Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention

  • Alessia Renzi | alessia.renzi@uniroma1.it Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy.
  • Rachele Mariani Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy.
  • Michela Di Trani Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy.
  • Renata Tambelli Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy.

Abstract

Expressive writing techniques are methods focusing on written emotional expression that require people to write about traumatic or difficult experiences, with the objective of promoting an elaboration of these events. The general aim of the study is to investigate the influence of alexithymia, a deficit in emotional regulation processes, on the effects of an expressive writing intervention, analyzing the writing protocols through the use of the Linguistic Inquiry and Word Count (LIWIC) and Referential Process (RP) linguistic measures via IDAAP software. Thirty-five women undergoing an assisted reproductive treatment participated in the study and filled out a sociodemographic questionnaire, the 20-item Toronto Alexithymia Scale. They also underwent three session of writing, following a request that they write about their emotions regarding their current situation. The women enrolled were divided into two groups: low alexithymia and high alexithymia, comprising individuals with a TAS-20 total score lower or higher than the mean, respectively. Analyses within the groups during the three writing sessions revealed that the women with low alexithymia reported a greater number of words expressing affectivity, sadness and future perspective, whereas no significances in the high alexithymia group emerged. Moreover, when analysing differences between the groups, high-alexithymia women reported lower scores in RP indexes and fewer words expressing sadness, future perspectives and we verbal. In conclusion, these preliminary findings may confirm the hypothesis that alexithymia affects the effectiveness of expressive writing through a difficulty in becoming involved in the writing process and a lack of symbolizing processes.

