The effects of alexithymia and attachment dimensions of therapists on the perception of patient emotions

Pierpaolo Congia, Massimo Portas

It is well known that identifying emotions expressed by the patient and rating their intensity are
essential skills for a psychotherapist. Among the personal characteristics affecting such therapist
capabilities, an important role has recently been suggested for adult attachment dimensions and
alexithymia. In this study, we initially generated a profile for adult attachment, alexithymia and
emotional distress of the participants — students and teachers of a four-year course in psychotherapy.
Then, after watching a film which realistically reproduced a psychotherapy session, participants
were asked to indicate the prevailing emotion observed, to evaluate its intensity, and other personal
features of the patient. Our results indicate that the level of alexithymia correlates with an average
intensity of emotions but negatively with the accuracy rating of emotion intensity. Anxiety associates
with lower accuracy in identifying the prevailing emotion while avoidance positively correlates with
accuracy as indexed by the degree of concordance between students and teachers about the importance
ranking of observed emotions. These data suggest that a therapist’s adult attachment and emotional
self-awareness significantly affect perception of patient emotions and underscore the importance of
investigating these two key areas to improve the efficacy of psychotherapy training.

Keywords
Emotion recognition, Alexithymia, Adult attachment, Psychotherapy.

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