The Role of Alexithymia in Trauma Therapy Outcomes: Examining Improvements in PTSD, Dissociation, and Interpersonal Problems

Objective: Alexithymia is a personality trait that reflects deficits in the cognitive processing and regulation of emotions (Taylor & Bagby, 2013). It has been closely linked to childhood trauma and reported by individuals presenting with other trauma-related conditions, such as posttraumatic stress disorder (PTSD), dissociation, and interpersonal problems (Powers, Etkin, Gyurak, Bradley, & Jovanovic, 2015). Addressing the emotional deficits associated with alexithymia is fundamental to resolving issues of childhood trauma and, therefore, is at the core of many trauma therapy models (e.g., Cloitre, Koenen, Cohen, & Han, 2002). The current study aims to build upon this foundation by examining the role of alexithymia in the improvements of trauma-specific difficulties prior to and following trauma therapy among treatment-seeking women with histories of childhood abuse. Method: Data were collected from 167 participants attending Women Recovering from Abuse Program (WRAP), an 8-week, Stage I, day treatment program using primarily group therapy for women with histories of severe childhood trauma. Participants' level of alexithymia, PTSD, and dissociative symptoms, and interpersonal difficulties were assessed at three time points. Results: Significant positive relationships were found between improvements in alexithymia and improvements on all trauma-specific outcomes over the course of treatment (e.g., baseline to posttreatment) and between distinct stages of WRAP. Conclusions: These findings underscore the role of alexithymia in trauma therapy, and the need to properly attend to the deficits and issues related to alexithymia at initial stages of therapy with survivors of childhood abuse in order to facilitate improvements in trauma-specific symptoms. Clinical Impact Statement This study advances our understanding of the important role of alexithymia in trauma therapy outcomes, as improvements in alexithymia throughout therapy were found to be associated with positive outcomes. These results have important clinical implications since they highlight the importance of attending to the deficits and issues related to alexithymia at initial stages of therapy with survivors of childhood abuse. These findings also suggest that clinical interventions that target emotion regulation, that emphasize increasing one's awareness of emotional and other internal states, are on the right track to promoting recovery from trauma.