and how even though he was reluctant to believe it at first, when he began to accept the possibility, I felt validated and less scared.

  25. NT here. I scored high on externally-oriented thinking. I think the reason I scored that way is that I said I didn’t *prefer* to talk about other people’s feelings. The thing is that I think other people’s thoughts and feelings are their business. If they want to share them with me, I’ll listen. I’ll be sympathetic, and give feedback and support, and all that stuff. But if they don’t, that’s cool, b/c I own my thoughts and feelings too, and don’t feel obligated to share them if I don’t want to. So to say I “prefer” to talk to other people about their feelings rather than activities and so on would seem creepy and intrusive to me.

    1. So what you’re saying is that you have that weird thing known as boundaries? :-D

      Preference does set it up to be a choice, where I think for people who are alexithymic it’s stronger than that. More of an imperative, if that makes sense.

      1. I always have thought about boundaries. My mother, as I was growing up, tried to teach me to be a Southern lady. Some of that training didn’t take; some of it did, that I wish hadn’t – it took years before I was able to express anything negative until I was good and angry, and then my anger took over and expressed it for me – very destructive and something I still work on.. But one thing that I am glad I learned was to mind my own business, not make personal comments unless invited, not ask personal questions, and so on. If somebody offers something you can ask a follow-up question, and if somebody seems to want to talk, you can assure them that you’ll listen. But that’s about it.

        When my daughter was small I nudged her toward expressing the kinds of feelings I wasn’t supposed to, but verbally and in a calm and respectful way, and I made a conscious effort to be accepting of her feelings. To do that I had to kind of enter into her world with her. But now that she’s grown, and lives about an hour away, I stay out of her business. Haven’t ever asked her to friend me on Facebook (not that I use it anyway) because she needs a life apart from her mommy. I’m very interested in what she does but I only want to know what she chooses to share with me.

        And that’s my personal essay, ha ha. I do want to add that I was interested to read your marriage thoughts, and that the grits thing would have irked the stew out of me. If you want some say yes, if you don’t, say no. I just don’t read minds.
        : )

        1. Those sound like good basic rules for boundary keeping. I try to be the same way with my daughter. We’re not facebook friends and I wait for her to share what she chooses about her life (though perhaps sometimes I take that too far and appear uninterested, which isn’t the case). Parenting an adult child is a good lesson in finding workable boundaries. :-)

          The grits thing . . . that was annoying, yeah. We don’t do that anymore.

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