Alexithymia - what is it, and how does it effect relationships?

 Alexithymia means 'no words for feelings'. 50% of individuals with Autism will also suffer with Alexithymia. There is a questionnaire that cam be found at www.embrace-autism.com called the OAQ which will give you a good indication if it is present. 

Sufferers with the condition struggle to read their own emotions, and as a result rarely talk about how they are feeling. Often a sufferer when asked how they are feeling will usually reply that ' they are fine'. Often it is a problem retrieving the right word to describe their inner feelings. Individuals with Alexithymia can also struggle to read the emotions of others. They will often focus their attention away from feelings and live in a world of logic and practicality. Often people with Alexithymia are aware that they are experiencing an emotion they just don't know which emotion it is. 

It is important to realise that although people with alexithymia struggle to recognise emotions it does not mean they don't care about other people. People with Alexithymia can recognise when people are in a negative state and it makes them feel distressed. The problem is they can't work out what they are feeling or what the other person is feeling, therefore can't work out a solution for making the other person feel better or to lessen their own distress. 

People with Alexithymai can have a rigid thinking style that does not take into account emotions. They can present with a lack of joy, and appear humourless. There can also be a lack of fantasies and imagination. 

Alexithymia can cause great distress as the inability to talk about emotions means that depression. stress and anxiety will often not be recognised , understood or discussed. I have had clients with Alexithymia that have told me they have never suffered with depression but when asked if they have ever had suicidal thoughts have responded that they regularly struggle with suicidal thoughts. A person cannot ask for help if they are unable to access the language to describe how they are feeling. Individuals with alexithymia will often not seek out counselling for this reason. 

Unfortunately Alexithymia can also create a total lack of interest in the world of emotions which obviously will lead to tremendous problems with emotional intimacy in romantic relationships. Partners of individuals with Alexithymia will complain of a lack of connection and feeling lonely and emotionally neglected in the relationship. While the sufferer of Alexithymia will feel confused and at a loss as to how to improve the situation. 

Writing or journalling can be useful tools to help individuals with Alexithymia access their feelings. Also The Feelings Wheel is a great visual aid for identifying and labelling emotions.  The wheel organises 72 emotions into 6 key areas - sad, happy, angry, scared, calm, strong. The structure helps to better differentiate feelings. The feeling Wheel can be accessed here - https://www.calm.com/blog/the-feelings-wheel. There is also a feelings list for those that find the layout of the wheel disorientating. 

CBT is also very successful in helping individuals with Alexithymia better access and understand their feelings. As their feelings begin to be better accessed and expressed  emotional intimacy begins to develop and the couple starts to feel better connected. It requires patience and time but I have seen many individuals with alexithymia learn to better understand themselves and their emotions, which leads to a better connection to those around them. 

 

The Double empathy problem

 In Neurodiverse Relationships, misunderstandings happen on both sides.

Autism is a social communication disorder that can effect how an individual interprets tone of voice, body language and what has been said. Often the sensitivity and low self esteem that can lie at the heart of an autistic individual can lead to hearing criticism when no criticism was made. This can leads to a defensive response which can lead to a breakdown in healthy communication.

Likewise the neurotypical partner can misread the facial expressions or intensions of their neurodiverse partner. Sometimes autism can lead to a lack of facial expression, which means that often what is shown on the face is not representative of what is going on underneath.

The autistic partner struggles to read their neurotypical partner but likewise the neurotypical partner struggles to read their neurodiverse partner, this leads to a mountain of frustrations and hurts which when built up over years can lead a relationship into total crisis and breakdown. 

Understandings need to be formed on both sides. Both need to put in the effort to better understand the different operating systems and brain wirings at play. 

Some helpful points to better understand one another 

1. Look with curiosity not with blame. 

2. Never assume.  What is going on inside is often not what you think. 

3. When in doubt, ask.

4. If you know your partner struggles to recognise or talk about their emotions, try asking what they are thinking. From hearing what thoughts are present, feelings can be ascertained.

5. Be very clear with one another about what you need. Do not assume your partner knows what your needs are. Often couples are quick to tell their partner what they don't need, but struggle to ask for what they do need.

