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Introduction: Emotions Without Words
“How do you feel?” This simple question can cause a real block for some autistic adolescents. Not that they feel nothing – on the contrary, they may be overwhelmed by intense internal sensations – but because they can’t identify what they’re feeling or put words to it.
This phenomenon has a name: alexithymia. From the Greek a (absence), lexis (word) and thymos (emotion), this term literally means “the absence of words for emotions”. Alexithymia affects approximately 50% of autistic people, compared to only 10% of the general population. It is therefore a common characteristic, but often unknown and misunderstood.
Alexithymia is not a lack of emotions. Alexithymic adolescents feel emotions with as much intensity – sometimes even more – than others. But they struggle to identify them, to differentiate them from one another, to connect them to their causes, and to express them verbally. It’s as if their internal emotional world were a confused mass of sensations without labels.
This difficulty has important repercussions on emotional regulation, social relationships and psychological well-being. Understanding alexithymia is essential to effectively support your autistic adolescent in managing their emotions.
In this article, we will explore what alexithymia is, how it manifests, what its consequences are, and above all, how you can help your adolescent develop better emotional awareness and expression.
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What is Alexithymia?
A Multi-Faceted Difficulty
Alexithymia is a complex concept that encompasses several distinct but related dimensions. The first dimension concerns the difficulty identifying emotions. The alexithymic person struggles to recognize what they’re feeling. They may perceive physiological activation (accelerated heartbeat, muscle tension, lump in the throat) without being able to name the corresponding emotion. They may confuse different emotions (mistaking anger for anxiety, for example) or not distinguish emotional nuances.
The second dimension is the difficulty describing emotions. Even when an emotion is partially identified, expressing it verbally remains a challenge. The emotional vocabulary may be limited, descriptions may remain vague (“I feel weird”, “I don’t know”, “bad”). Emotions may be described in physical rather than emotional terms (“I have a stomach ache” rather than “I’m anxious”).
The third dimension relates to externally oriented thinking. The alexithymic person tends to focus on concrete facts and external events rather than on their internal experience. They may have difficulty with introspection and reflecting on their own mental states. Conversations about emotions may seem abstract or uninteresting.
Finally, a fourth dimension concerns the difficulty distinguishing emotions from bodily sensations. Emotions are accompanied by physical manifestations, but in the alexithymic person, these bodily sensations are not correctly “translated” into emotional experience. Hunger can be confused with anxiety, fatigue with sadness, excitement with distress.
Alexithymia and Autism: A Close Link
The high prevalence of alexithymia in autistic people (approximately 50%) suggests a significant link between these two conditions. Several hypotheses explain this association.
The interoceptive hypothesis proposes that alexithymia is linked to difficulties processing internal bodily signals (interoception). Autistic people frequently present interoceptive particularities, which could explain their difficulty perceiving and interpreting the physical manifestations of emotions.
The social development hypothesis suggests that early difficulties in communication and social interaction in autistic people can affect the normal development of emotional awareness. Learning to identify emotions occurs largely through social interactions and language, areas where autistic people may encounter obstacles.
The neurological hypothesis points to differences in the functioning of brain regions involved in emotional processing, particularly the insula (interoception) and the prefrontal cortex (emotional regulation).
Whatever the explanation, alexithymia is now recognized as a common characteristic of autism, distinct from autism itself but often associated. Some emotional difficulties attributed to autism may actually be linked to co-occurring alexithymia.
Alexithymia is Not Absence of Emotions
It is crucial to distinguish alexithymia from absence of emotions (anhedonia) or emotional indifference. The alexithymic adolescent feels emotions, sometimes even very intensely. They are not cold, insensitive or lacking in empathy. They simply have difficulty identifying and expressing what they feel.
This distinction has important implications for support. The goal is not to “create” emotions in your adolescent, but to help them become aware of those they already experience and to develop a vocabulary to express them.
The stereotype of the autistic person “without emotions” is largely false and can be harmful. Many autistic people experience their emotions very intensely; it’s their expression that may seem attenuated or atypical, particularly due to alexithymia.
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How Does Alexithymia Manifest in Daily Life?
Vague Responses to Emotional Questions
The most visible sign of alexithymia is the difficulty responding to questions about emotions. “How do you feel?”, “What’s wrong?”, “What does it make you feel when…?”: these questions can provoke in your adolescent a silence, a shrug, a sincere “I don’t know”, or a purely factual response that avoids the emotional dimension.
This is not ill will or a refusal to communicate. Your adolescent genuinely doesn’t know how to answer these questions. Their internal world is partially opaque even to themselves.
