Associations Between Emotional Abuse and Neglect and Dimensions of Alexithymia: The Moderating Role of Sex

Abstract

Objective: Child maltreatment, specifically emotional maltreatment (i.e., an act, such as belittling, blaming, or rejection, that is potentially harmful to a child’s emotional development), has emerged as an important correlate of alexithymia. However, the evidence is mixed with regard to how emotional abuse and neglect might relate to dimensions of alexithymia (i.e., externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings). Furthermore, research is needed to identify individual factors that might influence these associations. The current study examined the links between emotional abuse and neglect and externally oriented thinking, difficulty describing feelings, and difficulty identifying feelings and evaluated whether sex moderated these associations.

Method: Participants included 500 emerging adults (49.6% male) who completed an online battery of questionnaires assessing history of child maltreatment and dimensions of alexithymia.

Results: Regression analyses revealed that emotional abuse was associated with difficulty describing feelings and externally oriented thinking, but not difficulty identifying feelings. Emotional neglect was associated with difficulty identifying feelings, but not difficulty describing feelings or externally oriented thinking. There were no sex differences associated with difficulty describing feelings or externally oriented thinking. However, sex moderated the associations between emotional abuse and neglect and difficulty identifying feelings such that emotional abuse and neglect were both more strongly associated with difficulty identifying feelings for females.

Conclusion: These results suggest that, in the aftermath of emotional maltreatment, sex may play an important role in the development of difficulty identifying feelings.

“He doesn’t talk about his feelings.” That can be a symptom of emotional abuse.
The authors write: “Child maltreatment, specifically emotional maltreatment (i.e., an act, such as belittling, blaming, or rejection, that is potentially harmful to a child’s emotional development), has emerged as an important correlate of alexithymia.”

Alexithymia is a personal trait characterized by the subclinical inability to identify and describe emotions experienced by one’s self or others. The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating.

What happens when a therapy patient doesn’t talk about his feelings? The patient will re-experience the childhood emotional maltreatment that caused the disorder in the first place !! “You don’t talk about your feelings!” “I can’t help you if you don’t talk about your feelings.” My psychiatrist at GW said, “You don’t seem to know what you’re supposed to be doing here. You’re supposed to talk about your feelings!” That’s belittling the patient about something he has no control over. Imagine a doctor saying to a diabetes patient: “You don’t produce insulin. You’re supposed to produce insulin. That’s why your illness never improves. You’re not doing what you’re supposed to do!”

The Problem of Scapegoating in Therapy

A scapegoat by his nature is a singleton.  He is the one person to blame.  The singleton by definition has no reference group.  There are no other people like him.

In therapy I am sometimes treated like a singleton.  It is as if the therapist is saying, “You have no reference group.  You do not belong to a class of similar patients.  There is no class of persons who do not talk about their feelings.   Such a person is not the subject of scholarly investigation.”  Is that not what the therapist is saying, in effect?  “This is not a recognized problem.  You are simply a bad patient.”

When a therapist treats a patient as a singleton, as if he has no reference group, as if he is not a representative of a class of persons — is that not a form of scapegoating?

But more.  I think about all the research I do into mental issues.  Can we perhaps see that as a defense against scapegoating, therefore?  When I research groups of people with problems similar to mine, and I not saying implicitly, “You see there is a reference group of persons like me.  I am not a singleton.  I am representative of a class.”  Again: Is my research fundamentally a defense against guilt?  The guilt associated with scapegoating?  In Kleinian terms, is my research a defense against depressive anxiety, namely the guilt of the depressive position?

And that brings us back to Didier Anzieu’s theory about Freud. Anzieu’s book, Freud’s Self-Analysis is an important, enormously detailed . . . study of Freud’s early life as mirrored in the dreams he chose to recount and analyze in The Interpretation of Dreams. From a Kleinian viewpoint, Anzieu considered Freud’s “elaboration of psychoanalytic theory . . . corresponded to a setting up of obsessional defenses against depressive anxiety’—emphasizing Freud’s need to ‘defend himself against it through such a degree of intellectualisation’.”

Wait, that’s another guilt-inducing accusation they level at me:  “You intellectualize.  You need to stop intellectualizing!”  But is there not a reference group of people who do self-analysis?  Am I a singleton?

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