When your teen has been through a traumatic experience, it’s natural to attribute the changes you’re seeing to trauma symptoms. You might notice emotional numbness, or that they struggle to talk about how they feel, which leads to blank responses when you ask how they’re doing.
But sometimes what you’re seeing might be a separate but closely linked condition called alexithymia. This is a difficulty in identifying and understanding emotions that’s common in trauma-exposed teens.
This page covers what alexithymia is and how it links to trauma and other mental health conditions. It also covers what support is available for your teen if they’re experiencing alexithymia.
To do this, we focus on:
Alexithymia, which literally means “without words for emotions”, was first used by psychologists for clients who entered therapy without the ability to describe their emotions.[1]
They noticed that instead of talking about their feelings, people with alexithymia would tell stories in a flat, monotone way or focus on explaining the logic behind why they acted in a certain way.[1]
Today, alexithymia is a term used to describe when someone has trouble putting their emotions into words. For teens, the signs vary, but three main areas are usually associated with alexithymia:
It’s important to understand alexithymia, but it’s just as important to understand what it isn’t. If your teen is dealing with alexithymia, they still have and feel emotions. They just struggle to name and identify them.
It’s estimated that alexithymia affects around 9% of teens overall, but that number rises in trauma-exposed teens.[3]
The link between trauma and alexithymia is one of the most consistent findings in this area of research, but it’s not the easiest to understand. Many factors affect how strong that link is, especially the type of trauma a teen experienced.
For example, one large meta-analysis found that childhood maltreatment predicted higher rates of alexithymia.[4] Notably, emotional neglect and physical neglect were the strongest predictors, with both stronger than physical and sexual abuse.[4]
Other large reviews have found similar results. They also point to emotional abuse as a predictor in addiction to emotional and physical neglect.[5]
One idea is that children learn to name emotions through a process called Parent Socialization of Emotion.[6] This is when parents notice the emotions that a child is feeling, label them, validate them, and then help the child make sense of what they’re feeling.
For example, a parent might help their child distinguish between emotions that feel similar but aren’t the same, like frustration and anger.
When a child grows up in an environment where feelings are routinely dismissed or never acknowledged, that learning process never has the chance to fully develop. This could be part of how alexithymia develops.
A separate analysis found that emotional abuse and difficulty identifying feelings were the most strongly connected factors linking trauma to alexithymia.[7]
The idea here could be that if emotional abuse teaches a child that expressing emotions leads to punishment or ridicule, they refrain from doing so. They learn that focusing on feelings and expressing them isn’t safe, which may create the externally oriented thinking style, a main feature of alexithymia.
Research on adolescents looked at childhood maltreatment and later mental health difficulties. It found that alexithymia mediated the relationships between the two.[8] This suggests that alexithymia could be part of how early adversity translates into psychological difficulties later down the line.
A clinical study of adolescents found that emotional regulation difficulty was strongly linked to alexithymia.[9] Both helped explain how childhood trauma leads to psychological symptoms.
Mental health conditions are another important piece here. Both trauma and alexithymia independently raise the risk for certain diagnoses. This could mean that when they’re present together, the risk compounds. The most commonly linked diagnoses include:
Alexithymia, specifically a difficulty in identifying feelings, has been found to be one of the strongest predictors of depression in teens who’ve been through trauma.
Research tracking teens through childhood found that low emotional awareness predicted increasing mental health difficulties. Depression was one of the main diagnoses.[10]
The same research found that difficulty identifying feelings predicted later anxiety. This was especially true in teens who had experienced violence.[10]
One study of adolescents with depression found that those who self-harmed scored higher on alexithymia measures than those who didn’t. Childhood emotional abuse was an independent predictor of self-injury.[11]
Childhood trauma, alexithymia, and disordered eating are linked too. Research found that childhood emotional abuse was directly linked with restrictive eating, and childhood sexual abuse, separately, was directly linked with emotional eating.[12]
The researchers also identified both alexithymia and negative beliefs about emotions as potential pathways connecting childhood trauma and disordered eating.[12]
Watch for changes in eating patterns if your teen has a history of trauma, along with the other signs covered on this page. If you notice them, it’s a good idea to speak to a healthcare professional.
