FUTURE

What is it like to have never felt an

emotion?
By David Robson
19 August 2015
Caleb is telling me about the birth of his son, now eight months old. You know you
hear parents say that the first time they looked at their kid, they were overcome
with that feeling of joy and affection? he asks me, before pausing. I didnt
experience any of that.
His wedding day was equally flat. To illustrate his point, he compares it to a
Broadway show. In front of the stage, he says, the audience are transported by the
drama. Look behind the scenes, however, and you will find the technical engineers,
focusing on analysing the technicalities of the event.
People with the condition call themselves alexes
Despite taking centre stage at the ceremony, he felt similarly detached from the
tides of emotion swelling up in the people around him. For me, it was a mechanical
production, says Caleb (who asked us not to use his full name). Even as his wife
walked down the aisle, the only sensation he felt was his face flushing and a
heaviness in his feet; his mind was completely clear of joy, happiness, or love in its
conventional sense.
In fact, Caleb claims not to feel almost any emotions good, or bad. I meet him
through an internet forum for people with alexithymia a kind of emotional
colour-blindness that prevents them from perceiving or expressing the many
shades of feeling that normally embellish our lives. The condition is found in around
50% of people with autism, but many alexes (as they call themselves) such as
Caleb do not show any other autistic traits such as compulsive or repetitive
behaviour.

What does it mean to fall in love, when you lack the capacity to feel
affection?
Getting to the bottom of this emotional blindness could shed light on many serious
illnesses, from anorexia and schizophrenia to chronic pain and irritable bowel
syndrome. More personally, stories from the alex community lead you to reexamine experiences that you might think you know so well. How can you fall in
love, for example, when you lack all the basic tender feelings of affection that
normally spark a romance
Shells of feeling
To understand that emotional numbness, it helps to imagine emotions as a kind of
Russian doll, formed of different shells, each one becoming more intricate. At the
heart is a bodily sensation the skip in your heart when you see the person you
love, or the churning stomach that comes with anger. The brain may then attach a
value to those feelings you know if it is good or bad, and if that feeling is strong,
or weak; the amorphous sensations begin to take a shape and form a conscious
representation of an emotion. The feelings can be nuanced, perhaps blending
different types of emotions, such as bitter-sweet sorrow, and eventually we attach
words to them you can describe your despair, or your joy, and you can explain
how you came to feel that way.
When alexithymia was first described in 1972, the problem was thought to centre
on this last, linguistic stage: deep down people with alexithymia felt the same as
everyone else, but they just couldnt put the emotions into words. The scientists
hypothesised that this may result from a breakdown in communication between the
two hemispheres, preventing signals from the emotional regions, predominantly in
the right, from reaching the language areas, predominantly in the left. You need
that emotional transfer in order to verbalise what youre feeling, says Katharina
Goerlich-Dobre at RWTH Aachen University. This could be seen, most dramatically,
when surgeons tried to cure epilepsy by cutting the fibres that connect the two
hemispheres; although it reduced the seizures, the patients also appeared
emotionally mute as a result. Less sensationally, Goerlich-Dobres brain scans have
found that other people with alexithymia seem to have abnormally dense
connections in that neural bridge. This might create a noisy signal (a bit like a badly
tuned radio) that prevents emotional cross-talk, she thinks.

When surgeons cut the dense connections between the two hemispheres, patients
become emotionally mute and unable to express their feelings (Credit: Science Photo
Library)
Today, it seems clear that there may be many types of alexithymia. While some
might have trouble expressing emotions, others (like Caleb) might not even be
conscious of the feelings in the first place. Richard Lane, at the University of Arizona
compares it to people who have gone blind after damage to the visual cortex;
despite having healthy eyes, they cant see the images. In the same way, a
damaged neural circuit involved in emotional processing might preventsadness,
happiness or anger from bursting into consciousness. (Using the analogy of the
Russian doll, their emotions are breaking down at the second shell of feeling their
bodies are reacting normally, but the sensations dont merge to form an emotional
thought or feeling.) Maybe the emotion gets activated, you even have the bodily
responses, but it happens without you being consciously aware of the emotion, he
says.
Along these lines, a few recent fMRI scanning studies have found signs of a more
basic perceptual problem in some types of alexithymia. Goerlich-Dobre, for
instance, found reducedgrey matter in areas of the cingulate cortex serving selfawareness, potentially blocking a conscious representation of the emotions. And
Andr Aleman at the University Medical Centre in Groningen, the Netherlands,
detected some deficits in areas associated with attention when alexithymics look at
emotionally charged-pictures; it was as if their brains just werent registering the
feelings. I think this fits quite well with [Lanes] theory, says Aleman who had
initially suspected other causes. We have to admit they are right.

