Autism and Alyxithymia: Understanding the Disconnect Between Emotions and Words
Bridgette Hamstead
Many autistic people, including myself, experience emotions deeply but struggle to identify or express them in ways that neurotypicals expect. This is called alexithymia, and it creates a disconnect between emotions and words that can make self-awareness, communication, and emotional regulation incredibly challenging. It is not a lack of feeling—many autistic people actually experience overwhelming emotions—but rather a difficulty in recognizing, labeling, and verbalizing those emotions in real time.
For years, I internalized the idea that if I could not name my feelings, I must not be feeling them at all. I now know that is not true. Autistic people with alexithymia may express emotions through physical sensations, changes in behavior, or nonverbal cues rather than through words. Unfortunately, because society equates emotional expression with verbalization, many of us are misunderstood, dismissed, or even seen as cold or indifferent when, in reality, we care deeply.
This is why we need a broader, more inclusive understanding of emotional communication. Not everyone can—or should have to—process emotions the same way. Instead of demanding verbal clarity in the moment, we should recognize that emotions can be expressed through actions, written words, creative outlets, and body language. By shifting expectations, we can build more accessible and affirming spaces where autistic people do not have to prove their emotions to be understood.
________________________________________________________________________________
Autistic individuals experience emotions just as deeply as anyone else, but many struggle with identifying, expressing, or even fully understanding what they are feeling. This difficulty is often linked to a trait known as alexithymia, a condition characterized by an impaired ability to recognize and articulate emotions. While not all autistic people experience alexithymia, research suggests that a significant percentage do, making it a common but often overlooked aspect of the autistic experience. Because mainstream discussions about emotions assume that people can easily name and describe what they are feeling, those with alexithymia are frequently misunderstood. The assumption that emotions must be verbalized in order to be valid creates a disconnect between how autistic individuals actually experience emotions and how others expect them to express them.
Alexithymia is not a lack of emotion. It is a difficulty in accessing the language or cognitive clarity to describe emotions in a way that others understand. Many autistic individuals feel emotions intensely, sometimes even more so than neurotypical individuals, but they may struggle to pinpoint exactly what they are feeling in the moment. This can lead to frustration, confusion, and an increased likelihood of emotional overwhelm. Instead of being able to identify emotions as they arise, some autistic individuals may only realize they were feeling something much later, once the intensity has faded. This delayed emotional processing can make it difficult to regulate emotions in real time, leading to shutdowns, meltdowns, or seemingly disproportionate reactions to situations that others may not perceive as particularly distressing.
One of the most significant challenges of alexithymia is its impact on communication and relationships. Because emotions are such a central part of human interaction, neurotypical people often expect clear emotional expression as a way to gauge someone’s thoughts and feelings. When an autistic individual struggles to verbalize their emotions, they may be perceived as indifferent, cold, or unfeeling, even when this is far from the truth. This misunderstanding can strain relationships, as friends, family members, and partners may interpret a lack of verbalized emotion as a lack of care. In reality, many autistic individuals with alexithymia deeply care about their loved ones but struggle to express it in conventional ways. Without recognizing the disconnect between emotions and words, neurotypical individuals may misinterpret the autistic person’s emotional world, leading to unnecessary frustration on both sides.
Alexithymia also influences the way autistic people navigate emotional self-awareness. Many neurotypical individuals take for granted their ability to recognize when they are sad, anxious, or excited. For those with alexithymia, emotions may manifest primarily through physical sensations, such as a racing heart, muscle tension, or fatigue, rather than as distinct emotional labels. Someone may feel exhausted without realizing they are actually experiencing stress. They may feel physically sick without recognizing that they are overwhelmed by anxiety. This can make emotional regulation incredibly difficult, as identifying and naming an emotion is often the first step in managing it. Without that ability, emotions can feel like an unpredictable force, surfacing in unexpected ways and leaving the individual feeling out of control.
The disconnect between emotions and words can also have significant implications for mental health. Many autistic individuals with alexithymia struggle with anxiety and depression but may not recognize the symptoms as emotional states. Instead of describing themselves as sad or anxious, they may report feeling physically unwell, disconnected, or simply “off” without being able to explain why. This can make it difficult to seek appropriate support, as traditional therapeutic models often rely on verbal discussions about emotions. A therapist may ask how someone feels, expecting a straightforward answer, but for an autistic individual with alexithymia, this question may be impossible to answer in the moment. The inability to communicate emotions effectively can lead to feelings of isolation, frustration, and a sense of being misunderstood even in professional mental health settings.
