What is Alexithymia and how might it be a helpful concept?

Joelle and Gillian explore together the connection between the outward expression of emotion, internal awareness of varied emotional states, and social interactions.  How might the capacity to recognize and express emotions vary among those who are neurodivergent, depressed, anxious, and coping with the impact of trauma exposure?  Are there ways that educational staff and other supportive adults can help when there is either a character trait or state that results in restricted expression of affect?  Some helpful insight and tips were identified, as well as increased curiosity into this internal experience and outward expression. 

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Transcript

0:28

Welcome back to Stance of Curiosity. I'm Gillian Boudreau. And I'm Joelle Vanlent. Hi, everybody. Here we are in February, Joelle, we're doing it. It's Groundhog's Day. I forgot it was Groundhog's Day. I wonder if the groundhog saw their shadow. Many years. Oh, they did, which means more winter, which is. Okay. I mean, this means nothing to Vermont because you already knew that you were in for at least six more weeks of winter. Yeah and like years ago, I actually went to Gobbler's Knob in Punxsutawney Pennsylvania, and you, you go out in the middle of the night in the middle of the woods to an opening where there are literally thousands of people from all over the world there to celebrate Groundhog's Day. And then you wait a long time and it's very cold. And then these people pull a groundhog out of a... cage and it whispers to them and they tell you whether it saw its shadow or not. Yeah, it's a huge festival and I just want to say for anyone considering it, not worth it. Interesting. I think this festival was also depicted in the Bill Murray classic Groundhog Day. And not worth it. I think he also would have said the same. What did you find was underwhelming about it? It was cold. Okay. There were a lot of intoxicated people. Sure. Which... You know, whatever, no judgment, but like. Not really what I was looking for that night. Right. Mm-hmm. That particular night. I was worried about the groundhog. Sure. Yeah. And and if it was like quirky and fun and. The energy of the people was really positive, but definitely could have been just as fun from home. Yeah, I totally hear that. Yeah, yeah. Anyway, that's an aside. Advice that people didn't think they'd get from us. All right. So I had an idea. Okay. Yes, you did. You had a great idea. So we talk in our field a lot about something called flat affect or blunted affect, which I think comes up when a person does not show emotion through their facial expressions or their... voice tone. Fluctuation, or, you know, you know, they like appear as though they're, they're not expressing any emotion and often are feeling emotions internally, but that, that's not being expressed. They may not be experiencing a lot of variation in emotion. It's hard to tell. And so I was researching that a little bit and came across a term that I had not heard for a while called alexithymia. And I was reminded that it's a character trait, not— or it's a trait, or maybe we could say a state of being, but it's not a diagnosis. It's not a zone diagnosis. It's like a description of a way that someone is presenting or a state that they're in, and it goes along with other diagnoses or Um, presentations. And I thought it might be helpful to talk about it because it can really confuse those of us who are in the job of attunement and trying to figure out what's going on with someone and how can I support them. And if they're giving us no information, we sometimes can feel not just unsure what to do, we can um feel frustrated, disrespected, even yes, and so I just thought I, you and I have not talked about that before. I don't think no, I just wanted to bring it to you and see what your thoughts were. Yeah, I have so much to say about this. So I think of it a lot in my travels with neurodivergent kids. So yeah, it was interesting what we're now learning. That there is overlap with ADHD, which we can talk about. I have typically seen it the most with autistic folks I work with and sometimes with ADHD. I'm sorry, PTSD, so many acronyms. Particularly when I'm working with autistic kids. Um, Like, you know, I'll do presentations a lot on how anxiety, for example, shows up differently in many autistic kids than we might expect and how the risk is it then might engender. A not very helpful adult response. So, you know, my little song and dance on this will relate back to alexithymia, I think, which is that many a neurotypical kid experiences anxiety in a way that we, I guess, as largely neurotypical educators might expect. So maybe they'll feel worried. Maybe they'll present as a little meek. Maybe they'll have a lot of questions. Maybe they'll kind of seek proximity to an adult. Maybe they'll, you know, very much transparently be looking for help and for care. And so adults will typically respond to a meeker, more worried, you know, sort of affiliative kid looking for care with care, right? And with, like, oh, are you okay? Like, how can I help you? Oh, don't worry about that, sweetie, that kind of thing. What I've noticed, and there's data to support this, is that anxiety can present differently in autistic kids, and it can look more like irritability