Alexitimia:
Dificuldade de Expressão ou Ausência de Sentimento? Uma Análise Teórica
Palavras-chave:
Emoção, Cognição, Regulação emocional LeDoux, DamásioResumo
O objetivo deste ensaio é apresentar uma base conceitual para diferenciar emoções de sentimentos, a partir das ideias de LeDoux e Damásio, e usar essa base numa abordagem sobre o conceito e as origens da alexitimia, constructo recentemente desenvolvido para retratar a dificuldade de expressar emoções e sentimentos. Nessa abordagem, é questionado se o alexitímico não expressa ou não tem sentimentos. A conclusão deste ensaio é que no alexitímico as emoções ocorrem normalmente, mas os sentimentos, que requerem circuitos cerebrais adicionais em relação aos acionados pelas emoções, não são desenvolvidos de forma adequada. São apresentadas as limitações do trabalho e sugestões para um programa de pesquisa.
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Referências
Aleman, A. (2005). Feelings you can’t imagine: Towards a cognitive neuroscience of alexithymia. Trends in Cognitive Sciences, 9, 553-555.
Bach, M. (1994). Alexithymia: Relationship to personality disorders. Comprehensive Psychiatry, 35, 239-243.
Bach, M., Bohmer, F., & D. Nutzinger (1994). Alexithymia and somatization: Relationship to DSM IV-R diagnoses. Journal of Psychosomatics Research, 38, 529-538.
Bagby, M., & Taylor, G. (1999). Affect dysregulation and alexithymia. In G. Taylor & M. Bagby (Orgs.), Disorders of affect regulation (pp. 7-25). Cambridge: Cambridge University.
Bagby, R., Taylor, G., & Parker, J. (1994). The Twenty-Item Toronto Alexithymia Scale. Journal of Psychosomatic Research, 38, 23-40.
Bankier, B, Aigner, M., & Bach, M. (2001). Alexithymia in DSM IV Disorder - Comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder, and depression. Psychosomatics, 42, 235-240.
Barret, L. (2006). Solving the emotion paradox: Categorization and the experience of emotion. Personality and Social Psychology Review, 10, 20-46.
Baumeister, R., Vohs, K., DeWall, C., & Zhang, L., (2007). How emotion shapes behaviour: Feedback, anticipation, and reflection, rather than direct causation. Personality and Social Psychology Review, 11, 167-203.
Begley, S. (2008). Treine a mente, mude o cérebro (B. Casotti, Trad.). Rio de Janeiro: Objetiva. (Trabalho original publicado em 2007)
Bechara, A., Damasio, H., & Damasio, A. (2000). Emotion, decision making and the orbitofrontal cortex. Cerebral Cortex, 10, 295-307.
Berthoz, B., Artiges, E., de Moortele, P. F., Poline, J. B., Rouquette, S., Consoli, S., & Martinot, J. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. American Journal of Psychiatry, 159, 961”“967.
Caldas, N. (1999). Avaliação da alexitimia em usuários de drogas em centro de tratamento na cidade do Rio de Janeiro. Dissertação de Mestrado, Escola Nacional de Saúde Pública, Rio de Janeiro.
Candland, D. (2003). The persistents problems of emotions. Em D. Candland, J. Fell, E. Keen, A. Leshner, R. Plutchik, & R. Tarpy (Orgs.), Emotions (pp. 01-84). Nova York: Authors Choice.
Damásio, A. (1995) Toward a neurobiology of emotions and feeling: Operational concepts and hypotheses. The Neuroscientist, 1, 19-25.
Damásio, A. (1996). O erro de Descartes. Emoção, razão e o cérebro humano (D. Vicente & G. Segurado, Trad.). São Paulo: Cia das Letras. (Trabalho original publicado em 1994)
Damásio, A. (2000). O mistério da consciência (L. T. Mota, Trad.). São Paulo: Cia. das Letras. (Trabalho original publicado em 1999)
Decety, J., & Moriguchi, Y. (2007) The emphatic brain and its dysfunction in psychiatric populations: Implications for intervention across different clinical conditions. ByoPsychoSocial Medicine, 1, 22.
Gazzaniga, M., & Heatherton, T. (2005). Ciência psicológica (M. A. V. Veronese, Trad). Porto Alegre: Artmed. (Trabalho original publicado em 2003)
Grabe, H., Spitzer, C., & Freyberger, H. (2004). Alexithymia and personality in relation to dimensions of psychopathology. American Journal of Psychiatry, 161, 1299-1301.
