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Editorial Diabetes
“Eulexithymia” and Diabetes Care
Professionals Sanjay Kalra, 1 Yatan Pal Singh Balhara, 2 and Manish Bathla 3
1. Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India; 2. Department of Psychaitry and National Drug Dependence Treatment Center (NDDTC),
All India Institute of Medical Sciences (AIIMS), New Delhi, India; 3. Department of Psychiatry, MM Institute of Medical Sciences and Research, Mullana, India
A lexithymia is a personality trait that refers to the inability to express emotions in words. Medical professionals have been criticized for
being “alexithymic” by many observers. From a clinician’s perspective, an alexithymic diabetes care professional is one who is unable
to empathize with the patient, or to understand the patient’s emotional status and needs. In overzealous attempts at being “patient-
centric,” one often tends to undermine the importance of the fact that diabetes care is a two-way process. The diabetes care professional
is as important a component of diabetology as the person with diabetes. Balanced models and constructs are available which highlight the
equal importance of the physician and other stakeholders of the healthcare system as well. The term we propose is “eulexithymia,” which we
define as a balanced ability to express one’s emotions and understand others’ feelings. When used to describe a diabetes care professional, a
“eulexithymic” professional is one who understands and responds to a patient’s feelings in a balanced manner, without letting oneself be unduly
and inappropriately affected by them.
Keywords Alexithymia
Alexithymia, diabetes care professional,
compassion fatigue, eulexithymia
Alexithymia is a personality trait that refers to the inability to express emotions in words.
The term was coined by psychotherapist Peter Sifneos in 1973, who used it to imply “no words for
mood.” 1 Over the past half-century or so, the alexithymia construct has developed and evolved
into a refined paradigm, which helps us to understand the influence of emotions and personality
on illness and health. The core characteristics of alexithymia are marked dysfunction in emotional
awareness, social attachment, and interpersonal relating. 2 Alexithymic individuals have difficulty
in distinguishing and appreciating the emotions of others. This, in turn, leads to unempathic and
ineffective emotional responding.
Disclosure: Sanjay Kalra, Yatan Pal Singh Balhara,
and Manish Bathla have nothing to declare in relation
to this article. This article is a short opinion piece and
has not been submitted to external peer reviewers. No
funding was received in the publication of this article.
Authorship: All named authors meet the International
Committee of Medical Journal Editors (ICMJE) criteria
for authorship of this manuscript, take responsibility
for the integrity of the work as a whole, and have
given final approval to the version to be published.
Open Access: This article is published under the
Creative Commons Attribution Noncommercial License,
which permits any non-commercial use, distribution,
adaptation and reproduction provided the original
author(s) and source are given appropriate credit.
Received: September 29, 2017
Published Online: November 17, 2017
Citation: US Endocrinology, 2017;13(2):55–6
Corresponding Author: Yatan Pal Singh
Balhara, Department of Psychaitry and National
Drug Dependence Treatment Center (NDDTC),
All India Institute of Meidcal Sciences (AIIMS),
New Delhi, India. E: ypsbalhara@gmail.com
Alexithymia as an adjective for the diabetes care professional
Medical professionals have been criticized for being “alexithymic” by many observers. From a
clinician’s perspective, an alexithymic diabetes care professional is one who is unable to empathize
with the patient, or to understand the patient’s emotional status and needs. More accurately, the
term describes a diabetes care professional who is not responsive to the psychosocial reality of
diabetes. The psychosocial aspects of diabetes care have gained due recognition in recent years. The
publication of comprehensive guidelines on this topic has improved awareness of the importance
of psychosocial care as a part of diabetology praxis. 3,4 Simultaneously, enhanced appreciation of the
patient-centered model of care has created an environment where psychosocial aspects are given
due consideration. 5,6
The ideal diabetes care professional—preventing alexithymia
In overzealous attempts at being “patient-centric,” one often tends to undermine the importance
of the fact that diabetes care is a two-way process. The diabetes care professional is as important
a component of diabetology as the person with diabetes. It is this realization that lies at the heart of
discourse on the professional hazards of diabetes care professionals. 7
Comprehensive guidelines describe the characteristics of a good diabetes care professional in
great detail. The mnemonic “CARES” is used to describe these properties: Confident Competence,
Authentic Accessibility, Reciprocal Respect, Expressive Empathy, and Straightforward Simplicity. 8
Another useful mnemonic, “WATER,” lists the steps that effective communication or conversation
should include. WATER stands for a Warm welcome, followed by Asking and Assessing and then Telling
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