Alexithymia Questionnaire results

Today I would like to talk about Natalie’s and my alexithymia, our results of the Online Alexithymia Questionnaire, and how we reduced our scores.

If you want to know more about how alexithymia tends to present in autistic people, read this post:

Alexithymia & autism

My results

Early September 2017, I did the Online Alexithymia Questionnaire. My total score was 130/200, which indicates a high level of alexithymia.

The test distinguishes between different aspects of alexithymia, and presents individual scores as well. Here are my scores from September 2017:

• Difficulty Identifying Feelings — 24 Points <15–18>
  • High alexithymic traits.
• Difficulty Describing Feelings — 13 Points <10–12>
  • High alexithymic traits.
• Vicarious Interpretation of Feelings — 8 Points <8–9>
  • Some alexithymic traits.
• Externally-Oriented Thinking — 30 Points <18–21>
  • High alexithymic traits.
• Restricted Imaginative Processes — 22 Points <18–21>
  • High alexithymic traits.
• Problematic Interpersonal Relationships — 21 Points <15–18>
  • High alexithymic traits.
• Sexual Difficulties and Disinterest — 12 Points <10–12>
  • Some alexithymic traits.

As you can see, I scored particularly high on externally-oriented thinking, which, as far as I understand, is the ability to attribute mental states to other people, better known as theory of mind, or cognitive empathy (or part thereof). I also have a lot of difficulty identifying feelings, and apparently I have a rather restricted imaginative process, although this honestly surprises me, as I am quite imaginative. I don’t tend to imagine other people’s lives and feelings, however, so it may relate to that.

Let me say a bit more about what I take to be a core part of alexithymia:

Difficulty identifying feelings

Example 1

Sometimes I get overstimulated in the supermarket, in particular when it’s crowded, but even the fluorescent lights can be too much for me at times, as the light is very harsh, and I can see the flickering of the light even when most people don’t see it.

What often happened is that I am waiting in the queue, and I notice my hands become sweaty and my head starts leaking. What I “feel” in that moment is just that—being hot and sweaty. What I’m thinking is that I wish I was done here, so I can go outside to get fresh air. I always immediately feel better when I do.

Now, in terms of my bodily reaction, from what I gather this is a panic attack. Psychologists have confirmed that this is the case, but in terms of my mental state, they are confused, as I remain calm and rational despite my body having a rather intense response. I guess I should be happy with my alexithymia, or I would be consciously experiencing the panic bit of the panic attack, rather than just the “attack”.

Example 2

People have at times assumed I was angry, whereas I was actually upset, ashamed, or just dysregulated. I tend to get frustrated when someone tells me I have emotions that I am not actually experiencing, because it can seem like the other person is projecting, and/or that my account of my emotional experience is not heard or validated. That frustration can lead to anger (I suppose frustration in itself is low-level anger), and so I end up confirming what they already indicated—that I am angry. But was I angry initially, or did I become angry because other people think they know what I feel better than I do.

Normally, you would know best what you feel. In my case, however, that is not necessarily the case.

Natalie’s results

Also early September 2017, Natalie scores 110/200, which is an indication of at least some alexithymic traits.

Actually, she scored very similar to me, except she scores lower in sexual difficulties and disinterest, and she is considerably better in theory of mind.

• Difficulty Identifying Feelings — 23 Points <15–18>
  • High alexithymic traits.
• Difficulty Describing Feelings — 12 Points <10–12>
  • Some alexithymic traits.
• Vicarious Interpretation of Feelings — 9 Points <8–9>
  • Some alexithymic traits.
• Externally-Oriented Thinking — 15 Points <18–21>
  • No alexithymic traits.
• Restricted Imaginative Processes — 23 Points <18–21>
  • High alexithymic traits.
• Problematic Interpersonal Relationships — 22 Points <15–18>
  • High alexithymic traits.
• Sexual Difficulties and Disinterest — 6 Points <10–12>
  • No alexithymic traits.

Alexithymia decreasing

Alexithymia can be decreased, however. We believe alexithymia to be not just the result of trauma, but a protection mechanism of sorts, where you no longer feel certain feelings as they become detrimental to your wellbeing. But once you enter a safe environment, it is possible to get more in touch with your feelings again, and start processing rather than suppressing them. To read more on alexithymia as a protection mechanism, read the following post:

Alexithymia

Natalie’s decreased alexithymia

In late April 2018, Natalie took the same test again to see if her alexithymia decreased. Here are her results almost 8 months later:

• Difficulty Identifying Feelings — 16 Points <15–18>
  • Some alexithymic traits.
• Difficulty Describing Feelings — 8 Points <10–12>
  • No alexithymic traits.
• Vicarious Interpretation of Feelings — 8 Points <8–9>
  • Some alexithymic traits.
• Externally-Oriented Thinking — 11 Points <18–21>
  • No alexithymic traits.
• Restricted Imaginative Processes — 14 Points <18–21>
  • No alexithymic traits.
• Problematic Interpersonal Relationships — 17 Points <15–18>
  • Some alexithymic traits.
• Sexual Difficulties and Disinterest — 13 Points <10–12>
  • High alexithymic traits.

