How understanding alexithymia can improve PTSD treatment outcomes

Understanding alexithymia is important when considering resistance to PTSD treatment options. Australian and international guidelines for treating PTSD recommend trauma-focused treatments. Still, while gold-standard treatments such as Prolonged Exposure have been shown to be effective, not everyone responds to them. One potential reason for treatment resistance is that alexithymia is a common comorbidity with PTSD, and may prevent the necessary emotional engagement in therapy to process the traumatic memories.

Alexithymia in PTSD

Alexithymia is described as an inability to identify, describe or tune into feelings. It occurs in roughly 10% of the general population, but in combat veterans with PTSD, the rate is a startling 43%. When levels of alexithymia are higher, PTSD is found to be more severe. There has been an ongoing debate amongst practitioners and researchers as to whether alexithymia is a symptom of PTSD, overlapping with emotion numbing, or if it is a unique condition. Given that alexithymia may help to explain treatment resistance in PTSD, it is essential to gain a clearer understanding of its nature.

Phoenix Australia’s Dr Andrea Putica is an expert in the field of alexithymia. She recently passed her PhD focused on the nature of alexithymia in PTSD, how it impacts treatment response, and the mechanisms that may underpin this impact. 

Andrea’s work has shed light on potential alexithymia related mechanisms associated with treatment resistace across trauma-focused treatments for PTSD. Specifially, her work has found that alexithymia impacts how one processes trauma-related stimuli.

Dr Putica’s advice to practitioners is to consider alexithymia as part of assessment and treatment considerations across posttrumatic psychopathology.

“Being aware that emotional engagament is inherently difficult for some, and tailoring treatment to address these difficulties will go a long way in keeping someone engaged in trauma-focused or any insight-focused treatment.” says Dr Putica.