Neurodiversity effects every individual differently, work is required to fully understand how it effects you. With my own adhd I have learnt that this understanding and learning is an ongoing journey. However, the more I learn about my particular ' flavour ' of neurodiversity the more empowered I feel. I have also noticed this to be the case with the clients that I work with. Knowledge in power. 

The problems which arise in relationships when Autism is not diagnosed

 Often I will see couples in crisis where neurodiversity has not been recognised by either partner. Neurodiversity although growing in awareness, is still a poorly understood condition. I was born in the 70’s and it certainly wasn’t picked up in schools then, unless the symptoms were very extreme. Often individuals with asd go unnoticed in the school system as many are academically very able so fly under the radar. 

However often Autistic adults will recall not liking school struggling to fit in and finding the environment very stressful. It is at this time that most individuals with asd learn to mask to fit in with their peers. Anxiety depression, eating disorders and struggles with addiction can emerge at this time especially with the transition from primary school to secondary school or secondary school to university. 

If neurodiversity isn’t picked up in school it is very unlikely to be picked up at university or in a work environment. This means that many individuals with Autism are entering adult relationships without knowing that they have the condition. 

Many autistic adults are highly successful often thriving in their careers ( medicine, finance, law, engineering, computer programming, business, and  research can be chosen fields). However it is in their romantic relationship that the disability often shows itself. 

It is not unusual for partners of autistic individuals to suggest to me that they think their partners are narcissistic. Which is very sad when it is clear that what is actually present is autism. 

So why are partners suggesting narcissism? Often there will be a number of hurts that have accumulated when the autistic partner has failed to act in a neurotypical way usually in emotionally charged situation. When expectations are not met a harsh dialogue develops. Words such as cold, uncaring, disinterested, only interested in work, and selfish begin to be aimed at the Autistic partners. When what I am seeing is often completely the opposite. Highly emotional and painfully sensitive individuals who struggle to read the environment and are struggling to understand what is required of them emotionally . The growing criticism increases their sensitivity and will often lead to further withdrawal from the relationship. They are often confused by their partners emotions and complain of feeling they can do nothing right. The hurt neuro-typical partner will grow increasingly angry and resentful and cyclical rows will develop or worse still both will withdrawal to their individual corners. 

Alexithymia which often comes alongside Autism can further add to the challenges. Not being able to articulate how they are feeling means often the asd partner is unable to repair or explain themselves and so the distance between the couple grows further. 

One thing that is abundantly clear in my work with neurodiversity is that Autistic individuals are definitely not cold and uncaring, they feels things very deeply often so deeply they become completely overwhelmed by their emotions and the only way to cope is to shut down. The face of an autistic individual will often not show the emotional struggle and pain which is going on beneath the surface. 

In one session when Autism becomes recognised and understood, I have seen the narrative of the neuro-typical partner immediately soften. When the disability is understood the hurts begin to dissolve and compassion begins to take its place. 

Suddenly there is a reason for inflexible thinking, needing a lot of alone time, intimacy struggles, struggling with emotional expression, social anxiety, stress when travelling, disliking surprises, struggling with present giving, emotional overwhelm, obsessive special interests, blunt delivery and black and white thinking. 

With an understanding of the different brain wiring suddenly couples are given a key to finally access one another to repair the hurts and to at last start to connect. 

How Autism effects relationships

 Having worked for many years with couples where one partner has Autism there are common problems that come up time and again . 

Communication 

Autism is a social communication disorder which can present with difficulties reading emotions, reading body language and tone of voice and taking in things that have been said in a different way to how they had been intended. Autistic individuals often are very sensitive especially when feeling criticised. Partners of individuals with asd will complain of walking on eggshells or that they feel that however carefully they address issues that it often ends up upsetting their asd partner. This can lead to partners no longer raising issues to avoid arguments which can lead to a build up of resentments. Autistic individuals often feel misunderstood and criticised. The starting point for healing has to be to learn how to communicate so both partners feel heard and understood. I teach a communication tool based on The Gottman method but adapted for neurodiversity which can quickly and effectively transform communication in a neurodiverse relationship. 

