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Based on four clinical cases, this article aims to link the findings of a study led by the University of Liège, which was carried out to explore psychological changes in male perpetrators of domestic violence, and the actors involved in specific treatment programs. It focuses on the expression and evolution of alexithymia and its association with impulsivity and depression among users of a Belgian service, Praxis, which offers a group empowerment program for perpetrators of domestic violence. The findings indicated that male offenders reported more depressive feelings and more difficulty in identifying and expressing their emotions (alexithymia) than the general population. The discussion of clinical cases highlights an important hypothesis regarding the possible distinction between the presence of primary and secondary alexithymia.