The more extreme the emotion I should be feeling, the more it should be colouring how
Im thinking. In reality I have a clearer head, I become more analytical Caleb
Caleb himself describes a conscious disconnect that prevents emotions from
breaking through into his mind. For instance, one day at school he was working with
the student theatre. All week he had been struggling to produce the right sound
effects, but it just wasnt coming together. Eventually, his boss lost his cool and
started ripping into him. My response was that something weird was happening
with my body, he says. I could feel a tension, like my heart was racing, but my
mind was distracted It was an academic curiosity, and then I completely forgot
about the whole situation, he says. It seems that almost no event can penetrate
that indifference. The more extreme the emotion I should be feeling, the more it
should be colouring how Im thinking. In reality I end up having a clearer head I
become more analytical.
I can put up with unpleasant experiences because I know I wont have memory
associated with it Caleb
There is one, slim advantage: he finds it easier to cope with medical procedures,
since he doesnt attach the fear, sadness or anxiety to it. I can put up with an
awful lot of pain or unpleasant experiences because I know very shortly I wont
have an emotional memory associated with it, he says. But it means that positive
memories get washed away too.
Neural short circuit
It is a small pay-off, however: alexithymia seems to be linked to various other
illnesses, including schizophrenia and eating disorders, perhaps because emotions
normally guide us to take better care of our physical and mental health. Better
defining alexithymia could therefore offer insights into these disorders. It could also
give us a more nuanced understanding of autism. Despite the stereotypes, Geoffrey
Bird at Kings College London points out that around half of autistic people are
perfectly capable of perceiving and responding to others, and those with social
problems tend to also be suffering from alexithymia. For this reason, he thinks that
distinguishing the two, distinct, disorders could therefore lead to better guidance. At
the moment, misunderstandings can often stand in the way of some autistic people
getting the help they need. One autistic adult I worked with wanted to be a carer,
but she was told you dont have empathy so cant have the job, he says. Our
research shows that lots of people with autism are fully okay with emotions.

They are hypersensitive to bodily perceptions, and not able to focus on anything else,
which might be one reason why they develop chronic pain
Further work could also pin down the puzzling link to so-called somatic disorders,
such as chronic pain and irritable bowel syndrome, that seem to be unusually
common in people with alexithymia. Lane suggests its down to a kind of shortcircuit in the brain, created by the emotional blindness. Normally, he says, the
conscious perception of emotions can help damp down the physical sensations
associated with the feeling. If you can consciously process and allow the feeling to
evolve if you engage the frontal areas of the brain, you recruit mechanisms that
have a top down, modulatory effect on bodily processes, says Lane. Without the
emotional outlet, however, the mind could get stuck on the physical feelings,
potentially amplifying the responses. As Goerlich-Dobre puts it: They are
hypersensitive to bodily perceptions, and not able to focus on anything else, which
might be one reason why they develop chronic pain. (Some studies, have in fact
found that alexes are often abnormally sensitive to bodily sensations,
although other experiments have found conflicting evidence.)

People with alexithymia often travel a lonely road as they try to connect to their
emotions (Credit: Getty Images)
Physical sensations certainly seem to dominate Calebs descriptions of difficult
events, such as periods of separation from his family. I dont miss people, as far as

I can tell. If Im gone, and dont see someone for a long period, its a case of out of
sight, out of mind, he says. But I do feel physically a kind of pressure or stress
when Im not around my wife or my child for a couple of days.
Reconnecting to lost feelings
The hope is that eventually, doctors may be able to track down the origins of
alexithymia and stop the effects from snow-balling. Caleb thinks his alexithymia
emerged at birth and could be genetic. Upbringing and the emotional fluency of
your parents may also play a role, while for others, it may be caused by trauma
that shuts down peoples ability to process some or all of their emotions.
Lane, for instance, introduced me to one of his patients, Patrick Dust, who was the
subject of violent abuse from his alcoholic father experiences that put his life in
danger. One night, when he came home, my mother and he had another intense
verbal argument. He said 'Im going to get my shotgun and kill all of you' We ran
to a neighbours house where we called the police. For decades afterwards, he
found it difficult to interpret and understand his emotions, particularly the fear and
the anger he still felt towards his parents. He suspects this resulted in his
fibromyalgia chronic diffuse pain and tenderness across the whole body and an
eating disorder.
I discovered the tremendous anger I had felt, without much awareness of it. Its the
most important thing Ive done in my life Patrick Dust
With initial guidance from Lane and later by himself, Dust was able to revisit the
past and reconnect to the emotions he was locking away, which he thinks also
brought some relief to the fibromyalgia. I discovered the tremendous anger I had
felt, without much awareness of it, he explains. Its the most important thing Ive
done in my life. He has just finished writing a book about the process.
Caleb, too, has visited a cognitive behavioural therapist to help with his social
understanding, and through conscious effort he is now better able to analyse the
physical feelings and to equate it with emotions that other people may feel.
Although it remains a somewhat academic exercise, the process helps him to try to
grasp his wifes feelings and to see why she acts the way she does.

Not everyone with alexithymia may have his determination and patience, however.
Nor may they find a life partner who is willing to make the allowances his condition
requires. It takes a lot of understanding on my wifes part She understands that
my conceptions of things like love are a bit different, he says. In return, she may
benefit from his stability he is not swayed by the fickle tides of feelings. The
trade-off is that my relationship with my wife is a conscious choice, he says he is
not acting on a whim but a very deliberate decision to care for her. That has been
particularly helpful in the last eight months. It means that if were going through a
difficult situation if the kids up all night crying for me that doesnt affect our
relationship at all, because the connection isnt built on emotion, says Caleb.
Caleb may not have been transported to ecstasy by his wedding or the birth of his
child, but he has spent most of his life looking within, striving to feel and
understand the sensations of himself and the people around him. The result is that
he is certainly one of the most thoughtful, and self-aware, people I have ever had
the pleasure of interviewing someone who seems to know himself, and his
limitations, inside out.
Ultimately, he wants to emphasise that emotional blindness does not make one
unkind, or selfish. It may be hard to believe, but it is possible for someone to be
cut off completely from the emotions and imagination that are such a big part of
what makes us humans, he says. And that a person can be cut off from emotions
without being heartless, or a psychopath.