Summary
Alexithymia and interoception are related to how someone notices, understands and describes their internal experiences, including emotions and physical sensations. Alexithymia refers to difficulties identifying and describing emotions, while interoception is the ability to notice and interpret signals from inside the body. These experiences can vary significantly between individuals and are not conditions or diagnoses in themselves.
Someone experiencing alexithymia may find it difficult to recognise exactly what they are feeling or put their emotions into words. They may know that something feels wrong without being able to identify whether they are sad, anxious, angry, overwhelmed or experiencing another emotion. This can sometimes make it difficult to communicate emotional needs or understand why they are reacting in a particular way. Alexithymia does not mean that someone does not have emotions or does not care about other people; rather, the difficulty may be in recognising, understanding or describing their emotional experiences.
Interoception involves noticing signals from inside the body, such as hunger, thirst, tiredness, pain, temperature, needing the toilet, breathing, heart rate and muscle tension. People can differ in how strongly they notice these sensations and how accurately they interpret them. Someone with difficulties with interoception may not notice bodily signals until they become intense, or may find it difficult to work out what a particular sensation means. For example, they may realise they are extremely hungry only after they begin feeling unwell, or notice that they need to rest only once they are already exhausted.
Interoception and emotions can also overlap because emotions are often accompanied by physical changes. A racing heart, tense muscles, changes in breathing or a feeling in the stomach can occur alongside emotions such as anxiety, excitement or anger. If someone finds it difficult to notice or interpret these bodily signals, it may also be harder to recognise what they are feeling emotionally. However, alexithymia and interoceptive difficulties are not the same thing, and someone can experience one without experiencing the other.
These experiences can affect everyday life in different ways. Someone may find it difficult to recognise when they need food, water, rest or a break, understand what is causing distress, communicate how they feel or recognise when their emotions are becoming more intense. Difficulties identifying emotions or bodily needs can sometimes lead to frustration, overwhelm or misunderstandings with other people. At the same time, alexithymia or differences in interoception do not automatically mean that someone will experience significant difficulties, and people may develop their own strategies for understanding and communicating their internal experiences.
How it can impact mental health
Difficulties identifying, understanding or describing emotions can sometimes make it harder to recognise when something is wrong or communicate that support is needed. Someone may know that they feel uncomfortable, overwhelmed or that something is not right without being able to identify the emotion behind the experience. This can make it more difficult to understand what is contributing to distress and may leave someone feeling confused or frustrated by their own reactions.
Difficulties with interoception can also affect emotional wellbeing because physical signals are often connected to emotions. For example, a racing heart, changes in breathing, muscle tension or sensations in the stomach can occur during anxiety, stress or excitement. If someone finds it difficult to notice or interpret these signals, they may not recognise that they are becoming anxious or overwhelmed until their distress has become more intense. Conversely, unfamiliar or difficult-to-interpret physical sensations may sometimes cause additional worry or uncertainty.
These difficulties can sometimes affect how someone responds to stress. If a person does not recognise early signs that they are becoming tired, hungry, anxious or overwhelmed, they may continue with an activity until their distress becomes much more difficult to manage. Over time, this may contribute to increased stress, frustration, emotional exhaustion or feelings of being unable to cope.
Alexithymia can also affect relationships and communication. Someone may struggle to explain what they need, recognise their own emotional needs or understand why they are reacting in a particular way. This can sometimes lead to misunderstandings with other people and may contribute to feelings of isolation or frustration. However, difficulties expressing emotions should not be interpreted as a lack of emotion, empathy or care.
It is also important to recognise that alexithymia and interoceptive differences do not automatically cause poor mental health. Some people experience these differences without significant distress, while others may find them more challenging depending on their circumstances and the support available to them. Developing ways to recognise internal experiences, communicate needs and respond to early signs of distress can help protect emotional wellbeing and make it easier to seek support when needed.
How to help myself
Start by becoming more curious about what is happening in your body and emotions without expecting yourself to identify everything immediately. You could regularly pause and ask yourself what you can notice physically, such as your breathing, heart rate, muscle tension, temperature, stomach sensations, hunger, thirst or tiredness. You do not need to know what these sensations mean straight away; simply noticing them can help you become more familiar with your body’s signals.