Physical Intimacy 

Autistic individuals can often struggle with physical intimacy and this can be for a number of different reasons. Sensory processing disorder which may accompany the condition, can cause sensitivity to touch. Also sex drive can be effected, what I see with my clients is that either Autistic individuals have a very  low sex drive and very little interest in sex, or they are particularly interested in sex and regular sexual intimacy is particularly important to them. Both a very high sex drive or a very low sex drive can cause problems in the relationship with either their partner feeling rejected and that their asd partner is not attracted to them, or they feel pestered for sex often complaining that their autistic partner makes no effort with emotional intimacy but expects regular physical intimacy. Understanding is key to making progress in this area. Teaching the importance of, and skills for, emotional intimacy is vital in reconnection. Understanding one another’s sex drives and finding a balance that works for each person is also important. Learning about sensitivities around touch and closeness can help the autistic individual feel calm and stop the neurotypical partner feeling rejected. 

Emotional intimacy 

Small talk and talking about emotions can be extremely difficult for an individual with Autism and the difficulties in this area can lead to an emotional distance with the neurotypical partner often complaining of feeling lonely and disconnected. In order to build intimacy it is important to learn to talk to one another about your life and also your inner world. Without dialogue emotional intimacy cannot develop, and it is in this area where I can see couples really struggle. We enter a relationship to know and be know, and if that process doesn’t happen then the relationship struggles to develop past surface level. Love is feeling known, and understood and seen and heard and without emotional dialogue these needs are left unmet. Understanding each others love language and learning the skills necessary to meet each others needs is key to developing a strong connection. Often the needs of an autistic individuals can be very different from their partners. Both partners have to honour and respect and support these differences. Too often when hurt we seek to blame rather than to look with curiosity in order to better understand. A neurodiverse relationship is like a puzzle, which without understanding can feel fractured with pieces missing but once understood can be constructed to form a very beautiful picture. 

Overwhelm and the need for quiet time 

Autistic individuals are under a lot of stress on a daily basis. Masking,  (which so many autistic adults use to fit in) is exhausting. So often at the end of a working day quiet time is needed to replenish diminished energy and to calm overwhelm. However if the asd partner has a young family often they are expected to click straight into parenting as soon as they return home. This can lead to either shutting down or melting down. Time for calm is imperative for individuals with asd and designing this quiet times into busy family lives can be very challenging. But the result of not doing so can be devastating, not only to the mental health of the autistic partner but also to the damage created to the relationship of shutting down and withdrawing or exploding into a meltdown. 

Special interests and workaholism

It is not unusual to find autistic individuals suffering with workaholism. They are usually very successful in their chosen careers so this is where they get their self-esteem, as they often will receive a lot of praise and positive feedback at work. This is in contrast to their home life where they often will feel they are regularly getting things wrong. Their brain is wired for logic and solution focused rather than in the world of emotions so they are naturally drawn to spend more and more time at work. Often Autistic individuals can also have strong special interests, it might be a hobby or sport or a subject area like history or philosophy. Autistic individuals can get very distressed if they are not getting time with their special interest and this can cause conflict if it regularly takes them away from family life.  

With proper understanding and patience all these problems can be successfully navigated and connection strengthened. 

Autism in relationships often hiding in plain sight

 Asd also known as autism spectrum disorder is a social communication disorder that can cause an individual to be particularly sensitive to their environment and seek out routine and repetition in order to minimise the stress that comes with the condition. 

The biggest problem with Autism is that it is a condition that is very often misunderstood. It also has a stigma attached to it which means many people are fearful to investigate whether they might have it, and if it is suggested they might have Autism will often respond with statements such as ‘ we are all a little bit on the spectrum’ or ‘ I don’t believe in labelling people’. 

The statement that we are all a little bit on the spectrum is fundamentally false. No, we are not all a little bit on the spectrum, a person is either on the spectrum or not on the spectrum. Yes we might all tick a few boxes of Autism but that does not mean we are a little bit autistic. 

