Alexisomia in Psychosomatic Medicine: A Review
Alexisomia in Psychosomatic Medicine: A Review

Summary/Abstract: Psychosomatic medicine is an interdisciplinary field that examines the role of psychosocial factors in the development and course of bodily illnesses. While this field has focused for many years on alexithymia, known as difficulty in expressing emotions, in recent years researchers have turned their attention to the concept of "Alexisomia" (Shitsu-taikan-sho), defined as "difficulty in recognizing and expressing bodily sensations." Soon after Dr. Ikemi introduced to Japan the concept of alexithymia, coined by P. E. Sifneos in 1973, he noticed that patients with psychosomatic diseases have difficulty in describing not only their emotions, but also somatic feelings and sensations. Dr. Ikemi proposed naming the concept of the trait of lacking somatic awareness “shitsu-taikan-sho” in Japanese (“alexisomia” in English), meaning “shitsu” a lack, “taikan” bodily feelings/sensations, and “sho” condition/symptoms. This concept, introduced by Yujiro Ikemi, the founder of Japanese psychosomatic medicine, suggests that patients cannot read not only their emotions but also bodily signals vital for maintaining homeostatic balance, such as hunger, satiety, fatigue, and tension. When evaluated in terms of its relationship with interoception, it is seen that the insular cortex and anterior cingulate cortex, in particular, play a central role in the formation of bodily awareness. It is thought that alexisomia may be associated with functional connectivity disorders in these brain networks. This review examines the historical development, neurobiological basis, measurement tools, and clinical implications of the alexisomia in detail, accompanied by literature findings.

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