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References

Bagby, R.M., Parker, J.D.A., & Taylor, G.J. (1994). The twenty item Toronto Alexithymia Scale–I: Item selection and cross validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.
Ben Shlomo, S., Skvirsky, V., Taubman-Ben-Ari, O., Azuri, Y., & Horowitz, E. (2016). Mental health of women entering fertility treatment: What role do age and internal resources play? Stress and Health, 33, 470–476. doi:10.1002/smi.2733
Boivin, J. (2003). A review of psychosocial interventions in infertility. Social Science & Medicine, 57, 2325–2341. doi:10.1016/S0277-9536(03)00138-2
Bressi, C., Taylor, G.J., Parker, J.D., Bressi, S., Brambilla, V., Aguglia, E., … Invernizzi, G. (1996). Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: An Italian multicenter study. Journal of Psychosomatic Research, 41, 551–559.
doi:10.1016/S0022-3999(96)00228-0
Bucci, W. (1997a). Psychoanalysis and cognitive science. A multiple code theory. New York, NY: Guilford Press.
Bucci, W. (1997b). Symptoms and symbols: A multiple code theory of somatization. Psychoanalytic Inquiry, 17, 151–172. https://doi.org/10.1080/07351699709534117
Bucci, W. (2001). Pathways of emotional communications. Psychoanalytic Inquiry, 20, 40–70. https://doi.org/10.1080/07351692109348923
Bucci, W. (2002a). Multiple code theory and the referential process. Applications to process research. In P. Fonagy (Ed.), An open door review of outcome studies in psychoanalysis (2nd ed., pp. 192-195). London, UK: International Psychoanalytical Association.
Bucci, W., Kabasakalian, R., & the Referential Activity Research Group (2004). Instructions for scoring referential activity (RA) in transcripts of spoken narrative texts. Retrived from http://www.thereferentialprocess.org
Bucci, W., & Maskit, B. (2007). Beneath the surface of the therapeutic interaction: The psychoanalytic method in modern dress. Journal of the American Psychoanalytic Association, 55, 1355–1397. Https://doi.org/10.1177/000306510705500412
Bucci, W., Maskit, B., &Murphy, S. (2015). Connecting emotions and words: The referential process. Phenomenology and the Cognitive Sciences, 15, 359–383. https://doi.org/10.1007/s11097-015-9417-z
Campbell, R.S., & Pennebaker, J.W. (2003). The secret life of pronouns: Flexibility in writing style and physical health. Psychological Science, 14, 60-65.
Di Trani, M. (2007). Per chi? Il ruolo delle variabili individuali sugli effetti della tecnica della scrittura [For who? The role of individual dimensions on the effect of the expressive writing intervention]. In L. Solano (Ed.), Scrivere per pensare [Writing for thinking] (pp. 39–64). Milano, IT: Franco Angeli Editore.
Di Trani, M., Renzi, A., & Solano, L. (2014). Elaborare le esperienze difficili scrivendo. La tecnica della scrittura di James Pennebaker [Processing difficult experience trough writing. Pennebacker’s writing technique]. Nuove Arti Terapie, 24, 95–109. Retrieved from https://www.nuoveartiterapie.net/new/pdf/rivista/23-24-NuoveArtiTerapie.pdf
Di Trani, M., Mariani, R., Renzi, A., Greenman, P. S., & Solano, L. (2018). Alexithymia according to Bucci's multiple code theory: A preliminary investigation with healthy and hypertensive individuals. Psychology and Psychotherapy: Theory, Research and Practice, 91, 232-247. https://doi.org/ 10.1111/papt.12158
Edwards, E.R., Shivaji, S., Micek, A., & Wupperman, P. (2020). Distinguishing alexithymia and emotion differentiation conceptualizations through linguistic analysis. Personality and Individual Differences, 157, e109801
Frederiksen, Y., O’Toole, M. S., Mehlsen, M. Y., Hauge, B., Elbaek, H. O., Zachariae, R., & Ingerslev, H. J. (2017). The effect of expressive writing intervention for infertile couples: A randomized controlled trial. Human Reproduction, 32, 391–402. doi:10.1093/humrep/dew320
Galhardo, A., Cunha, M., & Pinto-Gouveia, J. (2011). Psychological aspects in couples with infertility. Sexologies, 20, 224–228. doi:10.1016/j.sexol.2011.08.005
Grabe, H.J., Frommer, J., Ankerhold, A., Ulrich, C., Groger, R, Franke, G.H., … Spitzer C. (2008). Alexithymia and outcome in psychotherapy. Psychotheraphy and Psychosomatics, 77,189-94. doi: 10.1159/000119739
Gourounti, K., Anagnostopoulos, F., Griva, F., & Vasmatzis, G. (2016). Alexithymia and fertilityrelated stress. Women & Health, 56, 312–325. doi:10.1080/03630242.2015.1088119
Grynberg, D., Chang, B., Corneille, O., Maurage, P., Vermeulen, N., Berthoz, S., Luminet O. (2012). Alexithymia and the processing of Emotional Facial Expressions (EFEs): systematic review, unanswered questions and further perspectives. PLoS ONE, 7, e42429. doi:10.1371/journal.pone.0042429
Klein, K., & Boals, A. (2001). Expressive writing can increase working memory capacity. Journal of Experimental Psychology: General, 130, 520-533.
Kupeli, N., Chatzitheodorou, G., Troop, N. A., McInnerney, D., Stone, P., & Candy, B. (2019). Expressive writing as a therapeutic intervention for people with advanced disease: a systematic review. BMC palliative care, 18, 65. doi:10.1186/s12904-019-0449-y
Lumley, M. A. (2004). Alexithymia, emotional disclosure, and health: A program of research. Journal of Personality, 72, 1271-1300.
Mariani, R., Maskit, B., Bucci, W., & De Coro, A. (2013). Linguistic measures of the referential process in psychodynamic treatment: The English and Italian versions. Psychotherapy Research, 23, 430–447. https://doi.org/10.1080/10503307.2013.794399
