Tag Archives: alexithymia

Coping Strategies Survey

This week’s questions are all about coping strategies. Traveling, panic attacks, aging, job hunting, emotions, obsessions – it’s a great mix and I think we’re going to come up with a great big pool of potential strategies that we can all draw on when needed.

You know the drill–if you’re on the spectrum, either formally diagnosed or self-identified, you’re welcome to join in. Answer as many or as few as you like. Do it here or anonymously at Survey Monkey.


1. I am wondering if travelling is hard for all Aspies as they age or if it is just me?  I like my home at night and my own environment. I prefer to be as close to it as possible…and I get sick or upset if I stay away…my tolerance is two days from home max and two weeks to recover…Does anyone else feel this way? Does it get worse with age or in certain decades? more details here

2. Is liking or disliking foreign travel related to ability to pass for NT at home?

3. Do you experience problems with long flights? If yes, which aspects are most problematic? (which travel stages: e.g. planning, navigating airports, flying, unfamiliar surroundings at the destination etc – and which problematic factors: e.g. sensory overload, executive function issues, anxiety / panic attacks etc) How do you cope with long flights? (what are your coping strategies)

4. How do you cope with panic attacks in unavoidable situations that you can’t leave, such as during flights?

5. Do you find yourself getting more autistic as you get older? Did your coping strategies improve with age due to experience or psychological assistance (I shy away from the word ‘treatment’) or did they deteriorate over time because of a decrease in overall energy?

6. How do you cope with strong emotions, especially strong negative emotions, especially if you’re also alexithymic? How do you support someone going through a very difficult time emotionally (nothing practical to be done)? How do recognise what the feelings are, and how do you respond in a way that comforts the person?

7. How do you motivate yourself to job hunt? more details here

8. A question that is specifically for people who menstruate: do you notice changes during your menstrual cycle. With changes I mean changes in sensory perception, abilities to cope and/or compensate, EF, etc.

9. If you’ve been heavily obsessing about an interest for a while do you find you have to have a short break from it because it has got too intense?

10. Has anyone taken concerta/ritalin/other stimulant drug prescribed to help ADHD type symptoms and reacted very badly to them physically? What effect did it have on you in the short and long term?


Taking the Personality and Emotion Test

Those of you who didn’t like the flashing photos in the last two tests will be relieved to know that this week’s test is a series of multiple choice questions. The Personality and Emotion test at Test My Brain looks at three areas:

  • how frequently you experience negative emotions like fear, worry, anger, frustration, and self-consciousness

  • how sensory seeking you are

  • how much you enjoy social interaction

Their working hypothesis is that people who score higher on the second two will score lower on the first. In other words, if you enjoy sensory and/or social aspects of life, you are less likely to experience high levels of negative emotions. I like the inclusion of sensory elements in this test. I’m not “social seeking” but I’m highly sensory seeking. In fact, much of what I find enjoyable about life falls under the heading of sensory input. It’s nice to see that acknowledged as valid, alongside the more traditionally valued social interaction.

I want to talk some more about the individual sections when I share my scores, so let’s take the test first.


The test takes 10 to 15 minutes. To start, go to testmybrain.org and click on the Go! button next to the “Personality and Emotion” test.

You’ll be asked to make your browser window large. I kept mine the size I normally use and it worked fine. The next screen is a simplified informed consent form. You’ll be told what the research is being used for and asked to consent (agree). The next screen collects some anonymous demographic information.  Continue reading Taking the Personality and Emotion Test

Silence II: Variation

I have more than one kind of silence. There is the very bad kind, the crushing kind. That one I could do without.

There is also the heavy silence. I can force the words to come out, but each one is an effort, like lobbing boulders out of a pit. They land in the dirt around me, scattered, muffled, obscured by clouds of dust. Lobbing boulders is hard work.

There is the accidental silence. The words fly away, leaving gestures, grunts, nothing at all. “Didn’t you see my eyes get wide?” I ask The Scientist when he wonders why I didn’t warn him about the wall he was about to back into.

There is the silence of too much. Too much input. Too much to process. Too many people, things, noises, questions, answers, objects, movement. I feel myself fading into the scenery, disappearing. I become silence itself.  Continue reading Silence II: Variation

Silence I: Frustration

The first in a 3-part series on silence. 


My silence is frustrating. For me. For others.

I don’t mean the silence between the words, the comfortable kind, the long drive in the car, relaxed lunch in the park, playing video games for hours side-by-side on the couch, reading together kind of silence.

Frustrating silence is the kind that arises in place of words, filling up all the space where the words should be. It starts with a heaviness in my chest, like my breastbone has become a plate of armor thick enough to stop a lance or a bullet or a barrage of charged emotions.

