The stability of alexithymia in acute and nonacute disease was studied in 69 patients with 'psychosomatic' digestive disease and in 47 control patients. Methods used were the Beth Israel Hospital Questionnaire, Lazare's Personality Test, and the Rorschach Test. Subjects were interviewed to assess their somatic well-being and the psychological meaning of the illness. Three different alexithymia groups were found. The first consisted of the nonalexithymic patients who scored low in both testings and who seemed to be 'average persons' in the light of personality tests. The second comprised the patients who developed alexithymia as a reaction to illness. They had good cognitive control but a tendency to hypochondriac worry. The last consisted of patients whose alexithymia decreased during an acute disease. They were egocentric and rigid personalities who enjoyed being ill because they then felt that they were loved and noticed. This division was found to be independent of the patients' medical diagnosis.