Examining Proposed Changes to the Conceptualization of the Alexithymia Construct: The Way Forward Tilts to the Past

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Abstract
Fifty years ago, Psychotherapy and Psychosomatics published an article by John Nemiah and Peter Sifneos [1] in which they reported some clinical observations on the mentation of a group of patients with “classic” psychosomatic diseases. This article, together with a book chapter published in the same year [2], heralded the soon to be introduced concept of alexithymia [3], which encompassed the cognitive characteristics that Nemiah and Sifneos had reported. The concept was not entirely new, which Nemiah and Sifneos readily acknowledged, and they noted that Ruesch [4] had described some of the same characteristics in the late 1940s; in addition, the cognitive style resembled the operational thinking (pensée opératoire) that Marty and de M’Uzan [5] had observed among somatically ill patients in France. As a theoretical concept, alexithymia quickly captured the interest of psychosomatic medicine specialists and was chosen as the main theme of the 11th European Conference on Psychosomatic Research held in Heidelberg in 1976 [6]. Though there were some critics of the concept, the majority of conference delegates agreed that alexithymia should be conceptualized as a hypothetical multifaceted construct that could be operationalized and evaluated empirically. On the final day of the conference, Sifneos [7] confidently predicted that “alexithymia is here to stay whether we like it or not and it is going to be with us for the rest of our lives” (p. 369). He recommended that a scientific approach be taken to further investigate the construct.

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