Development and application of the propensity/ability framework in alexithymia: “Do you” versus “Can you” engage with your emotions?

Alexithymia is a multi-dimensional trait characterized by difficulties in emotional processing, but its driving mechanisms remain somewhat contentious. The highly transdiagnostic nature of alexithymia, and its associations with reduced treatment efficacy, suggest that these mechanisms may be particularly important targets for intervention. Here we outline how carefully distinguishing the frequency and depth with which an individual tends to engage a given mechanism (i.e., propensity) from the functional capacity which an individual possesses (i.e., ability) might enable more appropriate and precise inferences regarding the contributions of various cognitive mechanisms to alexithymic emotional processing. We propose a propensity/ability framework to more formally define these terms and identify criteria for research methods that might better differentiate mechanistic inferences. We then apply this framework to cognitive-behavioral research on alexithymia in three domains: interoception, attention and avoidance, and expression. Despite a particularly strong theoretical emphasis on emotion-related ability deficits, existing alexithymia research seems to focus primarily on propensities and beliefs about abilities, rather than abilities themselves. Moreover, although extant work has documented associations between alexithymia and both abilities and propensities in each of these domains, relatively little work has examined influences on abilities and propensities across multiple domains. Future work might therefore benefit from the development of a multi-method and multi-measure battery of alexithymia assessing both propensities and abilities in multiple forms of emotional cognition. Such enhanced precision in the measurement of the mechanisms driving emotional expertise may in turn afford greater precision in diagnosis and treatment of clinical conditions.