Geoff Bird explores overlap between autism, alexithymia

[@djtobs2]

As someone diagnosed with autism (Asperger syndrome) at the age of 9, and has only come across alexithymia in the last 12 months this makes a lot of sense. My ToM has always been considerably better than my emotional capacity. This was often put down, by my educational physiologists, as an inference to my level of intelligence. But this makes so much more sense, in the how my mild Asperger syndrome and my (self diagnosed) alexithymia interact with each other.

[@nickglover9007]

There is a clear need to have a ASD diagnostic instrument / model that does pick up and tease out any co-existing Alexithymia. (It is unlikely that current ASD diagnosis instruments do). As Alexithymia is common as a co-occurring issue re Autism (Also in Anorexia, etc) it is really extremely important to pick up on any co-existing Alexithymia

[@jenncron]

Imagine the seismic shift in the autism assessment and research communities, never mind the financial implications of this change.

[@nickglover9007]

Bit of a fuzzy webinar sound wise, but the implications here which show the neglected aspect of Alexithynia as critical for understanding ASD are highly important. One does need to differentiate these two separate conditions to understand either, let alone when they may be combined. Alexithymia for example co-exists not only in Autism / Aspergers, but is also found, co-existing at elevated levels, with major depression, eating disorders, substance abuse, schizophrenia, BPD, etc. However Alexithymia is also found, again in elevated levels, in many medical / physical conditions too. For example, in Lupus, Asthma, Arthritis, Heart disease, Breast cancer, Fibromyalgia, IBS, Chronic digestive complaints, Chronic pain, etc. ASD with or without Alexithymia, is a extremely important field of study with public health implications, ASD diagnostic implications, and finally intervention (of ASD) implications. Alexithymia is found in around 10% of the general population, and is roughly equal in prevalence regarding gender and ethnicity. I would state that Alexithymia can be reduced, by the use of a variety of psychotherapies - as long as these therapies target core Alexithymia symptoms, which are largely in the emotional sphere, emotional regulation and interoceptive spheres as well. Eminent people who have done research into Alexithymia have not paid as much attention to the interventions side of the Alexithymia question to date , and that is where research really needs to focus now. I am not in any way suggesting Alexithymia is easily reduced, but that it can be in many instances once we use the right combination of psychotherapeutic interventions. Also in how we account for cultural and situational factors that may also impact on Alexithymia levels, such as (an otherwise non-clinical population) University students. But also in Colleges and High School student populations.. Hence the whole area of Alexithymia (also needs looking at) beyond it been a largely 'individual' disorder. But also one that is also impacted by the type of 'setting' one is in. Hence were not just looking at say psychotherapeutic interventions, but also factors involved in how a particular setting might end up contributing to the elevating of Alexithymia and, importantly, how these 'context' factors can be understood and hopefully modified. If this effects many levels of Education (settings of) this then has major consequences for the health of very large numbers of students. Hence a focus on interventions for Alexithymia needs to consider not just in terms of individual 'psychopathology' or let's say, broadly speaking addressing Alexithymia's core emotional deficits, but equally that there is a need to be willing & able to address the 'setting' or context factors as well. Alexithymia cannot remain another neglected (e.g. stigmatized) phenomena / condition in the way that ASD was, and still can be. I fear the same stigma negativity that can easily apply to Autism individuals, can equally apply to Alexithymia. This is in evidence owing to so few intervention opoortunities despite which supports empathy function. ( this condition been on the clinical radar for 30 years plus. It is this stigma factor that very possibly slows down a wider research into practice framework, let alone then exploring interventions for individuals, plus systemic interventions to possibly modify 'Cultural-setting' factors. /Alexithymia factors. We clearly need a worldwide closer collaboration between (Alexithymia) researchers, combined with clinicians /therapists, educators, & those individuals / populations directly affected by Alexithymia (including but beyond those who may also have Autism). We also need to know why Alexithymia is found in so many other conditions which are entirely different conditions. Alexithymia might turn out to be a almost universal default 'traumatic like' condition, which 'attaches itself' to, or cuts across, many other co-existing conditions. As well as Alexithymia been found in an otherwise 'non clinical' group or so called 'normal' population (such as Students, in the Military, etc). Researchers need to work more closely with those who might be willing to further develop and test treatment interventions. Funding should be available for decent scale intervention programmes. Plus the 'lived experience' group cannot be so left out of any such much needed Difficulties with interoceptive awareness are related to Alexithymia not Autism alone. The stories that Alexithymia sufferers can tell us is as important as anything else, and the stigma 'against them' or, let's say, a neglect of their condition, cannot go on so ignored. Returning back to Autism and Alexithymia, it is clear now that when someone / anyone, is diagnosed with Autism, that Alexithymia must also be ruled in or out, as a important co-existing condition. I would mention to Geoff Bird that ToM capacity (or Mentalizing) in ASD is highly variable, as it is in everyone. I do not think ToM issues lead to Alexithymia, as too many people without overt ToM deficits have been found to have Alexithymia. My hypothesis is that 'Alexithymia is essentially a 'cognitive-affective-interoceptive' response whereby emotion recognition is (partially) deactivated / inhibited when the individual faces some kind of (consciously felt or non-felt) traumatizing event, or an 'event' which over time produces fear, and thus contributes to a maladaptive (self protective) threat response'. Clearly some individuals are more prone to this Alexithymia response pathway more than others. The emotion coping system (at a neurological level) is possibly overwhelmed by certain emotional / affective demands, and that sadly this Alexithymia response does not easily self repair. In Alexithymia the interoceptive system becomes likewise negatively affected. However in Autism interoceptive sensibility remains more intact. In fact some Autistic individuals have superior Interoceptive sensibility capacities, (see reference). The need for interventions is the most crucial next step regarding addressing Alexithymia. When I say trauma I mean something, e.g. an event, an experience, that induces fear which triggers emotional dysregulation in the face of any threat signals from a 'fear like' source, but not just childhood trauma. This might suggest that, at some level, individuals 'know' that they are Autistic and that this may trigger an emotional 'threat' response that allows Alexithymia to 'attach' itself alongside ASD, etc. The lack of care for many ASD individuals is a compounding factor which might be a further Alexithymia risk. That AS people remain empathic towards others is a sign of their longing to be understood as well as evidence they do really feel for others. One just has to consider the incredible variety of people who develop Alexithymia, including the threat like Alexithymia response (emotional numbing) that has been clearly found in Soldiers returning from combat / war zones. If one considers the plight of children in War zones one can only imagine the spread / prevalence of Alexithymia in these helpless individuals. As far as I know the prevalence of Alexithymia in, say Syrian war-affected Children, has not been accounted for, but very clearly needs to be. Their (emotional) pain needs to be way more the subject of decent Research, which then needs to help guide or inform some meaningful compassionate & care responses (including empathy) towards this additionally neglected 'Alexithymia-wounded' population. Reference: 'The feeling of Me Feeling for You: Interoception, Alexithymia and Empathy in Autism'. Cari-Lene M., et al (2018). in Journal of Autism and Developmental disorders. thank-you.

