2 The body as a (muffled) sound box for emotion 43 3. The second era: operationalizations and matching diagnostic instruments In the second era, alexithymia as a concept transformed from a ‘categorical’ clinical phenomenon to a ‘dimensional’ personality trait. Focus shifted from providing the best point-by-point definition, to determining which psychological processes underlie alexithymia. Severely limited emotional perception emerged as a central or ‘core’ element of alexithymia [43-47]. Various groups of clinicians and researchers have taken on the task of further elaborating the definition of alexithymia and developing appropriate diagnostic instruments to measure it. This has resulted in several definitions of alexithymia, each with its own repertoire of self-reporting questionnaires, observation scales and/or semi-structured interviews (for details, see our discussion in Section 5 on clinical implications and diagnostics below). The two most frequently used definitions are discussed below. The differences between the two definitions appear to be gradual rather than fundamental, but appearances are deceptive. The main difference that we will return to is whether reduced (physical) emotionality is a feature of alexithymia [48, 49]. The first definition was introduced by Taylor, Bagby and Parker [50, 51] and has been the gold standard for years, along with corresponding diagnostic instruments, such as the Toronto Alexithymia Scale (TAS), devised by the same group of authors. Their definition of alexithymia is also referred to as the Toronto model - after the location of the university with which the researchers are affiliated. Their definition of alexithymia is as follows: 1. Difficulty with: (a) identifying emotions and (b) distinguishing them from non-emotional physical sensations. This often leads to the somatic interpretation of the physical signals of emotions; 2. Difficulty describing specific emotions; 3. Impaired imagination and empathy, which is reflected, among other things, in a poor fantasy life; 4. An externally oriented way of thinking aimed at concrete stimuli. These four characteristics are believed to reflect underlying deficits in the mental representation of emotions. Taxometric research indicates that alexithymia is a relatively stable, uniform multidimensional personality trait in which these four elements can be grouped together within two higher order factors: ‘affective awareness’ and ‘operational thinking’ [52, 53]. Difficulty identifying and describing
RkJQdWJsaXNoZXIy MjY0ODMw