or prickliness, which we might also lump into flat affect. Because for me, you know, I don't. I'm pretty old, I don't know how many of our listeners would remember that MTV show Daria. With, like, the, you know, the character Daria, who just everything is kind of like this. And it can cause a person to seem pretty sarcastic, pretty sardonic, and perhaps a little bit cold and unfeeling. And kind of irritable. So when somebody is dealing with alexithymia, they might show their anxiety in ways that look prickly and irritable to those around them. And unfortunately, a prickly and irritable presentation tends to make the people around you less likely to offer care and support. And more likely to either be a little snarky toward you or to kind of leave you be and get out of your way. So, so the hard thing I think for the person experiencing alexithymia is that, and especially for autistic kids, alexithymia first means that emotions can be a little bit confusing to the person themselves. So when I'm helping clients with alexithymia, I mean, sometimes it's really starting with the sensory system, right? So it's like, I don't know— this is a very on the nose example, but it's like, oh. you know, you didn't get this thing you wanted or a friend didn't want to play with you. Um, you know, maybe the experience at first is like, I felt, boy, I felt tightness in my chest or, you know, I felt like my skin was kind of electrified. That's weird. And it can take a while to sort of translate that to an emotion, right? Sometimes it takes folks with alexithymia. A little bit of work to connect physical sensations to emotional meaning is really how I think about it. So, so, if I'm a kid with autism who might be alexithymic, I mean, first I have to explain even just to myself what. Physical, what my physical sensations might be pointing to emotionally. And then I might have to find words for it that some probably neurotypical adult is going to understand. So now I'm trying to translate across neurotype. And maybe then I can get the care I need. But if those steps can't happen, then yeah, we often do see a kid. Who looks a little prickly or totally unflappable. Who might then be really confused adults if they are anxious and might be seeking care, but in an atypical way. Right. So, like, if it starts out with not having a lot of self-awareness of your internal emotional state. Yeah. I think I do want to just bump that. I think it actually can be a high awareness of internal distress. Uh-huh. But. Uncertainty on how that might crystallize into an organized emotion. Okay, right, right. And also. Not having yet internalized a continuum of a variety of emotions. Yes. And the words that we in our culture might use— to label those emotions and totally those emotions and those needs. And so it's sort of like I was working with a, with an educator recently who said that, in response to a child's escalation. The first thing they did was ask the child if they would be willing to put their hand on their own. Like. heart and feel their own heartbeat and then say, 'Does it feel like your heartbeat is going very fast and the child said yes and and then the adult said, 'So here's what I think that might mean. Wow.' So you're like just starting with biofeedback, right? Like just like very basic, like awareness. And so. If alexithymia starts with that, both lack of internal, like more complex awareness, like what am I? Feeling and, and, and on a varied way, and then a paired lack of ability to articulate that verbally or you know, with with the use of other like visual communication supports. Um, You know, I mean, that's, so that's like where the learning needs to start. But I think that... It's like developmentally, we could have someone who is very intelligent and very verbally capable, who has that basic lack of internal awareness and communication system. So we might start with... processing that talks about the negative impact of their behavior and asks them to repair for that, which you can see now like is actually miles down the road. Yes, the person needs to start, and it's like, well, you're telling me that I made other people feel bad. You know, too bad for them. I think, if I'm understanding correctly, you might not actually have— a varied emotional experience of a lot of low-level emotions— and so like, you should feel like anger and frustration, but you might not feel like lower levels of regret or remorse or, or like sadness or. And so I think, if you're not actually feeling those things, it doesn't mean that you're not empathic. It doesn't mean that you don't want social connection. It doesn't mean that you don't care about others. But this is so complicated when you break it down because we're assuming that people have it in an innate way. And when they don't— and you're actually trying to teach it or build it— I think it's really complicated. And we start way down the road, which is where we accidentally create a shame cycle or where punishment around that would be completely counterproductive. Oh man, that's such a good point, right? It gets into discipline, doesn't it? Yeah. Right. Yeah, because... All right. It's like, how can it, right? If. If a kid is still working on even knowing what they themselves are feeling. Right. And what might have led up to a challenging moment. It is a tall order to be so surprised when they may