A number of conceptually similar emotion-focused coping styles have been related to physical well-being. We assessed the relationship between two of these constructs, alexithymia and repressive coping, on the basis of both psychometric and psychophysiological comparisons. Questionnaires were used to classify 86 healthy female subjects as low anxious, high anxious, or repressors. These subjects then completed a self-report measure of alexithymia and participated in a stressful laboratory task in which they delivered a self-disclosing speech. Emotional response patterning was assessed by comparing self-reported negative affect to heart rate responses elicited during the stressful speech task. Results indicated that the alexithymia scores of high anxious subjects were significantly greater than those of repressors. Consistent with the psychometric data, high alexithymics exhibited an emotional response pattern characteristic of high anxious subjects (self-reported negative affect greater than heart rate), whereas low alexithymics exhibited a response pattern characteristic of repressors (heart rate greater than self-reported negative affect). The results suggest that alexithymia and repressive coping are quite distinct, with repression being more similar to low alexithymia than to high alexithymia.