[@eScential]

Yes, sound quality makes this content inaccessible to my neurology, however tantalizing. Your paragraph? is also inaccessible visually due to formatting, however dataful I perceive your sharing. Along with reformatting, I wish to suggest you reconsider your rigid black/white static characteristics. Perhaps you allow for more variation within a neurotype, but you portray individuals securely sealed in boxes when autism is realistically noted for coexisting "hyper/hypo" characteristics that vary in a "spikey" pattern within the individual autistic AND Over time/circumstances. The spikiness cannot be equated to the predictive development of fixed attributes that vary quite gradually, if at all, barring damage or deliberate inculcation. The allistic NONvariability within and among individuals distinguishes them from superficially similar autistics. Autistics are more distantly diverse from other autistics, and from self in time than from an allistic or the entirety of allistics. I empathize with the difficulty this presents to 'define and contain' science. This presentation is bringing out fertile ideas that i wish to pursue from a printed source before evaluating but a paradigm reconstruction rather than a nudge will be required stop harmful role-casting and allow growth of comprehension.

[@eScential]

I know my communication is alien to allistics so I offer example from in my being. I am alexithymic and do not lack empathy. Like my word usage, it appears differently from allistic norm where actual sharing of a 'feeling' with another is irrelavent, only ability to create perception of compassion. 'Empathy' and compassion are proscribed for any noncongruent being so the paradigm is much more of a social management tool than any actual compassion at the group level. "Alexithymia" is 'no words for feelings' tho connotation is broader and flexible, often to stigmatize. I actually know all those words but cannot hook to interceptions. I have no deficit of interoception, i believe superbly excessive...... possibly alongside some interoception 'blackhole' agnosias. Idk if 'therapy' could help me organize and emo-connect but making it a 'lack of words' blocks addressing. What i know I do feel and many hyperempathic autistics experience is a 'hyper-interoception' of the interoception of other beings. I don't know how to deal with my own interocepting! How do I figure out what to do to cope with your interocepting AT me, much less fix it all up for you allistics?😮 Check those entitlement demands😂 (That is not personal to Nick or Geoff or any individual allistic btw)