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Alexithymia.

Since I started therapy almost three years ago, I have often had difficulty feeling feelings or naming them. My therapist would ask what I was feeling and I would answer honestly, “I don’t know”. She would ask if I could guess, and I could never guess. I felt like I was being difficult or obstinate, but I really could not put a name to these things. I told her it felt like a neurological blindspot; your eyes look at something straight on but because of your optic nerve, you don’t actually see what you’re looking at, even though you know something is there. When I am asked questions about what I’m feeling, I know there is a feeling there but I literally can have no idea what it is or what it’s called. And now I have a name for it.

The analytic relationship has still been challenging. I find sitting across the room from my analyst to either be under or overstimulating. I often feel dead and like I’m meeting someone for an interview.

I mentioned this to my analyst about three weeks ago, and I gradually came to realize that I wanted her to sit next to me, which, as I’ve mentioned, she denied. She initially seemed like she would be willing, but then she consulted with her colleagues and changed her mind. She cited the “rules” of analysis; she talked about how it’s better to talk about what I want, etc. Her supervisor gave me articles and books to read. We’ve been sitting on the floor, still apart, in effort to reduce the feeling of formality.

Nothing is working. I can’t feel her. I want to let her in my space, in my world, and it’s not working.

Her supervisor’s reading material was offensive because he seemed to think that it was that I didn’t want to talk. On the contrary, sitting next to my analyst would, in my mind, reduce my anxiety enough so that I could talk. But reading his recommendations wasn’t a total loss. He suggested that I read The Neuroscience of Psychotherapy: Healing the Social Brain by Louis Cozolino. I did read it, and it talked about how mild to moderate stress was important for the possibility of change as allowed by the neuroplasticity of the brain, etc. etc. Nothing new. But Cozolino also mentioned alexithymia, and said that it was an inability to put words to feelings.

I did a ton of research. I read Fonagy and McDougall and Taylor and Orbach. I took an online test. I scored high. I emailed my analyst. It was a Sunday, but she responded with interest.

This past week has been a whirlwind of research and discussion. Alexithymia is a character trait in which people may have anywhere from mild to severe difficulty articulating feelings or having empathy for the feelings of others (I do not think the latter characteristic matches me, thankfully). People may have a distinct lack of dreams or fantasies, or have very logical dreams. This is me. They may have difficulty with social relationships. Also me. I find that I am able to maintain maybe about three relationships at any one time; additional relationships overwhelm or exhaust me and I regrettably break them off or significantly draw back.

Alexithymia is not an actual diagnosis and so it is only a trait. My “diagnosis” (though I do not believe in diagnoses) is borderline, with this alexithymia thing now tagged on. Interestingly, both BPD and alexithymia are marked by a lack of ability to mentalize. Mentalization can be improved with oxytocin. And what produces oxytocin? Physical contact. Like sitting next to your analyst.

I’ve proposed this again to my analyst, now with about ten research papers, ranging from evidence-based treatments to psychoanalytic vignettes, to back up what I know I need. I emailed lead researchers in the field asking for their assistance. (They have been so nice and helpful!) My analyst said yesterday that she has a “draft in mind” about signing some permission slip thing if she were to sit next to me. I am very hopeful. She has gotten my hopes up twice before and then let them down, but she is also aware that she has done this so I’m hoping she is not repeating her behaviour. If she is, then I’ve found yet another therapist I cannot work with.

But, even if that’s the case, I now have a name for the blindspot. Now I just have to find someone who will help me get rid of it.