The Italian weighted reflection and reorganization list (I-WRRL): A new linguistic measure detecting the third phase of the referential process

Introduction In psychotherapy process research, Multiple Code Theory (MCT; Bucci, 1997, 2015) remains an inspirational and important point of reference for researchers, clinical psychologists, and psychotherapists interested in the reconceptualization – both clinically and empirically – of psychoanalytic theory. Moreover, MCT made explicit some psychotherapeutic implications of adopting an embodied, intersubjective and contextual conception of the mind. The central hypothesis of MCT is that our experience of the world is coded in at least three systems – non symbolic, nonverbal symbolic, verbal symbolic – that are not completely connected and integrated with each other. In psychotherapy the Referential Process (RP) is activated, with an attempt at connecting these systems and shaping three phases: (a) arousal in which one or more patterns of emotion are activated within the interaction, (b) symbolization in which the patient expresses in words what he is experiencing on an emotional level, and (c) reorganization/reflection in which the experience is reorganized and reframed, creating greater and more varied connections between the three systems of experience. According to MCT, each of the three phases are manifested in different linguistic styles: the first one, arousal, would be characterized by silences and fragmented verbalizations with high disfluency; the second one, symbolization, by vivid, concrete, specific, and clear language; and the third phase, reorganization, is manifested in speech by a reflective and at the same time vivid language. Only for the symbolization phase do we have a weighted and validated dictionary of the Italian words that captures the relative linguistic style – the Italian Weighted Referential Activity Dictionary (I-WRAD; Mariani, Maskit, Bucci, & De Coro, 2013). The two other main dictionaries are unweighted (and therefore less sensitive): the Italian disfluency and reflection dictionaries, which detect the arousal and reorganization/reflection phases respectively. Our goal has been to construct a weighted dictionary called the Italian Weighted Reflection and Reorganization List (I-WRRL) that will captures the reorganization phase of the referential process, which is considered crucial for an effective psychotherapeutic process. According to the operative definition of the reorganization and reflection function (Bucci, Maskit, Murphy, Zhou, & Fishman, 2018) that we have adopted, the linguistic style of the third phase of the referential process is characterized by (a) an active search for a subjective and emotional meaning of the experience, (b) a vividness indicating an emotional engagement with what one is talking about and (c) a sense of wonder and novelty with respect to emerging meanings. Method Six independent raters have applied the WRRL manual (Bucci, Maskit, Murphy, Zhou, & Fishman, 2018) to 1,010 text units from psychotherapy sessions, autobiographical narratives, adult attachment interviews, and autobiographical literary books. After having achieved a good reliability on a first set of units (alpha = .927; ICC = .679), the 6 raters were divided into 3 pairs, with each pair coding 1/3 of the entire text units corpus. They assessed the extent to which the reorganization/reflection function was present in each text unit by assigning a score ranging from 0 (absent) to 10 (highly present). Results In order to construct the I-WRRL only the words with al least 4 occurrences from at least two different text units were considered. Through this process, a dictionary of 764 words typical of the reorganization and reflection function was composed. Each word was assigned a weight. The dictionary then applied to 32 additional text units and was found to account for 85% of the text. The correlation between the manual scores and the scores arrived at by the use of the dictionary was positive (r = .25). Conclusion IWRRL is a new measure that is distinguishable from other measures of reflection in the psychotherapeutic process. First of all, it is an automatic and indirect measure of the reorganization/reflection phase and so it is less affected by any evaluator bias (patient or therapist) or rater’s subjectivity; secondly, it is based mainly on language style – typically defined by function words – rather than on conversation content; thirdly, I-WRRL does not measure just the function of reflection or abstract thought but specifically the reflective and reorganization function when activated in relation to a process of emotional engagement and associated to a sense of novelty and wonder, which is typical of an effective psychotherapeutic process. The construction of this new dictionary thus makes it possible to investigate the reorganization and reflection phase with more precision and completeness, in connection with the other three phases of the RP. I-IWRRL and I-WRAD together are instruments useful both for outcome/process research and for clinical monitoring and supervision in practice