Exploring Alexithymia: Reviewing at Risk Populations and Treatment Pathways

This thesis explores the relationship between alexithymia and co-morbid mental health concerns, with a focus on developing practical tools for improving therapeutic interventions. Through a combination of qualitative and quantitative methodologies, including smallest space analysis (SSA), exploratory factor analysis (EFA), binomial logistic regression, and thematic analysis, the research provides a comprehensive understanding of how emotional regulation deficits manifest in both clinical and non-clinical populations.

Key findings include the identification of distinct emotional processing profiles namely, the compromised child, the compromised adult, and the alexithymic, that demonstrate the spectrum of alexithymic traits. The results suggest that while early trauma is a significant predictor of emotional processing difficulties, not all individuals exposed to trauma develop alexithymia. This finding underscores the need for personalised therapeutic approaches based on individual emotional capacities and life experiences. One of the main contributions of the research is the development of a narrative-based screening tool for identifying alexithymia and emotional processing deficits. The tool was trialled in a clinical setting, demonstrating high interrater reliability and practical utility for care planning. The tool’s integration into personalised therapy highlights its potential to improve therapeutic outcomes by enabling early identification and intervention for individuals with emotional regulation difficulties.

Qualitative insights from interviews with therapists revealed the challenges of working with clients who struggle to articulate emotions, emphasising the importance of adaptive therapeutic strategies. The research also provides evidence for the need to shift away from traditional self-report measures of alexithymia, which may not accurately capture the emotional experiences of affected individuals. Overall, this thesis advances both theoretical and practical understanding of alexithymia, offering new frameworks for assessing and treating emotional processing deficits in trauma-affected populations. The findings have been disseminated through academic conferences, clinical training, and journal submissions, and have led to discussions at the governmental level on the importance of addressing alexithymia in mental health care policy.