Derek Brahney for Mosaic. Source photograph from iStock by Getty ImagesEvery tenth man hardly recognizes his emotions. The new study suggests a significant connection between our ability to feel our own body and to be aware of our feelings.
Stephen was married twice. Two weddings. Two marriage vows. But he has no happy memories of any of the marriages. Moreover, they are not about any of his relations at all.
He met his first wife at 16 at a nursing education course. Six years later they were married. And three years after the wedding divorced. He says that she was never the same, she did not really suit him.
Twenty years later, in 2009, on a dating site, he met his second wife. And the next year, together with his father and her two adult children, they registered marriage in the city of Sheffield.
He smiles at wedding photos, knowing that smiles are expected of him, but he explains: “According to inner feelings, everything connected with emotions seems to be a pretense. Most of my reactions are learned. In an environment where everyone is cheerful and joyful, there is a feeling that I am lying. Pretend to be. But the way it is. It's a lie. ”
Happiness is not the only feeling that Steven has a problem with. Admiration, shame, disgust, hope and even love - he does not feel them either. “I feel something, but I really can't discern feelings between myself.” The only emotions familiar to him are anger and anger.
Such big problems with emotions are sometimes associated with autism, which Stephen does not have, or with psychopathy, which he does not have either. Last year, at 51, he finally found out what kind of frustration: a little-known diagnosis called alexithymia, if not exactly translated from Greek: “there are no words for emotions”.
Despite the name, the problem with people with alexithymia is not to describe emotions, but because they simply do not have enough of them. But everyone has their own experience. Someone has gaps and distortions in the spectrum of emotions. Others feel something, but cannot describe. Still others take their feelings for something else, for example, butterflies in the stomach for the feeling of hunger.
Surprisingly, despite the fact that this disorder usually remains undetected, according to statistics, every tenth person has impairments from this spectrum. A new study reveals not only what goes wrong, not only offers new methods of treatment of disorders associated with emotions, but also reveals how people experience emotions.
After working as a nurse for ten years, Stephen decided to change the type of activity. Two years of university courses, degree in astronomy and physics, then work as a game tester. He built a successful career, working in the testing departments in various companies, management departments and speaking at conferences around the world. For him, there is no problem to communicate the facts to colleagues. But as for personal relationships or any situation where emotions are involved, everything goes “wrong”.
He explains: “At the beginning of a relationship, I’m all about what constitutes a partner. I was told that our honeymoon lasted longer than expected. But after a year, everything changes. Everything is falling apart. I become a person that I really am not. I react with my mind, not with my heart. It is clear that this is wrong. Unbelievable. Fake Because it is a fake. And you can pretend for a long time. ”
He and his wife have not lived together since 2012. The therapist prescribed antidepressants for him. He maintained contact with his wife, but it was clear that the relationship was no more. In June 2015, Stephen attempted suicide. “I wrote to Facebook and Twitter that I intend to commit and someone — I never found out who — called the police. I was taken to the hospital. ”
The psychiatrist directed Stephen to a series of consultations, and then to a course of psychodynamic psychotherapy, a type of Freudian therapy that reveals how the unconscious affects thoughts and behavior, similar to psychoanalysis.
In Sue Gerhard's book Why Love is Important, recommended by the psychotherapist, he first met the term alexithymia. “I brought a book for therapy, and we began to discuss my diagnosis. It is clear that I had a vocabulary. Words to describe emotions. But despite the right words for the emotions, their combination was something else ... I thought that I could not speak well about feelings and emotions and so on. But after a year of therapy, I came to the conclusion that when I talk about emotions, I have no idea what I'm talking about. ”
The term “alexithymia” is first used in the Freudian book of 1972. Most psychologists are not happy about Freud's ideas right now. As Jeff Bird, a professor at Oxford University, explains: “It’s not that we don’t respect these traditions, but in cognitive, neuro, experimental science there are not so many people interested in anything related to Freud.”
But when Byrd read about alexithymia, he found the description interesting. "It's amazing". For most, "with weak emotions, you can be unsure of what you feel, but with strong ones, you
know how you feel." However, there are people who do not know.
Byrd began his academic career with the study of autism spectrum disorders, empathy and awareness of emotions, which led him to alexithymia. In one of his first studies on this topic, he associated alexithymia with a lack of empathy. The study included a list of 20 items developed by the University of Toronto. If you cannot feel your own emotions in a certain way, it makes sense that you cannot understand the emotions of others.