not be ready to jump into the body of the next person. And, you know, yeah. Are we asking kids? Are we asking alexithymic kids? to be able to feel and understand and put words to the experience of other people over and above how they can even do that for themselves, I think, is maybe the question. Right. So, like, what we do is we teach them, like, when you do... such and such. You're supposed to say, 'I'm sorry,' and then do these steps, and then you'll get back to... your privileges, quote unquote, and routine. So they just learn to go through those motions, but it's not helping them. Yeah. It's not. Yes, it's just like they learn a routine, like brushing your teeth is what you do before you go to bed, like saying 'I'm sorry.' You know, picking up some stuff is what I do after I have a meltdown. Right. It's like... how is that? It's not— it's totally disconnected, paired, and yeah, paired response that's helpful. And so I think, where it gets confusing for us as adults supporting individuals, is that this character trait or state is that they need us. We need to know that that's what's going on, first of all. And then we need to back up and meet them where they are. Um. I think if it's depression or trauma, it might be someone who didn't have that character trait but is in that kind of state. And you can't feel what you don't feel. Like we don't have control over our feelings. Good point. Yeah. They can be very inconvenient. So like, you know, I can. I can swear at someone and you can ask me later, you know, you should apologize. And if I don't feel sorry, I don't feel sorry. Right, right. You can't make yourself. Yeah, I can apologize, but I can't make myself feel sorry. I either do or I don't. So it's one of my pet peeves is that. When we force apologies, we're teaching kids to be inauthentic and lie. So I would rather we do like a statement of responsibility and authentic repair that does not include lying about how we feel. Yeah. And a statement of responsibility in this case could be, I did swear at you. I'm hearing that that upset you or scared you. And so here's what I'm willing to do to try to repair that. Right. Next time I'll do this instead. Right. Right. No, but it's true. That is different. Right. Because with depression and trauma, I think there's often like a numbing effect to, to, we might call this, this flat or blunted affect. So it's. Yes, it's sort of like if the person were able to access the sensory experience in their body that perhaps they already know goes with guilt or remorse or something like that. Then they would probably be able to name it, but they can't get to that sensory feeling. Because of the depression or the trauma, whereas. I think with autism, it's... there may indeed be full access to sensory sensation. And it's difficult sometimes to coalesce those sensory sensations into a feeling that somebody else might understand. Right, because they might not be what we expect based on our experience, such as, for example, if I'm a neurotypical person. I expect a school bus to be noisy. Yes. But not terrifying. Yes. And yet, at the same time, I might expect watching somebody else play a video game to be boring. And not fascinating. Yes. Yeah, so... So then, like, if the first thing that the adult that's helping this person needs to know is that this is going on, I think what it comes back to for me is something that I feel like I... come back too often when I try to figure out, like, Well, how do we know what to do? Because it is actually a very different, you've got to a similar place, alexithymia, you're at a similar place from an avenue of neurodivergence or autism. versus an avenue of depression and trauma. Totally different, but here we are. I think the good news is that I keep coming to the fact that actually what we do is not hugely different, which is really comforting because our jobs are already so complicated. What we do is we start with... supporting increased self-awareness and validation of emotion modeling, and teaching what the words are that they could use to label their internal experience. And it's really okay to just, I keep saying this lately for whatever reason, it's okay to just guess. Yes. Like, it looks like you're feeling blank. Cause like most kids, most people will tell you, or at least in their, in their head, think like that's wrong. And I think you could just get like, it looks like you're feeling because what they see is that you're trying to understand how they're feeling. And, and if they're wrong, they're not going to start mislabeling their emotions. They're just going to be like, 'Oh no, that's not right.' Yeah. Especially. Yeah. I think, especially if you frame it as a guess, right. It looks like you might, you might be feeling, I do think that especially with autistic kids, there is a risk that they might fold this into some sort of masking process or sort of construction of a construction of a false self. That's more, uh, understand like, understandable to other people. If they do have a really aggressive adult, who's like, 'You're obviously angry.' Even if they don't feel angry, they might be like, 'I guess I'm an angry person and that will make me make more sense to everyone else.' But if we frame it as, 'I don't know, but it looks to me like you might be feeling blah, blah, blah.' Let me know if that feels right. Then I think they can