Gross, J., & Thompson, R. (2006). Emotion regulation: Conceptual foundations. Em J. J. Gross (Org.), Handbook of emotion regulation (pp. 3-22) New York: Guilford.
Grotstein, J. (1999). Alexithymia: The exception that proves the rule of the unusual significance of the affects. Em J. Graeme, R. Taylor & M. Bagby (Orgs.), Disorders of affect regulation (pp. XI-XVIII). Cambridge: Cambridge University.
Hane, A., & Fox, N. (2006). Ordinary variations in maternal caregiving influence infants’ stress reactivity. Psychological Science, 17, 550-556.
Helmes, E., McNeill, P., Holden, R., & Jackson, C. (2008). The construct of alexithymia: Associations with defense mechanisms. Journal of Clinical Psychology, 64, 318-331.
Jula, A., Salminem, J., & Saarijarvi, S. (1999). Alexithymia: A facet of essential hypertension. Journal of the American Heart Association, 33, 1057-1061.
Kirmayer, L. (1987). Languages of suffering healing: Alexithymia as a social and cultural process. Transcultural Psychiatry, 24, 119-136.
Kleinginna, P. R., & Kleinginna, A. M. (1981). A categorized list of emotion definitions with suggestions for a consensual definition. Motivation and Emotion, 5, 345-379.
LeDoux, J. (1998). O cérebro emocional. Os misteriosos alicerces da vida emocional (T. B. Santos, Trad.). Rio de Janeiro: Objetiva. (Trabalho original publicado em 1996)
LeDoux, J. (2000). Emotional circuits in the brain. Annual Reviews in Neuroscience, 23, 155”“184.
LeDoux, J. (2007). Unconscious and conscious contributions to the emotions and cognitive aspects of emotions: A comment on Scherer’s view of what an emotion is. Social Science Information, 46, 395-407.
Lumley, M., Ovies. T., Stettner, L., Wehmer, F., & Lakey, B. (1996). Alexithymia, social support and health problems. Journal of Psychosomatic Research, 41, 519-530.
Lumley, M., & Sielky, J. (2000). Alexithymia, gender and hemispheric functioning. Compreensive Psychiatry, 41, 352-359.
Maciel, M., & Yoshida, E. (2006). Avaliação de alexitimia, neuroticismo e depressão em dependentes de álcool. Avaliação Psicológica. , 5, 43-54.
MacLean, P. (1949). Psychosomatic disease and the “visceral brain”. Journal of Psychosomatic Medicine, 11, 338-353.
Morera, O., Culhane, S., Watson, P., & Skees, M. (2005). Assessing the realibility and validity of the Bermond-Vorst Alexithymia Questionnaire among U.S. Anglo and U.S. Hispanic samples. Journal of Psychosomatic Research, 58, 289-298.
Nada, P. (1997). Alexithymia and cancer. Japanese Journal of Psychosomatic Medicine, 37, 585-588.
Panksepp, J. (2008). The affective brain and core consciousness: How does neural activity generate emotional feelings? Em M. Lewis, J. Haviland-Jones & L. Barrett (Orgs.), Handbook of emotion (pp. 47-67). New York: Guilford.
Parker, J., Taylor, G., & Bagby, M. (1998). Alexithymia: Relationship with ego-defense and coping style. Compreensive Psychiatry, 39, 91-98.
Prazeres, N., Parker, D., & Taylor, J. (2000). Adaptação portuguesa da Escala de Alexitimia de Toronto de 20 Itens (TAS-20). Revista Oficial de La Associacion Iberoamericana de Diagnóstico y Evaluacion Psicológica, 9, 9-21
Romei, V., DeGennaro, L., Fratello, F., Curcio, G., Ferrara, M., Pascual-Leone, A., & Bertini, M. (2008). Interhemispheric transfer deficit in alexithymia: A transcranial magnetic stimulation study. Psychotherapy and Psichossomatics, 77, 175-181.
Rose, S. (2006). O cérebro no século XXI. Como entender, manipular e desenvolver a mente (H. Londres, Trad.). São Paulo: Globo. (Trabalho original publicado em 2005)
Scherer, K. (2005). What are emotions? And how can they be measured? Social Science Information, 44, 695-729.
Schore, A. (1994). Affect regulation and the origin of the self. New York: Lawrence Erlbaum.
Schore, A. (2003a). Affect dysregulation and disorders of the self. New York: Norton & Company.
Schore, A. (2003b). Affect regulation and the repair of the self. New York: Norton & Company.
