Psychoanalysis and Empirical Research

Abstract

An extensive body of research on the alexithymia construct is reviewed to show how various empirical methodologies can be used to evaluate the validity and increase our understanding of theoretical and clinically derived psychoanalytic concepts. The historical background of alexithymia and the theoretical framework in which the construct was formulated are presented, after which measurement- and experiment-based approaches to construct validation are described. This is followed by a review of empirical investigations that have yielded evidence that alexithymia is a dimensional personality trait associated with several illnesses of interest to psychoanalysts. Empirical research also supports clinical observations and impressions that individuals with high degrees of alexithymia principally employ primitive defenses, have a limited capacity for empathy, exhibit deficits in mentalization, and do not respond well to traditional interpretive psychotherapies. Also reviewed is empirical research that implicates genetic and environmental/developmental factors in the etiology of alexithymia, in particular childhood trauma and insecure attachments, factors generally associated with deficits in affect development and affect regulation. The clinical relevance of the empirical research findings is discussed in the final section.

Alexithymia as a mediator of the relationship between child sexual abuse and psychological distress in adolescence: A short-term longitudinal study

“…These results with youths support studies on adult populations that showed that alexithymia is a relevant concept in understanding the onset of difficulties (Taylor and Bagby, 2013;Li et al, 2015). However, research with this population generally found stronger effects for girls between child maltreatment, alexithymia and maladaptive outcomes (Swannell et al, 2012;Brown et al, 2017).…”

“…The use of self-report measures could possibly have implied informant biases, especially for alexithymia. Indeed questions have been raised about the capacity of alexithymic individuals to accurately report their own deficit of affect awareness (Taylor and Bagby, 2013). Single respondent for all measures is also a limitation of the current study.…”

“…A meta-analysis conducted by Frewen et al (2008) reported a large effect size between alexithymia and posttraumatic stress disorder. Relatedly, several studies identified an acute level of alexithymia among populations who experienced trauma such as combat veterans and survivors of childhood abuse (Taylor and Bagby, 2013).…”

“…Indeed, childhood trauma appears to be a major risk factor for alexithymia (Taylor and Bagby, 2013). According to Krystal (1988), alexithymia is a defensive mechanism used by victims to face trauma and avoid being overwhelmed by a multitude of negative emotions by distancing themselves from them.…”

“…These discrepant results may be linked to methodological issues and limitations such as a small number of participants disclosing CSA in the samples considered as well as reliance on cross-sectional designs (Taylor and Bagby, 2013). To our knowledge, none of these studies have relied on a prospective design with a sample of youth.…”