Alexithymia refers to difficulty identifying and expressing emotions.
Alexithymia and autism aren’t the same thing, but they often occur together. Having alexithymia may worsen symptoms of autism — especially communication challenges.
Autistic people with alexithymia can strengthen their emotional and social skills with the right support. This may include therapy, support groups, mindfulness, and/or stress management.
People living with alexithymia have trouble identifying their emotions. Sometimes referred to as “emotional blindness,” it’s not a stand-alone condition or official symptom of autism spectrum disorder (ASD). However, research shows that it might be more common among autistic people.
Among the general population, about 10% of people experience alexithymia. But a review of 15 articles on the topic found that alexithymia affects about half of autistic people. Learning more about the connection between autism and emotional awareness can help you better understand yourself and know when to seek support.
Alexithymia versus autism
You don’t have to have autism to have alexithymia, but people with autism are more likely to experience it. Autism can make it harder to understand and manage emotions and communicate with others.
Research shows that many of these challenges might actually come from alexithymia, which is a separate issue that affects how people feel and express emotions. It’s important to understand this difference, and scientists are still learning how autism and alexithymia are connected.
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What alexithymia looks like in people with autism
Autism exists on a spectrum. This means it affects people differently and ranges in severity. Similarly, alexithymia can present in a variety of ways.
Here are some examples of what it can look like in autistic people:
Interoception: This term refers to an inability to detect what’s happening in your body. For example, let’s say you have an upset stomach because you’re feeling anxious. If you have alexithymia, you might not detect that sensation or the feelings attached to it.
Emotional recognition: Alexithymia doesn’t just impact a person’s ability to identify their own emotions. It can also make it harder to sense others’ emotions and respond appropriately. For example, if you can’t tell that someone is sad, you might not offer support. The person may perceive you as uncaring, even if that’s not the case.
Vocal affect recognition: Communication involves so much more than language. A person’s tone can tell you a lot about what they’re trying to say. For example, let’s say someone says something sarcastic, like, “Good luck with that.” If you miss their tone, you might mistake their sarcasm for sincerity.
Social isolation: If you struggle to identify feelings, it may be harder to engage socially. For example, let’s say you had a tough day at work. When a friend asks you how you’re doing, you’re unable to express yourself. So you miss an opportunity to ask for and receive support.
How emotional blindness affects autistic people
Emotional blindness can affect anyone. But people who live with alexithymia and autism may face unique challenges. In some instances, alexythymia may make autistic symptoms worse.
For example, autism on its own can involve communication challenges, special interests, and repetitive behaviors. But when alexithymia is also present, people may have an even harder time expressing themselves and forging connections. This can make it harder to advocate for yourself, form relationships, and succeed at work or school.
Navigating emotions as an autistic person
Alexithymia and autism aren’t things to be cured, but they can be managed with the right support. There are therapists who specialize in working with neurodivergent people.
Therapists can also help you navigate emotions as an autistic person and explore evidence-based interventions, like:
Mindfulness: Mindfulness is the process of slowing down to pay attention to what’s happening in your mind, body, and surroundings. Activities like breathing exercises and connecting with your five senses can help you tune into your emotions.
Group support: Social skills groups provide a great opportunity to practice noticing and responding to others’ emotions in a safe environment.
Stress management: If you don’t realize you’re stressed, you’re at greater risk of burnout and other challenges. Learning to manage stress can help you become more resilient and reduce the impact of alexithymia.
Music therapy: This approach has been shown to help people who struggle to articulate their emotions with words. Some people are better able to express themselves through music or other creative outlets.
Emotional skill building: You can use a variety of programs (like smartphone apps) to practice identifying and expressing emotions. Strengthening these skills can help you better manage alexithymia.
Knowing whether challenges come from autism or alexithymia can help you find the right kind of support, but it’s also OK if that feels overwhelming. What truly matters is getting help that feels safe and understanding, no matter the label.
Brandy Chalmers, LPC
Clinical reviewer
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Alexithymia is when someone has trouble identifying and expressing emotions. It’s not an official symptom of autism, but it’s more common among autistic people. Living with autism and alexithymia can involve some unique challenges. It can make it harder to communicate, form relationships, and ask for help when you need it.
Fortunately, alexithymia can be managed with help from a neurodivergent-friendly therapist. With the right support, you can improve your social-emotional skills and form meaningful relationships.
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Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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