The Affective Dimension of Alexithymia: a Neurological Link with the “Cold-blooded” Personality
Over the past few decades, extensive research has analysed the personality construct of alexithymia, due to its strong connections with a multitude of physical and psychological disorders (Luminet et al., 2004). However, the association between alexithymia and the cold-blooded personality has rarely been investigated due to its underrated importance in the medical field. The present article is the first to gather and explain the main neurological, psychosomatic, and physical links between alexithymia and the cold-blooded personality, intending to propose a novel, possible path toward the understanding of highly common physical and psychological disorders associated with both alexithymia and the cold-blooded personality.
A short introduction
Alexithymia, or “no words for feelings”, is described as “a construct of personality characterised by impairments in cognitive, emotional and affective processing” and can be divided into two dimensions. The cognitive dimension refers to one’s abilities to identify, analyse and verbalise both their own and others’ feelings, while the affective dimension, concerns the extent to which one’s emotions are subjective, rather than objective (Goerlich-Dobre et al., 2015; Laricchiuta et al., 2015, p. 109).
Alexithymia’s impairments on both the cognitive and affective dimensions do not only restrict one’s ability to communicate but, most importantly, affect one’s behavioural response to an emotional situation or environment. Hence, those who are affected by alexithymia, estimated to be around 15% of the general population, tend to behave in a cold and detached manner when faced with emotion-inducing stimuli (Luminet et al., 2004; Pouga et al., 2010).
The use of “social temperature” to describe one’s personality has always been central to our perception and judgement of others, and several studies have found that our decision to establish a relationship with someone is largely based on how socially warm we perceive them (Ijzerman et al., 2012). This is understandable, as socially cold people tend to avoid social contacts, which makes it harder to build a relationship.
Over the years, socially cold individuals have been categorised as the cold-blooded personality, which refers to one’s behavioural approach to emotionally arousing situations. Cold-blooded individuals are usually described as having avoidant behaviour toward manifestations of affection and empathy. Due to these behavioural characteristics, they generally score high on psychiatric diseases such as psychopathy, which is why researching correlates of the cold-blooded personality would open a new route toward understanding such diseases (Hare, 1996; Woodworth & Porter, 2002).
Because of the behavioural similarity between individuals with a cold-blooded personality and those affected by alexithymia, a correlation has recently been established and research examining social behaviour has found a strong link between alexithymia and the cold-blooded personality (Goerlich-Dobre et al., 2015).
However, do all individuals with alexithymia also possess a cold-blooded personality?
Type 1 alexithymia and the cold-blooded personality
Based on the two dimensions of alexithymia – cognitive and affective – two subtypes of alexithymia have been identified:
Type 1: characterised by substantial deficits in both the affective and cognitive dimensions. This is the most dangerous type of alexithymia, as it is associated with schizoid personality and psychopathy, as well as with several other psychological diseases, such as depression, generalised anxiety disorder, and various personality disorders. Type 1 alexithymia is, therefore, best described as the “emotional equivalent of blindsight” (Laricchiuta et al., 2015, p. 113; Woodworth & Porter, 2002)
Type 2: characterised by deficits limited to the cognitive level, with individuals being able to experience emotions but not to demonstrate and describe them. Type 2 alexithymia is also detrimental to both the individual and others, as it is linked to schizophrenia and borderline personality disorder, however, it is considered less harmful.
Based on this distinction, Laricchiuta et al. (2015) explained that only Type 1 alexithymia is strongly associated with cold-blooded personality and suggested that the two are cognitively equivalent.
But what does this association imply from a neurological perspective?
The cognitive dimension - Neural associates of alexithymia and the cold-blooded personality
The neurological link between Type 1 alexithymia individuals and cold-blooded individuals lies in their inability or reduced ability to feel empathy. Several studies analysing cold-blooded individuals showed that the latter score very low in emotional intelligence and empathy tests, however few of them explain why this is the case from a biological perspective (Moeller et al., 2011). However, by analysing the neurobiology of Type 1 alexithymia individuals we can understand more of what goes on from a biological perspective in cold-blooded individuals.
