Chronic fatigue patients more likely to suppress emotions

[JaimeS]

I got two more articles on this idea published on two other platforms on Friday morning. Geez.

 

[JaimeS]

I'm guessing they plan this crap out together in a darkened room in the halls of psychobabble:

Cognitive Alexithymia Mediates the Association Between Avoidant Attachment and Interpersonal Problems in Patients With Somatoform Disorder

In case you're wondering, "alexithymia" is defined as "a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self."

DOI:
10.1080/00223980.2016.1175997
Jurrijn A. Koelena*, Liesbeth H.M. Eurelings-Bontekoeb & Stefan Kempkec

• Received: 12 Feb 2015
• Accepted: 1 Apr 2016
• Published online: 16 May 2016

Alert me
ABSTRACT
Patients with somatoform disorder (SFD) are characterized by the presence of chronic physical complaints that are not fully explained by a general medical condition or another mental disorder. Insecure attachment patterns are common in this patient group, which are often associated with interpersonal difficulties. In the present study, the mediational role of two types of alexithymia and negative affectivity (NA) was examined in the association between attachment styles and interpersonal problems in a group of 120 patients with SFD. Patients were requested to fill out several self-report questionnaires for the assessment of attachment strategies, alexithymia, NA, and interpersonal problems. Cognitive alexithymia (i.e., the inability to identify and verbalize emotions) mediated the relationship between avoidant attachment patterns and interpersonal problems, even after controlling for NA. Preliminary findings also suggested that NA acted as a moderator of the mediator cognitive alexithymia. These results have important implications for clinical practice, as this study clearly shows that interpersonal problems do not automatically follow from insecure attachment strategies, but are contingent upon alexithymic features. It is recommended to target alexithymic features in patients with SFD, particularly in the context of negative emotions. Therefore, cognitive alexithymia may be an important therapeutic focus, specifically in the treatment of avoidant patients with SFD.

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KEYWORDS

• cognitive alexithymia,
• insecure attachment,
• interpersonal problems,
• mentalization,
• somatoform disorder

So, I was wondering to myself what "targeting" alexithymic features would look like as a treatment strategy, because I'm a glutton for punishment, right?

Here are further symptoms of alexithymia:

Alexithymia is also understood to have two components; a cognitive component where people might face challenges with thinking and emotions while trying to name, understand and talk about feelings, as well as an affective component where people might struggle with the experience of sharing, responding to and sensing emotions. People who experience the effects of alexithymia might notice some different things such as:

• A lack of impulse control
• Violent or disruptive outbursts
• Indifference towards other people
• Difficulties with articulating emotions
• Difficulties with naming different kinds of emotions
• Struggling to identify emotions expressed by others
• Heightened sensitivity to sights, sounds, or physical touch
• A narrow capacity to understand the reasons behind certain emotions

...great, that's... great. I'm really having no trouble naming my emotion as rage.

Treatment?

The treatment options for alexithymia are often times very different from typical counseling or talk therapy. For people living with alexithymia, a mental health professional will often concentrate on building a foundation of naming emotions and appreciating a range of feelings. The process will likely include both consideration of the experiences of other people and self-reflection. Even though some people with this emotional comprehension might sound very basic to others, for a person with alexithymia the process of growing their emotional intelligence and capacity may be difficult. Things such as:

• Group therapy
• Daily journaling
• Skill-based therapy
• Engaging in the creative arts
• Various relaxation techniques
• Reading emotional books or stories

Guys, I think we're looking at the treatment for the milder autistic spectrum disorders. Boldface mine.

Seriously, it's fascinating how we can be both emotionally labile and unpredictable and also have a completely flat affect and no emotional response whatsoever. It's magic.

-J

 

[TiredSam]

An article by people without an ounce of empathy about what they see as other people's interpersonal problems.

Heightened sensitivity to sights, sounds, or physical touch

Oh lovely, the psychologization of sensory intolerance begins.

I have no trouble at all articulating the emotions I'm feeling at the moment, I just choose not to out of consideration for those who are offended by colourful language.

 

[JaimeS]

Oh lovely, the psychologization of sensory intolerance begins.

"....begins"?

*sigh*

 

[worldbackwards]

Funnily enough, having read this abstract I'm really not struggling to identify and verbalise my emotions.

 

[TiredSam]

Funnily enough, having read this abstract I'm really not struggling to identify and verbalise my emotions.

I hope you're not suffering from:

• A lack of impulse control
• Violent or disruptive outbursts

They'll get you one way or the other ...

 

[chipmunk1]

Alexithymia is also understood to have two components; a cognitive component where people might face challenges with thinking and emotions while trying to name, understand and talk about feelings, as well as an affective component where people might struggle with the experience of sharing, responding to and sensing emotions. People who experience the effects of alexithymia might notice some different things such as:

• A lack of impulse control
• Violent or disruptive outbursts
• Indifference towards other people
• Difficulties with articulating emotions
• Difficulties with naming different kinds of emotions
• Struggling to identify emotions expressed by others
• Heightened sensitivity to sights, sounds, or physical touch
• A narrow capacity to understand the reasons behind certain emotions

No one knows what Alexithymia really is, where it comes from, how to treat it, how to distinguish it from similar illnesses. There is no lab test for it. It is based on a vague constellation of symptoms.

