By Yana Shenker, LCSW-R
Founder, Resilient Mind Psychotherapy
Emotional challenges come in many forms, and two conditions that are often misunderstood or confused are alexithymia and social anxiety. Both affect how people connect with themselves and others, but they are not the same.
At Resilient Mind Psychotherapy, we often meet clients who wonder whether they are experiencing difficulty identifying emotions, fear of social situations, or a mixture of both. Recognizing the differences can help individuals seek the right support, whether it’s through a therapist for social anxiety or therapy designed to address emotional awareness.
What Is Alexithymia?
Alexithymia is not a mental health disorder on its own, but rather a trait characterized by difficulty identifying, describing, or expressing emotions. People with alexithymia may say:
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“I know I feel something, but I can’t put it into words.”
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“I don’t know if I’m sad or just tired.”
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“People tell me I come across as distant or cold, but I don’t mean to.”
Research suggests alexithymia can be linked to early trauma, certain neurological conditions, or long-term coping mechanisms. It often co-occurs with depression, PTSD, or autism spectrum conditions.
What Is Social Anxiety?
Social anxiety disorder (sometimes called social phobia) is a diagnosable mental health condition. It is defined by intense fear of social situations, especially those involving judgment or evaluation by others.
People with social anxiety may worry about:
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Saying the wrong thing and being embarrassed
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Blushing, sweating, or trembling in front of others
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Being negatively judged in work, school, or social settings
This fear can lead to avoidance, isolation, and distress that interferes with daily life. Unlike alexithymia, the problem isn’t about identifying feelings—it’s about being overwhelmed by them in social contexts.
If you suspect social anxiety might be playing a role in your life, a good place to start is with our free social anxiety test. But first, let’s explore how alexithymia and social anxiety differ, where they overlap, and what treatment options may help.
Key Differences Between Alexithymia and Social Anxiety
Although both conditions can make relationships difficult, they stem from different core struggles.
| Feature | Alexithymia | Social Anxiety |
|---|---|---|
| Core issue | Trouble identifying or describing emotions | Fear of social situations and judgment |
| Emotional awareness | Limited self-awareness, difficulty labeling feelings | Strong awareness but overwhelming fear of evaluation |
| Social interactions | May seem emotionally distant or detached | May avoid social settings out of fear |
| Physical symptoms | Emotional numbness, flat affect | Blushing, sweating, rapid heartbeat, trembling |
| Treatment focus | Improving emotional literacy and awareness | Reducing fear responses, building confidence in social settings |
Where They Overlap
Some individuals may experience both alexithymia and social anxiety, which can complicate diagnosis and treatment. For example, a person who struggles to identify emotions might also feel heightened anxiety in social interactions because they cannot clearly express themselves. Conversely, someone with social anxiety may withdraw so often that their ability to understand and communicate emotions weakens over time.
How Therapy Can Help
The good news is that both conditions can be managed with professional support.
Therapy for Alexithymia
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Emotion coaching helps individuals learn to identify and label feelings.
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Mindfulness-based approaches encourage awareness of physical sensations tied to emotions.
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Expressive therapies such as journaling or art therapy can provide nonverbal outlets for feelings.
Therapy for Social Anxiety
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Cognitive Behavioral Therapy (CBT) is one of the most effective treatments, teaching clients to challenge fearful thoughts and gradually face social situations.
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Exposure therapy helps desensitize clients to social fears step by step.
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Social skills training builds confidence in communication and self-expression.
If social anxiety is your primary struggle, seeking guidance from a therapist for social anxiety can provide tailored strategies for managing fear, reducing avoidance, and improving quality of life.
Supporting a Loved One
Family members and partners often feel confused when a loved one seems withdrawn or avoids social contact. Here are some supportive steps:
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Listen without judgment – Let them describe their experiences in their own words.
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Encourage, don’t push – Gentle encouragement is more effective than forcing social situations.
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Learn together – Reading about alexithymia or social anxiety can help reduce stigma and increase empathy.
Final Thoughts
While alexithymia and social anxiety may look similar on the surface, their roots are quite different. Alexithymia is about struggling to connect with one’s emotions, while social anxiety is about the fear of how others perceive you. Both, however, can deeply affect daily life and relationships.
At Resilient Mind Psychotherapy in Brooklyn, we provide therapy for both emotional awareness challenges and social anxiety. Whether you’re unsure which condition applies to you, or you recognize signs of both, professional support can help you move toward healthier self-expression and more fulfilling relationships.
FAQs
1. Can someone have both alexithymia and social anxiety at the same time?
Yes. Some individuals struggle both to identify emotions (alexithymia) and to feel comfortable in social situations (social anxiety). Therapy can help address both together.
2. Is alexithymia considered a mental health disorder?
No, alexithymia itself is not a disorder. It is a personality trait or emotional characteristic that often co-occurs with other conditions like PTSD, depression, or autism spectrum disorder.
3. How common is social anxiety disorder?
Social anxiety disorder is one of the most common mental health conditions, affecting about 7% of the U.S. population in any given year, according to the National Institute of Mental Health.
4. What kinds of therapy help improve emotional awareness in alexithymia?
Approaches like mindfulness, CBT, and expressive therapies (such as journaling or art therapy) can help individuals build emotional vocabulary and awareness.
5. How do I know if I should seek therapy for these challenges?
If emotional struggles interfere with daily life, relationships, or school/work, it’s a good idea to seek help. A therapist can clarify whether difficulties stem from alexithymia, social anxiety, or both.
References
American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Harvard Health Publishing. (2019, April 1). What is social anxiety disorder? Harvard Medical School.
https://www.health.harvard.edu/mind-and-mood/social-anxiety-disorder-treatments-and-tips-for-managing-this-challenging-condition
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (2016). Alexithymia: Clinical implications, psychosomatic contributions, and future research directions. Psychotherapy and Psychosomatics, 85(2), 91–100.
https://pubmed.ncbi.nlm.nih.gov/2027937/