Matthiesen, S., Klonoff-Cohen, H., Zachariae, R., Jensen-Johansen, M. B., Nielsen, B. K., Frederiksen, Y., … Ingerslev, H. J. (2012). The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing assisted reproductive technology (ART) treatment: A randomized controlled pilot study. British Journal of Health Psychology, 17, 362–378. doi:10.1111/j.2044-8287.2011.02042.x
Maskit, B. (2014). The Discourse Attributes Analysis Program (DAAP) Operating Instructions. figshare. Retrived from: http://dx.doi.org/10.6084/m9.figshare.947740
Maskit, B., & Murphy, S. (2011). The Discourse Attributes Analysis Program. Retrieved from http://www.thereferentialprocess.org/the-discourse-attributes-analysis-program-daap.
Maskit, B., Bucci, W., & Murphy, S. (2012). Computerized language measures. Retrieved from
https://sites.google.com/site/referentialprocess/dictionary-measures-and-computer-programs.
Messina, A. Beadle, J.N., & Paradiso, S. (2014). Towards a classification of alexithymia: primary, secondary and organic. Journal of Psychopathology, 20, 38-49
Negri, A., Esposito, G., Mariani, R., Savarese, M., Belotti, L., Squitieri, & B., Bucci, W. (2018). The Italian weighted reflection and reorganization list (I-WRRL): A new linguistic measure detecting the third phase of the referential process. Research in Psychotherapy: Psychopathology, Process and Outcome, 21, 5-6
Nemiah, J. C., Freyberger, H., & Sifneos, P. E. (1976). Alexithymia: A view of the psychosomatic process. In O. W. Hill (Ed.), Modern trends in psychosomatic medicine (Vol. 3, pp. 430–439). London, UK: Butterworths.
Paez, D., Velasco, C., & Gonzalez, J. L. (1999). Expressive writing and the role of alexythimia as a dispositional deficit in self-disclosure and psychological health. Journal of Personality and Social Psychology, 77, 630-641.
Panagopoulou, E., Montgomery, A., & Tarlatzis, B. (2009). Experimental emotional disclosure in women undergoing infertility treatment: Are drop-outs better off? Social Science & Medicine, 69, 678–681. doi:10.1016/j.socscimed.2009.06.031
Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162–166. doi:10.1111/j.1467-9280.1997.tb00403.x
Pennebaker, J. W., & Chung, C. K. (2007). Expressive writing, emotional upheavals, and health. In H. S. Friedman & R. C. Silver (Eds.), Foundations to health psychology (pp. 263–284). New York, NY: Oxford University Press.
Pennebaker, J. W., Booth, R. J., & Francis, M. E. (2007). Operator’s manual: Linguistic inquiry and word count: LIWC2007. Austin, TX: LIWC.net.
Pennebaker, J.W., Mayne, T.J., & Francis, M.E. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72, 166-183.
Pennebaker, J. W., Mehl, M. R., & Niederhoffer, K.G. (2003). Psychological aspects of natural language use: our words, ourselves. Annual Review of Psychology, 54, 547-577.
Petrie, K.P., Booth, R.J., & Pennebaker, J.W. (1998). The immunological effects of thought suppression. Journal of Personality and Social Psychology, 75, 1264-1272.
Porcelli, P., Bagby, R.M., Taylor, G.J., De Carne, M., Leandro, G., Todarello, O. (2003). Alexithymia as predictor of treatment outcome in patients with functional gastrointestinal disorders. Psychosomatic Medicine, 65, 911–918
Renzi, A., Solano, L., Di Trani, M., Ginobbi, F., Minutolo E., & Tambelli, R. (2019): The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment. Psychology & Health. doi:10.1080/08870446.2019.1667500
Rohrbaugh, M. J., Shoham, V., Skoyen, J. A., Jensen, M., & Mehl, M. R. (2012). We-talk, communal coping, and cessation success in a couple-focused intervention for health-compromised smokers. Family Process, 51, 107–121. doi:10.1111/j.1545-5300.2012.01388.x
Silva, A., Vasco, A., & Watson, J. (2018). Alexithymia and emotional processing: a longitudinal mixed methods research. Research in Psychotherapy: Psychopathology, Process and Outcome, 21. https://doi.org/10.4081/ripppo.2018.292
Smyth, J.M. (1998). Written emotional expression: effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66,174–184.
Solano, L. (2013). Lo psicologo ovunque possibile [The psychologist everywhere]. In L. Solano (Ed.), Tra mente e corpo [Between mind and body] (pp.485–516). Milano, IT: Raffaello Cortina Editore.
Solano, L., Donati, V., Pecci, F., Persicheeti, S., & Colaci, A. (2003). Post-operative course after pailloma resection: Effects of written disclosure of the experience in subjects with different alexithymia levels. Psychosomatic Medicine, 65, 477-484.
Tausczik, Y. R., & Pennebaker, J. W. (2010). The psychological meaning of words: Liwc and computerized text analysis methods. Journal of Language and Social Psychology, 29, 24–54.
Taylor, G. J. (2004). Alexithymia: 25 years of theory and research. In I. L. Temoshok & A. Vingerhoets (Eds.), Emotional expression and health (pp. 137–153). Hove & New York, NY: Brunner-Routledge.
Taylor, G. J., & Bagby, R. M. (2013). Psychoanalysis and empirical research: The example of alexithymia. Journal of the American Psychoanalytic Association, 61, 99–133. https://doi.org/10.1177/0003065112474066
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1997). Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press.
Published
2020-09-07
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Keywords:
Expressive Writing Intervention, alexithymia, multiple code theory, linguistic measures
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How to Cite
Renzi, A., Mariani, R., Di Trani, M., & Tambelli, R. (2020). Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(2). https://doi.org/10.4081/ripppo.2020.452