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 CodeTheory (MCT; Bucci, 1997, 2015) remains an inspirational and im-portant point of reference for researchers, clinical psychologists,and psychotherapists interested in the reconceptualization – bothclinically and empirically – of psychoanalytic theory. Moreover, MCTmade explicit some psychotherapeutic implications of adopting anembodied, intersubjective and contextual conception of the mind.The central hypothesis of MCT is that our experience of the worldis coded in at least three systems – non symbolic, nonverbal sym-bolic, verbal symbolic – that are not completely connected and in-tegrated with each other. In psychotherapy the Referential Process(RP) is activated, with an attempt at connecting these systems andshaping three phases: (a) arousal in which one or more patternsof emotion are activated within the interaction, (b) symbolizationin which the patient expresses in words what he is experiencing onan emotional level, and (c) reorganization/reflection in which theexperience is reorganized and reframed, creating greater and morevaried connections between the three systems of experience. According to MCT, each of the three phases are manifested in differentlinguistic styles: the first one, arousal, would be characterized bysilences and fragmented verbalizations with high disfluency; thesecond one, symbolization, by vivid, concrete, specific, and clearlanguage; and the third phase, reorganization, is manifested inspeech by a reflective and at the same time vivid language. Onlyfor the symbolization phase do we have a weighted and validateddictionary of the Italian words that captures the relative linguisticstyle – the Italian Weighted Referential Activity Dictionary (I-WRAD;Mariani, Maskit, Bucci, & De Coro, 2013). The two other main dic-tionaries are unweighted (and therefore less sensitive): the Italiandisfluency and reflection dictionaries, which detect the arousal andreorganization/reflection phases respectively. Our goal has beento construct a weighted dictionary called the Italian Weighted Re-flection and Reorganization List (I-WRRL) that will captures the re-organization phase of the referential process, which is consideredcrucial for an effective psychotherapeutic process. According to theoperative definition of the reorganization and reflection function(Bucci, Maskit, Murphy, Zhou, & Fishman, 2018) that we haveadopted, the linguistic style of the third phase of the referentialprocess is characterized by (a) an active search for a subjectiveand emotional meaning of the experience, (b) a vividness indicat-ing an emotional engagement with what one is talking about and(c) a sense of wonder and novelty with respect to emerging mean-ings. Methods: Six independent raters have applied the WRRL man-ual (Bucci, Maskit, Murphy, Zhou, & Fishman, 2018) to 1,010 textunits 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 as-sessed the extent to which the reorganization/reflection functionwas present in each text unit by assigning a score ranging from 0(absent) to 10 (highly present). Results: In order to construct theI-WRRL only the words with al least 4 occurrences from at leasttwo different text units were considered. Through this process, adictionary of 764 words typical of the reorganization and reflectionfunction was composed. Each word was assigned a weight. Thedictionary then applied to 32 additional text units and was foundto account for 85% of the text. The correlation between the manualscores and the scores arrived at by the use of the dictionary waspositive (r=.25). Conclusions: IWRRL is a new measure that is dis-tinguishable from other measures of reflection in the psychother-apeutic process. First of all, it is an automatic and indirect measureof the reorganization/reflection phase and so it is less affected byany evaluator bias (patient or therapist) or rater’s subjectivity; sec-ondly, it is based mainly on language style – typically defined byfunction words – rather than on conversation content; thirdly, I-WRRL does not measure just the function of reflection or abstractthought but specifically the reflective and reorganization functionwhen activated in relation to a process of emotional engagementand associated to a sense of novelty and wonder, which is typicalof an effective psychotherapeutic process. The construction of thisnew dictionary thus makes it possible to investigate the reorgani-zation 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/processresearch and for clinical monitoring and supervision in practice.