Psychotherapy with Alexithymic Patients

  • Henry Krystal


Alexithymia presents a number of problems in regard to “uncovering”, dynamic, psychoanalytic or “anxiety producing” psychotherapy. In patients with active psychosomatic disease, the patients may, instead of experiencing strong emotion, develop a serious or even life-endangering exacerbation of their illness. Under these circumstances, we must be mindful of Sifneos’ admonition that psychotherapy should be contraindicated (1). In the addictive patients, the increase in intensity of their difuse distress may drive them to drink, or whatever their usual form of drug abuse involves (2). Most of all, the conclusion has been reached by many who have tried it, that these patients simply do not respond to insights derived from psychotherapy (3, 4, 5, 6, 7) or any “form of treatment which emphasized verbal expression and requires a capacity for emotional interaction” (5, p. 261). The hazards of psychotherapy with psychosomatic patients and their peculiar rigidity led Sifneos to caution that any but supportive psychotherapy was contraindicated (8). This peculiar rigidity and unresponsiveness to therapeutic intervention made Sifneos conclude that the defect was organic (8). Studies supplied the statistical evidence of an inherited trait involved in alexithymia (9). But the problem was not laid to rest here.


Object Representation Psychodynamic Psychotherapy Psychosomatic Disorder Emotional Interaction Supportive Psychotherapy 
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Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Henry Krystal
    • 1
  1. 1.Department of PsychiatryMichigan State UniversityEast LansingUSA

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