Sengupta, A., & Giri, V. (2009) Alexithymia and managerial styles: Implications in Indian organizations. Journal of the Indian Academy of Applied Psychology, 35, 71-77.
Sifneos, P. (1972). Short-term psychotherapy and emotional crisis. Boston: Harvard University.
Sifneos, P. (1973). The prevalence of alexithymic characteristics in psychossomatics patients. Psychotherapy and Psychossomatics, 22, 255-262
Sifneos, P. (2000). Alexithymia, clinical issues, politics and crime. Psychotherapy and Psychosomatics, 69, 113-116.
Spitzer, C., Siebel-Jurges, U., Barnow, S., Grabe, H. J., & Freyberger, H. (2005). Alexithymia and interpersonal problems. Psychoterapy and Psychossomatics, 74, 240-246.
Taibnia, G., & Zaidel, E. (2005). Alexithymia, interhemispheric transfer, and right hemispheric specialization: A critical review. Psychoterapy and Psychossomatics, 74, 81-92.
Taylor, G. (2000). Recent development in alexithymia theory and research. The Canadian Journal of Psychiatry, 45, 134-142.
Taylor, G., Parker, J., Bagby, M., & Boukes, M. (1999). Relationship between alexithymia and psychological characteristics associated with eating disorders. Journal of Psychosomatic Research, 41, 561-568.
Veríssimo, R. (2005). The assessment of alexithymia: A psychometric study comparing two self-report measurements. Journal of Psychosomatic Research, 58, 14-15.
Wiethaeuper, D., Balbinotti, M., Pelisoli, C., & Barbosa, M. (2005). Estudos da consistência interna e fatorial confirmatório da Escala Toronto de Alexitimia-20 (ETA-20). Revista Interamericana de Psicologia / Interamerican Journal of Psychology, 39, 221-230. Retirado em outubro/2007, de http://www.psicorip.org/Resumos/PerP/RIP/RIP036a0/RIP03924.pdf .
Wood, R., & Williams, C. (2007). Neuropsychological correlates of organic alexithymia. Journal of the International Neuropsychological Society, 13, 471”“479.
Yehuda, R., Steiner, A., Kahana, B., Binder-Brynes, K., Southwick, S., Zemelman, S., & Giller, E. (2004). Alexithymia in holocaust survivors with and without PTSD. Journal of Traumatic Stress, 10, 93-100.
Yoshida, E. M. P. (2000). Toronto Alexthymia Scale-TAS: precisão e validade da versão em português. Psicologia: Teoria e Prática, 2, 59-74.
Yoshida, E. M. P. (2005). Stress e alexitimia [Resumo]. Em Portal da Educação Física (Org.), Anais do II Congresso Brasileiro de Stress (p. 96). São Paulo.
Bach, M. (1994). Alexithymia: Relationship to personality disorders. Comprehensive Psychiatry, 35, 239-243.
Bach, M., Bohmer, F., & D. Nutzinger (1994). Alexithymia and somatization: Relationship to DSM IV-R diagnoses. Journal of Psychosomatics Research, 38, 529-538.
Bagby, M., & Taylor, G. (1999). Affect dysregulation and alexithymia. In G. Taylor & M. Bagby (Orgs.), Disorders of affect regulation (pp. 7-25). Cambridge: Cambridge University.
Bagby, R., Taylor, G., & Parker, J. (1994). The Twenty-Item Toronto Alexithymia Scale. Journal of Psychosomatic Research, 38, 23-40.
Bankier, B, Aigner, M., & Bach, M. (2001). Alexithymia in DSM IV Disorder - Comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder, and depression. Psychosomatics, 42, 235-240.
Barret, L. (2006). Solving the emotion paradox: Categorization and the experience of emotion. Personality and Social Psychology Review, 10, 20-46.
Baumeister, R., Vohs, K., DeWall, C., & Zhang, L., (2007). How emotion shapes behaviour: Feedback, anticipation, and reflection, rather than direct causation. Personality and Social Psychology Review, 11, 167-203.
Begley, S. (2008). Treine a mente, mude o cérebro (B. Casotti, Trad.). Rio de Janeiro: Objetiva. (Trabalho original publicado em 2007)
Bechara, A., Damasio, H., & Damasio, A. (2000). Emotion, decision making and the orbitofrontal cortex. Cerebral Cortex, 10, 295-307.
Berthoz, B., Artiges, E., de Moortele, P. F., Poline, J. B., Rouquette, S., Consoli, S., & Martinot, J. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. American Journal of Psychiatry, 159, 961”“967.