Possible physical causes for the above symptoms:

Brain damage
Developmental disorders
Neurological disease
Hormonal Problems
Abnormal electrical brain activity
Other unknown causes

In my opinion it is a shame that they diagnose and "treat" people based on half-baked psychological theories.

 

[Aurator]

So, I was wondering to myself what "targeting" alexithymic features would look like as a treatment strategy,
Seriously, it's fascinating how we can be both emotionally labile and unpredictable and also have a completely flat affect and no emotional response whatsoever. It's magic.

-J

The alexithymia nonsense and the absurdity of the contradiction you mention was discussed in the comments section of one Amazon review of O'Sullivan's "It's all in your Head", where the professional philosophaster Richard Gipps, well known to some of us, said:
"the links between mind, brain, immunity etc., and [O'Sullivan's] understanding of ME/CFS as psychological in cause and maintenance...is also backed up by studies on increased alexithymia and clinically frequent observations on stress disavowal in ME/CFS patients."

Which earned the reply:

"For years psychiatrists tasked with shining their light on ME/CFS patients have seized upon the most meagre evidence of heightened emotion or stress in patients' testimonies in order to build a case for psychological causation. The patients, convinced by their own experience of it that their illness is organic not psychological, have only one hope: that biomedical research into their disease will be approved and funded and one day they may escape from the hell they find themselves in. But they know what the psychiatrist interviewing them is about: finding, at all costs, "evidence" of psychological causation...

Naturally, the patients are diffident towards being probed in this way by the psychiatrist, and are careful not to unburden themselves too freely about sorrows and disappointments that they, like all people, will inevitably have experienced at various points in their lives and especially now. So what do the psychiatrists, frustrated a little by the patients' reticence, do? They carry out studies in which they now interpret disavowals of stress (in the interests of self-preservation) and a mere absence of emotion in the patients' testimonies as evidence of psychological causation. Henceforth, whatever the patients say or don't say, psychological causation can be effortlessly demonstrated. It is checkmate, and the patients are the losers. It is the consummate victory as well as the consummate deception - 'a thing of beauty', as a certain Simon Wessely might say."

 

[chipmunk1]

"alexithymia" is defined as "a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self."

right and it is sooo sub-clinical that only the psychs with sophisticated questionnaires can notice it.

• Group therapy
• Daily journaling
• Skill-based therapy
• Engaging in the creative arts
• Various relaxation techniques
• Reading emotional books or stories

and i would love to know how many of these therapies are based on solid scientific evidence?

My guess is, most aren't!!!

Reading emotional books or stories, really???

Although not fully empirically validated, alexithymia is a useful clinical construct

http://www.psychiatrictimes.com/som...atient-has-no-story-tell-alexithymia/page/0/4

Useful to push cr*p on helpless people?

In reality Alexithymia=concept of emotional/sexual repression as cause of illness= Freudian psychology disguised as science.

It was discovered by a psychoanalyst.

http://news.harvard.edu/gazette/story/2010/05/peter-emanuel-sifneos/

 

[Karena]

I wonder if the doctors who dismiss us have alexithymia. They seem indifferent to our problems and unable to understand why we feel certain emotions (anger, frustration, etc.)

Regarding the study on suppression of emotions, I can't figure out where they're coming from. Are we hypochondriacs who exaggerate everyday aches and pains? Or are we emotionally stunted people who make ourselves sicker by suppressing how we feel? Perhaps the former helped cause the latter.

In my case, I often suppress my emotions because being honest only causes me grief. It takes too much out of me to explain things to other people. And most folks don't want to know how I really feel physically or emotionally. That's why I appreciate this forum. It gives me an opportunity be honest about myself.

 

[JaimeS]

right and it is sooo sub-clinical that only the psychs with sophisticated questionnaires can notice it.

Haha! Absolutely. It's a very finely-tuned subjective questionnaire.

• Group therapy
• Daily journaling
• Skill-based therapy
• Engaging in the creative arts
• Various relaxation techniques
• Reading emotional books or stories

Psych: *hands patient a book of poetry*
Patient: *reads book of poetry*
Psych: Did you enjoy that? Do you feel you understood the emotions?
Patient: It was a good book, and of course I understood the emotions they were expressing. *pause* I liked the one about the tree?
Psych: You're cured!

I'm not saying art and reading and journaling doesn't make people feel more relaxed. I'm sure it does! I write and that relaxes me.

I just don't see how that's a foundation for anything about anything except the very general statement "art often makes people feel more relaxed", or to be more accurate, "the aim of art is often to elicit an emotional response. It is sometimes successful at doing so."

-J

 

[JaimeS]

Additionally, I have to wonder if the type of psychologists who produce studies like these are implying that if everyone just joined a painting class, any moderate mental illness would be significantly improved and any minor ones eradicated.

...*closely considers this point of view...*

I really do like painting...

 

[Aurator]

In reality Alexithymia=concept of emotional/sexual repression as cause of illness= Freudian psychology disguised as science.

