Table 1 Representative descriptions on shitsu-taikan-sho (alexisomia) and its related ideas by Yujiro Ikemi

1. We have repeatedly noticed that so-called alexithymic features exist together with disturbances in awareness of body sensations. For example, girls suffering from anorexia nervosa do not seem to know what fatigue is (1977) [19].

2. Recently, an interesting theory has been advocated that the neurophysiological dissociation of neocortical intellectual functions and subcortical emotional functions may be an important feature of the basic pathology of psychosomatic disorders. This state has been called “alexithymia”. According to our observations, this dissociation involves not only the awareness of emotions, but also awareness of body sensation. Emotion, which is a neurophysiologic phenomenon (produced through “emotional circuits”) is closely related to bodily sensation, and can be created and altered by physiologic procedures (1979) [20].

3. In the state of cortical hyperactivity (ergotropic dominance) and inhibition of subcortical activity, ego-related feedback of different kinds may develop which replaces the normal proprioceptive afferent feedback from the body itself. This process may contribute to the formation of alexithymic state. From this point of view somatopsychic approaches may play an important therapeutic role in treating the so-called alexithymic state, or psychosomatic conditions where the dissociation between ego functions and emotion (feelings) is playing the predominant role (1979) [20].

4. One is the primary importance of restoring an optimal level of interoceptive awareness to the patient so that he, or rather his body, can learn prohomeostatic self-control. For this purpose the somatopsychic orientation is indispensable, and we envision it becoming an essential basis of both psychosomatic and general clinical medicine (1979) [20].

5. Alexisomia refers to the disturbance in one’s bodily sensations with psychic prevalence of the alexithymic features. Ikemi and Ikemi argued that patients with alexithymia also have this alexisomic defect (1985) [6].

6.In many cases of ‘alexithymia’, where there is an observed difficulty in the awareness and expression of feelings, there also seems to be a difficulty in the awareness and expression of bodily feelings. We have tentatively coined the term ‘alexisomia’ to designate this condition where certain persons have difficulties in expressing how their bodies feel (1986) [21].

7.I wish to focus my speech to the holistic awareness which can be the root of holistic medicine and the root of Oriental somatopsychic self-control which plays an essential part in the enlargement of experiential level by the dissolution of alexithymia, alexisomia and alexicosmia. Soon after I introduced Prof. Sifneos’s concept of “alexithymia” to Japan, I noticed that in many cases of alexithymia there also seemed to be a difficulty in the awareness and expression of bodily feelings and the natural order implicit in the body. I have coined the term “alexisomia” to designate a condition, where certain persons have difficulty in expressing how their bodies feel, and the term “alexicosmia” to designate a condition marked by a lack of awareness to the natural order (1990) [2].