Emotional Confusion
The alexithymic adolescent may confuse different emotions. They may not distinguish anger from frustration, anxiety from excitement, sadness from fatigue. All negative emotions may blend into an undifferentiated mass of “feeling bad”, without nuances or distinctions.
This confusion makes emotional regulation very difficult. How can you calm anxiety if you don’t distinguish it from anger? How can you respond to an emotional need if you don’t identify which emotion signals that need?
Physical Expression of Emotions
In the absence of emotional awareness and vocabulary, emotions are often expressed through the body. Your adolescent may somatize: stomach aches, headaches, muscle tension, unexplained fatigue. These physical symptoms are real and may be the only way their body expresses an unidentified emotional distress.
The expression can also be behavioral: agitation, aggression, withdrawal, intensified repetitive behaviors. These behaviors may seem to “come out of nowhere” because the adolescent themselves doesn’t perceive the underlying emotion that motivates them.
Sudden Emotional Crises
Paradoxically, alexithymia can lead to sudden and intense emotional outbursts. Unidentified emotions accumulate beneath the surface without being regulated. When they finally emerge, they can do so in a disproportionate and uncontrollable manner.
These crises can surprise those around them (“everything was fine and suddenly…”) as well as the adolescent themselves. They may not understand why they’re reacting so strongly, which adds confusion and distress to the situation.
Difficulty Anticipating Emotional Reactions
Alexithymia makes emotional anticipation difficult. Your adolescent may not predict that a situation will stress them, that a person will irritate them, that an activity will bore them. They may accept commitments without realizing they will cost them emotionally, or find themselves in difficult situations they could have avoided if they had anticipated their reaction.
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The Consequences of Alexithymia
On Emotional Regulation
Emotional regulation relies on the ability to identify what you’re feeling in order to respond appropriately. Alexithymia compromises this essential first step. Without awareness of the emotion, it’s impossible to implement appropriate regulation strategies.
The alexithymic adolescent may therefore seem to have deficient emotional regulation, when the problem is actually upstream, at the identification level. DYNSEO’s courses on emotion management address this crucial distinction and offer adapted strategies. Discover the course “Managing Emotions in an Autistic Adolescent”
On Social Relationships
Social relationships largely depend on emotional communication. Expressing what you feel, understanding what the other person feels, adjusting your responses according to the emotions at play… All these skills are complicated by alexithymia.
Your adolescent may seem distant, cold or disinterested when they actually feel a lot. They may have difficulty responding empathically because they don’t know how to express the compassion they feel. They may unintentionally hurt by not showing the expected emotions in certain situations.
On Mental Health
Alexithymia is associated with an increased risk of psychological difficulties: depression, anxiety, somatoform disorders. The difficulty identifying and expressing emotions can prevent seeking appropriate help (“I don’t know what’s wrong, so I don’t consult”) and complicate classic therapies based on exploring emotional experience.
The link with autistic burnout is also significant. The accumulation of unidentified and unregulated emotions can contribute to the exhaustion characteristic of burnout. [Découvrir nos articles sur le burnout autistique]
On Autonomy and Decision-Making
Emotions play an important role in decision-making. They signal to us what is good or bad for us, what corresponds to our values and needs. Alexithymia can therefore complicate important decisions: educational choices, friendly and romantic relationships, leisure activities.
Your adolescent may have difficulty knowing what they really want, what they enjoy, what makes them happy. This identity uncertainty can be a source of confusion and frustration.
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Helping Your Adolescent Develop Emotional Awareness
Starting from the Body
Since emotions have physical manifestations, starting from the body can be an access route to emotional awareness. Help your adolescent identify bodily sensations: where do they feel something in their body? What sensations? Tension, heat, cold, knot, tingling?
Gradually, you can help them make the connection between these sensations and emotions. “When you have this ball in your stomach and these sweaty hands, it’s often anxiety.” These associations are not universal (everyone feels emotions differently in their body), so observe and learn together your adolescent’s specific “bodily vocabulary”.
Using Visual Supports
Emotions are abstract, which makes them difficult to grasp for many autistic people who think in a more concrete and visual way. Visual supports can help: emotional thermometers, emotion wheels, pictograms, images representing facial expressions and situations.
DYNSEO’s MON DICO application allows you to create a personalized visual dictionary of emotions. You can add photos of your adolescent expressing different emotions, images of situations that trigger certain emotions in them, and pictograms they find meaningful. This personalized support can become a valuable communication tool for expressing emotional states that are difficult to verbalize. Discover MON DICO
Developing Emotional Vocabulary
A limited vocabulary limits emotional awareness. Help your adolescent enrich their repertoire of emotional words, going beyond basic terms (happy, sad, angry) to explore nuances: frustrated, disappointed, irritated, anxious, serene, enthusiastic, nostalgic, relieved…
Books, movies, series can be supports for exploring and naming characters’ emotions. “In your opinion, what does he feel in this scene? Why?” These indirect discussions can be less confronting than talking directly about your adolescent’s emotions.
