Alexithymia: Treatment Interventions

Year 2014, Volume: 6 Issue: 1, 22 - 31, 06.11.2014

Miray Şaşıoğlu Çağla Gülol Ahmet Tosun

https://doi.org/10.5455/cap.20130515054141

Abstract

Alexithymia means "no words for emotions" and the psychotherapy process is known to be negatively influenced, as the level of alexithymia increases. Therefore, alexithymia score is considered as an essential tool helping clinicians treat the patients. In this literature review, ongoing discussions on the alexithymia treatment will be studied by focusing on the long-term effects of the alexithymic characteristics on the treatment results and the prominenet psychotherapy approaches in the alexithymia treatment. In the light of the related studies' results, the treatment of alexithymia will be examined in terms of its progress in time from pharmacotherapy to psychotherapy; problems of attachment and progress in psychotherapy; psychotherapeutic techniques, which help clinicians overcome the obstacles in the treatment process. At this point, the focus will be on group therapy and cognitive-behavioral therapy, as they are considered as the prominent therapies in comparison with the other therapy approaches in the treatment of alexithymia.

Keywords

Alexithymia, Treatment, Psychotherapy, Group Therapy, Cognitive Behavioral Therapy

Aleksitimi: Tedavi Girişimleri

Abstract

Aleksitimi "duygular için söz yokluğu" anlamına gelmekte ve kişideki aleksitimi düzeyi arttıkça, psikoterapi sürecinin de olumsuz etkilendiği bilinmektedir. Dolayısıyla aleksitimi skorlarından da hastaların klinik tedavisinde uzmanlara yol gösterecek önemli bir araç olarak yararlanılabileceği düşünülmektedir. Bu kuramsal derleme çalışmasında, aleksitimi tedavisinin günümüzde ne noktada olduğu sorusuna yanıt aranmaktadır. Bu soruyu yanıtlamak için aleksitimik özelliklerin uzun vadede terapi sonucu üzerindeki etkileri ve aleksitimi tedavisinde öne çıkan psikoterapi yaklaşımlarına odaklanılmaktadır. Bu bağlamda, ilgili araştırmaların sonuçları ışığında, aleksitimi tedavisinin farmakoterapiden psikoterapiye gelişimi; aleksitimik bireylerin psikoterapide bağlanma ve ilerleme sorunu; tedavilerindeki engelleri aşmak için yararlanılabilecek psikoterapötik yöntemler ve aleksitimi tedavisinde diğer yaklaşımlara kıyasla öne çıkan grup terapisi ve bilişsel davranışçı terapi alt başlıkları ele alınmaktadır.