absolutely. It's you know, I think the self-awareness piece is really important. You know, if I'm thinking about And again, my work is so immersed in autism right now, but. You know, if I think about autistic kids I've worked with who, you know, perhaps early on in their elementary school years, they were like, you know, they were throwing chairs or turning over desks. And at the time, if you would have asked them the dreaded why question. Right. They, who knows, they might've made up something totally outlandish because the fact is that they didn't know why. Right. And then over time, you know, sometimes I like to start with the question with all exothymic kids. Never like, how did you feel about that? But more like, what did you think? About that. Or, you know, what were you thinking in that moment? Or, you know, like if we go for the cognitive, we'll still get to the internal experience, but we might get a clearer answer or an answer that it's easier for us to work with as a helper if we first start with thinking. But. you know, it's it's really I think Alexithymic kids can learn. you know, I love that neurofeedback, that biofeedback idea with hand on the heart. Sometimes like Alexithymic kids can relate to that. Maybe their face got hot. Or, you know, that maybe their limbs felt jumpy or, you know, maybe their chest felt fiery. All of those things. We're kind of working on interconnecting the interoception, so the ability to feel one's body. Yes, to an emotion, but also to just a causal, you know, a cause and effect situation. Even if a kid gets to wear like, you know, I had a conflict with a friend. I thought that's not fair. I got Buzzy in my arms and then. The desk turned over. Mm-hmm. Even if it's just sort of creating that pathway, right? Or helping make sense of that chain over and over and over. You know, after a few years of that, you will have a fifth grader who can be like, 'They said this to me, I got really angry.' And, you know, that led me to do X, Y, Z. And it's true that once we do get the connection to the emotion, it makes repair easier. And it also makes it a little bit easier for the kid to learn different ways or to sort of head the really big behavior off at the past. Thank you. You know, it can be a little bit easier, I think, for lots of people to be like, 'Oh, I'm starting to get angry.' What else can I do? Rather than, 'Oh.' Like I have electricity in my limbs. What can I do? Because sometimes that limb experience is already pretty far down the the regulatory path and can't always be reined in right away, but I think it does start with self-awareness and sometimes that's awareness of just thoughts and body sensations if the emotions are too mysterious. Hmm-hmm. So if you can identify the physiological feeling and come up with a shared label for that.

Then what you can say is the plan is: 20:48

when you feel that heart rate, your heart's pounding or you're buzzy in your arms, the plan is... you know, that, you know, that you, you don't do this and that's where we do our flight plan or whatever. Exactly. Maybe you take a break. Maybe you ask for help. Maybe you throw the beanbag that's on, you know, like something. Yeah, exactly. So it's like instead of that, do this. Then over time, we start pairing more sophisticated. Uh, you know, maybe labels on that for for what purpose? Like, not to shape them into some societal cultural idea of what it is to be normal. No, we're pairing the words so that they can be effective self-advocators and people can recognize what they might need. I think I say a lot of times, like, I didn't expect that you would. Throw things on the floor right when you did, because I didn't notice that things weren't going well for you leading up to that. Did you, were you surprised that you threw the things on the floor? Right. Like, did you expect that you, and like, sometimes kids will say, 'I was getting really.' Irritated and then people kept telling me to do things, so then I threw stuff on the floor. I was like, 'Okay.' That's a form of alexithymia— like we didn't see the lower, the outward signs of the lower level irritation, and so we didn't do anything different. Yes. Another version is like, 'No, I didn't feel anything until I was furious. And then I didn't do anything until I'd had it. And then I threw everything on the floor.' It's like. Because I think it could be either or something in between. I think we do need to know that. Were you feeling a ramp up? And just showing nothing outwardly. Or were you not actually, were you actually like really fine until you weren't? So it has to be a genuine question. Like I didn't expect that. It was surprising. Were you also surprised? Yeah. Yes. Because that's, that's really important because you would intervene differently, right? If somebody is experiencing. Yeah, maybe they just can't. really feel their feelings below a certain level of intensity quite yet. Then they might really feel like, yeah, I totally thought I was fine. And then all of a sudden I was engulfed in flames and kind of lost my head. Or they might be like, no, I actually was very. very aware of the distress inside my body and could feel it mount in a linear way, but I didn't have the words for it. So I couldn't, you know, do anything about it. Or maybe I even did have the words for it. I didn't feel comfortable saying those are, those are three. All