It was discovered by a psychoanalyst.

http://news.harvard.edu/gazette/story/2010/05/peter-emanuel-sifneos/

Could I politely but firmly point out that it was not "discovered" but rather invented. There's a crucial difference.

Also, sorry to be boring, but the etymology of alexithymia given by the OED is erroneous; either that or the Greek inventor of the term had a very poor knowledge of the etymology of his own language. The prefix ἀλεξί- (alexi-), in Modern as well as Ancient Greek, means "shunning, preventing, warding off" not
"without words" : http://www.perseus.tufts.edu/hopper/resolveform?type=start&lookup=aleci&lang=greek

The Greek Wikipedia page for alexithymia confirms my suspicions that the OED etymology is wrong.
None of this matters to the imbecilic psychiatrists who bandy the word about though; and, let's face it, they're wrong about so many more important things than this.

 

[Sean]

Regarding the study on suppression of emotions, I can't figure out where they're coming from. Are we hypochondriacs who exaggerate everyday aches and pains? Or are we emotionally stunted people who make ourselves sicker by suppressing how we feel?

QED!

One way or another.

They are just reaching, ever harder and further, to find something, anything, to stave off the inevitable.

 

[Forbin]

Regarding the study on suppression of emotions, I can't figure out where they're coming from. Are we hypochondriacs who exaggerate everyday aches and pains? Or are we emotionally stunted people who make ourselves sicker by suppressing how we feel? Perhaps the former helped cause the latter.

Quotes from the study:

Conclusions: CFS participants had lower observer-rated emotional expression than HC, despite greater distress and higher autonomic arousal. This may have implications for their ability to access social support at times of stress.

Hiding one’s emotions may mean that others cannot detect the need to provide support, which could contribute to the development or maintenance of fatigue.

It is important to note that the lower observer rated emotional expressivity in the CFS group compared to HCs occurred in the context of this higher self-reported distress in the CFS group, indicating at least some success at hiding emotions from others. This could result in other people failing to identify a need to support the individual, potentially contributing to the development or maintenance of fatigue.

http://www.apa.org/pubs/journals/releases/hea-hea0000341.pdf


This is, coincidentally (I hope), the theme of the popular Pixar film "Inside Out," i.e. that suppression of negative emotions ("Sadness" in the film) prevents others (the parents in the film) from recognizing your distress, thus depriving you of the emotional support of others.

The theory must be very fashionable. It was, after all, made into a cartoon.

​

 

[JaimeS]

Uh, it's great to be in touch with one's emotions.

Implying that being in touch with one's emotions is an effective treatment for ME/CFS seems awful and comical by turns.

Heck, implying that's what's wrong with us in the first place is pretty awful. Let me go with an 'I statement'.

When I see psychobabble about people with my illness, I feel angry, skeptical, and disdainful. There is some disbelief mixed in, that people can be so willfully stupid and destructive as to say that the symptoms of a disease identified over and over as neurological in origin will be mitigated by standing in a circle and holding hands.

But seriously, my favorite is the tendency to believe that neurotransmitters are the same as emotions. It's like they really absorbed that serotonin = "happy" and oxytocin = "love" reductionist nonsense taught in their high school bio classes and blocked out the rest. High adrenaline without visible panic doesn't mean a clinical inability to express oneself, because adrenaline is not another word for 'panic'.

The people who gave teens with CFS epi/norepi-blockers (read: anti-anxiety meds) discovered that the teens did not suddenly perk up when cut off from their source of adrenaline. Spoiler alert: instead, their symptoms worsened. They were capable of less activity than before the drug was administered.

The researchers concluded that our adrenaline is likely high because that's what keeps us walking and chewing gum at the same time: it's a physical crutch that helps us partially make up for our energetic lack elsewhere.

Sometimes I envision these 'emotions' researchers sitting around a table planning their study, thinking, "I know this theory doesn't make 'sense' per se, as I understand 'sense'... except I'm sure listening to music and drawing is nice for everybody... I like art, I should paint more... I know I haven't considered alternate theories for what I've discovered or read the relevant literature... but fv@k it, you know, I deserve that cover of Psychology Today."

-J

 

[Joel1970]

I have trouble regulating my body temperature, and often sweat for no apparent reason. But apparently sweating must mean I'm coping with stress.

I think that it is a sign that your body is experiencing duress not stress. Any time I push too hard I start sweating like crazy and don't stop until I stop completely rehydrate and sometime use ice packs.

 

[JaimeS]

I think that it is a sign that your body is experiencing duress not stress.

All semantics. We experience stress when we encounter anything that puts our bodies under stress (don't you love the English language?) That means physical stress and emotional stress are still stress.

-J

 

[Joel1970]

All semantics. We experience stress when we encounter anything that puts our bodies under stress (don't you love the English language?) That means physical stress and emotional stress are still stress.

-J

Yes but that isn't the type of stress they are referring to is it? They are referring to the psychological aspect of the body's reaction not the physiological aspect.

 

[JaimeS]

Sure @Joel1970 -- in this article I'm sure they're talking about emotional stressors. But you were quoting Webdog, who was talking about autonomic stuff and its relation to stress... not quoting the article.

Def not important!