Alexithymia. What to Do When You Don’t Know What You Feel

You’ve probably heard phrases like “I don’t know what’s wrong with me,” “I feel off,” or “I struggle to put what I feel into words.” For many people, that difficulty is occasional. But for others, it’s part of daily life: we’re talking about alexithymia, a psychological term that describes the inability to clearly identify and express emotions.

In therapy, I often see how this phenomenon particularly affects men. Not because they feel less, but because culturally they’ve been taught to repress vulnerability. And even when it doesn’t meet the criteria for a diagnosis of alexithymia, the outcome is evident: communication problems in relationships, anxiety, difficulties with intimacy, or even physical symptoms stemming from unexpressed emotional tension.

What Is Alexithymia?

Alexithymia is not an illness in itself, but rather a psychological trait. It is characterized by:

• Difficulty identifying which emotion is being felt.

• Problems verbalizing those emotions to others.

• A tendency to focus on the physical rather than the emotional (for example, noticing “tightness in the chest” instead of recognizing anxiety).
  
  

According to recent studies, alexithymia affects between 8% and 10% of the general population, and is more prevalent in men (Mattila et al., 2006). This difference does not appear to be biological, but cultural: from childhood, men have generally been given less space to talk about emotions.

How Alexithymia Affects Daily Life

1. Romantic relationships

One of the main factors that intensify misunderstanding in a relationship is the difficulty of communicating emotions. Comments like “you never tell me how you feel” are common in men with alexithymia. This often erodes trust and eventually creates emotional distance.

2. Psychological well-being

Not knowing what you’re feeling is enough to lead to frustration, anxiety, or irritability. The person lacks the “internal tools” to process emotions, which encourages the buildup of mental tension.

3. Physical health

The connection between body and mind is increasingly clear. In fact, rather than a connection, we should speak of an inseparable union. A study published in Psychosomatic Medicine found that alexithymia is associated with a higher risk of somatization: headaches, gastrointestinal problems, or insomnia without an apparent medical cause (Taylor, 2000).

Alexithymia and Men: A Necessary Perspective

Although anyone can experience traits resembling alexithymia, it tends to appear more frequently in men. The reason has to do with the norms of masculinity: “men don’t cry,” “you have to be strong,” “expressing emotions is a sign of weakness.”

This cultural conditioning means that many grow up without a rich emotional vocabulary, which later makes their relationships—both family and intimate—more difficult. Often, what appears in therapy as a couple’s issue or a performance problem actually has its roots in a prior emotional disconnection.

Can Alexithymia Be Overcome?

The good news is yes: although alexithymia is often a stable trait linked to neurobiological factors, in cases where it depends on context (upbringing, culture, education, etc.), emotional intelligence can be trained. The key lies in working on the connection between thought, emotion, and body. Here are some strategies:

1. Name physical sensations

When you notice tension, heat, or pressure in the body, ask yourself: what emotion might be behind this? For example: tightness in the chest may be linked to anxiety, warmth in the face to shame or anger.

2. Emotional journal

Spend a few minutes each day writing down how you felt in different situations. There’s no need to be poetic, short phrases are enough, like “I was frustrated when I was interrupted during the last meeting.”

3. Visual emotional scales

Using tools such as Robert Plutchik’s  wheel of emotions can help expand emotional vocabulary and distinguish nuances (for example, “annoyance” is not the same as “anger”).

4. Psychological therapy

Professional support is essential. Through therapy, strategies are developed to identify emotions, communicate them, and reduce the anxiety associated with that disconnection.

Alexithymia and Intimate Well-being

In the intimate sphere, alexithymia can trigger what we call  performance anxiety. A man may be unable to express what he needs or feels, which increases both mental and physical pressure during sexual encounters.

This is where practical resources such as breathing techniques, mindful pauses, or even support tools designed for men become key pillars in moving forward with the process. In this regard, if performance anxiety affects ejaculation control, the  MYHIXEL Control solution can help you regain it, while if it affects your ability to maintain erections,  MYHIXEL Ring is a strong recommendation as a complement to your intimate experiences.

These resources do not resolve alexithymia itself, but they do help reduce the performance-related tension while therapy works on developing better emotional management.

Practical Exercises to Start Today

If you feel that this inability to name your emotions is strongly affecting you, here’s a simple plan you can add to your daily routine:

• Morning: when you wake up, spend 1 minute identifying how you feel in a single word.

• During the day: set an alarm every 3 hours to remind you to check in on your emotional state (happy, tired, tense…).

• Night: write down 3 moments that generated some emotion and name them.

These micro-habits are not a substitute for therapy, but they work as training to begin connecting with your inner world. And if you suspect you may have alexithymia, don’t hesitate to reach out to a professional who can support you in this process.

Conclusion

Alexithymia doesn’t mean you don’t feel. It means you struggle to put into words what’s happening inside you. Recognizing this trait is therefore the first step toward working on it.

Doing so not only improves communication with your partner or the quality of your relationships, but also directly impacts your overall well-being: less anxiety, more connection with yourself, and greater confidence in daily life.

The return to routine, as happens every September, can be the perfect time to start listening to yourself more and living with greater emotional awareness.

References

• Mattila, A. K., Salminen, J. K., Nummi, T., & Joukamaa, M. (2006). Age is strongly associated with alexithymia in the general population. Journal of psychosomatic research, 61(5), 629–635.  https://doi.org/10.1016/j.jpsychores.2006.04.013 

• Taylor, G. (2000). Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Journal of Psychosomatic Research. https://doi.org/10.1016/S0022-3999(00)00083-0