Almond

Alexithymia is the most common medical term for the symptom or condition of not being able to identify, fully express, or process one’s own emotions or those of others. While alexithymia can be a singular diagnosis, researchers have not yet definitively classified it. Experts have variously considered it a symptom that occurs in tandem with other diagnoses, a standalone disorder, or, sometimes, a simple personality difference between individuals. Symptoms of alexithymia vary but typically include difficulty processing and understanding emotion, overly logical thought patterns, and difficulty understanding bodily reactions, particularly when caused by emotion.

Alexithymia is often comorbid with other diagnoses, particularly neurodevelopmental ones. Some estimate that at least 50% of people with autism have alexithymia. Other diagnoses, such as PTSD or brain injuries, can also be comorbid with alexithymia; in most cases, it is not known how the varying diagnoses affect one another. Anorexia nervosa and other eating disorders are extremely common in individuals with alexithymia, possibly because of the difficulty to internal regulate or understand their own emotions. Additionally, depression and anxiety are extremely common comorbid diagnoses; as with other diagnoses, it is unclear whether alexithymia causes these disorders, is caused by them, or is a mixture of the two. Alexithymia is heavily associated with social isolation, complicating these comorbid experiences further.

Many aspects of Almond’s portrayal of alexithymia misrepresent current research and understanding of the condition. While the amygdala is not irrelevant to the condition—as it is one of the key parts of the brain involved in emotional processing—it is not typically the singular cause of the condition. Additionally, while it is theoretically possible for Yunjae to have alexithymia without comorbid diagnoses, it is very unusual. The novel’s insistence that Yunjae does not feel emotions at all is also inaccurate to most documented experiences of people with alexithymia. Most people with alexithymia know they have emotions, and some are even aware of deep and powerful emotions like rage and grief. The issue lies not in feeling the emotions, but in understanding, processing, and labeling them. It is extremely unusual for a person with alexithymia to believe they have no emotions at all. Distress is often caused by feeling emotions but having no framework to handle them appropriately. Additionally, alexithymia does not have a known “cure” or solution. Therapy can help people with alexithymia learn to process their emotions more healthily and assist with the associated social difficulties, but Dr. Shim’s repeated mantra that Yunjae can simply “grow out” of his more intense alexithymia is at best inaccurate and at worst extremely harmful. While it is possible that he was misdiagnosed, as Dr. Shim states, this portrayal of alexithymia does not necessarily reflect the experiences of real people with the condition.

The novel also touches on broader neurodivergent experiences as well, such as masking. Masking, or hiding one’s true personality traits and behaviors to appear neurotypical, is an extremely common symptom of neurodiverse conditions, particularly autism. Often caused by bullying, parental demands, or other social pressures, masking is also associated with negative mental outcomes. Neurodivergent people who mask extensively often struggle to unlearn such behaviors, which can lead to burnout, mental health conditions, complications in self-understanding, and difficulty receiving support from others. While Yunjae does not explicitly mask throughout the entire novel, Almond accurately displays the struggle of identity that can come from a life spent pretending to be someone else for the benefit of others.