Why "What do you feel?" is hard to answer

By Mindum · Published 14 October 2026

Being asked "What do you feel?" and going blank can have more than one explanation. One way to describe it is that the question asks for two things at once: noticing signals in the body, and finding a word for them. Studies find higher scores on a questionnaire about difficulty identifying and describing feelings in some autistic groups [1], and a small set of studies found lower interoception (sensing signals from inside the body) in some ADHD groups [3]. These studies describe groups. They do not cover what to say or do in the moment.

What are the two jobs in the question?

The first job is to sense what is happening inside the body. The second job is to match that sensation to a word such as "anxious", "tired" or "fine".

This split is one way to describe the question. No single study found it. The two jobs also overlap, and researchers do not always separate them.

What is interoception?

Interoception means sensing and interpreting signals from inside the body, such as heartbeat, hunger, breathing or tension [6].

This is closest to the first job. A racing heart, a tight jaw and an empty stomach are all signals.

Some autistic adults describe difficulty interpreting body signals [8]. That paper collected written accounts from an online forum. It says nothing about how common this is.

What is alexithymia?

Alexithymia is a research word for finding it hard to identify and describe feelings. It does not describe having no feelings. It is usually measured with a questionnaire called the TAS-20.

The questionnaire has three parts: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking, a habit of focusing on outside events rather than inner states [9]. Researchers count how many people score at or above a line the questionnaire sets. The line is a research tool, and a score above it is not a diagnosis.

In the two-job description, this is closest to the second job. Difficulty identifying feelings can also involve telling body sensations apart from feelings, so it touches both.

What do the questionnaires and tests show?

High scores also appear in general-population samples. In a German general-population sample, about 10% scored at or above the usual line on this questionnaire [4]. A Finnish general-population study classed 13% of its sample as alexithymic [5]. The two studies differ in country, age range and possibly method, so the figures are not directly comparable.

A separate combined analysis compared autistic and non-autistic groups that were recruited for other studies. Roughly half of the autistic participants scored above the line, and about 5 in 100 of the non-autistic participants did (study results ranged from about a third to about 60%) [1]. That also means about half of the autistic participants did not. The two kinds of samples were recruited differently, so their percentages should not be compared with each other.

The authors of that analysis list limits. The studies differed a lot from each other. Only one adjusted for depression or anxiety, which the authors call important confounders. In that one, the group difference remained. The questionnaire has been tested mostly with autistic people who need less daily support, so the picture may be incomplete and may not apply to autistic people who use little or no speech [1].

A 2025 review of 31 studies pooled five adult studies on how accurately people detect their own heartbeat. The combined result pointed to slightly lower accuracy in autistic adults, but the range was compatible with no difference, so it is inconclusive in either direction. Findings on how people rate their own body awareness were mixed. The authors rated 13 of the 31 studies as low quality, many of them small [2].

The heartbeat test measures one kind of body signal. The questionnaire measures how people describe their feelings. They do not have to match.

What do studies find in ADHD?

Five studies compared people with and without ADHD. In three of them, interoceptive accuracy (mostly measured with heartbeat tasks) was lower in the ADHD group [3]. The review does not say which three. Three of the five studies were with children and two with adults. The adult studies covered ages 19 to 37, and the review does not say what they found. In the other two of the five, no lower interoception was found.

The authors rated study quality as moderate. They note that medication use was poorly reported. Some ADHD groups also included autistic children, so the results cannot be attributed to ADHD alone. The review did not look at alexithymia [3].

Can interoception be trained?

A 2023 review of 31 randomized trials found that 20 showed interoception-based interventions improving interoception more than comparison conditions, while the evidence for symptom improvement was inconclusive [7].

Where is the moment itself covered?

None of the studies described here tested what helps when the question comes up, such as choosing from a list, answering later or starting with the body. When you can't find the words gathers short sentences written by Mindum, a phone feature, and guidance from a health service page. None of it is a tested method.

What this does not show

• These studies describe groups of people on questionnaires and tests. They say nothing about what any one person experiences.
• A score above the line describes how someone answered a questionnaire. It says nothing about a diagnosis, and it does not mean half of autistic people "have" alexithymia. The questionnaire may fit some groups better than others.
• The questionnaire measures difficulty identifying and describing feelings. It does not measure whether feelings are present, and similar scores are found in people who are not autistic or ADHD.
• The heartbeat results cover one kind of signal. They say nothing about how people sense hunger, pain or temperature. Heartbeat tasks are also debated as a measure, because scores can reflect guessing or knowing a resting heart rate.
• The comparison between people with and without ADHD rests on five small studies, plus twelve studies in general samples that link more ADHD symptoms to lower interoception. Neither shows a cause.
• Most of these studies looked at autism or ADHD on its own, so they cannot say how the two fit together in someone who has both.
• Whether training interoception helps with symptoms is inconclusive.
• Reading this article cannot say anything about one person. If difficulty identifying feelings causes distress or gets in the way of daily life, a clinician who knows neurodevelopmental conditions can look at it with the person, including the role of anxiety, low mood or past experiences.

Sources

1. Kinnaird E, Stewart C, Tchanturia K. Investigating alexithymia in autism: a systematic review and meta-analysis. European Psychiatry. 2019;55:80-89. doi:10.1016/j.eurpsy.2018.09.004
2. Klein M, Witthöft M, Jungmann SM. Interoception in individuals with autism spectrum disorder: a systematic literature review and meta-analysis. Frontiers in Psychiatry. 2025;16:1573263. doi:10.3389/fpsyt.2025.1573263
3. Bruton AM, Levy L, Rai NK, Colgan DD, Johnstone JM. Diminished interoceptive accuracy in ADHD: a systematic review. Psychophysiology. 2025;62(2):e14750. doi:10.1111/psyp.14750
4. Franz M, et al. Alexithymia in the German general population. Social Psychiatry and Psychiatric Epidemiology. 2008;43(1):54-62. doi:10.1007/s00127-007-0265-1
5. Salminen JK, et al. Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland. Journal of Psychosomatic Research. 1999;46(1):75-82. doi:10.1016/s0022-3999(98)00053-100053-1)
6. Khalsa SS, et al. Interoception and mental health: a roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2018;3(6):501-513. doi:10.1016/j.bpsc.2017.12.004
7. Heim N, et al. Psychological interventions for interoception in mental health disorders: a systematic review of randomized controlled trials. Psychiatry and Clinical Neurosciences. 2023;77(10):530-540. doi:10.1111/pcn.13576
8. Trevisan DA, Parker T, McPartland JC. First-hand accounts of interoceptive difficulties in autistic adults. Journal of Autism and Developmental Disorders. 2021;51(10):3483-3491. doi:10.1007/s10803-020-04811-x
9. Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23-32. doi:10.1016/0022-3999(94)90005-190005-1)

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