It is important to understand that there should be no shame attached to being diagnosed with Autism. It is a different brain not a wrong brain. Many people with Autism are particularly intelligent with maing gifted. in fields such as maths, finance, computer programming, engineering, music, gardening, art and creativity, research, medics and inventors. The autistic brain often hyper focuses on areas of interest and this hyper focus and ability to think outside the box often raises people to the top of their field. 

The Autistic brain is wired differently and where it struggles is in reading and understanding the emotions and feelings of others. This does not mean a lack of empathy as often autistic individuals feel emotions with particular intensity. But reading the intentions and emotions of others is often a struggle. 

Symptoms of autism are a liking of routine, a dislike of surprises, hyper focus on particular interests, emotional overwhelm, emotional dysregulation, sensitivity to criticism, low self esteem, a lack of theory of mind ( inability to put themselves in the shoes of others and to feel what they are feeling) to feeling calm in nature or around animals, sensitivity to noise, lights, textures, touch and smells, social anxiety, easily drained in social situations, bluntness often speaking without a filter , can seek to control their environment in order to minimise internal stress, overthinking, fear of  making mistakes and a fear of what others think of them. 

The difficulty with recognising Autism is that it can wear vastly different hats from person to person.  An individual with  autism  can be an introvert but also many autistic individuals can  be very socially motivated . Some autistic individuals have a very low sex drive with little interest in sex while others place very high importance on sex. Some individuals with autism seek a lot of physical contact while others are very uncomfortable with physical touch. 

Adhd further complicates the situation with at least 50% of autistic individuals also having adhd . If an autistic individual also has adhd they are less likely to seek routine and repetition and more likely to thrive on change and new experiences . Autistic individuals are usually very organised and precise while individuals with adhd are often chaotic and disorganised. 

Alexithymia adds a further layer of complexity. At least 50 % of autistic individuals also have alexithymia. Alexithymia means in Latin no words for feelings. Individuals with alexithymia will often struggle to recognise and speak about their emotions which makes emotional intimacy difficult. However there are many autistic individuals who don’t suffer with alexithymia and are very able to recognise and talk about their emotions. 

These vastly different presentations ( and I have touched on just a few) can lead to an under diagnosis and misdiagnosis of the condition.  It is not unusual for adhd to be diagnosed but Autism missed. Alexithymia is very under diagnosed and yet causes a lot of problems in relationships. 

But do not minimise the impact the effect Autism can have in relationships. If ignored or minimised it can make the difference between the relationship thriving or breaking down. 

So where should you start if you suspect Autism in yourself or your partner? 

There are excellent questionnaires at  www.embrace-autism.co.uk . Here you can find the AQ which is the gold standard questionnaire for autism designed by Simon Baron Cohen from Cambridge University and also the Cat-q which will pick up masking which is often very prevalent in women with Autism.  

This website also has questionnaires for Alexithymia and short questionnaires for adhd ( although the questionnaires for adhd are far less thorough). 

The problem that can sometimes occur relying solely on questionnaires is that questions can be misinterpreted, and also if a person fears an Autism diagnosis it might distort how they answer the questions. Two heads are better than one filling out these questionnaires so it is best to get your partner to look over the answers. 

In my next post I will outline how Autism affects romantic relationships snd what can be learnt to help ease the challenges that can arise. 

How adhd effects Relationships

 Adhd stands for attention deficit hyperactivity disorder and it is one of the most common  neurodevelopmental disorders that is present from childhood ( although often not diagnosed until much later in life). Everyone with adhd presents slightly differently, as the saying goes " If you've met one person with adhd you've met one person with adhd'. It is definitely not a one size fits all condition. 

The main symptoms are restlessness ( mental or physical or both), impatience, bluntness, emotional sensitivity especially sensitive to criticism, procrastination, disorganised, lack of attention to detail, talking too much, impulsive, indecisive, forgetful, can lose things often, lack of a filter, constant busyness as if driven by a motor, daydreaming, difficulty focusing unless interested then can hyper-focus, emotional dysregulation, quick to anger, sensory processing disorder, time blindness, poor executive function skills  (the inability to plan, focus attention, remember instructions and manage time), procrastination, many ideas but problem with follow through, lack of motivation, struggle to switch off a very busy mind, sleep problems, it can cause addiction issues ( alcohol, shopping, sugar, computer gaming, work), rapidly fluctuating moods, trouble staying focused during conversations often interrupting or talking over the other person. Individuals with adhd are more likely to suffer with low self-esteem, anxiety or depression. 

