Figure 7.

Emotional awareness and putative mechanism of alexithymia and alexisomia. Proprioceptive, visceral, hormonal, immune, and metabolic signals on the bodily physiologic state constitute interoception, which is the basis of the core affect. The core affect represents the basic affective state with specific properties of valence (pleasure or displeasure) and arousal (agitation or calmness). Emotions are constructed and categorized through bodily internal information (core affect), information from past experiences, and external sensory information (visual, auditory, olfactive). Emotional awareness has different levels: at the lower level, there is the interoceptive awareness, which is strongly connected to bodily state and core affect. Difficulty in interoceptive awareness is called alexisomia. At higher levels of emotional awareness, there is the categorization process that integrates the three sources of information and constructs an emotional state. The difficulty in categorization results in a reduced cognitive awareness, which is called alexithymia.