Handb Clin Neurol. 2021;183:47-62. doi: 10.1016/B978-0-12-822290-4.00004-9.


Humans are highly adept at differentiating, regulating, and responding to their emotions. At the core of all these functions is emotional awareness: the conscious feeling states that are central to human mental life. Disrupted emotional awareness-a subclinical construct commonly referred to as alexithymia-is present in a range of psychiatric and neurological disorders and can have a deleterious impact on functional outcomes and treatment response. This chapter is a selective review of the current state of the science on alexithymia. We focus on two separate but related issues: (i) the functional deficits associated with alexithymia and what they reveal about the importance of emotional awareness for shaping normative human functioning, and (ii) the neural correlates of alexithymia and what they can inform us about the biological bases of emotional awareness. Lastly, we outline challenges and opportunities for alexithymia research, focusing on measurement issues and the potential utility of formal computational models of emotional awareness for advancing the fields of clinical and affective science.

Keywords: Alexithymia; Emotional awareness; Emotional communication; Emotions; Interoception; Neurological disorders.

Publication types

  • Review

MeSH terms

  • Affective Symptoms*
  • Emotions*
  • Humans