2 The body as a (muffled) sound box for emotion 53 4.2 Neuro(psycho)logical alternatives for the term alexithymia 4.2.1 Blindfeel Dissatisfied with the original terminology coined by Sifneos [15] – which was essentially no more than a phenomenological description – Lane and his colleagues have sought a naming convention that does more justice to the underlying psychophysiological processes. Their initial search led to the proposal to change the name of alexithymia to ‘blindfeel’, based on a phenomenon called ‘blindsight’ that is described in the neurological literature. Blindsight is associated with lesions in the primary visual cortical receiving area, V1. Patients with blindsight claim that they are blind. Yet, when presented with visual tracking and other select visual tasks, their behavioral responses indicate that they perceive the visual stimuli at some level – but are not consciously aware of doing so. It is assumed that these patients are, therefore, dependent on the transfer of visual information via other routes. This creates the peculiar phenomenon that people can name (with a higher probability than mere chance) the presence and location, sometimes even the movement, shape and color, of an object that is in their proximal environment. At the same time, these persons are not aware of the object; that is, the visual stimuli that form the basis of their perception are not experienced subjectively. They are blind, yet in a way they see. Lane and colleagues [45] observed how the cognitive-functional deficits characterizing alexithymia showed similarities with this neurological condition. When emotionally aroused, the alexithymic individual manifests behavioral and autonomic responses; however, based on his deficit in interoceptive awareness, the individual will typically say that he does not feel anything or that he does not know how he feels. According to Lane et al. [45], the problem in alexithymia consists of deficient development of conscious awareness of emotion, allowing for the possibility that some rudimentary form of emotional experience exists (e.g., awareness of bodily sensations). The analogy with emotional awareness is that alexithymic individuals also experience ‘basic’ but not ‘higher’ or more advanced cerebral processing, resulting in emotions not being consciously experienced [10]. 4.2.2 Agnosia and anomia Over time, the term ‘blindfeel’ has been referred to a couple of times in the scientific literature but has not replaced the use of the original term. However, this did not stop Lane from contriving improved terminology for the phenomenon. Recently, in keeping with the levels of emotional awareness theory, Lane has proposed to discard the term ‘blindfeel’ and to instead distinguish alexithymia at two levels: the level of being unable to become aware of emotions, i.e., ‘affective agnosia’, and the level of being unable to identify emotions, or ‘affective anomia’ [89, 93]. In this new formulation, affective agnosia coincides with – and thus replaces – the concept of ‘blindfeel’ [89].
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