Alexithymia as a disorder of affect regulation entails a patient’s reduced ability to process emotional information. The purpose of this study was to evaluate the impact of alexithymia [as measured by the Toronto Alexithymia Scale (TAS)-26, German version] on affective correlates in a dyadic therapeutic interaction (as recorded by the Emotional Facial Action Coding System). Interviews with 12 in-patients with various psychosomatic disorders (anxiety, depression, somatisation) were videotaped and evaluated for facial affect display. The corresponding emotional reactions of the therapists (split screen) were recorded separately. Patients with high alexithymia scores (TAS-26 total score) tended to display less aggressive affects than those with low scores. The therapists’ predominant emotional reaction to alexithymic patients was contempt. Our findings underscore the deep-rooted nature of alexithymia as a disorder of affect regulation. Since facial affects play a major role in the regulation of emotional interaction, this disorder may evoke negative reactions of potential caregivers.

No abstract

Facial affective behavior of patients and therapists is assumed to be closely related to patients' interpersonal patterns and therapists' involvement in these patterns. In this study, facial affect displays of patients and therapists during intake interviews were analyzed to determine their impact on the outcome of the subsequent short-term inpatient psychotherapy. Interviews of ten successful and ten unsuccessful patients (15 female, five male) with two therapists were analyzed with Friesen and Ekman's EMFACS procedure. Feeling states of patients and therapists were registered using the Differential Affect Scale. Reciprocal dyadic patterns of facial affect were determined based on the same lead affect of patient and therapist. As expected, reciprocal patterns predicted an unsuccessful treatment outcome and showed a correlation to positive feeling states in the therapist during the interview. Our data suggest that, in unsuccessful cases, therapists became overly involved in patients' interpersonal patterns.