2 The body as a (muffled) sound box for emotion 63 and decreasing the level of alexithymia. Overall, dedicated programs have been somewhat more effective than other psychological treatments. Still, effects have been modest at best [115, 140]. As of yet, there is no ‘gold standard' of treatment for alexithymia. Given current insights, we expect that when such a gold standard becomes available, it will result from an inter- or transdisciplinary effort in which empirical, scholarly knowledge from the psychological and medical (neuro)sciences is combined with both practice-based knowledge from the clinical field, as well as domain-specific knowledge from other areas of (technological) science. Regarding the input that will come from the domain of mental health care, a specific role seems to be reserved for scientist-practitioners with an (academic) background in forms of body-oriented psychotherapy. Outside the direct field of mental health care, researchers in the field of affective neuroscience, physiologists and developers of software applications that can map possible biomarkers will be needed. Various initiatives for transdisciplinary projects in the past 10–15 years in which biofeedback techniques were integrated into standard treatment by using ‘wearables’ (portable electronic devices with various [bio]sensors worn on the body – such as, watches, clothing, and jewelry) have shown promising results. Such wearables along with their user-friendly apps can provide a display of emotion-linked body signals such as heart rate, skin conductance, breathing, tone and loudness of voice, and movement. An example of how this could develop in the near future is part of a project by one of the authors (YD). In this project, a multidisciplinary team is working on a smartwatch/smartphone application that combines a continuous measurement of physiological variables with cognitive behavioral therapy principles to offer personalized training of interoception and emotional awareness [141, 142]. 6. Integration and conclusions This chapter explores the topic of alexithymia and how the concept has evolved throughout three eras of research and practice [5]. The third era has just begun and is expected to be a more medical, affective-neuroscientific approach than the previous eras, which focused more on clinical descriptions (era 1) and psychological traits (era 2). Recent findings in neuroscience highlight the quintessential role of the body in understanding alexithymia and emotional awareness. Emotional awareness first requires awareness of the physical body. Although this insight is still fairly new in the realm of alexithymia and still undergoing empirical research investigation, it basically traces back to the initial research on emotion at the end of the 19th century by William James and Carl Lange (for a critical review, see: [143]).
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