Use simple words, scales or visual tools to help describe your experiences when emotions are difficult to identify. Instead of trying to find the exact emotion, you could start with broader categories such as comfortable or uncomfortable, calm or activated, or low, neutral or high. Rating how strongly you feel something from 0–10 can also make changes easier to notice. Over time, you may begin to recognise patterns between particular physical sensations, situations and emotions.
Build regular routines around basic physical needs rather than relying entirely on recognising internal signals. Eating regular meals, drinking enough fluids, taking medication as prescribed, getting enough sleep and taking planned breaks can be helpful if you do not always notice hunger, thirst, tiredness or other bodily needs until they become intense. External reminders, alarms, checklists or visual schedules can provide useful prompts.
Keep a record of situations where you notice changes in your body, mood or behaviour. You could write down what happened beforehand, what you noticed physically, what you were thinking, what you did afterwards and how you felt later. You do not need to use formal emotion words if they do not feel natural; describing what happened in your own words can still help you identify patterns.
Try different ways of communicating your internal experiences. If describing emotions verbally is difficult, you could use written messages, emotion cards, rating scales, drawings or examples of situations that help explain what you mean. You can also tell someone that you are unsure what you are feeling and describe the physical sensations or behaviours you have noticed instead. Being unable to name an emotion immediately does not mean that your experience is not valid.
Pay attention to changes in your behaviour as possible signs that something is happening internally. Becoming quieter, more irritable, restless, withdrawn or overwhelmed may sometimes indicate that you need food, rest, reduced sensory demands, emotional support or a break, even if you cannot identify the feeling causing it. Looking at these patterns with curiosity rather than judging yourself can make it easier to recognise your needs.
Give yourself time to develop these skills. Alexithymia and differences in interoception can mean that recognising and interpreting internal experiences does not always happen automatically. You do not need to force yourself to identify emotions or bodily sensations in a particular way. Finding strategies that help you understand and communicate your own experiences is more important than trying to experience them in the same way as someone else.
How to help a loved one
Try to understand that someone may experience and communicate emotions differently from you. They may know that something feels wrong without being able to identify or explain exactly what they are feeling. Avoid repeatedly asking questions such as “How do you feel?” if they find this difficult. Instead, ask what they have noticed physically, what has happened, or whether they would like help working out what they might need.
Pay attention to changes in their behaviour or physical presentation that may indicate they are becoming overwhelmed or that one of their basic needs has not been met. They may not always recognise hunger, thirst, tiredness, pain or the need for a break until these sensations become intense. Offering practical prompts such as asking whether they have eaten, had something to drink or need some quiet time can be helpful, while avoiding making decisions for them.
Give them time and space to communicate. If speaking about emotions is difficult, encourage other ways of expressing themselves, such as texting, writing things down, using emotion scales or describing physical sensations. Do not pressure them to name an emotion immediately. Describing what they can notice in their body or what has happened can be a useful starting point.
Avoid assuming that a lack of emotional expression means that they do not care. Someone experiencing alexithymia may have strong emotions but find it difficult to recognise, interpret or describe them. They may also express care, affection or distress in ways that are different from what you expect. Focus on how they communicate rather than assuming that emotions are absent because they are not expressed in a familiar way.
Help create predictable routines where appropriate. Regular meals, hydration, sleep, medication, breaks and other daily activities can provide useful external structure when internal bodily signals are difficult to recognise. Reminders, calendars or agreed routines may help, particularly during periods of stress or overwhelm.
Be patient when they are trying to understand what they are experiencing. You could help them notice connections between situations, physical sensations, emotions and behaviour by gently asking questions such as whether they noticed anything in their body or whether something changed before they began feeling overwhelmed. However, avoid telling them what they are feeling or insisting that a particular interpretation must be correct.
Most importantly, ask what type of support they find useful. Different people experience alexithymia and interoceptive differences in different ways, so strategies that help one person may not work for another. Offering choices, respecting their communication style and allowing them to remain involved in decisions about their needs can help them feel understood and supported.