Keywords

Aleksitimi, Tedavi, Psikoterapi, Grup Terapisi, Bilişsel Davranışçı Terapi

References

• Lesser EM. A review of the alexithymia concept. Psychosom Med 1981; 43:531-543.
• Sifneos PE. Alexithymia: past and present. Am J Psychiatry 1996; 153:137-142.
• Bankier B, Aigner M, Bach M. Alexithymia in DSM-IV disorder: comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder and depression. Psychosomatics 2001; 42:235-240.
• Tolmunen T, Heliste M, Lehto SM, Hintikka J, Honkalampi K, Kauhanen J. Stability of alexithymia in the general population: an 11-year follow-up. Compr Psychiatry 2011; 52:536-541.
• Batıgün AD, Büyükşahin A. Aleksitimi: psikolojik belirtiler ve bağlanma stilleri. Klinik Psikiyatri Dergisi 2008; 11:105-114. Ogrodniczuk JS, Piper WE, Joyce AS. Effect of alexithymia on the process and outcome of psychotherapy: a programmatic review. Psychiatry Res 2011; 190:43-48.
• Ogrodniczuk JS, Piper WE, Joyce AS, Abbass AA. Alexithymia and treatment preferences among psychiatric outpatients. Psychother Psychosom 2009; 78:383-384.
• Vanheule S, Verhaeghe P, Desmet M. In search of a framework for the treatment of alexithymia. Psychol Psychother 2011; 84:84-97.
• Grabe HJ, Frommer J, Ankerhold A, Ulrich C, Groger R, Franke GH et al. Alexithymia and outcome in psychotherapy. Psychother Psychosom 2008; 77:189-194.
• Taylor GJ. Recent developments in alexithymia theory and research. Can J Psychiatry 2000; 45:134-142.
• Zackheim L. Alexithymia: the expanding realm of research. J Psychosom Res 2007; 63:345-347.
• Salminen JK, Saarijarvi S, Aairela E, Tamminen T. Alexithymia: state or trait? one-year follow-up study of general hospital psychiatric consultation out-patients. J Psychosom Res 1994; 38:681-685.
• Martínez-Sánchez F, Ato-García M, Córcoles Adam E, Huedo Medina TB, Selva España JJ. Stability in alexithymia levels: a longitudinal analysis on various emotional answers. Pers Individ Diff 1998; 24:767-772.
• Bach M, Bach D. Predictive value of alexithymia: a prospective study in somatizing patients. Psychother Psychosom 1995; 64:43-48.
• Sifneos PE. Alexithymia and its relationship to hemispheric specialization affect and creativity. Psychiatr Clin North Am 1988; 11:287-293.
• Hintistan S. Aleksitimi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2012; 1:333-346.
• Tacon A. Alexithymia: a challenge for mental health nursing practice. Aust N Z J Ment Health Nurs 2001; 10:229-235.
• Krystal H. Alexithymia and the effectiveness of psychoanalytic treatment. Int J Psychoanal Psychother 1982; 9:353-378. Mohaupt H, Holgersen H, Binder P, Nielsen GH. Affect consciousness or mentalization? a comparison of two concepts with regard to affect development and affect regulation. Scand J Psychol 2006; 47:237-244.
• Lane RD. Neural substrates of implicit and explicit emotional processes: a unifying framework for psychosomatic medicine. Psychosom Med 2008; 70:214-231.
• Guttman H, Laporte L. Alexithymia, empathy, and psychological symptoms in a family context. Compr Psychiatry 2002; 43:448-455.
• Lydiard RB, Brawman-Mintzer O. Panic disorders across the life span: a differential diagnostic approach to treatment resistance. Bull Menninger Clin 1997; 61(2 suppl A):66-94.
• Rosenbaum JF. Treatment-resistant panic disorder. J Clin Psychiatry 1997; 58(suppl 2):61-64.
• Rasting M, Brosig B, Beutel ME. Alexithymic characteristics and patient–therapist interaction: a video analysis of facial affect display. Psychopathology 2005; 38:105-111.
• Mitrani J. Toward an understanding of unmentalized experience. Psychoanal Q 1995; 64:68–112.
• Taylor GJ, Bagby RM, Parker JD. Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge, Cambridge University Press, 1997.
• Swiller HI. Alexithymia: treatment utilizing combined individual and group psychotherapy. Int J Psychother 1988; 38:47
• Apfel-Savitz R, Silverman D, Bennett MI. Group psychotherapy of patients with somatic illnesses and alexithymia. Psychother Psychosom 1977; 28:323-329.
• Frawley W, Smith RN. A processing theory of alexithymia. Cogn Syst Res 2001; 2:189-206.
• Berthoz S, Consoli S, Diaz FP, Jouvent R. Alexithymia and anxiety: compounded relationships? a psychometric study. Eur Psychiatry 1999; 14:372-378.
• Taylor GJ, Bagby RM, Parker JD. The alexithymia construct: a potential paradigm for psychosomatic medicine. Psychosomatics 1991; 32:153-164.
• Wolf H. The contribution of the interview situation to the restriction of fantasy life and emotional experience in psychosomatics patients. Psychother Psychosom 1977; 28:58-67.
• Warnes H. Alexithymia: clinical and therapeutic aspects. Psychother Psychosom 1986; 46: 96-104.
• Rickles WH. Self psychology and somatization: an integration with alexithymia. Progress in Self Psychology 1986; 2:2122
• Stingl M, Bausch S, Walter B, Kagerer S, Leichsenrig F, Leweke F. Effects of inpatient psychotherapy on the stability of alexithymia characteristics. J Psychosom Res 2008; 65:173-180.
• Taylor GJ, Ryan D, Bagby RM. Toward the development of a new self-report alexithymia scale. Psychother Psychosom 1985; 44:191-199.
• Dereboy IF. Aleksitimi özbildirim ölçeklerinin psikometrik özellikleri üzerine bir ön çalışma (Tıpta uzmanlık tezi). Ankara, Hacettepe Üniversitesi, 1990.
• Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia Scale–I: item selection and cross-validation of the factor structure. J Psychosom Res 1994, 38:23-32.
• Leising D, Grande T, Faber R. The Toronto Alexithymia Scale (TAS-20): a measure of general psychological distress. J Res Pers 2009; 43:707-710.
• Güleç H, Köse S, Güleç MY, Çitak S, Evren C, Borckardt J et al. Yirmi soruluk Toronto aleksitimi ölçeğinin Türkçe uyarlamasının geçerlik ve güvenirliğinin incelenmesi. Klinik Psikofarmakoloji Bülteni 2009; 19:214-220.
• Lesser IM. Current concepts in psychiatry: alexithymia. N Engl J Med 1985; 312:690-692. de Groot JM, Rodin G, Olmstead MP. Alexithymia, depression, and treatment outcome in bulimia nervosa. Compr Psychiatry 1995; 34:53-60.
• Beresnevaite M. Exploring the benefits of group psychotherapy in reducing alexithymia in coronary heart disease patients: a preliminary study. Psychother Psychosom 2000; 69:117-122.
• Rufer M, Hand I, Braatz A, Alsleben H, Fricke S, Peter H. A prospective study of alexithymia in obsessive-compulsive patients treated with multimodal cognitive behavior therapy. Psychother Psychosom 2004; 73:101-106.
• Spek V, Nyklicek I, Cuijpers P, Pop V. Alexithymia and cognitive behaviour therapy outcome for subthreshold depression. Acta Psychiatr Scand 2008; 118:164-167.
• Miray Şaşıoğlu, Uzm. Klinik Psikolog, Psikonet Psikoterapi ve Eğitim Merkezi, İstanbul; Çağla Gülol, Dr. Klinik Psikolog, Elan Vital Danışmanlık, İstanbul, İstanbul; Ahmet Tosun, Yrd. Doç. Dr.,Okan Üniversitesi, İstanbul Yazışma Adresi/Correspondence: Miray Şaşıoğlu, Psikonet Psikoterapi ve Eğitim Merkezi, İstanbul, Turkey. E-mail: [e-mail] Yazar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no1/ Çevrimiçi yayım / Published online 15 Mayıs/May 15, 2013; doi: 10.5455/cap.20130515054141