When You Can’t Feel What You Feel: How Alexithymia and Interoception Shape Emotional Exhaustion

TL;DR

Struggling to name what you're feeling—or even recognize that you're feeling anything at all—may be more than just “being out of touch.” It could be alexithymia, a difficulty identifying and describing emotions, often tied to low interoceptive awareness (the sense of internal bodily states). Together, these issues can fuel emotional exhaustion. But there’s good news: therapies that restore interoceptive connection may break this cycle—and equine-assisted therapy is one powerful way to start.

Why Emotional Burnout Isn’t Just “All in Your Head”

Many high-functioning people hit a point where exhaustion isn’t just mental—it’s emotional. You’re tired but can’t rest. You’re overwhelmed but can’t cry. You’re numb and wired at the same time.

This isn’t a mindset problem. It’s a breakdown in the system that helps you feel, process, and regulate your internal state.

The Science: Alexithymia and Interoceptive Blindness

Alexithymia refers to the inability to identify and articulate emotions. It often coexists with low interoceptive awareness—meaning you have trouble sensing your body’s internal cues like hunger, heart rate, or anxiety.

Research shows that this combination makes it significantly harder to recognize when you're stressed, emotionally overwhelmed, or approaching burnout (Brewer et al., 2016; Desdentado et al., 2022; Herbert et al., 2011).

It’s like driving a car without a dashboard—you can’t see when you’re running on empty until you stall out.

The Loop That Fuels Exhaustion

Low interoceptive awareness makes it hard to detect subtle signs of stress or emotional strain.Alexithymia makes it hard to translate those signs into feelings or actions.Emotion dysregulation becomes the norm—because you’re not aware enough to intervene in time.

This leads to chronic emotional overload and eventual exhaustion (Desdentado et al., 2023; Li et al., 2024).

Breaking the Cycle with Body-Based Therapy

To heal emotional exhaustion, we need more than insight—we need reconnection.

Equine-assisted therapy supports this in a unique way. Unlike talk therapy, it bypasses the cognitive roadblocks of alexithymia by inviting you into a relationship that’s felt, not spoken. Horses respond to subtle shifts in your body and emotion, often before you’re even aware of them.

This feedback loop builds interoceptive awareness—the very skill that people with alexithymia often lack (Naber et al., 2019). It gives you a nonverbal mirror, one that reflects your emotional state with honesty and compassion.

Clients often describe moments of unexpected clarity:

• “I didn’t know I was holding so much tension until the horse moved away.”

• “When I slowed my breathing, the horse came closer. I felt seen without words.”

This Isn’t Woo. It’s Nervous System Reeducation.

These sessions aren’t about “fixing” you. They’re about helping your body remember how to listen and respond. When you restore your ability to feel what you feel, emotional regulation becomes easier, and the exhaustion begins to lift.

The Invitation

If you’ve felt emotionally flat, disconnected from your own body, or like your emotions are locked behind a wall you can’t describe—this work may be the missing piece.

On a peaceful horse farm in central Israel, Esther Adams, Psy.D offers 2–4 hour therapy intensives that support deep, embodied transformation for those ready to reconnect from the inside out.

Book your breakthrough. Leave lighter.https://www.therapyinisrael.com/contact

References

• Brewer, R., Cook, R., & Bird, G. (2016). Alexithymia: a general deficit of interoception. Royal Society Open Science, 3. https://doi.org/10.1098/rsos.150664

• Desdentado, L., Miragall, M., Lloréns, R., & Baños, R. (2022). Disentangling the role of interoceptive sensibility in alexithymia, emotion dysregulation, and depression in healthy individuals. Current Psychology, 42, 20570 - 20582. https://doi.org/10.1007/s12144-022-03153-4

• Herbert, B., Herbert, C., & Pollatos, O. (2011). On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness?. Journal of Personality, 79(5), 1149-75. https://doi.org/10.1111/j.1467-6494.2011.00717.x

• Desdentado, L., Miragall, M., Llorens, R., Navarro, M., & Baños, R. (2023). Identifying and regulating emotions after acquired brain injury: the role of interoceptive sensibility. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1268926

• Gaggero, G., Bizzego, A., Dellantonio, S., Pastore, L., Lim, M., & Esposito, G. (2021). Clarifying the relationship between alexithymia and subjective interoception. PLoS ONE, 16. https://doi.org/10.1371/journal.pone.0261126

• Trevisan, D., et al. (2019). A meta-analysis on the relationship between interoceptive awareness and alexithymia: Distinguishing interoceptive accuracy and sensibility. Journal of Abnormal Psychology. https://doi.org/10.1037/abn0000454

• Scarpazza, C., Zangrossi, A., Huang, Y., Sartori, G., & Massaro, S. (2021). Disentangling interoceptive abilities in alexithymia. Psychological Research, 86, 844 - 857. https://doi.org/10.1007/s00426-021-01538-x

• Li, N., Chuning, A., Durham, M., Killgore, W., & Smith, R. (2024). Does emotion regulation mediate the relationship between interoception/alexithymia and co-morbid depression/anxiety? Current Psychology. https://doi.org/10.1007/s12144-024-06612-2

• Zdankiewicz-Ścigała, E., et al. (2021). Relationship between interoceptive sensibility and somatoform disorders in adults with autism spectrum traits. PLoS ONE, 16. https://doi.org/10.1371/journal.pone.0255460