As you can see, her alexithymia in a few categories disappeared, and others lowered considerably.

But unlike the first time she took the test, she now scores high in the sexual difficulties and disinterest domain. Her alexithymia likely showed a temporary increase as old traumas came up and she was unable to process them at once.

In any case, she is generally a lot more in tune with her emotions, and is better able to deal with them when they come up. In fact, whereas initially, Natalie scored within the dark blue range, she, as of April 2018 scores on the lower end of the light blue range.

My decreased alexithymia

On 30 September 2018 I redid the Alexithymia Questionnaire, and this is what I scored:

• Difficulty Identifying Feelings — 19 Points <15–18>
  • High alexithymic traits.
• Difficulty Describing Feelings — 12 Points <10–12>
  • Some alexithymic traits.
• Vicarious Interpretation of Feelings — 10 Points <8–9>
  • High alexithymic traits.
• Externally-Oriented Thinking — 20 Points <18–21>
  • Some alexithymic traits.
• Restricted Imaginative Processes — 15 Points <18–21>
  • No alexithymic traits.
• Problematic Interpersonal Relationships — 16 Points <15–18>
  • Some alexithymic traits.
• Sexual Difficulties and Disinterest — 12 Points <10–12>
  • Some alexithymic traits.

I have to admit something. Perhaps 200 is not the maximum range of this test (the highest I have seen is 177, so I assume the Alexithymia Questionnaire has a maximum score of at least 180), because while I only just score within the dark blue range on the diagram above, the dark blue line of which is placed at 52% (104) of 200, on the diagram the test gives me, the line falls in the middle of the light blue range, suggesting a maximum score of 230. So whereas on my diagram I score “high on alexithymic traits”, on the test I score as having “some alexithymic traits”.

In any case, I now no longer have any alexithymia when it comes to the restricted imaginative process domain, which I think is on account of the imagination I use to make jokes, which I felt I had less of a safe place for before. As such, I now use my imaginative process not only for functional reasons, but even employ some in social situations.

For some reason, my score for vicarious interpretation of feelings went up a bit, and I now show high alexithymia in this domain whereas I had only some alexithymia before. Other than that, my score in the last domain remains the same, but my scores in all other domains lowered—some of which quite considerably.

Alexithymia decreased

I initially scored 130 on the Alexithymia Questionnaire, and a year later I scored 104. That’s a reduction in alexithymia of 20%.

Natalie scored 110 initially, and 8 months later she scored 84. That is a reduction in alexithymia of 23.6%.

I don’t know whether alexithymia can go away completely, but Natalie and I demonstrated one can expect at least a 20% reduction of alexithymia.

How we did it

What always works for me is the fact that Natalie asks more questions; while my initial response to how I am feeling is vague, or I answer, “I don’t know”, when Natalie urges me to think about it, I can usually find more nuance—possibly with some guidance. As such, I have become better at identifying my feelings, and have become more in tune with my emotion in general.

Anurag Yadav said about the post What does it feel like to have alexithymia?:

I read about a section of Hegel’s philosophy. I haven’t read the idea in its entirety, so it’s kinda left open to interpretations, at least in my head (philosophy majors forgive me for my impudence). The idea was about how our conversations are reflections of ourselves onto others, and that how we project ourselves onto others while trying to get across what we’re trying to say and gain a sort of self-consciousness in the process.

One of the things I’ve recently realized is that a lot of our feelings are nothing but vague evanescent musings, if not given corporeality via expression and acknowledgement by others. Perhaps Natalie’s assertion about your mood can be explained by this idea?

What he is getting at is that when Natalie tries to help me identify my emotions, perhaps she imprints onto me what she thinks my emotion is while that may not be the case, and thus somehow what comes to the surface are my emotions molded by Natalie’s imprint. But I don’t think this is what happens. Rather, she lets me identify something within me which, without her, I either don’t know or don’t care to identify or describe my feelings, unless urged to reflect again. So I rather think it’s about imposing reflection than personal emotions. And even if emotions are imprinted and as a result, I misidentify my emotions, I would probably not be aware of the error, and whatever emotion is being identified may just be what needs to be processed. So even a misidentified emotion could serve as an anchor to bring forth an emotion and process it, rather than let it build up inside.

In general, Natalie and I—push each other to—engage in a lot of reflection and communication, and where we might have our failings we go to therapy to help us identify the underlying issues and the emotions involved.

So I can rightfully say communication, identification, and validation are the keys to reducing alexithymia.