2 The body as a (muffled) sound box for emotion 47 Most contemporary research on the link between alexithymia and limited interoception has focused on the cardiovascular system, through the use of a heartbeat detection task [13, 85-87], but not exclusively [86]. Results consistently show that, in general, people who are less able to sense their own heartbeat, score higher on alexithymia. In another type of research, an imaging study in brain-injured patients showed that the degree of damage to the anterior insula determined the degree of alexithymia [88]. Overall, findings have indicated that internal body awareness (interoception) constitutes a necessary, however not a sufficient, condition for achieving emotional awareness. Emotional awareness comes about through a series of processes at different neurocognitive levels. Current theories on alexithymia assume that alexithymic persons do, in fact, have somatic sensations in response to emotional events and that they are also often aware of these bodily reactions. However, they (most often) lack the necessary skills or the vocabulary to translate these sensations and interpret them as an emotional feeling [8, 59, 89]. In the next sections, we discuss a model that describes emotional awareness on several levels.
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