of those can get us to an explosive, unexpected behavior. But the intervention on that is really different. And for a kid, for a kid who is struggling to feel things below a certain level of intensity. I know I'm like always the mindfulness queen and that can be annoying, but you know, that's, that's the kid, right. Who really— even when they're not escalated— might want to do some work to see if they can feel their heart beating and how fast. That might be a kid who, you know, would do really well with kind of tactile stuff and just be given interesting things to feel with their hands and to like really get into that with a trusted adult, just to get used to it. Feeling stuff and talking about that feeling. And then, you know, sometimes even something as ancient as the alert curriculum, that old sort of OT regulation thing, can be very helpful for kids who just are literally learning how to tap into their internal sensations, because we, we can't really get to a feeling without the internal sensations. Now for kids who are all too well tapped into their internal sensations, but don't know how to make sense of what's happening. To get help with it, then that is much more about emotional naming. right? Making a plan, that kind of thing. Right. Right. So that's an example of where our approach would actually be quite different. And in terms of, the adult. The adult response, if they're not feeling the buildup and they're just realizing when they're inflamed, it's... That's when we have to do a lot of observational data collection and figure out, like, is it the task? Was it something in the environment? And we do a lot of scheduled non-contingent breaks. That's right. Tasks or situations that become risk for escalation are introduced in smaller doses with increased support. Yeah, it's sort of like being that external executive functioner for kids for a while, right? If we now know that the kid is not going to feel it themselves. Yeah, until they're already totally dysregulated. Yeah,

then our job does become: 25:34

Yeah, that antecedent behavior, consequence stuff, like what does it seem like often happens just before a big thing? What can we learn about that, right? How can we sort of change the environment? To make, and also how can we keep a close eye on this kid so that we can do those respectful guesses, you know, to be like, okay, I think this kid might now be at a 10 out of a hundred. You know, what if I got in there and checked in with them about that? Is there any way we could do a quick little regulate or distract? before the kid themselves has the ability to kind of feel that ramp up and, and intervene in a stage-wise way. Yeah, cool. Okay, so this is not something that either you or I had connected a lot in the past, alexithymia and ADHD. So. I was reading about alexithymia and it said that one research study So that 41% of people with that trait of alexithymia are, are also ADHD. So that's, but it's not the same in the reverse. I do not think that there is such a high percentage of people with ADHD that have that presentation. Cause like in our. We talked about this briefly. And in our shared clinical experience, people with ADHD more often might have been quite animated. And have like widely varying emotions or expression of emotion? Yeah. Sometimes ADHDers have really intense, I would call it emotional access— so that they're actually feeling things even a little bit more strongly than might be effective. I get it. Yeah. And so. It's similar to the student who can focus really, really well when they're doing something that is preferred and high confidence. That's not unusual with ADHD. Not at all. the the the The deficit of attention is on things that are not preferred. Or high interest. Usually, and actually, there's an ability to hyper focus or get into flow state. When you are like totally engaged or engrossed in what you're doing. That's common. But that's like sort of another myth of ADHD is, well, they can pay attention to their... Legos and do that for hours so they couldn't possibly have ADHD. Absolutely. Right, but I think this is something that might... might... I can think back now and realize that it might have come up a few times, but I wasn't making the connection. Because what adults will say is they are, they do not care. Yeah, but... At all about the negative impact they've had. Um, They seem to not show any regret or remorse and stare at you with a blank expression. And even when they're doing things that are fun, they're not really showing a different facial expression voice tone. But their energy is different and their um ability to maintain is different. And so I think that it's, it's really important to think about. When we're learning that about someone, one of our main tools is to very gently figure out a way that somebody or a couple people have an ability to talk about that with the person. And do some of that work around beginning to. Recognize varied internal states and have labels for it. But then, also, we're advocating for people that are new to this— person is that this is not disrespect. This is not lack of care for others. Yes, right. This is actually a character trait. I like the word 'character trait' in this case, in ADHD, because I don't think it's a state they're in. I think it's a character trait. That might be more unique, that requires some, like, paving