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Identifying vs describing feelings

Alexithymia is often described as “difficulty identifying and describing feelings,” but those are different processing bottlenecks. This model helps you locate where the breakdown is happening and what kind of support is most useful.

In session, “I don’t know how I feel” can mean very different things. Sometimes the issue is internal recognition: the body signal is present, but it isn’t being categorized as a specific emotion. Other times the issue is external communication: the person has some internal sense of what’s happening, but can’t translate it into language for another person.

Distinguishing these mechanics can clarify pacing, intervention choice, and what “progress” should look like week to week.

Alexithymia: barriers to emotional processing

The items below mirror the diagram (left, shared, right).

Venn diagram showing barriers to emotional processing: identifying feelings (internal recognition), describing feelings (external communication), and shared barriers like limited emotional vocabulary.

Difficulty identifying feelings

Internal recognition

This is a processing deficit where the brain struggles to distinguish between physical sensation and emotional states. The signal exists, but it is not reliably categorized.

Primary barriers

  • Poor interoception: Inability to feel internal bodily signals.
  • Somatization: Interpreting emotions strictly as physical illness.
  • Misattribution of arousal: Confusing anxiety with hunger, fatigue, or caffeine.
  • External thinking style: Defaulting to facts/solutions over internal experience.
  • Dissociation / numbing: Going blank, shutting down, or feeling “nothing.”
  • Delayed processing: Feelings register later, after the moment has passed.

Difficulty describing feelings

External communication

This is a verbalization deficit. The individual may be aware of an emotional state but lacks the ability to translate that state into language for others.

Primary barriers

  • Retrieval block: “Tip of the tongue” phenomenon under stress.
  • Performance anxiety: Fear that words will fail to capture the reality.
  • Ineffability barrier: Belief that the feeling is too abstract for speech.
  • Theory of mind gaps: Assuming others already know how you feel.
  • Fear of vulnerability: Holding back language that would expose needs or feelings.
  • Lack of modeling: Not having examples for how to name feelings with clear everyday words.

Shared barriers (affects both)

  • Limited emotional vocabulary: Not having enough labels to categorize and communicate states.
  • Low emotional granularity: Collapsing distinct emotions into “fine/bad/stressed.”
  • Cognitive bypassing: Moving to analysis/solutions before the feeling is named.