The Sixth Personality Trait

Prevalence in the general population:10%.

​According to the well-established framework of the Five Factor Model (FFM) — often referred to as the “Big Five” — personality fits neatly into five broad personality dimensions or traits, each representing a continuum: conscientiousness (high among task focused and orderly individuals), openness to experience (high among individuals with a broad range of interests, sensitive to art and beauty, and who prefer novelty over routine), agreeableness (high among cooperative and polite individuals), extraversion (assertive and sociable), and neuroticism(also thought of as the opposite of emotional stability).

Besides the “Big Five”, a distinct personality trait has been long-known but often overlooked: alexithymia.

The prevalence of alexithymia in the general population is estimated to be about 10%, and seems to be normally distributed in the population for both genders.

Identified in the mid-seventies, alexithymia translates from the Greek to mean “no words for emotions”.

Historically, alexithymia was intended to reflect the personality of the “boring” patient in psychotherapy, unable to put feelings into words, and with whom the conversation boils down to an enumeration of a few physical complaints before drying up very quickly.

Alexithymia is currently characterized by the sub-clinical inability to identify and describe emotions in the self (low emotional awareness), and the difficulty in distinguishing and appreciating the emotions of others, which can lead to unempathic and ineffective emotional responding (FeldmanHall & al., 2013).

According to recent research on the relationship between alexithymia and the “Big Five” personality traits (Heshmati & Pellerone, 2019), alexithymia appears to be positively associated with neuroticism (strongest predictor of alexithymia), and negatively associated with conscientiousness and openness to experience.

Alexithymia construct is also inversely related to psychological mindedness, which refers to a person’s capacity for self-reflection, and which includes an ability to appreciate emotional nuance and complexity, as well as to recognize the connections between past and present, and insight into one’s own and others’ motives and intentions.

In concrete terms, the person high in alexithymia will say that he or she feels bad, without knowing if he or she is angry, sad or frustrated. However, it should not be assumed that the alexithymic person does not feel anything. They feel their emotions physically (sensations), but are unable to “conceptualize” or “mentalize” them on a cognitive level (to make connections between emotions and thoughts), and therefore to verbalize them (Genoud et al., 2005).

In most people, emotional expression tends to rise and fall gradually, so that their inner awareness of their emotions and ability to express them are in sync.; if they get angry, they are aware of their anger and express it accordingly. On the contrary, people high in alexithymia may be more likely to show wide fluctuations between no sense of awareness and a sudden and unregulated spike in emotional activation (they “explode”).

The combination of avoidance of strong feelings along with an inability to understand the nature of one’s own feelings can lead to difficulties when individuals are involved in close relationships. They will stay away from highly emotional experiences, both good and bad, and they will also be unable to express themselves clearly to their partners.

Individuals high in alexithymia often tend to have a poor fantasy life, resulting in a utilitarian form of thinking, a tendency to use action to avoid conflicts and stressful situations (Nemiah, Freyberger, Sifneos, 1976).

Although there seems to be strong empirical support for alexithymia being a stable personality trait (Taylor & al., 1997, p. 37), which varies in intensity from person to person, and as such is not classified as a mental disorder, current research suggests a strong association between alexithymia and a variety of psychosomatic and psychological disorders (some authors used to refer to alexithymia as a psychosomatic personality (Bertagne, 1992)).

A high rate of alexithymia (approximately 40%−60%) is indeed reported among individuals with psychosomatic disorders and mental health disorders such as anxiety disorders, depressive disorders, eating disorders, addictive disorder, obsessive-compulsive disorder, and autism spectrum disorder (Ricciardi & al., 2015).

Several studies have also found an association between alexithymia and a wide range of medical conditions, such as asthma, allergies, hypertension, diabetes, myocardial infarction, and even cancer (Ricciardi & al., 2015).

However, in chronic pathologies, it is difficult to know whether the alexithymia that may be associated with it is a factor that contributed to the onset of the illness or a consequence of the chronic stress that the disease represents for the subject.

Furthermore, since alexithymia is a common feature of neurological disease, with most evidence available for patients with traumatic brain injury, such as a stroke or epilepsy, it has also been argued, that significant trauma, psychological distress or even chronic stress could likely elicit an alexithymic type of emotional reaction (Mattila 2007).

