Alexiphrenia & Alexithymia

THE MIND BLOCK OF BRAIN FOG.

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Inspiration: Whitney Dafoe's Brain fog Explanation

This post is inspired by Whitney Dafoe's recent amazing blog post on brain fog. In particular this sentence:

"You are alive and completely conscious, and completely aware of yourself and how you feel, but your mind cannot think or feel anything."

This is severe brain fog. In its more moderate form, you can see vague outlines of thoughts and feelings, abstractions so to speak.

For a detailed account of what this fogginess feels like I highly recommend Whitney's blog post.

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Alexithymia

Is a medical term for the inability to identify or name what you are feeling.

It comes from the greek roots:

A - No / Not / Non

Lexi - Words

Thymia - Feelings

Alexithymia is a common symptom of Autism and is also a diagnostic term of its own.

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Alexithymia - More Than Lack of Words

Alexithymia is not just the inability to express your feeling through verbal or written language. You cannot name or identify them at all.

As someone with ASD, I have suffered from alexithymia my whole life. Even when I am deeply emotional about something I cannot identify that emotion. I may start crying and have no idea if I am angry, sad, frustrated, or even crying happy tears.

But to be clear: alexithymia does not mean I do not feel emotion. I simply cannot identify what emotion I am feeling. I feel only the physical attributes and cannot cognitively identify the emotion without working backwards from logical deduction.

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Humans Think In Language

Cognitive linguists such as George Lakoff propose that language is not just a tool for communication, but also a tool for thought.

People use metaphorical thinking to understand abstract concepts and language is crucial for this process. Without language we would not be able to think about anything besides our immediate physical reality.

In philosophy of mind, the language of thought hypothesis proposes that all thought occurs in a mental language often dubbed "mentalese."

All of this is to say that the ability to think in language (regardless of outward expression through speech or writing) is deeply entwined with our ability to think at all.

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Proposed Term: Alexiphrenia

Would refer to the mental block between noticing a thought and being able to identify or express it in language.

It comes from the same derivation as alexithymia

A - No / Non / Not

Lexi - Words

Phrenia - Mind / Thoughts

Alexiphrenia could lead to seeing only abstract foggy thoughts that cannot be distilled into true ideas or in severe form lead to inability to access thoughts at all.

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Is Severe Alexiphrenia The Inability To Think?

Can you think of the color blue and not allow the word blue anywhere in your mind?

Now try to think about racism and not allow the word anywhere in your mind.

Now try to have an expressable thought without involving a single word.

The more abstract a concept the more we rely on language to be able to think about it. But there are cognitive processes that do not rely on language.

I believe this is why brain fog is so torturous. Like tantalus, our brains have not fully stopped, but the ideas float out of reach or perhaps fully walled away.

We can still see our surroundings, hear speech, see faces, these basic cognitive processes.

Perhaps this is why so often severe patients must completely isolate from noise and light, especially other people, because our brains have not managed to shut this part of cognition down, draining vital unavailable ATP.

Completely aware, yet unable to think a single thought.

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Brain fog, Alexithymia & Alexiphrenia

I believe alexithymia and alexiphrenia are extremely useful terms for describing these specific aspects of brain fog.

I think that rather than reducing brain fog to alexithymia & alexiphrenia, it is important to recognize these aspects as distinct and unique symptoms.

We must recognize that brain fog contains both known cognitive dysfunctions such as memory issues, executive dysfunction, problem-solving issues, and alexithymia as well as dysfunctions that we have yet to properly study as symptoms such as alexiphrenia or "fogginess".

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Brain fog Broken Down

With these new terms in hand, we can list and describe brain fog by more specific symptoms:

1.) Problem-Solving Dysfunction - Loss of "general intelligence"

2.) Executive Dysfunction - As present in ADHD. Includes

-Time blindness

-Difficulty switching and starting tasks

-Difficulty with planning/prioritization

-Inhibitory control issues

3.) Memory Dysfunction - Both in memory formation and recall

4.) Alexithymia - Inability to recognize what you are feeling despite still experiencing emotion

5.) Alexiphrenia - Inability to recognize what you are thinking or distill thoughts into expressible terms

As we continue to study brain fog and catalog patient experiences we may be able to further describe and break down the massive cognitive dysfunction present in MECFS.

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What Causes Alexithymia & Alexiphrenia?

The cause of brain fog is unknown. Prominent theories include:

-Low perfusion and provision of oxygen to the brain

-Lack of energy for brain function

-Neuroinflammation

-Neurotransmitter imbalances

I personally believe that a combination of all of these factors likely causes brain fog, and that this may explain why different patients have such different prominent symptoms within brain fog.

I believe that studying the causes of brain fog will produce much stronger results if symptoms are properly differentiated from within the umbrella of brain fog. New terms like alexiphrenia are just one part of this important process of properly articulating and breaking down this complex and debilitating condition.

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What is brain fog when we break it down?

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Brain fog is often described as the most debilitating symptom of Myalgic Encephalomyelitis aka MECFS. But like Post Exertional Malaise it is not really a single symptom.

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There are the cognitive dysfunctions like memory and problem solving issues.

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There is the executive dysfunction causing problems with planning, prioritization, time management, and impulse control.

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And then there is the fogginess itself the thoughtless void that steals our very sense of self. The part of brain fog that we all know and yet is still unlabeled.

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Here's my take on what's going on.

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Alexithymia is a symptom of autism as well as a known psychological phenomenon. I happen to have experienced it my whole life.

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Alexithymia is the inability to identify or name emotions. But it is more than just doing a poor job expressing your feelings. You literally do not know what you are feeling even as the feelings affect your body and emotional state.

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I propose the new term alexiphrenia to mean the inability to identify or name thoughts. Like alexithymia, this goes beyond the inability to express ourselves in words.

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Philosophy of mind has a theory that we must think in a mental language, mentalese. All of our current psychological models assume this theory, it is why therapy can work.

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If we are unable to take our thoughts and distill them into mentalese then we are practically unable to think at all.

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To me alexithymia and alexiphrenia are the best way to capture that void that severe brainfog can become.

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We are still present, our minds are still there, our feelings are still there, but without mentalese they are locked away, we cannot manipulate or identify them.

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What do you think?

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Do the categories of

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Cognitive Dysfunction

Executive dysfunction

&

Alexiphrenia & alexithymia

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Capture your brain fog experience? Or is there even more?

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Without labels, without breaking this symptom down and expressing it, we will never be able to properly study and solve it.