Myth Buster
Myth: Alexithymia means someone does not have emotions
Truth: People with alexithymia can experience emotions but may find it difficult to identify, understand or describe what they are feeling
Myth: If someone cannot explain how they feel, they must not care
Truth: Difficulty describing emotions does not mean someone lacks feelings, empathy or concern for other people. They may communicate their emotions and care in different ways
Truth: Difficulty describing emotions does not mean someone lacks feelings, empathy or concern for other people. They may communicate their emotions and care in different ways
Myth: Alexithymia and interoception are the same thing
Truth: They are related but different. Alexithymia involves difficulties identifying and describing emotions, while interoception involves noticing and interpreting signals from inside the body
Myth: Everyone experiences interoception in exactly the same way
Truth: People differ in how strongly they notice and interpret internal sensations such as hunger, thirst, pain, tiredness, temperature, breathing and heart rate
Myth: If someone does not notice their body’s signals, they are ignoring their needs
Truth: Someone may genuinely have difficulty recognising internal signals until they become more intense. External reminders and routines can sometimes help them notice and respond to their needs
Myth: You should always be able to name what emotion you are feeling
Truth: Identifying emotions can be difficult for some people. Someone may recognise that they feel uncomfortable or that something is wrong without being able to identify a specific emotion
Myth: Alexithymia means someone is emotionally cold or uncaring
Truth: Alexithymia describes difficulties with identifying and describing emotions. It does not mean that someone lacks emotions, empathy or meaningful relationships
Myth: Interoception is only about noticing physical illness
Truth: Interoception involves many everyday bodily signals, including hunger, thirst, tiredness, pain, temperature, breathing, heart rate and muscle tension. These signals can also be connected to emotional experiences
Myth: Everyone with alexithymia or interoceptive differences needs treatment
Truth: These experiences vary between individuals and are not diagnoses in themselves. Support may be useful when difficulties are causing significant distress or affecting someone’s everyday life, but not everyone will need intervention
Support
Support can be helpful when difficulties identifying emotions or noticing bodily signals are causing distress or affecting someone’s everyday life. Speaking to a trusted friend, family member, teacher, employer, university support service or another trusted person can provide an opportunity to explain what is difficult and identify practical ways to make things more manageable. Someone does not need to have a diagnosis to ask for support.
A GP or other healthcare professional can be a useful starting point if difficulties with recognising emotions or bodily sensations are affecting eating, sleep, self-care, relationships or daily functioning. They can explore the person’s individual experiences and consider whether further assessment or support may be appropriate. It can be helpful to describe specific difficulties, such as not recognising hunger until becoming very hungry, struggling to identify emotions or finding it difficult to notice when stress is building.
Support from education or work may also be useful when these difficulties affect concentration, communication or daily responsibilities. Depending on the person’s needs, adjustments could include written rather than verbal communication, additional processing time, clear routines and expectations, scheduled breaks or access to a quieter environment.
Practical strategies can provide additional support when internal signals are difficult to recognise. Regular routines for meals, hydration, sleep and breaks, alongside reminders, calendars or visual prompts, can reduce the need to rely entirely on recognising internal cues. These strategies can be adapted according to what works best for the individual.
If difficulties with emotions are contributing to anxiety, low mood, relationship difficulties or feeling overwhelmed, psychological support may also be helpful. A mental health professional can provide a space to explore these experiences and develop strategies for recognising, communicating and managing emotions. Support should be based on the person’s individual needs rather than assuming that everyone with alexithymia or interoceptive differences requires the same intervention.
The aim of support is not to make someone experience or express emotions in a particular way. It is to help them understand their own experiences, communicate their needs and manage everyday life in ways that work for them.
Therapy interventions
Therapy is not a treatment for alexithymia or differences in interoception themselves, and neither is a mental health diagnosis. However, psychological and practical interventions can be helpful when difficulties identifying emotions or noticing bodily signals are affecting someone’s emotional wellbeing, relationships or everyday functioning. The most appropriate approach will depend on the individual’s needs and the difficulties they are experiencing.
- Cognitive Behavioural Therapy (CBT) – Can help someone explore connections between physical sensations, thoughts, emotions and behaviours, while developing strategies for recognising emotional responses and managing distress.
- Acceptance and Commitment Therapy (ACT) – Can help someone develop greater awareness and acceptance of internal experiences while identifying personal values and finding meaningful ways to respond to difficult thoughts, emotions or bodily sensations.
- Emotion-Focused Therapy (EFT) – Can support someone to develop greater awareness of emotions, understand emotional experiences and practise identifying and expressing feelings in ways that feel manageable.