The positives of the condition are many, with great imagination and creativity, emotional sensitivity, interpersonal intuition, energetic enthusiasm, hyper-focus, courageous, good at multi-tasking, zest for life, spontaneous, great conversational skills and resilience. People with adhd often have a unique perspective and are often very quick thinking. 

This is a long list, and no-one with adhd is likely to tick every box. What is important is understanding how it effects you. Knowledge is power with neurodiverse conditions and especially when trying to manage relationships. 

Some people with the condition have add rather than adhd, which is adhd minus the hyperactivity. The mind and body is usually less busy, and there is usually not the restlessness found in adhd.

Firstly it is important to note that just because a person has adhd does not mean that they are therefore responsible for all the difficulties that occur in their relationship. Everyone brings their own emotional baggage to a relationship. However there are problems that can occur more frequently when a partner has adhd, and it is good to be aware of these problems, so that you can learn tools to navigate them. Below are some of the most common problems I see that occur in a relationship effected by adhd. 

Parent- child dynamic

When the individual with adhd struggles with executive functioning skills often they are very forgetful, procrastinate, and can be disorganised and careless. As the relationship develops often their partner will find themselves having to constantly remind and organise in order to get things done. The neurotypical partner will often complain that they feel like they are the parent in the relationship or that it is like having an extra child. The partner with adhd will often complain that they are constantly being criticised and nagged and can't do anything right. This is not a healthy dynamic and can lead to a lot of stored up resentments in both partners. 

Feeling unheard

Often partners of individuals with adhd will complain that they feel unseen and unheard. That they feel their partner is disinterested when they speak and rarely listen to what is being said. They complain of having to repeat instructions or remind about upcoming events. They also complain of being interrupted and talked over. That complain that their adhd partner will rarely let them finish a sentence without interruption or impatience. Impatience and struggling to focus are two of the main symptoms of adhd which can very quickly lead to a complete breakdown in communication between a couple and much stored resentment. Good communication is the foundation for any relationship and this is often very negatively effected in the presence of an adhd mind. 

Emotional sensitivity and dysregulation

Individuals with adhd are often highly emotionally sensitive, feeling everything with extreme intensity. A lot of individuals with adhd also suffer with RSD which stands for rejection sensitivity dysphoria. This coupled with the fact that a lot of neurodiverse individuals also struggle with very low self-esteem, can mean that they are highly reactive communicators. The slightest criticism can create a huge explosive reaction or a complete shutdown both of which are very difficult for their partner to cope with. These explosions can pass through quickly but the damage is done, and individuals with adhd can sometimes expect their partners to recover at the speed they do. I will often hear from the neurothypical partners that they feel like they are walking on eggshells and that they often won't raise issues for fear of their partner's reaction. Again this means that resentments are being stored unresolved. A further complication is that adhd individuals can be very blunt with their delivery to others which can feel very hypocritical when they themselves are so sensitive to what others say to them.

Workaholism and other addictions

It is suggested that adhd is caused by a lack of dopamine and therefore activities or substances that create dopamine are going to be highly attractive to those with adhd. We are often attracted to what we are good at and the adhd brain often thrives in a work environment ( if you have found a career that interests you). Work can calm the overactive adhd brain by keeping it active and stimulated, and this often leads to work addiction. Alcohol, sugar, nicotine and caffeine are also substances loved by the adhd brain as are the activities of shopping ( often impulse buying)  and computer gaming. Having an active addiction is like having a third person in a relationship and that third person takes priority and gets the majority of the attention. This can often leave the neurotypical partner feeling neglected and unimportant. Work addiction in particular is an addiction that gets very little press but can cause significant damage to relationships, with partners often feeling that while their partners work they are left carrying the majority of childcare and household tasks. This quickly leads to a build up of resentment. 