But what really aroused an interest in alexithymia in Byrd was his interaction with autists. “There was a point of view that autists lack empathy. Nonsense. This is immediately clear, it is worth meeting with autistic people. ”
In a series of studies, Bird discovered that half of people with autism also have alexithymia - these are people who have difficulty expressing emotions and empathy, but the rest do not. In other words, emotion-related difficulties are inherent in alexithymia, not autism.
Byrd really wanted to share this. He talked with feeling about one of the volunteers with autism, but without alexithymia: “A dear boy, with such a high IQ that we could not measure, could not resist a single job. But he was a volunteer at the medical center because he wanted to do something useful. He was told: "Since you have autism, you lack empathy, so you will not be able to care for the elderly." This is ridiculous."
Byrd conducted a series of studies on alexithymia outside the context of autism. In particular, he found that people with alexithymia had no problems with recognizing faces and could distinguish the image of a gloomy and smiling person. “But those who had the frustration were especially strong, despite the fact that they could distinguish between a smile and disapproval, did not know what they meant. It was really strange. ”
Many of the people with this disorder told Byrd that they were told about their differences by others, but some realized that they had the disorder themselves. “I think that this is not seeing the color, everyone says what red or blue it is, and you understand that in this part of the human experience you simply do not take part.”
Trying to better explain alexithymia, Byrd and his colleagues came across a kind of looping: Stephen has problems with emotions, because he has alexithymia, which is characterized by problems with emotions. They tried to break this circle.
Derek Brahney for Mosaic. Source photograph from iStock by Getty ImagesIn situations that Steven described as strong emotions — for example, a declaration of love — he sensed a change within the body. “I felt heart palpitations and a surge of adrenaline, but for me it's always scary. I do not know how to respond. I want to run away or show aggression. ”
Anger, fear and embarrassment, he understands. “Everything else feels the same. This feeling is like, “Uh, I'm not very comfortable, this is not quite right.”
For Rebecca Brewer, a former student of Byrd, and now a lecturer at Royal-Holloway College in London, this makes sense. “People with alexithymia know they have emotions, but they don’t know which ones,” she explains. “So, they may have depression, as they have difficulties with the difference of different negative emotions and the definition of positive emotions. As with anxiety disorder, if a person experiences an emotional response associated with heart palpitations, it is possible to admire, he does not know how to interpret it and may start to panic because of what is happening with his body. ”
The ability to detect changes inside the body — everything from an increased heartbeat to blood loss, from a full bladder to an extension of the lungs — is called interoception. This is your perception of your own inner state.
Different emotions are associated with different physical changes. With anger, for example, heartbeat increases, blood rushes to the face, wrists are compressed. Obviously, these physical changes are not associated with certain emotions: if you have a quick heartbeat at the sight of a spider, then it is from fear, not from sexual arousal.
Bird and his colleagues found that people with alexithymia have a reduced ability to reproduce, define or interpret these internal changes in the body, sometimes this ability is completely absent. IQ of these people is normal. Like any other, they understand that they see a spider, and not an attractive partner. But either their brain does not give a signal to the body for physical changes characteristic of experiencing emotions, or the brain parts incorrectly process the signals of the body.
In 2016, Bird and Brewer, along with Richard Cook of the City University of London, published research findings describing alexithymia as a “generalized interoception deficit”. So, there was an explanation for problems with emotions, and at the same time, the statement that the perception of body signals is important for emotional experience for everyone else.
This idea is also reflected in everyday speech: in the English language they apologize “from the heart”. If you love someone, then "with all your heart." When you are really angry, the “blood boils”. Instead of talking about excitement, they say “butterflies in the stomach” (this is caused by the outflow of blood from the digestive system).
Most people may not be familiar with alexithymia, but there is another disorder associated with a lack of emotion and empathy that seems to fascinate us even more than it repels: psychopathy. Can we learn more about how we feel understanding psychopaths?
Lieke Nentzhes is a little over thirty, she is slim and she has a quiet voice. It is hard to imagine her spending hours in a small room with inmates psychopaths, including serial killers, who have no hands tied.
