Effect of Alexithymia on the Process and Outcome of Psychotherapy: A Programmatic Review
Abstract
Most psychotherapeutic approaches assume that individuals have some access to their emotions. Thus, patients who are unable to identify, differentiate, and articulate their emotions present therapists with a difficult challenge. Such patients may suffer from alexithymia. Despite much attention in the clinical literature, research on alexithymia in the treatment setting has been sparse. Thus, many of the assumptions about psychotherapeutic treatment of alexithymic patients remain untested. This article summarizes findings from a series of studies that examined the effect of alexithymia on various aspects of the psychotherapeutic enterprise. Findings indicated that alexithymia has little effect on patients' treatment preferences, yet there was some tendency for alexithymic patients to prefer group therapy. However, alexithymia was associated with poor outcome in both traditional psychodynamic psychotherapy and supportive therapy. This negative effect was found in individual and group psychotherapies. In the context of group therapy, higher levels of alexithymic features elicited negative reactions from one's therapist, which partially contributed to the poor outcome experienced by such patients. Finally, the negative reaction that therapists had toward patients with high alexithymia appeared to be in response to the lack of positive emotion expressed by these patients. Clinical implications and ideas for future research are considered.
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Not only CBT, but other therapies are also designed to increase awareness of interception and emotion and how to express them.
“Not only CBT, but other therapies are also designed to increase awareness of interception and emotion and how to express them, which were already indicated in an earlier review [57].”
From Psychological Treatments for Alexithymia: A Systematic Review (2024) · cites this paper as [57]
Alexithymia has been described as interfering with psychotherapy.
“Although alexithemic patients were prepared to participate in therapy consisting of a psychodynamic oriented multimodal therapy (3), alexithymia has also been described as interfering with psychotherapy (4), such as group psychotherapy, individual psychodynamic psychotherapy, and supportive therapy.”
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Predicting symptoms in major depression after inpatient treatment: the role of alexithymia
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Metacognition as a Predictor of Improvements in Personality Disorders
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Alexithymia and Somatization in Chronic Pain Patients: A Sequential Mediation Model
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Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis
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Empathy, Alexithymia, and Theory of Mind in Borderline Personality Disorder
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Alexithymia and Maladaptive Regulatory Behaviors in Substance Use Disorders and Eating Disorders
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Temperament, character traits, and alexithymia in patients with panic disorder
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Alexithymia and psychological distress in fibromyalgia and chronic migraine: A cross-sectional study
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Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis
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Psychological Treatments for Alexithymia: A Systematic Review
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- Authors
- Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S.
- Affiliations
- University of British Columbia (CA)
- University of Alberta (CA)
- Corresponding author
- Ogrodniczuk, John S.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 190
- Issue
- 1
- Pages
- 43-48
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2098604952
- Cited by
- 249
- References
- 65
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 17 · 2023: 16 · 2022: 14 · 2021: 25 · 2020: 23 · 2019: 17 · 2018: 20 · 2017: 13 · 2016: 19 · 2015: 18 · 2014: 15 · 2013: 13 · 2012: 3
- FWCI
- 5.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- alexithymia, psychotherapy outcome, treatment preferences, group therapy, individual psychotherapy, psychodynamic psychotherapy, supportive therapy, therapist reactions, emotional awareness, positive emotions
- MeSH terms
- Affective Symptoms, Humans, Psychiatric Status Rating Scales, Psychotherapy, Treatment Outcome
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