Pychotherapy of a Patient with Prominent Alexithymic Characteristics

Psychotherapists are often aware of the difficulty in treating patients using dynamic methods when patients have a predominant somatic presentation with poor psychological elaboration of their difficulties. Sifneos (1972) coined the term 'alexithymia' to describe patients who have difficulty in recognising and verbalising their emotions, associated with a restricted fantasy experience. Freyberger (1977) distinguished two forms of alexithymia Primary alexithymia which is innate, and which possible predisposes to various psychosomatic disorders, and secondary alexithymia, which is acquired, and serves a defensive function. Krystal (1979) noted that alexithymia is the single most factor diminishing the success of psychotherapy and suggests modifications in therapy as follows. First, enabling the patient to introspect and observe the nature of his alexithymic disturbance. Next enabling the patient to tolerate affects. Finally to help the patient to verbalise affects.