Alexithymia: When Teens Struggle to Identify Emotions

How Parents Can Help Teens Recognize Emotions

Parents can create opportunities for teens to explore feelings without fear of getting the answer wrong. Here are some ways to help:

Start With Physical Sensations

Physical sensations are sometimes easier to name than emotions, and teens with alexithymia can often physically feel the bodily sensation of an emotion but find it hard to connect it to a named feeling. 

Try asking your teen what they notice physically before they give it an emotional label. Questions to begin this discussion may include:

• “Does your body feel tense or restless?”
• “Do you feel like moving, shouting, crying, or hiding?”
• “Do you notice any feelings in your stomach, shoulders, or chest?”

Use More Specific Choices

Open-ended questions may be too broad, so it may be helpful to offer small sets of choices to help your teen narrow down their experience. This can look like:

• “Are you feeling more angry or worried?”
• “Do you need comfort or some space?”

Use an Emotion Wheel or Visual Scale

Visual tools can sometimes provide language when words are not coming easily. One example of a visual tool is an emotion wheel. An emotion wheel can help teens start by identifying an emotion from broad categories, like anger, to more specific feelings like rejection or embarrassment. 

A numbered scale may also help. An example of a numbered scale could look like this:

________________________________________

0 =                                5 =                                  10 =
Neutral             Uncomfortable            Completely
and calm          but manageable      overwhelmed

Notice how the scale does not include any emotions, just numbers that help identify the internal experience. A teen may not be able to know exactly what they are feeling, but they could identify where they are on the scale, which can provide useful information and help parents respond earlier. 

Allow Extra Processing Time

Some teens are better able to understand their emotions once the situation or the peak has passed. But they may need hours or days before they can put words to what happened. Parents can provide support by removing pressure through phrases such as:

• “You don’t have to answer right away.”
• “We can come back to this later.” 
• “You can write it down or text me if talking feels hard.”
• “It is okay if you are still figuring it out.”

Offer Different Forms of Emotional Expression

Some teens express themselves more easily through outlets that do not involve conversation, including:

• Writing.
• Music.
• Movement. 
• Memes or images.
• Drawing.

Parents can see which methods work for their teen. They can then create space for that form of emotional expression to become a starting point for verbal discussion. 

What Parents Should Avoid

The shift that helps most is from interrogation to curiosity, treating alexithymia as something you’re working out together rather than a question the teen is failing to answer. Parents should avoid making emotional expression more difficult through actions such as: 

• Repeatedly demanding that the teen explain how they feel.
• Telling them what they feel.
• Comparing them with more expressive siblings.
• Assuming they don’t care.
• Requiring eye contact.

It is still appropriate to maintain boundaries around unsafe or disrespectful behavior, as emotional difficulty can be validated and explored without excusing harmful actions. 

Can Therapy Help With Alexithymia?

Therapy can help teens with alexithymia by: 

• Strengthening their emotional awareness.
• Expanding their emotional vocabulary.
• Helping them learn to notice body cues.
• Encouraging them to practice expressing their needs. 

Cognitive behavioral therapy and body-focused approaches tend to be the most common therapeutic approaches, as they help bridge the gap between physical sensations and emotional labels. However, the most appropriate approach will depend on the teen’s needs, history, and whether alexithymia occurs alongside a mental health concern.

When to Seek Mental Health Treatment

Professional treatment may be helpful when alexithymia appears to contribute to serious distress or interferes with a teen’s daily life. You should consider seeking an evaluation if your child:

• Has frequent emotional outbursts.
• Experiences persistent anxiety or depression symptoms.
• Withdraws from family or friends.
• Uses substances or unsafe behaviors to cope.
• Finds it hard to communicate basic needs.
• Expresses hopelessness or thoughts of self-harm.

Call or text 988 in the United States if a teen is experiencing suicidal thoughts or needs immediate crisis support. Call 911 or go to the nearest emergency department when there is an urgent danger.