Navigating Alexithymia and Interoception Challenges in Autistic Adults

Lisa Dube, MSW, LICSW
2 days ago
3 min read

Understanding emotions and bodily sensations can be difficult for many autistic adults. Two key factors often play a role in these challenges: alexithymia and interoception difficulties. These conditions affect how people recognize and respond to their feelings and internal bodily signals. This post explores what alexithymia and interoception mean, how they impact autistic adults, and practical ways to manage these challenges.

Eye-level view of a quiet room with soft lighting and a comfortable chair

What Is Alexithymia?

Alexithymia is a condition where a person struggles to identify and describe their own emotions. It is not a mental illness but a trait that affects emotional awareness. Many autistic adults experience alexithymia, which can make it hard to understand what they feel or to express those feelings to others.

People with alexithymia might:

Find it difficult to name emotions like sadness, anger, or happiness.
Confuse physical sensations with emotions (for example, feeling tense but not realizing it’s anxiety).
Have trouble recognizing emotions in others, which can affect social interactions.

Alexithymia is common in autism, but not all autistic people have it. When it is present, it can add to the challenges of navigating daily life and relationships.

Understanding Interoception and Its Role

Interoception is the sense that helps us perceive internal bodily signals. This includes feelings like hunger, thirst, temperature, heart rate, and the need to use the bathroom. Interoception also connects to emotional awareness because many emotions trigger physical sensations.

For autistic adults, interoception can be less accurate or harder to interpret. This means they might:

Miss cues like hunger or fatigue until they become intense.
Struggle to notice signs of stress or anxiety in their body.
Find it confusing to link physical sensations to emotions.

Difficulties with interoception can lead to challenges in self-care and emotional regulation. For example, not recognizing hunger can affect eating habits, while missing stress signals can increase anxiety or overwhelm.

How Alexithymia and Interoception Affect Daily Life

Together, alexithymia and interoception challenges can create a complex experience for autistic adults. Some common impacts include:

Emotional confusion: Not knowing what they feel or why can cause frustration and isolation.
Communication barriers: Difficulty expressing emotions can lead to misunderstandings with family, friends, or coworkers.
Self-care struggles: Missing bodily signals can affect eating, sleeping, and managing health.
Increased anxiety: Unrecognized emotions and physical sensations can build up, leading to stress or panic.

For example, an autistic adult might feel overwhelmed but not realize it’s due to hunger or tiredness. Without this awareness, they may become irritable or shut down, which others might misinterpret.

Practical Strategies to Support Emotional and Bodily Awareness

While alexithymia and interoception challenges can be tough, there are ways to improve awareness and manage their effects. Here are some practical tips:

1. Use Visual Tools

Visual aids like emotion charts or body maps can help identify feelings and sensations. These tools provide a reference for naming emotions or locating where sensations occur in the body.

Keep an emotion wheel nearby to point to feelings.
Use body diagrams to mark areas of tension, pain, or other sensations.

2. Practice Mindfulness and Body Scanning

Mindfulness exercises encourage paying attention to the present moment, including bodily sensations. Body scanning involves slowly focusing on different parts of the body to notice feelings or tension.

Try guided mindfulness apps designed for beginners.
Spend a few minutes daily noticing breath, heartbeat, or muscle tightness.

3. Develop a Routine for Checking In

Regularly checking in with yourself can build awareness over time. Set reminders to pause and ask:

What am I feeling right now?
Do I notice any physical sensations?
Am I hungry, thirsty, or tired?

Journaling these observations can also help track patterns and improve understanding.

4. Seek Support from Therapists or Support Groups

Working with professionals familiar with autism and alexithymia can provide tailored strategies. Therapists can teach emotional recognition skills and coping techniques.

Support groups offer a space to share experiences and learn from others facing similar challenges.

5. Use Technology Aids

Some apps and wearable devices track physical signals like heart rate or stress levels. These can provide external feedback to help interpret internal states.

Heart rate monitors can alert to rising anxiety.
Mood tracking apps can link emotions with daily activities.

Building Understanding in Relationships

For autistic adults, explaining alexithymia and interoception difficulties to friends, family, or coworkers can improve communication. Sharing how these challenges affect emotional expression and bodily awareness helps others respond with patience and support.

Encourage open conversations about:

How emotions might not be obvious.
The need for clear, direct communication.
Ways others can help, such as asking simple questions or giving space when overwhelmed.