Maria Luisa Martino

Effects of Guided Written Disclosure Protocol on mood states and psychological symptoms among parents of off-therapy acute lymphoblastic leukemia children:

This study assesses the effects of Guided Written Disclosure Protocol on psychological distress in mothers and fathers of off-therapy acute lymphoblastic leukemia children. An experimental group participated in the writing intervention with a control group subject only to test-taking standards. The Symptom Questionnaire and Profile of Mood States were administered at baseline, post-intervention, and follow-up. Guided Written Disclosure Protocol had significant effects on the progressive reduction of anxiety, depression, somatic symptoms, hostility, tension–anxiety, and fatigue–inertia within the experimental group. However, the control group distress levels tended to worsen over time. The mediating role of emotional processing was highlighted.

Health and Writing Meaning-Making Processes in the Narratives of Parents of Children With Leukemia

There is literary evidence stating that expressive writing affects health outcomes. Nevertheless, the processes underlying its benefits remain unclear. In our previous article, we described the benefits of writing; in this article, we investigate the meaning-making processes underlying the traumatic experiences of parents of children with leukemia in off-therapy. We collected the writings of 23 parents and grouped them according to the parents’ psychological outcome (low/good/high) with respect to anxiety, as assessed during a follow-up. We qualitatively analyzed the texts written by parents with good psychological outcomes to highlight their main meaning-making processes, that is, how they put into words the shattering experience, reordered the events, connected their emotions and the events, reevaluated the event, and reconstructed the time process. We found that parents with low/high outcomes articulated these processes differently. Furthermore, we discussed the uses and functions of written narration for each group.

Understanding Cancer Patients’ Narratives: Meaning-Making Process, Temporality, and Modal Articulation

Temporality is a fundamental dimension of each narrative process of meaning making. In fact, the narration constructs and organizes temporal frames that connect ones own experiences. From this point of view, oncological illness is experienced as a traumatic experience that interrupts the sense of continuity of ones own life, resulting in the configuration of different temporal frames, which are not always able to support the processes of elaboration of this experience. The aim of this article is to explore the way the modal verbal predicates (must, can, will, know) are organized and work in relation to the representation of time in narrations of cancer patients. The modal verbal predicates—introducing the meanings of possibility, knowledge, will, desire, duty, need, or ability—allow us to organize the relationship between the subject, action, and context. Six narrations of cancer experience were analyzed—one for each time frame (linear, circular, fragmentary, static, cyclic, and spiral) proposed by Brockmeier (2000)—by means of quali-quantitative analysis of the use of modal verbs. Narrations show specific modal positioning: dispersion, plasticity, focusing, rigidity, and poverty. It is possible organize them along a continuum from plasticity to rigidity. The modal plasticity is the capacity to reconfigure a new temporal relation between subject and context, whereas modal rigidity shows a repetition of a specific and same modality in connecting subject and context. This preliminary research allows us to reflect about some possible clinical implications to support and foster processes of meaning making of cancer conditions.

Linguistic Markers of Processing Trauma Experience in Women's Written Narratives During Different Breast Cancer Phases: Implications for Clinical Interventions.

Research into the change processes underlying the benefits of expressive writing is still incomplete. To fill this gap, we investigated the linguistic markers of change in cognitive and emotional processing among women with breast cancer, highlighting the differences and peculiarities during different treatment phases. A total of 60 writings were collected from 20 women: 10 receiving chemotherapy and 10 receiving biological therapy. We performed a series of repeated measures ANOVA for the most meaningful LIWC linguistic categories, including positive/negative emotions and cognitive processes, to assess change over three sessions. Results demonstrated a significant increase in the positive emotions category for the entire group of women, with particular relevance for the biological therapy group of women, and a marginally significant (p = .07) greater use of words indicating cognitive processes for women receiving biological therapy. For the negative emotions category time was significant for the whole group of women, showing a peak of use in the second session of writing. Peculiar differences in the linguistic markers of processing trauma were observed between the two groups. Although the writing intervention is a support for both groups of women, it seems to be beneficial when there is a large time gap since the administration of chemotherapy and, thus, when the patient can revisit the experience. The relationship of the illness with life can be rearticulated, and the writing becomes a space for resignifying the traumatic cancer experience.

Modal articulation: The psychological and semiotic functions of modalities in the sensemaking process

Within a semiotic and psychodynamic frame, we present and discuss the psychological construct of modal articulation. By modality, we mean the way a subject organizes the meaning of his/her own experience according to categories of necessity, possibility, opportunity, will, knowledge, permission, and duty. Modality is a relevant topic in some branches of philosophy, logics, linguistics, and semiotics, but there is no systematic discourse about it in psychology. The proposal of this work is to deal with some interesting and promising features of modal categories in the sensemaking process of subjective experience. Modalization is presented as a relevant semiotic organization in each contextual and dynamic sensemaking process in order to perform three functions: (a) connection between affective matrix and subjective experience, (b) mediation between subjective positioning in intersubjective context, and (c) vectorialization of action, namely orienting subjective agency in becoming temporal. Theoretical, methodological, and clinical implications are discussed.

Meaning-Making Process Related to Temporality During Breast Cancer Traumatic Experience: The Clinical Use of Narrative to Promote a New Continuity of Life

Previous research has agreed that meaning-making is a key element in the promotion of patients’ well-being during and after a traumatic event such as cancer. In this paper, we focus on an underestimated key element related to the crisis/rupture of this meaning-making process with respect to the time perspective. We consider 40 narratives of breast cancer patients at different times of treatment, undergoing chemotherapy and biological therapy. We collected data through writing technique. We performed an interpretative thematic analysis of the data and highlighted specific ways to signify time during the different treatment phases. Our central aspect “the time of illness, the illness of time” demonstrates that the time consumed by illness has the risk of becoming an illness of time, which transcends the end of the illness and absorbs a patient’s past, present, and future, thus saturating all space for thought and meaning. The study suggests that narrative can become a therapeutic and preventive tool for women with breast cancer in a crisis of temporality, and enable the promotion of new semiotic connections and a specific functional resynchronization with the continuity/discontinuity of life. This is useful during the illness and medical treatment and also after the treatment.

La ferita del confine: la condizione di liminalità del corpo e della psiche

The process of meaning-making of personal experience is realized through the development of borders. They represent dynamic semiotic devices that allow us simultaneous processes of distinction and connection, separation and integration, individuation and belonging. In a semiotic and psychodynamic perspective, the skin is the first and fundamental boundary process that makes possible the development of identity, the intersubjective dimension and sharing within life contexts. The illness appears as a life discontinuity constituting a laceration of personal somatic, psychic, social borders. From this wound, the victim of an illness may find his/herself in a state of liminality. This concept, originally anthropological, is of current interest in the psychological context as the main feature is the feeling of disorientation, isolation, fragmentation, exclusion from the world of others. In clinical terms, the elaboration of the liminal experience can occur through the construction of new border systems that can construct new meaning to the many aspects of life.