- Mindfulness-Based Approaches – Can help someone develop awareness of physical sensations, thoughts and emotions without immediately judging or reacting to them. This may support greater recognition of internal signals over time.
- Counselling – Provides a supportive space to explore difficulties with identifying or communicating emotions, relationship difficulties, stress and the emotional impact of not always understanding what is happening internally.
- Psychoeducation – Can help someone understand alexithymia, interoception and the relationship between physical sensations, emotions and behaviour. It can also help family members or carers understand why someone may communicate their experiences differently.
- Occupational Therapy (OT) – Can provide practical support with recognising and responding to bodily signals, developing routines around eating, drinking, sleep and self-care, and using external prompts or sensory strategies when internal cues are difficult to notice.
Helplines
NHS 111 (Option 2)
NHS 111 is an NHS service providing urgent medical and mental health advice and support. It can help with mental health concerns, emotional distress, anxiety, low mood, suicidal thoughts and other urgent health problems.
Phone: For mental health support, call 111 and select the mental health option (option 2).
Opening times: Available 24 hours a day, 7 days a week.
Samaritans
Samaritans is a charity providing emotional support to anyone who is struggling to cope or needs someone to talk to. They are there for people experiencing all sorts of difficulties, including stress, anxiety, loneliness, relationship or family problems, bereavement, feeling overwhelmed and concerns about mental health or suicide.
Phone: 116 123
Opening times: 24 hours a day, 7 days a week, 365 days a year
Website: www.samaritans.org
Shout
Shout is a free, confidential text messaging service that provides support to anyone who is struggling to cope. It can help with a wide range of issues, including stress, anxiety, low mood, loneliness, relationship difficulties, bullying, self-harm, suicidal thoughts, feeling overwhelmed and other mental health challenges.
Text: SHOUT to 85258
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
Website: http://www.giveusashout.org
Mind
Mind is a mental health charity providing information, advice and support for people experiencing mental health difficulties. They cover a wide range of mental health and wellbeing issues, including anxiety, depression, stress, relationships, loneliness, coping with difficult experiences and managing everyday life. Mind provides information to help people understand what they are experiencing, know their rights, find appropriate support and feel less alone.
Phone: 0300 123 3393
Opening times: 9am–6pm, Monday to Friday (excluding bank holidays)
Email: info@mind.org.uk
Website: www.mind.org.uk
YoungMinds
YoungMinds is a national charity supporting the mental health and wellbeing of children and young people. They provide information, advice and support for parents and carers who are concerned about a young person’s mental health, and help people understand mental health difficulties, find appropriate support and access useful resources. Their Parents Helpline can provide information, advice, emotional support and signposting to other services.
Parent helpline: 0808 802 5544 (9:30 am – 4 pm on Mondays, Thursdays and Fridays, and from 9:30 am – 6 pm on Tuesdays and Wednesdays)
Email: parents@youngminds.org.uk
Webchat: https://www.youngminds.org.uk/parent/parents-helpline/
Childline
Childline is a free service for young people to talk to a counsellor about anything. The service is available 24 hours a day, 7 days a week. Childline is available to anybody who is 18 years old or younger.
Phone: 0800 1111
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
You can also find helpful resources, speak to a counsellor online or send a message on their site.
Website: www.childline.org.uk
For adults concerned about a child, the NSPCC can be contacted
NSPCC
NSPCC is a children’s charity that works to protect children and prevent abuse and neglect. They provide support and advice for adults about child abuse, neglect, child safety, online safety and children’s mental and emotional wellbeing.
Phone: 0808 800 5000
Opening times: 10 am–4 pm, Monday–Friday
Email: help@nspcc.org.uk
Email opening times: 11 am–4 pm, 7 days a week
Website: www.nspcc.org.uk
CALM (Campaign Against Living Miserably)
CALM (Campaign Against Living Miserably) is a charity providing support for people who are struggling with their mental health or experiencing emotional distress. They support people with issues including low mood, anxiety, loneliness, stress, suicidal thoughts and difficult life experiences.
Phone: 0800 58 58 58
Opening times: 5pm–midnight, every day
Webchat: 5pm–midnight, every day
WhatsApp: Available through the CALM website
Website: www.thecalmzone.net
