Incomprehensible emotions – a neuropsychological perspective on alexithymia

Alexithymia is defined as a syndrome of relatively constant individual characteristics, manifested primarily in problems with mental reflection on one’s emotions. It embraces the components included in the cognitive dimension, involving difficulties in identifying, verbalizing and analysing one’s feelings, as well as the components of the affective dimension, namely weak emotional arousability and constricted imaginal capacities. Among individuals with a high level of alexithymia, disturbed emotion regulation and increased risk of developing mental health problems, depressive and anxiety disorders, in particular, are found. The prevalence of alexithymia is estimated at approximately 10% in the general population and over 20% in the clinical population. The first part of the article covers the relation of alexithymia to mental disorders. Subsequently, the evidence of neural correlates and mechanisms of alexithymia is reviewed, with particular focus on functional neuroimaging studies. Cognitive and affective components of alexithymia were found to be associated with activation of different brain structures. Furthermore, the pattern of those relations was found to vary depending on the valence of presented emotional stimuli. The foregoing associations indicate great complexity of the neuropsychological underpinnings of alexithymia. The discussed evidence provides a valuable insight into the possible neuropsychological mechanisms of alexithymia. Nevertheless, it should be considered insufficient for their complete identification. Finally, specific methodological recommendations for further research, as well as some possible therapeutic implications of the results of neuroimaging studies on alexithymia, are offered.