Mission Prep is here to help you or your loved one take the next steps towards an improved mental well-being.
If you’ve noticed any of these signs in your child, even mildly, it’s worth seeking a professional opinion. Trauma alone is very complicated, and if alexithymia or other mental health conditions are present too, the complexity only grows.
You’re not expected to diagnose this yourself, and you’re not supposed to know for certain whether your child needs clinical attention. This is the job of a professional clinician who is able to identify underlying conditions.
If a clinician determines that your child could benefit from extra support, the encouraging news is that trauma recovery is achievable. So is recovery from alexithymia and other mental health conditions.
As a parent, it can be hard to even imagine that your child might need support. But understanding the alexithymia treatment process and what it involves can help ease some of the worries you may be facing.
Because naming emotions is a learnable skill, there are structured approaches that start with teaching emotional vocabulary. Aids and techniques like emotion charts and body mapping that connect physical sensations to emotional states give your teen a way to communicate what’s happening when they don’t yet have the words.
You can practice this at home by saying how you feel and why. For example, if you say that you’re feeling frustrated because the meeting went badly, you give your teen a template for connecting an experience to an emotion.
If your teen is dealing with complex trauma, the expert consensus recommends a phased approach. This might mean building emotional awareness and regulation skills before any work on trauma memories begins.
This is important because the skills needed to process trauma safely are the exact ones that trauma may have prevented from developing.
TF-CBT is a modified version of CBT that includes components focused on building emotional expression and regulation skills. TF-CBT can be difficult for someone with alexithymia initially, but the framework within it and additional supports give them the chance to build.
Dialectical behavioral therapy teaches people to name and manage their emotions. This can be very beneficial for those with alexithymia. Analysis shows that DBT-based approaches may be linked to self-reported decreases in alexithymia and increases in emotion-identification skills.[13]
Trauma treatment can take place in either an outpatient or inpatient setting, depending on the needs of your teen.
Outpatient treatment provides more flexibility through sessions that allow your teen to return home afterwards, or attend treatment virtually.
However, if the combination of trauma, alexithymia, and potentially other co-occurring mental health conditions is too complex for outpatient sessions, residential treatment could be considered.
In a residential setting, emotional awareness work can take place daily in an environment built entirely around your teen’s recovery. Other diagnoses can also be addressed to provide comprehensive treatment.
Residential treatment gives your teen the chance to remove themself from the environment they currently live in, perhaps the same environment that is keeping alexithymia or other conditions in place.
If you’ve watched your child have difficulty connecting with their own emotions while trauma continues to affect their life, residential care can help. It provides the intensity this kind of work requires.
Mission Prep provides treatment for teens experiencing various mental health conditions. Mental Health support is a phone call away – call 866-901-4047 to learn about your treatment options.
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If anything on this page has resonated with what you’re seeing in your teen, support is available. At Mission Prep Teen Treatment, we use evidence-based therapeutic approaches and innovative interventions to foster sustainable change for adolescents and their families.
To best serve each teen, we offer tailored treatment programs at various levels, including residential and outpatient mental health programs.
Our clinical team is experienced in working with teens whose difficulties don’t fit neatly into one category. When trauma, emotional processing difficulties, and mental health conditions overlap, treatment needs to address all of them together rather than one at a time. That’s how our programs are built.
Our facilities are an important part of the treatment process at Mission Prep Teen Treatment. We believe it’s critical for teens to have a safe and welcoming environment to build the tools they need to facilitate healing. We maintain modern and welcoming homes to provide stability to adolescents throughout treatment.
Mission Prep Teen Treatment accepts insurance and is in-network with most major providers. We are happy to help you check your insurance coverage for mental health care.
If you’ve been wondering whether your teen needs more support than they’re currently receiving, that concern is worth acting on. Contact us online or call 866-901-4047 to speak with a caring member of our team who can answer any questions you might have. Reach out for a free, no-obligation conversation.
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