Series: From Sensation to Words — Part 1
You know something is happening.
Your shoulders are up around your ears. Your stomach has tightened. You’re talking faster, or you’ve suddenly become very quiet.
Someone asks, “What are you feeling?”
You have an answer for what happened. You may have several theories about what the other person meant. But the question itself stops you.
I don’t know.
That answer may be quite accurate. Noticing a change in your body and knowing what emotion it means are different things.
Interoception is the perception of signals from within the body: breathing, heartbeat, hunger, temperature, a churning stomach. Proprioception gives you information about your body’s position and movement. You might notice that you’re holding your breath and pressing your feet into the floor before you have any idea why.
These signals matter. They don’t, however, arrive with captions.
A tight chest could accompany fear, grief, excitement, or an asthma flare. A hollow feeling could mean shock, sadness or that you forgot lunch. Even if you can sense the change clearly, you still need context to understand it.
What happened just before this? What did I want? What did I expect? What does this sensation remind me of?
Sometimes the difficulty is noticing. Sometimes it’s making sense of what you’ve noticed. Sometimes the words themselves are unavailable.
Researchers use the term alexithymia for difficulty identifying and describing feelings. It is a description of a pattern, not a verdict about someone’s capacity to feel.
In a review of 32 studies, researchers found that difficulty interpreting bodily signals was associated with greater difficulty identifying and describing emotions. But the relationship changed depending on how body awareness was measured. Simply paying more attention to sensations did not reliably solve the problem.
That distinction matters in therapy. A person can be intensely aware of a racing heart and still be baffled by it. Asking them to scan their body again may yield a more detailed description of the racing heart. It may not tell them whether they are frightened, angry, eager, or ill.
Some people also experience periods of disconnection from themselves. A meta-analysis of alexithymia and dissociation found that the two are associated, especially in clinical samples. An association doesn’t establish that dissociation causes difficulty naming feelings in any particular person. It does remind us that “I can’t tell” may be a very different experience from person to person.
Imagine that you leave a conversation feeling vaguely sick. You might first call it anxiety. Later, with more time, you notice that the feeling began when someone dismissed an idea you cared about. Perhaps you were hurt. Perhaps you were angry. Perhaps both.
The later understanding doesn’t mean the first bodily sensation was false. It means you had more information.
In therapy, I may ask what you notice in your body. I may also ask what happened between you and the other person, what you had hoped for, and what it was like to tell me about it. We can try a word and see whether it fits. You don’t have to accept a therapist’s interpretation because it sounds plausible.
Sometimes a word brings relief: Yes. That’s it.
Sometimes it brings a correction: No, not angry. Disappointed.
Both responses tell us something.
There isn’t a test you must pass before your experience counts. “I feel pressure in my throat, and I don’t know what it is yet” is a useful place to begin. The word yet leaves room for curiosity. It doesn’t demand that you manufacture certainty.
In the next part of this series, we’ll look at what can happen when someone does find a word for a feeling—and why being heard by another person may matter too.
Part 1: I Can Feel Something Happening. Why Can’t I Tell What I’m Feeling?
Part 2: Does Putting Feelings Into Words Really Help? Coming soon.
Part 3: Can Writing About Difficult Experiences Help? Stay tuned.
Anne Lindyberg, LMHC (Iowa), LCPC (Illinois), integrates the experiential therapy of Virginia Satir with Deep Brain Reorienting (DBR) and the Alexander Technique. She specializes in helping adults with complex and developmental trauma create lasting emotional change through therapy.
This article and other informational content on this website are provided for educational purposes only. They are not a substitute for individualized professional care, do not constitute advice specific to your circumstances, and do not establish a therapist-client relationship.
This work is created on the traditional and unceded lands of Indigenous peoples; a fuller acknowledgment of the land, its history, and its peoples is available on this website.
Van Bael, K., Scarfo, J., Suleyman, E., Katherveloo, J., Grimble, N., & Ball, M. (2024). A systematic review and meta-analysis of the relationship between subjective interoception and alexithymia: Implications for construct definitions and measurement. PLOS ONE, 19(11), e0310411. https://doi.org/10.1371/journal.pone.0310411
Reyno, S. M., Simmons, M., & Kinley, J. (2020). A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and non-clinical populations. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(1). https://doi.org/10.4081/ripppo.2020.439
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