of the way ahead in like a 504 or a student at a glance, or as we're just doing transition meetings and talking about somebody. Because it really can get us to a point, like you said before, like. It doesn't elicit empathy and adult support. That stance does not elicit naturally that compassion. And care that is actually needed. So we need to find other ways to schedule connection and outreach and support. So that we remember to do it because our mirror neurons aren't going to get tripped by this person at all. We're gonna— and so I think a lot of misinterpretations can happen and a lot of misses can happen in this case, which again is like unusual. But when I think back, might have been something that I could have talked about more often with people before I made this 'aha' connection more recently. Yeah, it's interesting, right? I mean... I like that idea that sort of having this in things that's good to know about this student, because we do have to, as educators, a little bit, do the opposite of what we naturally would, right? We have to really remember there's actually a lot of vulnerability here, right? There's a lot of, there's just as much emotional need here as there is from somebody who can clearly feel it and show it. Um, and not to assume that the flatness is, you know, oppositional or defined or anything like that. Um, yeah, with ADHD years, it's interesting to me. When you brought up this topic for today, I was like, oh, it's ADHD. I don't know. I usually think about it more with autism. But now that, you know, we look at that data and as you describe it. Sometimes with ADHDers, I will have the experience that they're going a little bit too fast for their emotional experience to catch up. or be fully felt. And so maybe that could be, you know, something to kind of feel into for educators in this position, right? As it's like ADHDers do sometimes have pretty good access to emotion, especially if they can slow down enough to feel them. But. Not every emotion can catch up with either a super duper busy mind in the case of inattention or a super duper busy body in the case of fiber activity and pulsivity. And so. ADHDers, I think, are sometimes outrunning their emotions before they've been able to feel or express them. Oh, yeah. That's so spot on in terms of what I've noticed. I've had so many kids explain a specific situation to me where things didn't go well. And I think one of the things that I've understood is that The mechanism of ADHD that creates a breakdown is somewhere like a school. Is that it? It's very hard to pay attention to multiple things at once. Yes. So it's like, where are all of your... Like materials. Where's your folder? Where's your lunch? Where's your coat? Where are the things? And it's like looking around, like, oh. And so it also could be like, um, you know, you're not doing what you're supposed to be doing, but you're completely missing all of the subtle cues that the teacher is starting to get. A feeling of urgency that we're about to transition. Other people are starting to stand up and gather things. All of that is not noticed because you're just focused on the one thing that you're doing. So when you look up and then people start asking you questions like, 'Why are you not picking up yet? Where are all of your things?' It's like, I don't really know the answers to all of that. Because I was paying attention to something else. Plus, now I've missed all these cues. And then there's that startle of like— I think people are annoyed with me or upset with me. And, um, yeah. So it's like, I've. what seemed obvious to others would be obvious to that person if they were paying attention to it. Yes. Yes. Oh man. Yeah. So I was an ADHD girl child and that feels, I feel very seen. Yes. That was the experience. It's like, well, I was, I was totally focused on this one thing. So no, I didn't read the room and I didn't realize that everyone's been. Livid with me for the last five minutes when I've been humming aloud and didn't know— or that, you know, I'm about to get maybe a serious consequence from my teacher who thinks I've just been willfully ignoring them this whole time. Like it, yes, that's right. School is very specific about where they want a kid's attention to go. And sometimes would like it to go in a few different directions at once. And that will cause an ADHD-er to miss the mark. And, you know, if we were to connect that back to Alexa Thymian. There's just such a level of overwhelm, right? Because even one's own feelings is something that requires attention. So it's like, you want me to pay attention to my own internal emotional experience too? Like you, you can pick one. I can like, I can know where my pencil is or I can know if I'm humming or I can know what I'm feeling. Right, right. Like the classic example I give is that someone with ADHD could be really good at telling a joke. They could also be really good at watching someone tell a joke and looking at how. The people are receiving it and knowing whether it's going landing yes they cannot do both at once right yes so i'm wondering if i'm wondering if people with adhd maybe they don't have alexithymia as often as it might seem in that research study i'm wondering if maybe their emotional state is a reflection of what they're paying attention to. Yes. Which might not be what everybody else is paying attention