The concept of alexithymia was first proposed in the 1960's by Sifneos and Nemiah to describe personality traits originally found in psychosomatic patients but which have since been found in other types of patients (alcoholics, drug addicts, traumatic stress disorder patients, sociopaths) as well as in the general population. Etymologically, alexithymia signifies: incapacity to speak one's emotions (from the Greek: a, lack; lexis, word; thymos, sentiments). Alexithymia is not the impossibility of feeling one's emotions, but rather the impossibility of associating them with corresponding mental representations and thus verbalizing them. Such patients tend to act out, to speak circumstantially, and to have difficulty in relationships. A neurophysiological substratum, the absence of connexions between the limbic system and the neo-cortical regions, has been suggested by Sifneos, who has distinguished primary and secondary alexithymia. A "biological" deficit seems to be responsible for primary alexithymia, such as in found in split-brain patients or aprosodias in patients with right hemispheric strokes. Secondary alexithymia, on the other hand, seems to be due to psychodynamic factors such as massive utilisation of defense mechanisms like denial, repression and regression. Appropriate psychotherapy for such patients is debatable, but it seems that in most cases the analytical approach should be replaced by more directive therapies, including relaxation and bio-feedback, to help patients learn to stimulate, master, and verbalize their emotions. The Beth Israel Questionnaire (BIQ) is a rating scale evaluating such traits that is filled out by the rater based on a clinical interview.(ABSTRACT TRUNCATED AT 250 WORDS)

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