Partial Hospitalization Treatment of the Alexithymic Patient: A Case Study

Abstract

Patients with alexithymia are a challenge to engage in treatment and require a diverse range of interventions to realize benefit. A partial hospitalization treatment program, offering multiple forms of group therapy in an integrated system, may be particularly helpful for patients with alexithymia. We examine the course of treatment for one alexithymic patient who participated in an 18-week intensive group- and dynamically oriented treatment program in Edmonton. Group support and feedback emerged as important elements in the treatment approach. Other features of the approach overlap with treatment guidelines for alexithymia found in the literature.

The Quest for Tailored Treatments: A Meta‐Discussion of Six Social Cognitive Therapies

“…So what might be the most helpful ingredients in metacognitive or mentalization-based therapy groups geared to patients who are alexithymic and/or avoidant? Joyce et al (2015) point to some essentials. Initially, we were struck by the therapist's and group members' ability to hypothesize and mentalize about Janet's behavior throughout the treatment.…”

“…On the other hand, Joyce, Nordhagen, Ogrodniczuk, Stovel, and Bjorge (2015) describe a patient with alexithymia who benefits from a brief intensive group-based treatment. On the other hand, data from Joyce et al (2015) seem to suggest that, at least for some highly alexithymic patients, exposure to other minds, in psychotherapy groups, is helpful, or to paraphrase Dimaggio et al (2008), through knowing others, you shall know thyself. But apart from the substance abuse, are there reasons to be cautious about group-based treatment for those who are avoidant and/or alexithymic?…”

“…In the case described by Dimaggio, D'Urzo, et al (2015), a patient with co-occurrent avoidant personality disorder (AVPD) and active substance abuse is treated for nearly one year before entering group psychotherapy. On the other hand, Joyce, Nordhagen, Ogrodniczuk, Stovel, and Bjorge (2015) describe a patient with alexithymia who benefits from a brief intensive group-based treatment. The patient with AVPD has an active substance abuse problem and would therefore be excluded from the day treatment program described by Joyce and colleagues.…”

“…According to these authors, Know yourself and you shall know the other." On the other hand, data from Joyce et al (2015) seem to suggest that, at least for some highly alexithymic patients, exposure to other minds, in psychotherapy groups, is helpful, or to paraphrase Dimaggio et al (2008), through knowing others, you shall know thyself.…”

“…Apart from group composition, the case study described by Joyce et al (2015) draws attention to two other aspects that may be of particular importance for group therapy with AVPD and/or alexithymic features. First, they point to the importance of getting patients to talk about specific autobiographical episodes.…”