to. Yes. So there's like an incongruence of emotion. Like I'm thinking about. the math problem that we're all doing. Yes. I'm not paying any attention to the fact that we're running out of time and it's about to be. like recess or whatever. Yes. So I'm looking slow. in my pace i'm looking like i have no urgency i'm not looking at all hurried or worried and and then um It's almost like you try, I try to bring. an adult could try to bring my attention to we're actually all needing to move faster because we're late for something. Yes. Which goes from 'I was feeling completely calm and focused' to 'now I'm like panicked'. Right. Now I can fully feel that too. Yes. Right. Yep. Yeah. I mean, that's a really interesting point. Maybe it's an incongruence of emotion, which is like you're not feeling the way that like there's some research on empathy that shows that one component of empathy is that you feel emotional congruence, which means you're feeling the way that most people are feeling in this situation. And we, we lose our empathy when we don't. So for example, I do not like amusement parks at all. Mm-mm. I don't like anything about it. And so, when I am there, and my children were younger, and they were joyful, and having the best time. I would build up to the point where I could no longer be there anymore. Yeah. And my emotional incongruence, they're having a joyous time. Most people at the amusement park actually are feeling a joyous time because most people chose to be there. So I am not. I'm increasingly incongruent in my emotions. I'm feeling uncomfortable and overwhelmed. And so I get to a point where I don't care. That I'm going to ruin the joy of the most people. Yes. In my life, I need to go. You've had it. So I have an unempathic response because of emotional incongruence. Ooh, yep. So I think we've cracked it. Maybe ADHD isn't— as alexithymic as some data suggests— but maybe it looks like that on the outside. Because of what they're paying attention to, and whether and how their emotions are or aren't incongruent with the expectation of that. Right. Moment. So what teachers could do, as they've gotten to know a student or special educators or school counselors or whoever,

they could say: 37:59

What we've learned about the student is that they don't show in their facial expression or voice tone how they're feeling. And so it's important to remain curious and ask questions. Rather than assume that they are. Um, not that what you're saying or the directions or the impact is not important to them. That's right. This is a kid who needs extra curiosity because you're likely to misinterpret. Where they are at, based on their. You know, straight ahead cues. That's great. I love that. Yeah. Very cool. Cool. Thanks for bringing that, Joelle. What an interesting topic. I'll have to think about that more. Hopefully we gave people some good takeaways that didn't make people feel more confused about. I think you did. Okay. I think you did have some good takeaways in there. I think I did too. Yeah. I think I did a lot of theorizing, but I think you brought us down to brass tacks several times in a way I appreciated. Well, that's a lot of our relationship. Tchoo! You're doing really great. Theories and insights and I have brass tacks. Yeah. So before we end, I did want to say it is a National School Counseling Week. Oh, yes, it is. Thanks for that reminder. Our school counselors are incredible in what they do. And nobody really knows what a school counselor does except the school counselor. And I almost know, but I still don't fully know. I feel the same way, yes. And they're incredibly valuable. And my commitment this week to honoring the school counselors is to tell as many people as I can to stop calling them guidance counselors. Yeah, there's Girl Counselors. Yeah, they're school counselors. They don't like to be called guidance counselors. It's an inaccurate term at this point. No longer. It's age. Don't do that. So a gift that we can give our school counselors is call them school counselors. That's right. That's my takeaway, my ending point. Yeah. I would say a gift we can give school counselors is to recognize that they are busier than we could imagine, even if they're busy with things that don't fit the standard mold of what people are usually busy with in a school building. Right. Always triaging. Yeah, exactly. Yeah. Yes. Incredibly valuable humans among many other valuable humans. Exactly. Yeah, exactly. Yep. Well, thank you, Joelle. Thank you to all the school counselors. Everybody, happy Groundhog's Day. Happy Groundhog's Day. We'll see you next time. Thank you for listening to another episode of Stance of Curiosity. Stance of Curiosity is an unscripted conversation between Jillian Boudreau and Joelle Van Lent. While both are licensed psychologists, this podcast is provided for informational and educational purposes only. The content presented should not be considered a substitute for professional, psychological, medical, or mental health advice, diagnosis, or treatment. Listeners should always consult with a qualified mental health professional whenever needed for specific concerns or questions related to their personal situation. Stance of Curiosity is produced by Jillian Boudreau and Joelle Van Lent. Our cover art is by Aaron Lanute and our music is upbeat indie folk by Twin Music. See you next time.