Do you have ADHD, Autism, or OCD? If you do, you might also have Alexithymia.

Have you ever had a moment where you just couldn’t find the words to describe what you were feeling? Maybe you knew you felt “off,” or “weird,” or “bad,” but you couldn’t name it—and that made it even harder to talk about it with someone you love. If that sounds familiar, you’re not alone—and you may be brushing up against something called alexithymia.

What is Alexithymia?

Alexithymia isn’t a mental health diagnosis—it’s more like a difference in how our brains process emotions. People with alexithymia often have trouble identifying, naming, and expressing what they’re feeling. It’s not that they don’t feel emotions—often, they feel a lot—it’s just that there’s a disconnect between the emotional experience and the ability to make sense of it.

Here’s a broader way to think about it: Alexithymia is a trait where emotions are felt but not easily understood, labeled, or communicated. It often shows up as a gap between the physical sensations of emotion (like a tight chest or upset stomach) and the language needed to name or share what’s happening inside. That can make emotional communication and connection really tricky—especially in close relationships.

Alexithymia shows up in both kids and adults, and while some people are born with it (what researchers call “trait alexithymia”), others may develop it over time—especially after trauma, chronic stress, or overwhelming emotional experiences.

How Common Is Alexithymia?

You might be surprised to hear that about 1 in 10 people in the general population experience clinically significant alexithymia. But among neurodivergent folks—especially those with autism, ADHD, or OCD—it’s far more common.

Group	Estimated Prevalence
General population	8–10%
Autistic adults	~50%
Adults with ADHD	20–44%
OCD, anxiety, PTSD, FND clients	30–75%
Chronic illness / trauma survivors	~36%

Alexithymia is often measured using the Toronto Alexithymia Scale (TAS‑20), a 20-item self-report tool that evaluates identifying feelings (DIF), describing feelings (DDF), and externally oriented thinking (EOT).

Why Is Alexithymia So Common in Neurodivergent People?

The short answer? Because the way our brains process emotion, attention, and sensory input plays a big role in how we experience our inner world.

Let’s break that down:

In Autism:

Alexithymia often comes from differences in interoception—that’s the ability to notice and interpret what’s happening inside your body. Many autistic folks experience either heightened or dulled sensory input, which can make it tough to figure out what physical feelings mean emotionally.

For example, you might feel your heart racing but not recognize it as anxiety. Or you might freeze up during conflict and not know why. This can make emotions feel confusing, unpredictable, or even invisible.

In ADHD:

The struggle here is often tied to emotional regulation and working memory. Emotions can come in hot and fast—frustration, shame, panic—but fade just as quickly. It’s like trying to grab a feeling that’s already two steps ahead of you.

People with ADHD often say things like:

• “I don’t know why I snapped, I just did.”

• “I felt something, but now I can’t remember what it was.”

• “I just shut down.”

This can lead to emotional impulsivity, reactive behavior, and difficulty explaining what just happened—all of which can impact relationships in a big way.

If You’re Both Autistic and ADHD:

(Which is very common, by the way!) You might experience both sensory confusion and emotional overwhelm. That can make alexithymia even more layered—and that much more important to understand.

How Alexithymia Affects Relationships

In therapy, one of the most painful things we see is when two people love each other—but can’t quite connect emotionally. Alexithymia is often part of that gap.

Here’s how it can show up:

• Emotional Disconnection: You want to be close, but it feels like your partner’s on a different wavelength. One of you is looking for emotional validation, the other is stuck in silence or confusion.

• Delayed Processing: It might take hours (or days) for someone with alexithymia to realize how they felt about something. That can make real-time conversations—and especially arguments—really tough.

• Shutdowns and Avoidance: When emotions feel too big or too hard to name, many people go quiet, get defensive, or check out. To their partner, this can feel like rejection.

• Repair and Apologies: If you don’t know what you’re feeling or why your partner is upset, apologizing or reconnecting after a fight becomes much harder.

• Misattunement: Emotional mismatches can create a cycle of misunderstanding—where one person feels neglected and the other feels overwhelmed or confused.

This is especially true in neurodivergent relationships, where communication styles, sensory needs, and emotional timing can differ significantly between partners.

What Therapy Can Do

At Therapy House, we work with individuals and couples to identify how alexithymia might be showing up in their relationships—and how to bridge the emotional gaps.

Depending on your needs, we might use tools like:

• Emotion wheels, word banks, and visual supports

• Interoceptive exercises like body scans or mindfulness

• Journaling prompts that help track feelings over time

• Practice conversations to name emotions in real-life situations

• Psychoeducation for both partners so nobody feels blamed

Most importantly, we help people understand that alexithymia is not a character flaw. It’s a difference in emotional wiring—and with support, that gap can shrink.

Final Thoughts

If you or your partner struggles to identify emotions—or if you often feel misunderstood, disconnected, or emotionally out of sync—you’re not alone. Alexithymia may be part of the picture, especially if you're navigating life with ADHD, autism, OCD, or anxiety.

The good news? With the right tools, language, and support, emotional connection can grow—even when it starts from a place of confusion or silence.