Chapter 1 22 Part I: (Trans)theoretical account of alexithymia Chapter two focusses on alexithymia as a general transdiagnostic, trans-modal factor in mental health. Although there is consensus that alexithymia is a phenomenon in which people experience difficulties in identifying and verbalizing emotions, the exact definition has been a topic of debate not long since first use of the term in 1973. With increasing knowledge, changing research paradigms and new and better research instruments, the concept has evolved over time as it went through different ‘eras’. In the current, only recently entered era, there is evidence of an ongoing endeavour to integrate existing and new knowledge from not only different individual authors, different research instruments, or different psychological theories, but also from other, more medically/biologically oriented areas of science. This gives rise to a multifaceted, transtheoretical account of alexithymia in which there is an increasing focus on the lack of emotional awareness and with that, the essential role of the human body in (experiencing) emotion. To provide the reader with a thorough understanding of the origins of the concept and its evolution over time into the trans theoretic concept as it is today, this chapter presents a broad overview and summary of past and current developments regarding alexithymia. Part II: Relationship between alexithymia and borderline personality pathology Chapters 3 and 4 focus on the associations between alexithymia and borderline personality pathology (BPP). Emotional dysregulation is regarded being at the core of BPP. Although this emotional dysregulation is likely to be the result of multiple potential underlying processes and factors, one factor that has increasingly been gathering attention is a lack of emotional awareness. As was learned from chapter two, prevailing contemporary views on alexithymia define it as in principle being a pathological lack of emotional awareness. The study presented in chapter 3 assesses the relationship between borderline personality pathology and (lack of) emotional awareness, including alexithymia. Although there is a steady stream of research on emotional awareness, alexithymia and BPP, there has not yet been an integration of results. A meta-analysis was conducted with a total of 39 studies, involving 8321 subjects. The study was the first to systematically assess overall results across studies. It also contains a preliminary exploration of the associations between the separate facets of alexithymia and BPP. Findings from the study contribute to a better understanding of the extent and intensity by which the concepts of BPP and emotional awareness/alexithymia are connected.
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