Despite these challenges, there are strategies that can help autistic individuals with alexithymia navigate their emotional experiences more effectively. Some find that using external tools, such as emotion wheels or lists of feeling words, can help them build a vocabulary for emotions over time. Others benefit from tracking their physical sensations and patterns in behavior to identify emotional triggers. Engaging in nonverbal forms of expression, such as writing, art, or music, can also provide a way to process emotions without relying on verbal articulation. Building self-awareness around alexithymia can help autistic individuals recognize that their emotional experiences are valid, even if they do not fit traditional models of emotional expression.
Understanding alexithymia also requires a shift in how society perceives and interprets emotions. The expectation that everyone should be able to immediately identify and verbalize their emotions is a narrow and neurotypical-centered perspective. Just because someone does not express emotions in a conventional way does not mean they do not feel them. Relationships, whether personal or professional, can benefit from a more flexible understanding of emotional communication. Instead of demanding verbal expression, loved ones and colleagues can learn to recognize other signs of emotion, such as changes in behavior, body language, or tone of voice. By making space for different ways of experiencing and expressing emotions, communication can become more inclusive and affirming.
Alexithymia is not a flaw or a deficiency, but rather a different way of processing emotions that requires a different approach to understanding and communication. For autistic individuals who experience it, the challenge is not in feeling but in translating those feelings into words that others understand. The more we acknowledge and accommodate these differences, the less alienating emotional expression becomes for those who experience it differently. True emotional connection is not about conforming to a singular way of expressing feelings. It is about creating space for different ways of experiencing, processing, and understanding emotions, allowing everyone to communicate in ways that feel authentic to them.
Examples and Recommendations for Navigating Alexithymia
Examples of How Alexithymia Affects Emotional Processing
Feeling physically tense, exhausted, or sick without realizing it is due to stress or anxiety.
Struggling to answer when someone asks, “How are you feeling?” because emotions are unclear or unprocessed.
Only recognizing emotional states after a delay, sometimes hours or days later.
Reacting strongly to a situation but not understanding why until much later.
Feeling overwhelmed but unable to pinpoint whether it is frustration, sadness, or sensory overload.
Having emotions expressed through actions rather than words, such as withdrawing from social interactions, becoming restless, or engaging in repetitive behaviors.
Finding it easier to process emotions through writing, art, or music rather than verbal conversations.
Recommendations for Autistic Individuals with Alexithymia
Use External Tools: Emotion wheels, charts, and feeling word lists can help build a vocabulary for emotions over time.
Track Physical Sensations: Keep a journal of physical symptoms and events to identify patterns in emotional responses.
Allow Processing Time: Give yourself space before responding to emotional situations rather than feeling pressured to react immediately.
Explore Nonverbal Expression: Writing, drawing, or using body movements can be helpful ways to process emotions without needing words.
Identify External Cues: Notice changes in sleep patterns, eating habits, or sensory sensitivities that might signal emotional shifts.
Practice Self-Compassion: Recognize that difficulty identifying emotions does not mean they are not real or valid.
Recommendations for Supporting Someone with Alexithymia
Avoid Pressuring for Immediate Emotional Responses: Give space for processing instead of expecting instant verbalization.
Use Open-Ended Questions: Instead of asking, “How do you feel?” try “Is this situation feeling overwhelming or frustrating?”
Recognize Nonverbal Emotional Cues: Look for behavioral changes, body language, or sensory regulation needs rather than expecting verbal confirmation of emotions.
Provide Alternatives to Verbal Expression: Encourage writing, art, or other forms of self-expression instead of assuming emotions must be spoken.
Respect the Need for Structure: Predictability and routines can help reduce emotional overwhelm and provide stability.
Avoid Making Assumptions: Just because someone does not express emotions in a conventional way does not mean they do not care or feel deeply.
By recognizing and accommodating different ways of processing emotions, we can create a more understanding and supportive world for autistic individuals with alexithymia.