When Nentges begins to speak, confidence is heard in her voice. “Once a large guy with long, disheveled hair sat down opposite me and suddenly asked (raising his voice, rising from his chair):“ Are you not afraid of me? ”I was surprised. I did not expect this. And I answered (without raising my voice, but confidently): “Why - maybe you are afraid of me?” He sat down. And he explained that he was ending his “re-socialization” therapy course, but nobody takes him to work because they are afraid of him. He was not angry. He was disappointed. ”
The nature of psychopathy is not completely clear, but psychologists generally agree that psychopathy is associated with a lack of empathy or guilt, not deep emotions and antisocial behavior - mistreatment of other people and, in some cases, participation in criminal activities.
It was assumed that some psychopaths are able to torture or kill people, because they do not process emotions properly - for example, they do not feel fear, and do not see it in other people.
Nentges works at the University of Amsterdam. Here in the Netherlands, if the criminal is found to have psychological abnormalities related to the crime, he is considered only partially responsible. Such criminals can spend several years in a regular prison before they are sent to a treatment center, or they can be immediately sent for treatment.
Nentzhes decided to interview such criminals from medical centers and prisons to find out how they manifest psychopathy (paying particular attention to various aspects of psychopathy), learn about their life experiences - education and criminal behavior - and measure interoception.
“Emotions are very important when you research psychopathy. More precisely, the lack of emotion. Could it be that criminals with psychopathy just have bad contact with their own body? ”She says.
In a series of interviews, Nentges asked questions to assess the level of empathy, to determine how much they repented of the crime committed. “Some were completely honest and answered“ I don't care, ”she says. “Others, with psychopathy, answered:“ Oh, but I very much empathize ”. They learned words to accurately describe feelings, could talk about empathy and compassion, but when you see the crimes they committed ... ”- here her words break off.
“One study found that psychopaths can describe emotions verbally, but they lack internal emotional experience,” she adds.
Since it is difficult to determine the ability of a person to recognize body signals, the interception associated with the heart rate is often measured. In one of the tests, participants are asked to count heartbeats for 25-50 seconds, possibly several times. Approximately 10 percent consider the pulse very good, 10 percent very bad, the rest - average.
In another test, volunteers are given a series of signals, and are asked to determine whether the series of signals are synchronized with their pulse. As in the previous test, 10 percent do very well, but 80 percent cannot do it at all.
Nentges brought the equipment for such tests to the interrogation room and measured 75 criminals. She revealed a clear correlation: the higher the assessment of the antisocial aspects of psychopathy, the lower their evaluation in the tests. At the very least, it can be assumed that psychopaths, who recognize body signals worse, feel less emotion and, therefore, less empathize with others.
These criminals are sometimes divided into two groups: those who have committed atrocious crimes and “white-collar workers” - fraudsters. When interviewing the first group, Nentges found one similarity with the second: “It was education. More precisely, its disadvantage. Emotional abuse. Sexual abuse. Neglect of parental responsibilities. A lot of physical abuse. I heard from them that they literally didn’t use emotions. All that they felt during the upbringing was fear. ”
As a child, Stephen suffered from inattention. When he was six, his mother deliberately set fire to their house while she and her children were inside. By luck, the father on his way to work remembered that he had forgotten dinner, and returned home.
Looking back, Stephen realizes that his mother suffered from postpartum depression. But she did not receive treatment, and “all I knew was anxiety and anxiety.” After the arson she went to prison. My father was a steelworker and worked in different shifts. “A neighbor contacted the custody service, and my dad was told to get the job done or they would take us away.” None of my father’s brothers or sisters wanted to take me or my brother because we were little rascals. We always had problems. Robbery shops. All that. Therefore, we ended up in an orphanage. ”
Stephen spent the rest of his childhood getting into different children's homes. The only emotions that he remembers are fear, anger and embarrassment. “Christmas, birthdays, unexpectedly kind-hearted people in an orphanage ... I could not get used to this. I have always been uncomfortable. Confusion in feelings that I misinterpret or cannot respond to them properly. ”
Alexithymia is often associated with injury or neglect at an early age, explains Jeff Bird. Researches of twins assume heredity. There is also a connection with some types of brain damage, in particular, with an island, a department that receives interoceptive signals.
As Rebecca Brewer notes, the anxiety Stephen experiences is often found in people with poor interoception. At the University of Sussex, Hugo Critchley and Sarah Garfinkel, specialists in psychiatry and neuroscience, are looking for ways to increase interoception to reduce anxiety.
