How Parental Alexithymia Impacts Families

Co-authored by Nikita Baxi and Robert T. Muller, Ph.D.

“I told my wife our son was leaking for no reason. She corrected me—he was crying.”

For Alex (name changed for anonymity), his 4-year-old son’s emotions were an impossible puzzle to decipher. Alex, like others who struggle with alexithymia, has difficulty recognizing and expressing his emotions.

We spoke to clinical psychologist Cynthia King, a specialist in trauma and founder of FemFwd, an organisation that seeks to help women improve their relationships. King explains that “alexithymia is the difficulty of identifying, labeling, and expressing feelings. People with alexithymia often have trouble distinguishing between feelings and the bodily sensations that accompany emotions.”

The Alexithymia Spectrum

Currently, there is confusion surrounding how to classify alexithymia compounded by a lack of evidence-based support; some researchers categorize it as a personality trait, others as a symptom or a state of being. We know that alexithymia exists on a spectrum, and research shows it can arise from a variety of factors including genetics, trauma, adverse childhood experiences, autism spectrum disorder, or brain injury.

Andreia Costa, a researcher specializing in autism spectrum disorder and alexithymia, explains that the challenges associated with alexithymia are that treatments for it are scarce, and it co-occurs with many disorders like depression and anxiety: “People who have alexithymia have more difficulties interacting with others and navigating complex social situations—this has a negative impact on many aspects of their lives, including familial relationships.”

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King states that limitations surrounding empathy and introspection can create challenges with respect to the important task of forming close bonds with others. Trouble recognizing emotions in oneself and in others also makes it harder to express and respond to needs, which can create a habit of poor emotional coping skills. This creates severe challenges in raising well-adjusted children for parents with alexithymia. However, it’s still possible to raise an emotionally healthy child; it just requires different tools and approaches.

Challenges for Parents With Alexithymia

When parents with alexithymia have difficulty identifying their own emotions and their children’s emotions, they are less likely to model or teach self-regulation skills. Learning skills that help with emotional regulation is crucial to a child’s developmental trajectory and well-being.

Poor self-regulation, on the other hand, may result in a tendency to respond to feelings and behaviours negatively, which can range from emotional outbursts to repressing or rejecting one’s emotions. When parents have issues expressing their emotions, kids do too.

King explains that people use different self-regulation techniques based on what emotions they’re feeling. Naturally, that poses a problem for people with alexithymia since it requires them to understand their feelings. As a result, emotional regulation is poorly developed, and ineffective strategies may be chosen when coping with emotions. Ultimately, the inability to cope with emotions creates negative consequences for the family system.

Beyond the effects on emotional regulation, research indicates that alexithymia predicts parenting styles or behaviours. Parents with alexithymia are more likely to follow authoritative or permissive parenting styles. The concern with this, specifically, is that permissive parenting can lead to poor emotion regulation and aggressive behaviour in the child.

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Behaviour and cognitive processes associated with alexithymia may pose a threat of emotional neglect in the context of parenting, and a subsequent risk of maladjustment in the child’s development. Those on the higher end of the alexithymia spectrum tend to have elevated aggression to deal with their psychological distress and lack of emotional insight. Aggressive responses toward their children’s negative feelings teach the child to suppress their emotions, which leads to a decline in the child’s mental and physical health.

A study found that high levels of parental alexithymia are associated with insecure attachment and increased anxiety. The child may interpret the parent’s behaviour as emotional neglect, and this may in turn threaten the child’s psychological well-being and sense of safety. When kids don’t feel heard or understood by their parents, it disrupts their social relationships.

“My parents didn’t express true empathy or caring in any way. Conversations with them were like talking to stubborn brick walls. I don’t have a relationship with them anymore,” one daughter of parents with alexithymia commented.

Michelle Kennedy, a certified parenting coach, emphasizes the need for empathy in familial relationships as it is necessary for validating the child’s experience and teaching them to accept and honour their emotions. This is a skill that helps kids recover from upset emotions without downplaying their feelings.

So, what tools can parents with alexithymia use to adequately support their children’s emotional growth?

King recommends that parents seek therapy, as symptoms of alexithymia may be resolved or improved, depending on the etiology. Alexithymia and its related outcomes can be improved using different strategies and tools. One suggestion is to use psychotherapy to target emotional regulation patterns. King notes that therapists can help the individual connect bodily arousal, facial expressions, and behaviours to a specific emotion. Other techniques that can improve emotional awareness are practising mindfulness, utilising feedback from family members, and keeping an emotions journal.

Costa also recommends interventions to teach strategies to recognize emotions, combined with therapies like cognitive behavioural therapy (CBT) and mentalization techniques, which have demonstrated potential for improvements in the ability to understand emotions. Dialectical behavioural therapy (DBT) is also helpful for improving identification and management of emotions, as well as for interpersonal skills like validating others’ emotions and mirroring responses, and for providing scripted responses that individuals with alexithymia can practise.

Learning emotional coaching skills also empowers the parent to be able to be more supportive of their child’s emotion regulation, behaviour, and social skills. Gentle parenting tactics and nonreactive behaviours are effective ways of responding to children’s disorderly behaviour or overwhelming emotions. Parents with alexithymia should teach their kids from a young age to verbalize their physical sensations and name their emotions to help the parent better respond to the child’s needs. Using an emotion wheel that lists feelings frequently associated with common physiological sensations can help the family more accurately describe emotions to each other.

King says that being transparent with children about alexithymia and educating them about the trait may help the child understand the parent’s behaviour. When interactions are particularly emotional, slowing down and giving the child space to process their feelings is crucial.