Caldas, N. (1999). Avaliação da alexitimia em usuários de drogas em centro de tratamento na cidade do Rio de Janeiro. Dissertação de Mestrado, Escola Nacional de Saúde Pública, Rio de Janeiro.
Candland, D. (2003). The persistents problems of emotions. Em D. Candland, J. Fell, E. Keen, A. Leshner, R. Plutchik, & R. Tarpy (Orgs.), Emotions (pp. 01-84). Nova York: Authors Choice.
Damásio, A. (1995) Toward a neurobiology of emotions and feeling: Operational concepts and hypotheses. The Neuroscientist, 1, 19-25.
Damásio, A. (1996). O erro de Descartes. Emoção, razão e o cérebro humano (D. Vicente & G. Segurado, Trad.). São Paulo: Cia das Letras. (Trabalho original publicado em 1994)
Damásio, A. (2000). O mistério da consciência (L. T. Mota, Trad.). São Paulo: Cia. das Letras. (Trabalho original publicado em 1999)
Decety, J., & Moriguchi, Y. (2007) The emphatic brain and its dysfunction in psychiatric populations: Implications for intervention across different clinical conditions. ByoPsychoSocial Medicine, 1, 22.
Gazzaniga, M., & Heatherton, T. (2005). Ciência psicológica (M. A. V. Veronese, Trad). Porto Alegre: Artmed. (Trabalho original publicado em 2003)
Grabe, H., Spitzer, C., & Freyberger, H. (2004). Alexithymia and personality in relation to dimensions of psychopathology. American Journal of Psychiatry, 161, 1299-1301.
Gross, J., & Thompson, R. (2006). Emotion regulation: Conceptual foundations. Em J. J. Gross (Org.), Handbook of emotion regulation (pp. 3-22) New York: Guilford.
Grotstein, J. (1999). Alexithymia: The exception that proves the rule of the unusual significance of the affects. Em J. Graeme, R. Taylor & M. Bagby (Orgs.), Disorders of affect regulation (pp. XI-XVIII). Cambridge: Cambridge University.
Hane, A., & Fox, N. (2006). Ordinary variations in maternal caregiving influence infants’ stress reactivity. Psychological Science, 17, 550-556.
Helmes, E., McNeill, P., Holden, R., & Jackson, C. (2008). The construct of alexithymia: Associations with defense mechanisms. Journal of Clinical Psychology, 64, 318-331.
Jula, A., Salminem, J., & Saarijarvi, S. (1999). Alexithymia: A facet of essential hypertension. Journal of the American Heart Association, 33, 1057-1061.
Kirmayer, L. (1987). Languages of suffering healing: Alexithymia as a social and cultural process. Transcultural Psychiatry, 24, 119-136.
Kleinginna, P. R., & Kleinginna, A. M. (1981). A categorized list of emotion definitions with suggestions for a consensual definition. Motivation and Emotion, 5, 345-379.
LeDoux, J. (1998). O cérebro emocional. Os misteriosos alicerces da vida emocional (T. B. Santos, Trad.). Rio de Janeiro: Objetiva. (Trabalho original publicado em 1996)
LeDoux, J. (2000). Emotional circuits in the brain. Annual Reviews in Neuroscience, 23, 155”“184.
LeDoux, J. (2007). Unconscious and conscious contributions to the emotions and cognitive aspects of emotions: A comment on Scherer’s view of what an emotion is. Social Science Information, 46, 395-407.
Lumley, M., Ovies. T., Stettner, L., Wehmer, F., & Lakey, B. (1996). Alexithymia, social support and health problems. Journal of Psychosomatic Research, 41, 519-530.
Lumley, M., & Sielky, J. (2000). Alexithymia, gender and hemispheric functioning. Compreensive Psychiatry, 41, 352-359.
Maciel, M., & Yoshida, E. (2006). Avaliação de alexitimia, neuroticismo e depressão em dependentes de álcool. Avaliação Psicológica. , 5, 43-54.
MacLean, P. (1949). Psychosomatic disease and the “visceral brain”. Journal of Psychosomatic Medicine, 11, 338-353.
Morera, O., Culhane, S., Watson, P., & Skees, M. (2005). Assessing the realibility and validity of the Bermond-Vorst Alexithymia Questionnaire among U.S. Anglo and U.S. Hispanic samples. Journal of Psychosomatic Research, 58, 289-298.
Nada, P. (1997). Alexithymia and cancer. Japanese Journal of Psychosomatic Medicine, 37, 585-588.
