Chapter 2 44 feelings constitute the first factor, decreased fantasy/imagination and externally oriented thinking combine to yield the second factor. The first two characteristics – both reflecting limited emotional awareness – describe the essence of alexithymia. The other two characteristics follow more or less from these deficiencies, as it is difficult to imagine what other people are feeling if an internal frame of reference is virtually absent. Also, thought processes take on a factual character if no emotional importance is attached to situations [43]. Psychometric research shows the first two characteristics and the overlying factor ‘affective awareness’ to be the most robust [54]. However, there is doubt as to whether a “reduced ability to imagine” is part of the alexithymia concept at all. Studies have repeatedly shown a questionable fit of this characteristic with the concept. As an independent characteristic, it appears to have the least convincing, even worrisome psychometric qualities within various instruments [54-56]. For these reasons, the feature ‘reduced ability to imagine’ disappeared from the revised TAS, the alexithymia questionnaire developed by Taylor, Bagby and Parker. Similar worries surround the facet of ‘externally oriented thinking’, which has also shown to have low internal consistency within various instruments. Hence, some scholars discourage use of this facet for clinical purposes [54]. The second dominant definition of alexithymia was put forward by Bermond and Vorst [57, 58]. This definition is also referred to as the Amsterdam model – again, after the location of the university with which the researchers are affiliated. In their model and its corresponding self-reporting questionnaire, they introduce ‘emotional arousability’ as a new element. They also put the characteristic ‘fantasizing’ back on the map. The resulting five characteristics are grouped into two distinctive higher order dimensions: cognitive and affective alexithymia. ‘Cognitive’ refers to the more rational-functional, verbal component in the processing of emotions, while ‘affective’ refers to the processes that play a role in imagination and being emotionally moved. The cognitive dimension consists of difficulty identifying and verbalizing feelings as well as difficulty in analyzing one’s own emotions; the affective dimension consists of a limited capacity for (physiological) ‘emotional arousability’ and ‘fantasizing’. Nevertheless, the Amsterdam model has not been without controversy. There is an ongoing scholarly debate about whether processes that concern limited emotional arousability or ‘affective response generation’ fall within the definition of alexithymia [59]. After all, this characteristic of emotional arousability refers to the absence of a physical reaction to emotional events or situations. In fact, a lack of (physiological) emotional arousability has been commonly associated with psychopathy, and the combination of a clear cognitive understanding of emotions
RkJQdWJsaXNoZXIy MjY0ODMw