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Alexithymia and Eating Disorders

As a social work intern in an outpatient clinic, I had a client who my supervisor diagnosed with alexithymia, a condition I’d never heard of. If I hadn’t gone into the mental health field, I probably never would have run across it. But, it turns out to be highly relevant to therapy and to eating disorders as well. 

Here’s what it looked like in my client. My client had been extremely close with her father who died after a long illness. She coped by coming into each session talking about a dead bird she’d seen in the gutter. She was ripped apart by the plight of this poor bird and could talk of little else. To make grieving easier, she used the defense mechanism of displacement to shift her feelings about her father onto the dead bird. 

Alexithymia means literally “no words for feelings” and “is prevalent in patients with psychosomatic problems, substance abuse, and anxiety disorders” along a continuum. (“The Cross-Cultural Brain” by E. Zaidel & J. Kaplan, Consciousness and Cognition, 2007,, accessed 9/13/19). It includes “difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. (“Alexithymia and eating disorders: a critical review of the literature” by M.E. Nowakowski, T. McFarlane & S. Cassin, Journal of Eating Disorders, vol. 1, article #: 21 (2013),, accessed 9/13/19).

This description rings true about clients with and without eating disorders. Some binge-eaters can tell me exactly what they ate (food by food and mouthful by mouthful), when they ate it, how it tasted, and how they felt afterwards, but struggle to answer simple questions about how they felt before bingeing. Some can identify what they think they felt before overeating without an actual memory of feeling it, saying, “I thought I should have felt frightened, but don’t think I did,” while others will insist they have no idea what they were feeling and fail to understand the importance of knowing this information.

If you are disconnected from your emotions as described above and think you might have alexithymia, therapy can help. If you’re already in treatment, talk with your therapist about your lack of experiencing emotions. It might be just the step you need to recover from your eating disorder and lead a fuller life.



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