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  • Alexithymia: A Phenomenological Approach
  • Fredrik Svenaeus (bio)
Abstract

This paper proposes a phenomenological understanding of alexithymia. The disturbance—an inability to express feelings—is presented, and conceptual problems concerning the diagnosis and theories of its etiology are discussed. In a survey of the clinical literature, explanatory theories suggested in the fields of neurophysiology and psychoanalysis are scrutinized. Three territories that fail to relate to each other in a proper way in the alexithymic personality type—language, feeling, and body—are by these means identified. In order to reach a coherent understanding of alexithymia, a phenomenological interpretation is developed with the aid of the philosophy of Martin Heidegger. The hermeneutics of “being-in-the-world” that Heidegger outlines in his first important work, Sein und Zeit, is utilized to find a connection between body, feeling, and language as meaning-structuring phenomena. The “worldliness” of the alexithymic person is understood as a defective form of attunement, similar to what Heidegger develops as das Man. The analysis of this form of being-in-the-world makes it possible to understand alexithymia as a defective meaning structure that embraces the social communion of language as well as the living body of the individual.

Keywords

psychosomatics, philosophy of psychiatry, phenomenology of illness, Heidegger, theory of feelings, attunement

Introduction

My intention in this paper is to try to show how the phenomenology of Martin Heidegger, developed in his first major work, Sein und Zeit (1986 [1927]), can be useful in understanding the disturbance of alexithymia—the inability to experience and express feelings. After having presented the history of the diagnosis as well as some conceptual problems associated with it, I turn to a presentation of the clinical literature. Some explanatory patterns of the disturbance in the fields of neurophysiology and psychoanalysis are scrutinized. Three territories that fail to connect to each other in a proper way in the alexithymic person—feeling, language, and body—are identified. Phenomenology is then suggested as a useful complement to the causal explanations in neurophysiology and psychoanalysis through its focus upon the very structure of the experiences of the alexithymic person. Phenomenology takes on a subjective, meaning-oriented perspective and initially brackets the causal explanations in order to reach an original understanding of what it is like to live through the vectors of feelings, body, and language.

Heidegger’s phenomenology of “being-in-the-world” is presented as a promising theory when it comes to understanding how these three territories can be thought of as different aspects of a human understanding which is being attuned, embodied, and articulated. Heidegger’s example of inauthentic being-in-the-world—das Man—is introduced and compared with the alexithymic [End Page 71] form of life. The basic diagnostic criteria—as well as typical traits of the alexithymic personality type introduced in the survey of the clinical literature such as operative thinking, lack of empathy, lack of imagination, and psychosomatic ailments—are interpreted with the help of the phenomenological model.

Finally I discuss phenomenology’s role in providing a better understanding of psychiatric disturbances like alexithymia. Is it possible with the aid of phenomenology to understand and draw a border between the healthy and the ill, or does phenomenology’s main role consist of providing adequate descriptions of the experiences of people already diagnosed as abnormal through other types or theories and criteria? Although I do not present a final answer to this question here, I hope to have shown in the paper how phenomenology can be useful in making us better able to reflect upon and criticize, as well as better understand, the diagnostic patterns of mental illness.

The History of Alexithymia

The diagnostic term alexithymia was coined by P. E. Sifneos (1972, 1973) in his work together with John Nemiah studying psychosomatic patients. Sifneos noticed that some of the patients had great difficulty in verbalizing and even experiencing feelings. He referred to them as “alexithymic”—that is, “having no words for feelings”—and considered this trait to be an important factor regarding the development of psychosomatic ailments. Since then the disturbance has received a growing interest, not only in psychosomatic research but also in psychoanalysis and in other fields of psychiatry. 1

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Additional Information

ISSN
1086-3303
Print ISSN
1071-6076
Pages
pp. 71-82
Launched on MUSE
1999-06-01
Open Access
No
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