title: What's in the name 'alexithymia'? A commentary on "Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud's legacy.".
abstract: The recent proposal of a new type of agnosia termed 'affective agnosia' extends Freud's legacy and captures the concept of not knowing one's own emotions. This concept links well with the theory of levels of emotional awareness and maps onto a hierarchical model of neural substrates of emotional experience, but does not encompass the pensée opératoire component of the alexithymia construct. Moreover, identifying agnosia and anomia subtypes, which connotes a categorical conceptualization of alexithymia, is inconsistent with the dimensional nature of the construct. We describe a more widely accepted definition of alexithymia, and argue that although aptly descriptive, the concept of affective agnosia does not advance the theory, measurement, and treatment of alexithymia. A review of alexithymia literature indicates that impairment in the mental representation of emotions has been a central aspect of alexithymia theory since the concept was introduced, and guided the development of the Toronto Alexithymia Scale and other measures of the construct. Moreover, techniques to enhance mentalization of emotions have been used by psychotherapists for several decades.
authors.affiliation: Department of Psychiatry, University of Toronto and Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G1X5, Canada. Electronic address: graeme.taylor@utoronto.ca.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Taylor
authors.affiliation: Departments of Psychology and Psychiatry, University of Toronto, 1265 Military Trail, Sy-131, Toronto, Ontario M1C1A4, Canada. Electronic address: rmichael.bagby@utoronto.ca.
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
authors.affiliation: Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9J7B8, Canada. Electronic address: jparker@trentu.ca.
authors.forename: James D A
authors.initials: JDA
authors.lastname: Parker
mesh_terms: D000342:Affective Symptoms; D000377:Agnosia; D001364:Awareness; D004644:Emotions; D006801:Humans
keywords: Agnosia; Alexithymia; Anomia; Emotional awareness; Mentalization; Primal repression; Psychotherapy; Toronto Alexithymia Scale; Trauma