The weight holds the words down, tethered tight, floating out of reach. I can see them, hear them. Inside me, there is a cacophony of noise as the words rattle and clash, struggling to escape. It feels as if I’m shouting and yet there is no sound, except within me.

Then one breaks free. Two. Five. A phrase or a sentence. Small and inadequate to the task, they float up, fill with breath, are shaped by tongue and lips. Often the ones that escape are the most practiced. Scripts. Platitudes. The reliable “I don’t know.”  Continue reading Silence I: Frustration

What I Want

At the end of July I embarked on a 30-day experiment, the aptly-named “What Do I Want” experiment. My intention was to report back at the end of August with a neat little of summary of what I’d learned.


Initially, I thought “what do I want?” meant learning to identify my needs and desires. That sounded intimidating. I had little idea where to begin so I began obsessing over decisionmaking. It was concrete and easy to construct rules around. It was also just scratching the surface of what I needed to be doing.

Wading deeper into the experiment, it became more difficult to separate what I want from other big questions of identity. What I am. How I act. How I think. Who I want to be.

I gradually began to realize that being autistic and alexithymic is only part of what makes “what do I want?” so hard to answer. There is a secondary element at work, an old defense mechanism. Wanting something, getting my hopes up, expressing a preference, letting desire creep in–that makes me vulnerable. To deprivation, to loss, to mockery, to pain. Not wanting feels safe. Ultimately, though, all it gets me is preemptive deprivation. There’s a lot of emptiness in not wanting.  Continue reading What I Want

Under Control

Control. It sounds like a good thing.

Self-control. I’ve got this under control. Control yourself.

For years, I had everything under control. I swore I did. Everything from family activities to how people were allowed to feel around me. Is some small detail unplanned? I’ll plan it. Someone has a problem? I’ll fix it, whether they want me to or not. Something needs to be done? I’ll take care of it. In fact, I’ll do it myself because that’s the only way it will get done right. Because only I know what the right way is.

See, everything under control.

This should feel good. My entire universe working according to my grand plan. Only it doesn’t feel good. It’s exhausting and it drives the people around me up a wall.

It’s also an illusion.   Continue reading Under Control

Interoception: How Do I Feel?

Let’s talk about interoception. I bet you’re already on the edge of your seat, right?

Okay, okay, first a definition. Interoception describes our sensitivity to sensations that originate in our bodies. Think pain, temperature, itch, sensual touch, sensations from our organs and muscles, hunger, thirst, and breathlessness.

All of these sensations combine to give us a sense of sentience. I’m hungry therefore I am.


Our Body’s Dashboard

Interoceptive feedback is important for keeping our bodies in good working condition. Think of them as the body’s dashboard. Are we low on fuel? Running too hot? Has it been too long since some critical service was performed or is a warning light flashing? Interoceptive sensations provide the feedback necessary for troubleshooting and correcting imbalances in the body.

Emotions often arise from our interoceptive sensations, too. When someone asks how you feel, you probably subconsciously check-in with your body, and realizing that you’re tired, hungry, hot, or achy, you reply, “not too great.” Or conversely, if your interoceptive sensations are in balance, you might report feeling happy or at least content.

Obviously not all emotions are tied to interoception, but it’s hard to be happy when you’re in pain or content when you’re itchy. For many people being hungry or tired is a direct route to being cranky and short-tempered. Those of us who are alexithymic experience this even more strongly, often struggling to identify the difference between emotions and physical sensations. I can’t explain how my body confuses “upset” with “cold,” but sometimes it does. Now I know that if I’m feeling cold when no one else around me is, I need to check in with my emotions. And put on a hoodie.

Engage Interoceptive Dampeners

But what if your interoceptive system is dampened? What if a sensation needs to be in the red zone before it comes up on the dashboard? Well, then you forget to eat or stare in wonder at your bleeding toes or don’t realize you might be in pain until you pass out. Sound familiar?

Many autistic people have dampened or muted interoception. We just don’t seem to notice what’s going on in our bodies until it reaches a level that other people would find intolerable. And often when we do notice it, it goes from “oh that’s happening” to intolerable really darn fast.

As often as I experience this in minor, inconvenient ways, I’m occasionally reminded of how dangerous it can be. Because hindsight is 20/20, I can see in retrospect that I recently had a UTI coming on for days before I picked up on the symptoms. One of the main symptoms is pain and other than a vague crampy feeling, I wasn’t experiencing any. Easy to ignore, so I did.

