Asked "what are you feeling right now?", someone with alexithymia answers honestly: "I don't know". It is not avoidance and not refusal. The emotional signal arrives — as tension, heaviness, agitation — but is not translated into "I'm angry" or "I'm afraid".
It has three described components: difficulty identifying emotions, difficulty describing them to someone else, and an externally oriented thinking style — focused on facts and actions rather than inner life.
It is not a diagnosis in itself but a trait on a continuum. It occurs more often alongside early trauma, emotional neglect and autism, but also in people with none of those — including, very often, in men raised where emotions were never named.