Garfinkel put forward a three-dimensional model of interoception, which was well received by other specialists. First, the objective accuracy of perception of interoceptive signals — for example, how good are you in calculating heart rate. Secondly, a subjective report - how much do you think you are good in perceiving body signals. And, thirdly, metacognitive accuracy - how much your idea coincides with how good you really are.
The third parameter is important because in various studies it turned out that the gap between how accurate they consider themselves to be when calculating heartbeats, for example, and how accurate the participants actually are, predicts their level of anxiety.
Lisa Quadt, a research associate at the Sussex group, is currently conducting a clinical trial to test whether reducing this gap in people with autism can reduce their anxiety.In an experimental study, Christian, Garfinkel and graduate student Abigail MacLanahan recruited a group of students who came to the laboratory for six sessions. In each session, they first counted heartbeats. The volunteers sat alone, with a rubber pulse oximeter on their index finger, and said how many strokes they counted. Then MacLanahan gave them the exact meaning so they could better understand how accurate.Then McLanahan forced them to do a few jumps with their hands up or climb a steep hill nearby - to increase their heart rate. (“Because some people really can't feel their heartbeat at all. I can't,” explains Quadt). Then they returned to the laboratory, counted the blows again and, as before, received feedback each time.It was just an experimental study in which students participated. But after three weeks, not only did the accuracy of the subjects improve in all three interoception parameters, but they also reported a decrease in anxiety by about 10 percent.For the main study, the volunteers diagnosed with autism spectrum disorder will perform the same tasks as in the pilot study, but once in the beginning and once at the end they will do them inside the fMRI scanner. This will allow the team to monitor activity in the islet, which receives data on heartbeats, and see how changes in this activity relate to connections in the amygdala, which detects threats, and the prefrontal cortex, which can decide whether a potential threat is dangerous or not and whether to worry. Hope, according to Crichley, is to strengthen the link between these two regions, which, as shown by previous studies, is associated with a decrease in anxiety.
Derek Brahney for Mosaic. Source photograph from iStock by Getty ImagesIn Oxford, meanwhile, Jeff Bird wants to consider the idea that there are two different types of alexithymia. People of the same type do not create enough bodily signals necessary for experiencing emotions, so they are unlikely to benefit from the training of groups from Sussex. People with a different type create all kinds of bodily sensations, but their brains do not process these signals in a standard way. This second group, which includes Stephen, the study may bring more benefits.Byrd emphasizes that although people with alexithymia have difficulty understanding emotions, this does not mean that they do not care about others. “For the most part, people with alexithymia can recognize that others are depressed, and this upsets them. The problem is that they cannot understand what the other person feels and how they themselves feel, and even more so how to make the other person feel better or how to reduce their own bad mood. I think this is important because alexithymia is different from psychopathy in this regard. ”Stephen says this is certainly true for him. And theoretically, the method of emotional preparation is what he would welcome. “I have a few books about emotions and feelings, and they don’t differ a bit because they don’t speak in sufficient detail about what sensations in your body are associated with what emotions.”At this point, given the lack of accessible alexithymia treatments, Stephen plans to use his new self-understanding, acquired through therapy, to try to move on. At first, he hoped that therapy would fix everything. “I thought that every day would be perfect, brilliant ... and I realized that this would not happen. I will always have problems and there will always be difficulties. ”He learned a valuable lesson from this. Although he and his wife still live separately, they regularly communicate, and now he tries not to reject her views on his anxiety. “Instead of saying“ No, ”I will listen. I think: “Well, you know what emotions are, but I do not, therefore I will listen to you, and either take into account your remarks, or not.” He also thinks about going to work with people who are struggling with substance abuse because he would like to return to a career where he can help people.Moreover, he decided to use his diagnosis. “Now that I know that I have alexithymia, I can read about it, it expands my possibilities. I can find out more. And I can develop certain tools that will allow me to confront her. ”People without alexithymia could probably use the same tools. Byrd did a job showing that people who more accurately sense their pulse are better able to recognize the emotions of other people; this is the decisive first step in becoming more sensitive. He plans research to see if heart training can increase empathy.Those who want to reduce the feeling of stress and anxiety in everyday life, but cannot or do not want to change the sources of stress, can focus on changing the signals from their bodies. Regular exercise should weaken the types of bodily signals (for example, from the heart and blood circulation) that the brain can interpret as alarming, therefore, anxiety will decrease.The knowledge that the signals from the bodies underlie the emotions expands our capabilities. What do you feel about this?