More research and longitudinal studies are still needed to establish whether alexithymia is a risk factor for medical and psychiatric disorders, and to develop adequate approaches aimed at coping with alexithymia (Taylor and al., 2012).

From a practical standpoint, whether alexithymia is rated high or low, everyone could benefit from increased awareness of their emotional state and better verbalization of their feelings. Not only will this improve self-awareness, which will better inform personal decisions, shape behavior and influence the quality of relationships, but it will also potentially contribute to better physical and psychological health.

For people “living with alexithymia”, training one’s ability to identify the fluctuating diversity of emotions and their nuances, considering both self-reflection and other people’s experiences, could significantly improve their lives.

For those who feel inspired to learn more about their emotions and how they affect their life, activities such as engaging in the arts or daily journaling, writing about one’s emotional experiences from the past week, month, or year, could be worth exploring.

And whether one suspects (or knows) that one is rather high in alexithymia or not, here are some questions one might ask to explore one’s emotional life (Bariso, 2019):
​
· How would I describe the way I make decisions?
· How do my mood or emotions affect my thoughts and decision-making?
· What effect does my communication have on others?
· What kind of attitudes in others bother me? Why?
· And, by the way, why am I reading this text now? What does it trigger in me?

References
Bach, M., De Zwaan, M., Ackard, D., Nutzinger, D. O., Mitchell, J. E. (1994). Alexithymia: Relationship to personality disorders. Comprehensive Psychiatry, 35, 3, 239–243.
Bariso, J. (November 29th, 2019). 5 of the Most Popular Questions on Emotional Intelligence, Answered. Retrieved from: https://www.inc.com/justin-bariso/5-of-most-popular-questions-on-emotional-intelligence-answered.html
Bertagne, P., Pedinielli, J.L., Marliere, C. (1992). L’alexithymie : évaluation, données quantitatives et cliniques. Encéphale, 18, 1, 121–130.
Davezies, P. (August 1st, 2013). Souffrance au travail, répression psychique et troubles musculo-squelettiques. Perspectives interdisciplinaires sur le travail et la santé. Retrieved from : https://journals.openedition.org/pistes/3376
FeldmanHall, O., Dalgleish, T., Mobbs, D. (2013). Alexithymia decreases altruism in real social decisions. Cortex, 49, 3, 899–904.
Genoud, P. A., Rossier, J., Reicherts, M. (September 2005). Dimensions of “Emotional Openness”, the five personality factors and Alexithymia. 9th Congress of the Swiss Society of Psychology (SSP), Genève.
Heshmati, R., & Pellerone, M. (2019). The Big Five Personality Traits and Dispositional Mindfulness as Predictors of Alexithymia in College Students. Clinical neuropsychiatry, 16(2), 98–106.
Krauss Whitbourne, S. (August 14th, 2018). The Most Important Personality Trait You’ve Never Heard Of. Retrieved from: https://www.psychologytoday.com/us/blog/fulfillment-any-age/201808/the-most-important-personality-trait-you-ve-never-heard
Ricciardi, L., Demartini, B., Fotopoulou, A., Edwards, M. (2015). Alexithymia. In Neurological Disease: A Review, Vol. 27, Is. 3, 179–187.
Mattila, A.K., Ahola, K., Honkonen, T., Salminen, J.K., Huhtala, H., Joukamaa, M. (2007). Alexithymia and occupational burnout are strongly associated in working population. Journal of Psychosomatic Research, vol. 62, no 6, 657–665.
Nemiah, J.-C., Freyberger, H., Sifneos, P.E. (1976). Alexithymia. A view of the psychosomatic process. In OW Hill : Modern trends in psychosomatic medicine, vol. 3, London, Butterworths, 26–34.
Ricciardi, L., Demartini, B., Fotopoulou, A., Edwards, M. (2015). Alexithymia in Neurological Disease: A Review, Vol. 27, Is. 3, 179–187.
Taylor, G. J., Bagby, R. M. (November 2012). The Alexithymia Personality Dimension (The Oxford Handbook of Personality Disorders). Retrieved from: https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199735013.001.0001/oxfordhb-9780199735013-e-30
Taylor, G. J, Bagby, R. M., Parker, J. (1997). Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge: Cambridge University Press.