Pouga et al. (2010) were among the first to suggest that abnormalities in the anterior cingulate cortex in Type 1 alexithymia individuals are associated with emotional inhibition and, more specifically, with a tendency to restrict the emotional impact of negative events. However, it was not until a few years later that these findings were explained through the association of alexithymia with a reduction in empathy. This is understandable, as empathy arises when we observe and understand someone’s suffering or, in the case of self-empathy, our own suffering. However, with a reduced emotional awareness toward ourselves and others, feeling empathy becomes much harder.
In support of this correlation, several neurocognitive studies investigating the main regions activated when empathising – the anterior cingulate cortex, the middle cingulate cortex and, the insula – have observed a consistent and significant reduction in volume in these areas in individuals with Type 1 alexithymia (Goerlich, 2011; Goerlich-Dobre et al., 2015; Moriguchi & Komaki, 2013). More specifically, Laricchiuta et al. (2015) showed that the lack of empathy in individuals with Type 1 alexithymia decreases the activation of premotor and motor areas in the prefrontal cortex responsible for emotional behaviour. This theory explains the major difference between individuals with alexithymia and those with a repressive personality. While the latter must cognitively force themselves to appear distant and unengaged, the first will naturally be emotionally detached due to their cognitive and motor impairments.
While these studies provide empirical evidence as to why Type 1 alexithymia and cold-blooded individuals deficit in emotional intelligence, they fail to explain whether and how these impairments could be partially cured or solved. Below, the present article presents additional evidence linking alexithymia with the cold-blooded personality and proposes a possible, novel pathway to the cure and perhaps even prevention of cognitive and affective emotional impairments.
Type 1 alexithymia, the cold-blooded personality and psychosomatic disorders
Several studies have found an interesting correlation between Type 1 alexithymia and physical disorders. Among these and in line with Goerlich-Dobre et al. (2015), Kano and Fukudo (2013) discovered that the insula and the anterior cingulate cortex, previously found responsible for emotional arousal in alexithymia, are also activated during physical sensations. Hence, abnormalities in these brain areas may result in a reduction in feelings of both physical and emotional warmth.
These findings align with vast research on embodied cognition that shows how feelings of emotional warmth/coldness can be induced by experiences of emotional warmth/coldness and vice versa. Among these, Bargh and Shalev (2012) provided additional evidence that the anterior insula is implicated in the processing of both physical temperature and emotional warmth and hypothesised that emotional and physical warmth could be substitutable to some extent. This is also consistent with a body of research in social psychology showing that, among the everyday metaphors used to describe psychological experiences through the physical world, the link between social warmth and physical warmth is best supported by empirical research (Zhang & Risen, 2014). This link is also supported by behavioural research, including studies showing that individuals with fewer warm social interactions tend to take more frequent and longer hot showers (Bohrani et al., 2017).
In line with the biological and behavioural evidence provided above, Kano and Fukudo (2013) explained that Type 1 alexithymia is found in approximately 40-60% of individuals with psychosomatic disorders and showed that cognitive and social deficits could lead to physical illness. Finally, Bohrani et al. (2017) employed the Quantitative Sensory Testing (QST) simulation battery and showed that Type 1 alexithymia individuals were insensitive to physical warmth.
This psychosomatic link is fundamental in studying not only the cold-blooded personality and alexithymia but also a large number of dangerous, associated psychiatric diseases. Based on this evidence, several recent studies have suggested that a novel pathway is open toward the treatment of such conditions: we could employ physical warmth to improve affective and cognitive warmth at an emotional level (Bohrani et al., 2017; Multani et al., 2017).
While these findings are extremely promising, several questions remain unanswered: Is the behaviour of cold-blooded individuals a consequence of Type 1 alexithymia? Do all cold-blooded individuals also have Type 1 alexithymia? And if not, how do they differ on a neurological level from those who do?
Future research should analyse the cognitive and biological associates of individuals with a cold-blooded personality compared to those with Type 1 alexithymia with the aim of understanding the extent to which they are comparable. Moreover, warmth stimulation on Type 1 alexithymia patients both singular and repeated, could allow us to understand whether this method could be employed in the short-term and long-term to improve emotional awareness.
*Edited by Samuel Jaffe
References
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