Then some harder to ignore symptoms started happening and my daughter, who I was visiting at the time, said, “you need to go get this checked now.” Left to my own devices, I probably would have taken a wait-and-see approach which would have been bad. Because a few hours later, shortly after getting my prescriptions filled, I was in intense pain. An hour early, at the walk-in clinic, the doctor asked me if I had any pain and, after thinking about it for a moment, I said, “maybe a little?”

My body had gone from zero to “MAKE IT STOP” in less than hour.

And thanks to my body’s poor interoceptive workings, I was rewarded with a kidney infection because unlike most women who dash off to the doctor at those first signs of a UTI, I wasn’t getting enough data to trigger my internal alarms. It wasn’t until I started having more obvious symptoms that I realized something might be wrong and took to Google to figure out what it could be. By the time I started getting the right antibiotics in my body, a common minor ailment has progressed to a potentially serious illness that I’m just starting to recover from two weeks later.

Unreliable Indicators

One of the purposes of interoception is to drive behavior.

Hungry? Eat.

Tired? Sleep.

Pain? Seek help.

Interoceptive sensations–especially pain–may be unreliable indicators in autistic individuals. Medical professionals often rely on pain and other self-reported symptoms of discomfort to assess the presence or seriousness of an illness. In my case, my interoceptive sensations were saying “meh” but my fever (which I didn’t realize I had) and high bacterial count were saying, “hey, big problem here!”

When you combine muted interoception with poor executive function–which may be further impaired by the stress of illness–you’ve got a recipe for disaster. This is why I need someone else to say, “we’re going to the doctor now.” It’s also why recognizing that autistic people may have unique pain, distress or illness signals is important for medical professionals, caregivers and loved ones. This can potentially lead to misdiagnosis or underdiagnosis.

Our nonstandard brain wiring can mean that we miss common warning signs or have difficulty knowing when to act on distress signals.

Two-Factor Imagination Scale (TFIS) Test

This week I took the Two-Factor Imagination Scale (TFIS) test. It was developed to identify the predominant imagination style used by alexithymic and non-alexithymic individuals. I have a couple of questions at the end of this write-up for those who take both TFIS and the Alexithymia Questionnaire.

Imagination–or the alleged lack of imagination in both autistic and alexithymic individuals–seems to be a hot topic around here lately.

Impoverished imagination is often included in the list of traits for alexithymia. Restricted imagination isn’t explicitly included as a diagnostic item for Asperger’s or autism, but it is part of the common ASD stereotype.

People see autistic kids lining up Hot Wheels or sorting Legos by color and assume there isn’t a whole lot going on in the imagination department. As someone who spent a lot of time in organizational-type play as a kid, I can assure you that I had a vivid imagination.

The thing is, it mostly took place inside my head. All that time I spent wandering around aimlessly in the yard or staring off into space? I was often playing with my imaginary friend Will, pretending to be somewhere else entirely. Will and I spent a lot of time on other planets because he was modeled on Will Robinson from “Lost in Space.”

I didn’t need toys to act out my imaginary scenarios. The possibilities that existed in my mind were more interesting than the pretend food my friends wanted to pretend cook or the pretend store they liked pretend shopping at. Sometimes I joined in, but often it just seemed like a less interesting version of real life. I get bored really easily. Picking some berries and pretending to cook and eat them didn’t hold my attention for long.

Spontaneous vs. Controlled Imagination

The Two-Factor Imagination Scale questions are supposed to gauge whether you have a more spontaneous or more controlled imagination process.

  • Spontaneous imagination is defined as effortless, surprising and instantaneous. For example, you’re washing the dishes and suddenly have a great new idea for a drawing. It feels like your idea literally “came out of nowhere.”
  • Controlled imagination is defined as a process that is consciously initiated, guided and terminated. For example, you’re washing the dishes and consciously decide to think about how to resolve a conflict with your roommate. You intentionally stay on task, brainstorming ideas and refining until you have an answer, at which time you stop thinking about it.

That’s not to say that spontaneous imagination is always creative while controlled imagination is always practical. You could suddenly have the perfect solution to your roommate crisis appear out of nowhere. You could also intentionally brainstorm and plan a new drawing.

The theory behind the TFIS is that people with high alexithymic traits are controlled imagination-dominant. The speculation about imagination in autistics is similar–that our imaginations are less flexible or less productive when it comes to generating novel ideas.

While the TFIS isn’t a measure of how imaginative an individual is, it may shed some light on how we use our imaginations. Keep in mind that neither type of imagination is superior–they simply represent different thinking styles.

Taking the Test

You can take the test at Aspie Tests. Once you click the “click here to start” link, you’re taken to a page that asks for age, gender, and diagnostic status. You also have to tick the box agreeing to the terms, but you don’t have to fill in the user name info.

