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Many studies seem to display a link between alexithymia and troubles with empathy. Indeed, clinical studies have found a low level among some alexithymic subjects of recognition of facial expressions, limited facial mimicry when these subjects were put under experimental stress and difficulty in perceiving the emotions of others with a low level of emotional consciousness. Also, alexithymia was found in Asperger syndromes associated with empathy disorders. The difficulty of perceiving one’s own emotions should be referred at the very least to this other difficulty characterized by the incapacity to perceive the emotions in others and more generally to constitute a theory of the mental states of others. The idea of an ontogenetic relation between the alexithymic functioning mode and another functioning mode in the autistic realm of the self should be considered. In a metapsychological perspective, the author develops the idea that primary and secondary alexithymia could be integrated in the developmental continuum from the normal to the pathological by referring to an early malfunction during the phase of autosensuality on the model of the fixation-regression topography. Primary alexithymia could refer back to troubles of empathy whereas secondary alexithymia would refer to a defensive strategy aimed at protecting from traumatic affects. Because of fixations or microfixations during the autosensuality phase, autistic protection manœuvres could have created the setting, at an early stage, for alexithymic functioning with a certain distorsion in the ability to recognize one’s feelings and those of others. Alexithymic functioning would be linked to a heavy, early use of identification by dismantelment generating excessive recourse to (endo or extrapsychic) negative hallucination processes of the zones of emotional life which were either forclosed (primary anexithymia) or traumatic and not well elaborated (secondary alexithymia). This functioning mode would be present in any individual and would belong to the autistic level of the self. Its exclusive recourse would mark its pathological character with a risk of psychosomatic decompensation in the case of emotional excesses which could not be contained in the last resort by these autistic protection manœuvres.