Introduction
Farges and Farges (2002) have done a critical review of literature talking about a link between alexithimia, wich difined as an incapacity by the subject of definding and expressing his own emotions, and consuming psychoactive substances especially alcohol and drugs . However, alexithymia concept doesn’t have a clear theoretical position yet. The aim of this research is to allow us to understand better the alexithymia concept instead of the other definitions wich are not clear enough.
It draws up an inventory of different works that have already been carried out in the world about alexythimia , in order to check if the link is realy existing between alexithymia and addiction to psychodropes.
At first, we will present a summary of the different concepts of alexithymia and then expose the different studies talking about the link between alexithymia and consuming drugs. After that, we will expose the crittics of the authors and finally we are going to give a conclusion about what this review gave us as informations about the adjustment of therapeutic treatments.
Sifneos (1973) is one of the first authors to define alexithymia as a form of inability to make connections between thought and emotions. Currently, studies tend to define alexithymia along four axes: (1) difficulties to communicate about own feelings with others, (2) inability to identify feelings and distinguish them from bodily sensations, (3) poverty of imaginary life and (4) thoughts with pragmatic content turned to the environment rather than the own sensations of the subject.
Farges and Farges (2002) mentioned that other authors proposed two distinguished forms of alexithymia: primary and secondary alexithymia. The former is considered innate and part of a personality trait. The second is defined as the consequence of trauma, following a somatic pathology or caused by of emotional development disturbence. It is more related to a transitionaly state.
From a neurobiological point of view, some of the clinicians and researchers consider that alexithymia is of organic origin, linked to a perturbation of the connection between the limbic system and the neocortex or an absence of the communication between the right and left hemispheres.
In clinic, alexithymia is measured by several tools like the Taylor’s Toronto Alexithymia Scale (TAS) (1985) wich evaluing four components: (1) difficulty on identifying feelings, (2) describing them to others, (3) reduced daydreams, and (4) outward-looking rather than own sensations.
A modified version of the TAS-20 (Bagby, 1994), self-assessment scale of 20 items, is also proposed. Another measure such as Beth Israel Questionnaire (BIQ, Sifneos, 1973) is the only instrument of hetero-evaluation. On the other hand Sifneos and Schalling (1969) also developed a scale named the Schalling Sifneos Personality Scale (SSPS) which is a self-assessment questionnaire that also measures alexithymia.
As the authors mentioned, the definition of alexithymia knows its first controverse. At a first step, Sifneos defines alexithymia as a particular cognitive state coming in psychosomatic diseases. But others studies conclued that alexithymia appears in pathologies which excluying somatic components, as addictive behaviour. Therefore, several researches were conducted to find out how alexithymic features appear in patients with addiction.
Differents researches across the world
Many researches came from European researchers (France, Italy, Finland, Poland) North-American ones (Canada and United State). Nevertheless, these researches used differents scales to measure alexithymia, or several kinds of dependance (alcohol, cocaine, weed).
At first, Rybakowski (1988), Taylor (1990), Kauhanen (1992), Loas (1996) and Pinard (1996) considered alexithymia as a primary reaction, predisposing people to have addictive behaviors and a negative factor to undertake an abstinence. Indeed, this concept would be a predictor of alcoholic relapses. The authors shown a link between alexythimia and consuming alcohol : alexithymia characteristics depend on the importance of alcohol consumation.
Others researches moderate these conclusions. Farges (2000), Haviland (1994) and Loas (1996) considered alexithymia as a response to an emotional suffering state. They highlight a correlation between depression, anxiety and alexithymia for people suffering from psychoactive dependance. Moreover, alexithymia would be a temporary response to this stress and depressive state signs : when the level of anxiety stabilizes, alexitymic carecteristics decrease. These researchers mentionned that emotional distress state leads patients to request care.
Conclusion
Farges and Farges (2002) emphasize on that problem to make a difference between alexithymia and depression. Indeed, we can observe a tangle between these two concepts, mostly in the case of addictive behaviors. Some of researchers lead them to question the concept of alexithymia. because of the difficulty to know if alexithymia is the cause, the result or an other way to measure depression.
About the contradictory conclusions of this review, the authors underline a lack of longer studies, i.e., over the course of several years, in order to know more precisely if alexithymia is an emotional reaction (secondary nature) or personality characteristics (primary nature).
For us, this article make the inventory of researches until 2002, so we remain careful about these conclusions. Because many studies were conducted on alexithymia during these last years. Nevertheless, this review allows us to observe that alexithymia is difficult to define. In fact, the different works the review mentioned question us about the manifestation of the difficulty to express and recognize emotions. Thus, this seems relevant to us to better apprehend alexithymia because, as future professionals, we think that the care will be different following the definition we have of alexithymia. Indeed, our reasoning would be moving towards these therapeutic questions which appear when alexithymic charecteristics come in.
Merlet Emmanuelle, Hasnaoui Soukaïna, Fragey Laura
Master 2 PPCECC
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