Practicing Real-Time Identification
Rather than asking retrospectively “how did you feel?”, try to help your adolescent identify their emotions in the moment, when the clues are still present. “I see you’re clenching your fists and breathing quickly. It might be anger or frustration?”
This regular practice helps create connections between observable manifestations and emotional labels. Over time, your adolescent can internalize this process and begin to identify their emotions more autonomously.
Emotional Journals
An emotional journal can help develop emotional awareness. It can take different forms depending on what suits your adolescent: free writing, checkboxes (predefined emotions to select), intensity scales, color codes, drawings.
The goal is not performance but regular practice of emotional introspection. Even simple entries like “Today I felt: 😐 in the morning, 😠 at lunch, 😊 when I got home” can help develop the habit of paying attention to one’s emotional states.
Not Forcing
It’s important not to turn every interaction into emotional questioning. Some adolescents may feel harassed by repeated questions about their emotions, especially if they experience these questions as tests they systematically fail.
Alternate moments of emotional exploration with times of simple presence without expectations. Accept “I don’t know” without insisting. The development of emotional awareness is a long process that cannot be forced.
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DYNSEO Programs as Development Tools
COCO and Emotional Recognition
The COCO THINKS and COCO MOVES program for 5-10 year olds includes the game “Mime an Emotion” which specifically works on emotional recognition. By miming and guessing emotions in a playful way, children gradually develop their ability to identify emotional expressions in others and, indirectly, in themselves.
COCO’s adapted audio instructions take into account the specific needs of autistic children, making the experience accessible and rewarding. Discover COCO
CLINT and Cognitive Functions
For adolescents and adults, the CLINT program strengthens the cognitive functions involved in emotional awareness: attention (paying attention to one’s internal experience), memory (remembering situations and associated emotions), and executive functions (analyzing and categorizing emotional experiences).
Daily training of 10-15 minutes with CLINT can contribute to improving the cognitive abilities that underlie the development of emotional awareness. Discover CLINT
Training for Parents
Understanding alexithymia is essential to effectively support your adolescent. The course “Managing Emotions in an Autistic Adolescent” addresses this theme and gives you concrete tools to help your child develop their emotional awareness while respecting their particularities. Discover the course
The course “Autism: Managing Difficult Situations in Daily Life” helps you understand behaviors related to unidentified emotions and respond appropriately. Discover the course
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Professional Support
When to Consult?
If your adolescent’s alexithymia has a significant impact on their daily life, relationships or well-being, professional support may be beneficial. Psychologists trained in autism can offer targeted interventions on developing emotional awareness.
Occupational therapy and psychomotor therapy can work on the bodily dimension of alexithymia, helping to develop interoception and awareness of the links between body and emotions.
Adapted Therapeutic Approaches
Certain therapeutic approaches are particularly suited to alexithymia. Body-based and sensorimotor approaches start from the body to access emotions. Mindfulness develops the ability to observe one’s internal states without judgment. Emotion-focused therapies specifically work on emotional identification and expression.
Be careful though: classic therapies that assume good emotional awareness (such as certain forms of cognitive-behavioral therapy) may require adaptations for alexithymic people.
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Conclusion: A Path Toward Better Emotional Connection
Alexithymia is not a condemnation to live disconnected from one’s emotions. Emotional awareness can develop, gradually, with the right tools and the right support. This development is a marathon, not a sprint: it requires time, patience and kindness.
Your adolescent feels. Intensely, sometimes. What they lack is not the emotions themselves, but the ability to identify them, name them, understand them and express them. These skills can be learned, at any age.
By helping them develop their emotional awareness, you’re offering them a precious gift for their whole life. A better understanding of themselves, better emotional regulation, richer and more authentic relationships. It’s an investment that’s worth it.
DYNSEO resources are designed to accompany you in this process. Training courses, adapted programs, visual communication tools… Together, we can help your adolescent put words to what they feel and experience their emotions more serenely.
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DYNSEO Resources Mentioned in This Article
- Course “Managing Emotions in an Autistic Adolescent”: Learn more
- Course “Autism: Managing Difficult Situations in Daily Life”: Learn more
- COCO THINKS and COCO MOVES: Discover the program
- CLINT, the brain coach: Discover the program
- MON DICO, customizable visual dictionary: Discover the program
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This article is part of our series on supporting autistic children and adolescents in managing their emotions. Discover our other articles on emotional intensity, autistic burnout and many other essential topics.