TFIS consists of 22 statements, which you  rate as “more often true” or “less often true”.

I had a lot of trouble choosing an option for many of the statements because I regularly have both controlled and spontaneous imagination experiences. I found myself answering questions in ways that directly contradicted each other, which got frustrating.

Once you’re satisfied with your answers (or can’t stand to look at the questions any longer) click the “Get Results” button to get your score.

Scoring the Test

There are three possible outcomes:

  • equal to or less than 45 = low spontaneous imagination
  • 46 to 59 = proportionate spontaneous/controlled imagination
  • equal to or greater than 60 = high spontaneous imagination

I scored 56.0 (proportionate spontaneous/controlled imagination), which isn’t surprising given how contradictory my answers felt. I think I use both types of imagination in tandem. Spontaneous ideas provide the start of a creative project or enrich the details. Controlled imagination fills in the gaps.

The Aspie Test site provides some interesting data on the scoring page. If you look only at the averages, it looks like people with ASD or suspected ASD have low spontaneous imagination and NTs have proportionate spontaneous/controlled imagination.

Average scores broken down by gender and neurotype
Average scores broken down by gender and neurotype

However, if you look at the graph, the data distribution isn’t “normal” which means the average scores don’t represent the majority of the people in each group. Look at where the yellow line peaks: the largest grouping of NT scores is at 40 (low spontaneous imagination) and the second largest is at 60 (high spontaneous imagination) making the average score of “proportionate” completely meaningless because the majority of NTs scored either low or high, not proportionate.

Distribution of scores by neurotype
Distribution of scores by neurotype

The same holds for the ASD scores. There’s a peak at 45 (proportionate) and a larger peak at 25 (low). The suspected ASD scores are literally all over the map, with no clear peak.

The Bottom Line

I’m struggling to draw any conclusions from this test, so I have questions for those who took it and would like to share:

  • How hard was it to choose answers that felt accurate?
  • Was your score surprising or what you expected?
  • Did you TFIS score “agree” with your alexithymia quiz score? (high alexithymic = low spontaneous imagination)

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


  • 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 . . .)


  • 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.

Emotional Dysfunction: Alexithymia and ASD

A typical aspie-NT conversation about feelings:

NT: What’s wrong?

Aspie: I don’t know.

NT: You look upset.

Aspie: . . .

NT: Are you sad? Angry?

Aspie: I don’t know.

NT: It’s okay. You can tell me.

Aspie: . . .

NT: Fine. Don’t tell me. I was just trying to help.

When an aspie says they don’t know what they’re feeling, it’s a literal statement. We aren’t trying to dodge the conversation. We aren’t withholding information. We aren’t being rude, mean, cold coy or vindictive.

I’ve had variations on the above conversation many times and it’s as frustrating for me as it is for the person who wants to know what’s wrong. The reason? I have difficulty identifying my emotions and even more trouble verbalizing them. Working through my emotional constellations has helped me identify some of the specific issues I–and many autistic people–have in processing and identifying feelings.

(Photo: Joe Shlabotnik / Creative Commons)

Predictably, I’ve grouped the issues into three general categories:

  • modulation (moderating the strength of my own emotions)
  • determination (identifying emotions in others)
  • discrimination (separating emotion directed at me from general expression of emotion)

Modulation: The Glitchy Volume Control

There is a common misconception that autistic people are unemotional. You’ll often hear this refuted by autistics themselves, who say they are too emotional. So which is it? For me, it’s both. My emotions gravitate toward the extremes of muted or intense; few emotional experiences fall in the midranges.

My default emotional state is neutral. I don’t feel especially good or bad. I’m present in the moment and content to be so. Externally, I may come across as serious or subdued, but reduced expressiveness shouldn’t be confused with a negative state of being or a lack of feeling.

The feelings are definitely there. Most of the time they quietly mind their own business and I need to consciously check-in to see what they’re up to. When they decide to fully surface on their own, however, they’re intense.

Unlike most neurotypicals, I don’t have a lot of ability to modulate the strength of my emotions.  Imagine a radio with an on/off switch and a glitchy volume control.

If you think about this in terms of the weak executive function associated with Asperger’s, it makes sense. Humans use reasoning, rationalization and labeling to modulate emotion. All of these methods fall under the umbrella of executive function. Labeling emotions, in particular, seems to be hard for aspies.

Determination: The Broken Mirror

Just as I have difficulty labeling my own emotions, I have trouble identifying what others are feeling. I struggle with interpreting facial expressions and body language. I’m weak at perspective-taking. Basically, when it comes to reading emotional clues, I’m like one of those old-time detectives who had to solve murders without any forensic evidence. There’s only so much information you can gather from what people tell you outright.

