Alexithymia and the Sexless Marriage

I want to discuss something called Affective Deprivation Disorder.  It’s a bit controversial in certain circles because the disorder was created and named after observing pairings in which one person had an autism spectrum disorder.  More specifically, one person in a coupling exhibited alexithymia, and the other person’s response to this, over time, was the development of a class of symptoms that came to be labeled as Affective Deprivation Disorder.

Firstly, what is alexithymia?

Alexithymia/ˌlɛksəˈθmiə/ is a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self.[1]The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating.[2]Furthermore, individuals suffering from alexithymia also have difficulty in distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responding.[2]Alexithymia is prevalent in approximately 10% of the general population and is known to be comorbid with a number of psychiatric conditions.[3]

Alexithymia is defined by:[9]

  1. difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal

  2. difficulty describing feelings to other people

  3. constricted imaginal processes, as evidenced by a scarcity of fantasies

  4. a stimulus-bound, externally oriented cognitive style. (online source)

Alexithymia is not the same as someone choosing to be consistently rational as a coping strategy to avoid dealing with their emotions.  In DBT (dialectical behavior therapy) terms, this is called “choosing rational mind”.  When a person is able to step into “emotional mind” but prefers “rational mind” regularly, this does not indicate alexithymia.

Having defined alexithymia, what is Affective Deprivation Disorder (AfDD)?

Affective Deprivation Disorder (AfDD) is a relational disorder resulting from the emotional deprivation sometimes experienced by the partner (or child) of persons with a low emotional/empathic quotient or alexithymia.

Coined by researcher Maxine Aston, AfDD was first applied to partners of adults with Asperger Syndrome, many of whom showed disturbing physical and psychological reactions to the lack of emotional reciprocity they were experiencing in their relationship. Maxine was later to broadenAfDD‘s applicability to include disorders other than Asperger’s such as depression, eating disorders, posttraumatic stress disorder, personality disorder, and substance abuse disorder in which the same low emotional intelligence or alexithymia is a key relational factor.

To qualify for a diagnosis of AfDD some or all of the following indicators in each category must be present:

One Partner must meet criteria for a diagnosis of one or more of the following:
• Low Emotional Intelligence
• Alexithymia
• Low Empathy Quotient

Relationship Profile includes one or more of the following
• High relational conflict
• Domestic abuse: emotional and/or physical
• Reduced marital or relationship satisfaction
• Reduced relationship quality

Possible Psychological Symptoms of AfDD
• Low self esteem.
• Feeling confused/bewildered.
• Feelings of anger, depression and anxiety
• Feelings of guilt.
• Loss of self/depersonalisation
• Phobias – social/agoraphobia
• Posttraumatic stress reactivity
• Breakdown

Possible Psychosomatic Effects
• Fatigue
• Sleeplessness
• Migraines.
• Loss or gain in weight.
• PMT/female related problems.
• ME (myalgic encephalomyelitis).
• Low immune system – colds to cancer.

Similar symptoms experienced by the SAD sufferer, are experienced by the AfDD sufferer. Yet there is an even more damaging effect for the AfDD sufferer insofar as it is another human being, they probably love, who is unintentionally responsible for their emotional deprivation. Emotional reciprocity, love and belonging are essential human needs, if these needs are not being met and the reason why is not understood, then mental and physical health may be affected. Awareness and understanding can eliminate this.

AfDD is a consequence of the relational situation a sufferer is in, therefore it is possible to find ways to rectify this. Just as sunlight restores the balance in SAD – emotional input and understanding can restore the balance in the person affected by AfDD. Relationships when one partner has alexithymia can work if both partners work together to understand their differences and develop a better way of communicating, showing emotional expression and loving that works for both of them.

The following treatment issues can be explored with those suffering AfDD:
• Rebuilding Self Esteem
• Having a voice
• Looking at negative responses.
• Looking at self image.
• Building confidence.
• Becoming assertive.
• Attending a Workshop.

Finding Self
• Identifying Parent – Child roles.
• Changing learned helplessness.
• Rebuilding self.
• Rebuilding family and relationships.
• Rebuilding a social life.
• Finding support.  (Maxine Aston)

In my case, the only way to rectify the situation was to leave the relationship.  What I can tell you is that the psychological symptoms associated with AfDD were all true for me.  What have I had to do then? Everything listed above.  Painstakingly.  Rebuild, rebuild, rebuild.

Why discuss this here? Well, I wrote a blog post dedicated to AfDD and alexithymia on another blog last year as I was processing the problems in my marriage.  It is the most highly viewed post I’ve ever written even making its way to the Huffington Post.  I’ve heard from countless people with the same message: “This is my life.”

The thing that is not talked about often enough in all this even among the “experts” is sex.  Sex is a difficult topic for many people, but it simply must be discussed in the context of something like AfDD.  Why? If a person is living in a sexless marriage/relationship, then I would wager they’re being deprived of a far more meaningful emotional and intimate relational experience, too.  This notion that sex is not a vital and life-giving part of our long-term relationships is ludicrous, and yet this is exactly what people living in sexless marriages really communicate when they cry and say, “I’m okay.  There’s a lot more to marriage than sex, right?”

It is simply not possible to rebuild self-esteem, self-image, look at negative responses, build confidence, and develop assertiveness when living under the shadow of constant sexual rejection from a person you love and desire.  It is too profoundly corrosive to one’s sense of self.

What is to be done then? Well, there are no easy answers here.  If you see yourself in any of this, then it’s important to start somewhere.  I started with rebuilding a social life and assessing my self-image and self-esteem.  I felt that I could do something about those three things completely apart from my then husband who met all the criteria for alexithymia.  I could not change the sexual dynamics, but I could begin to separate myself and my view of myself from how I perceived him to view me and his treatment of me.  That was my starting point.

And, I started taking care of myself sexually.  Enter the power of erotica and romantica.  Just because I was married to a man who no longer saw me as anything more than a means to an end did not mean that I had to agree.

What is important in a situation like this is that you do something.  Reversing that sense of learned helplessness is vital so that you can find your personal empowerment again.

Further Reading:

Affective Deprivation Disorder and Alexithymia in Marriage


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