Not being Present

Always being on the go with a restless energy and mind can mean that a person with adhd rarely feels at peace. They find holidays hard and either take their work with them or find it very difficult to switch off and relax. I will often hear partners of individuals with adhd complain about feeling very disconnected from their partner complaining that it feels like their partner constantly lives in their head and are rarely ' in the room'. It is difficult not to take it personally and partners are often left feeling neglected and unloved. Often an individual with adhd can be so restless mentally that they fail to pick up signs that their partner needs comfort or support. 

Consistently inconsistent 

Adhd can present with rapidly changing moods and also an ever changing mind. Decisions that are written in stone one day can be cast to the wind the next. Plans are made one day and dropped the next when the adhd mind has moved on to the next topic of interest. Hobbies are started and dropped, and diy jobs left unfinished. This ever changing weather system that is the adhd mind, can be very difficult to live with both for the sufferer and for their partner. 

All these problems are solvable with the right understanding and tools. adhd can bring layers of intensity, excitement and magic to a relationship when well managed, but can cause huge challenges when unrestrained. 

In a  relationship where neurodiversity is present we need to learn to look with kindness and curiosity rather than criticism and blame. The neurodiverse relationship contains two brains that operate very differently. It does not mean one brain is right and one is wrong, just different. Once neurodiversity is properly understood by the neurotypical partner often the narrative softens and expectations change. Both sides need to work together to better understand one another. It is not just the job of the neurotypical partner to navigate and understand the neurodiversity. Both partners need to learn a better understanding of one another and this can only be achieved by making an effort and doing the work. Relationships are often not easy, they take work, but I have seen many neurodiverse relationships transformed when constant commitment is applied and the different wiring of the brains fully understood. 

 

 

 

Why women are the main instigators of divorce.

 Did you know that over 65% of divorces are instigated by wives. So why are women so much more dissatisfied with the state of their relationships than men?  From the many couples I see I believe the answer largely lies in a lack of emotional and physical intimacy, and more importantly a total lack of understanding of what emotional and physical intimacy is.

Emotional intimacy is the connection between a couple that includes empathy, understanding, being open with your thoughts and feelings, reading each others emotions, showing an interest in how each other feels  sharing worries and shames, being vulnerable, showing and talking about your emotions, being present, noticing, caring, showing up for each other, having each other's backs.

I love the quote by Esther Perel ' Foreplay begins at the end of the last orgasm". 

Physical intimacy is far from being just about sex, it is about physical closeness and displays of affection. It can be seen in a knowing look, a warm smile, reaching for your partners hand, a warm embrace, stoking, admiring, sitting close to one another, touching, playing, a lingering kiss. It is an open expression of your feelings for one another. 

Love is a verb, and should be actively shown on a daily basis. 

Women regularly express to me that what they are looking for is to be seen, known, and understood. 

Countless times in January I will be contacted by a despairing wife who has received a Christmas present that was the last straw. A coffee maker for a women that doesn't drink coffee, a blue silk scarf for a women who has for years spoken of her dislike of blue, a balloon ride for a women afraid of heights. The message that these often well-meaning gifts have sent out to the women who receive them is, ' after all these years together I feel like you don't know me at all'.

Women don't always make it easy for men, their hurt born from a lack of intimacy can play out in harsh criticism and judgment that only leads men to retreat faster. How can a man show his soft and vulnerable underbelly when he feels as if he is already failing to make his partner happy? 

We all desire to be known, deeply known and cared for. Emotional and physical intimacy creates that intimate knowledge and understanding that sets your romantic relationship apart from all other relationships in your life. 

Intimacy is not easy for some people. Opening up emotionally can create feelings of intense vulnerability, leaving people feeling exposed to being hurt or rejected. Intimacy requires trust, patience and kindness and for many people the art of intimacy needs to be learnt. 

The good news is that it is never too late to learn the tools for emotional and physical intimacy. I have worked with many couples that have redefined their relationship developing far greater passion and connectedness with simple tools that can be easily learnt and make a huge difference.

At some point during the process there is often a 'lightbulb moment' and that sudden realisation and understanding creates meaningful and lasting change in their relationship.