At the extremes, this means that for some people emotional awareness is overwhelming, while for others it barely exists. Consider the college student who, one evening, spotted a fire that had broken out in his dorm, went to get a fire extinguisher, and put the fire out. Nothing unusual—except that on his way to get the extinguisher and then on the way back to the fire, he walked instead of running. The reason? He didn't feel there was any urgency.
This story was told to me by Edward Diener, a University of Illinois at Urbana psychologist who has been studying the intensity with which people experience their emotions.7 The college student stood out in his collection of case studies as one of the least intense Diener had ever encountered. He was, essentially, a man without passions, someone who goes through life feeling little or nothing, even about an emergency like a fire.
By contrast, consider a woman at the opposite end of Diener's spectrum. When she once lost her favorite pen, she was distraught for days. Another time she was so thrilled on seeing an ad for a big sale on women's shoes at an expensive store that she dropped what she was doing, hopped in her car, and drove three hours to the store in Chicago.
Diener finds that women, in general, feel both positive and negative emotions more strongly than do men. And, sex differences aside, emotional life is richer for those who notice more. For one thing, this enhanced emotional sensitivity means that for such people the least provocation unleashes emotional storms, whether heavenly or hellish, while those at the other extreme barely experience any feeling even under the most dire circumstances.
THE MAN WITHOUT FEELINGS
Gary infuriated his fiancée, Ellen, because even though he was intelligent, thoughtful, and a successful surgeon, Gary was emotionally flat, completely unresponsive to any and all shows of feeling. While Gary could speak brilliantly of science and art, when it came to his feelings—even for Ellen—he fell silent. Try as she might to elicit some passion from him, Gary was impassive, oblivious. "I don't naturally express my feelings,' Gary told the therapist he saw at Ellen's insistence. When it came to emotional life, he added, "I don't know what to talk about; I have no strong feelings, either positive or negative."
Ellen was not alone in being frustrated by Gary's aloofness; as he confided to his therapist, he was unable to speak openly about his feelings with anyone in his life. The reason: He did not know what he felt in the first place. So far as he could tell, he had no angers, no sadnesses, no joys.8
As his own therapist observes, this emotional blankness makes Gary and others like him colorless, bland: "They bore everybody. That's why their wives send them into treatment." Gary's emotional flatness exemplifies what psychiatrists call alexithymia, from the Greek a-fox "lack," lexis for "word," and thymos for "emotion." Such people lack words for their feelings. Indeed, they seem to lack feelings altogether, although this may actually be because of their inability to express emotion rather than from an absence of emotion altogether. Such people were first noticed by psychoanalysts; puzzled by a class of patients who were untreatable by that method because: they reported no feelings, no fantasies, and colorless dreams—in short, no inner emotional life to talk about at all.9 The clinical features that mark alexithymics include having difficulty describing feelings—their own or anyone else's—and a sharply limited emotional vocabulary.10 What's more, they have trouble discriminating among emotions as well as between emotion and bodily sensation, so that they might tell of having butterflies in the stomach, palpitations, sweating, and dizziness—but they would not know they are feeling anxious.
"They give the impression of being different, alien beings, having come from an entirely different world, living in the midst of a society which is dominated by feelings," is the description given by Dr. Peter Sifneos, the Harvard psychiatrist who in 1972 coined the term alexithymia.11 Alexithymics rarely cry, for example, but if they do their tears are copious. Still, they are bewildered if asked what the tears are all about. One patient with alexithymia was so upset after seeing a movie about a woman with eight children who was dying of cancer that she cried herself to sleep. When her therapist suggested that perhaps she was upset because the movie reminded her of her own mother, who was in actuality dying of cancer, the woman sat motionless, bewildered and silent. When her therapist then asked her how she felt at that moment, she said she felt "awful," but couldn't clarify her feelings beyond that. And, she added, from time to time she found herself crying, but never knew exactly what she was crying about.12
And that is the nub of the problem. It is not that alexithymics never feel, but that they are unable to know—and especially unable to put into words—precisely what their feelings are. They are utterly lacking in the fundamental skill of emotional intelligence, self-awareness—knowing what we are feeling as emotions roil within us. Alexithymics belie the common-sense notion that it is perfectly self-evident what we are feeling: they haven't a clue. When something—or more likely, someone—does move them to feeling, they find the experience baffling and overwhelming, something to avoid at all costs. Feelings come to them, when they come at all, as a befuddling bundle of distress; as the patient who cried at the movie put it, they feel "awful," but can't say exactly which kind of awful it is they feel.
This basic confusion about feelings often seems to lead them to complain of vague medical problems when they are actually experiencing emotional distress—a phenomenon known in psychiatry as somaticizing, mistaking an emotional ache for a physical one (and different from a psychosomatic disease, in which emotional problems cause genuine medical ones). Indeed, much of the psychiatric interest in alexithymics is in weeding them out from among those who come to doctors seeking help, for they are prone to lengthy—and fruitless—pursuit of a medical diagnosis and treatment for what is actually an emotional problem.
While no one can as yet say for sure what causes alexithymia, Dr. Sifneos proposes a disconnection between the limbic system and the neocortex, particularly its verbal centers, which fits well with what we are learning about the emotional brain. Patients with severe seizures who had that connection surgically severed to relieve their symptoms, notes Sifneos, became emotionally flat, like people with alexithymia, unable to put their feelings into words and suddenly devoid of fantasy life. In short, though the circuits of the emotional brain may react with feelings, the neocortex is not able to sort out these feelings and add the nuance of language to them. As Henry Roth observed in his novel Call It Sleep about this power of language, "If you could put words to what you felt, it was yours." The corollary, of course, is the alexithymic's dilemma: having no words for feelings means not making the feelings your own.
IN PRAISE OF GUT FEELING
Elliot's tumor, growing just behind his forehead, was the size of a small orange; surgery removed it completely. Although the surgery was declared a success, afterward people who knew him well said that Elliot was no longer Elliot—he had undergone a drastic personality change. Once a successful corporate lawyer, Elliot could no longer hold a job. His wife left him. Squandering his savings in fruitless investments, he was reduced to living in a spare bedroom at his brother's home.