This difficulty determining what others are feeling is a big contributor to the stereotype of the empathy-deficient aspie. If someone is giving off “I’m sad” cues that I fail to recognize, when I don’t console them, they’ll assume I’m cold and unsympathetic.

For neurotypical people, emotional interaction is like looking in a mirror. They expect to see a reflective emotion looking back at them and when they don’t, they assume the mirror is broken.

This isn’t to say I’m oblivious to other people’s emotional states. I get the obvious ones and the ones that I can derive from contextual clues. What I tend to miss are the subtle or unexpected emotional states.

Discrimination: Missing the Target

I’ve always been disturbed by confrontation and conflict, even when I’m only a bystander. By default, The Scientist is in charge of “confrontation with others.” If something needs to be argued over or complained about–a botched repair job or an over-cooked restaurant meal–that’s his department. While he’s making that phone call or waiting for the manager to appear, I go off and hide.

As an adult, I’m not proud of this. Why do I desperately need to flee a situation to which I’m nothing more than an observer?

Because, I recently realized, I don’t discriminate between anger that is aimed at me and anger in general. When someone is angry, I invariably feel like I’m the cause or the target, even when I rationally know that I’m not.

If The Scientist calls me after a bad day, I hear how upset he is and immediately feel distressed. Not distressed as in “I should console my husband because he’s had a bad day.” I feel distressed in a “this is incredibly stressful and I want it to stop” kind of way. My brain immediately goes into “fix it” mode, searching for a way to make the other person feel better so I can also relieve my own distress.

Of course, a conversation with an upset spouse is upsetting to most people. But what about a conversation between two strangers that I’ve merely overheard? Twice in the past two weeks I’ve witnessed one person berating another for an etiquette infraction at the swimming pool. (Yes, we take our lap swimming seriously around these parts.) Both times I felt my heartbeat skyrocket, as if the anger was directed at me. In reality, I’m sure neither of these people even noticed I was standing nearby.

Even now, as I’m sitting here in Starbucks typing, the woman at the next table is telling a story about how mad she is at her sister-in-law; I can feel my blood pressure rising at the tone of her words. Words that are completely irrelevant to me. Words that, thanks to my funky brain wiring, I find impossible to tune out.

Yes, not only does my autistic brain not know how to interpret the emotional content of other people’s conversations, it also refuses to tune them out. And people wonder why we aspies like to spend a lot of time alone.

It took me a long time and a lot of thought to figure out why I respond to secondhand distress like this. Why should I feel emotionally assailed when the angry words are aimed at another person?

In part it’s related to my upbringing, but there is also an element of weak executive control at work. In theory, I should be able to rationalize away my overreaction by telling myself that I’m observing generalized anger (or frustration or sadness), not anger directed at me. I should be able to put myself in the other person’s shoes and direct my emotions at the target of their distress, rather than feeling like the target myself.


The three areas where I have difficulty–modulation, discrimination and determination–are actually core traits of alexithymia.

Alexithymia (literally: having no words for emotions) is impairment in identifying and describing emotions. Specifically, it’s characterized by:

  • difficulty identifying feelings
  • difficulty distinguishing between feelings and bodily sensations related to emotional arousal
  • difficulty describing feelings to others
  • impoverished imagination and fantasy life
  • a stimulus-dependent, externally oriented cognitive style

When I look at the list of alexithymic characteristics, I also realize that when I’m emotionally uncomfortable, I’m more likely to have physical complaints. I’ll be feeling frustrated or sad, but  complain that I’m uncomfortably cold or intolerably sleepy. This isn’t a connection I would make on my own, but once I see it described as part of alexithymia–like so much about my autistic self–it suddenly makes perfect sense.

There is a lot of overlap between alexithymia and ASD, both in the perception of emotions and the difficulty in verbalizing feelings. Not only are autistic people very likely to exhibit the characteristics of alexithymia, their parents are as well. However, many non-autistic people also have alexithymia, so it isn’t exclusive to ASD.

Alexithymia isn’t a clinical diagnosis like autism. It’s a construct (theory) used to describe the traits of people who have difficulty verbalizing emotions. It’s also a helpful way of thinking about some of the challenges that aspies have with processing feelings.


More on Alexithymia and ASD:

  • Next Tuesday, we’ll be doing the Alexithymia Questionnaire for Take-a-Test Tuesday.
  • Alexithymia and Grief at Unstrange Mind is a challenging and insightful piece about the mourning process 
  • Great example of an Alexithymia cheat sheet in the form of a flow chart at Radical Neurodivergence