Panksepp, J. (2008). The affective brain and core consciousness: How does neural activity generate emotional feelings? Em M. Lewis, J. Haviland-Jones & L. Barrett (Orgs.), Handbook of emotion (pp. 47-67). New York: Guilford.
Parker, J., Taylor, G., & Bagby, M. (1998). Alexithymia: Relationship with ego-defense and coping style. Compreensive Psychiatry, 39, 91-98.
Prazeres, N., Parker, D., & Taylor, J. (2000). Adaptação portuguesa da Escala de Alexitimia de Toronto de 20 Itens (TAS-20). Revista Oficial de La Associacion Iberoamericana de Diagnóstico y Evaluacion Psicológica, 9, 9-21
Romei, V., DeGennaro, L., Fratello, F., Curcio, G., Ferrara, M., Pascual-Leone, A., & Bertini, M. (2008). Interhemispheric transfer deficit in alexithymia: A transcranial magnetic stimulation study. Psychotherapy and Psichossomatics, 77, 175-181.
Rose, S. (2006). O cérebro no século XXI. Como entender, manipular e desenvolver a mente (H. Londres, Trad.). São Paulo: Globo. (Trabalho original publicado em 2005)
Scherer, K. (2005). What are emotions? And how can they be measured? Social Science Information, 44, 695-729.
Schore, A. (1994). Affect regulation and the origin of the self. New York: Lawrence Erlbaum.
Schore, A. (2003a). Affect dysregulation and disorders of the self. New York: Norton & Company.
Schore, A. (2003b). Affect regulation and the repair of the self. New York: Norton & Company.
Sengupta, A., & Giri, V. (2009) Alexithymia and managerial styles: Implications in Indian organizations. Journal of the Indian Academy of Applied Psychology, 35, 71-77.
Sifneos, P. (1972). Short-term psychotherapy and emotional crisis. Boston: Harvard University.
Sifneos, P. (1973). The prevalence of alexithymic characteristics in psychossomatics patients. Psychotherapy and Psychossomatics, 22, 255-262
Sifneos, P. (2000). Alexithymia, clinical issues, politics and crime. Psychotherapy and Psychosomatics, 69, 113-116.
Spitzer, C., Siebel-Jurges, U., Barnow, S., Grabe, H. J., & Freyberger, H. (2005). Alexithymia and interpersonal problems. Psychoterapy and Psychossomatics, 74, 240-246.
Taibnia, G., & Zaidel, E. (2005). Alexithymia, interhemispheric transfer, and right hemispheric specialization: A critical review. Psychoterapy and Psychossomatics, 74, 81-92.
Taylor, G. (2000). Recent development in alexithymia theory and research. The Canadian Journal of Psychiatry, 45, 134-142.
Taylor, G., Parker, J., Bagby, M., & Boukes, M. (1999). Relationship between alexithymia and psychological characteristics associated with eating disorders. Journal of Psychosomatic Research, 41, 561-568.
Veríssimo, R. (2005). The assessment of alexithymia: A psychometric study comparing two self-report measurements. Journal of Psychosomatic Research, 58, 14-15.
Wiethaeuper, D., Balbinotti, M., Pelisoli, C., & Barbosa, M. (2005). Estudos da consistência interna e fatorial confirmatório da Escala Toronto de Alexitimia-20 (ETA-20). Revista Interamericana de Psicologia / Interamerican Journal of Psychology, 39, 221-230. Retirado em outubro/2007, de http://www.psicorip.org/Resumos/PerP/RIP/RIP036a0/RIP03924.pdf .
Wood, R., & Williams, C. (2007). Neuropsychological correlates of organic alexithymia. Journal of the International Neuropsychological Society, 13, 471”“479.
Yehuda, R., Steiner, A., Kahana, B., Binder-Brynes, K., Southwick, S., Zemelman, S., & Giller, E. (2004). Alexithymia in holocaust survivors with and without PTSD. Journal of Traumatic Stress, 10, 93-100.
Yoshida, E. M. P. (2000). Toronto Alexthymia Scale-TAS: precisão e validade da versão em português. Psicologia: Teoria e Prática, 2, 59-74.
Yoshida, E. M. P. (2005). Stress e alexitimia [Resumo]. Em Portal da Educação Física (Org.), Anais do II Congresso Brasileiro de Stress (p. 96). São Paulo.
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2010-05-11
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Freire, L. (2010). Alexitimia:: Dificuldade de Expressão ou Ausência de Sentimento? Uma Análise Teórica. Psicologia: Teoria E Pesquisa, 26(1), 15. Recuperado de https://periodicos.unb.br/index.php/revistaptp/article/view/17455
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