Reflective Functioning

As described in a myriad of ways by Fonagy and his colleagues (Fonagy et al., 1995), our efforts to try to understand both ourselves, and one another are among the most natural and crucial aspects of human functioning. Whether in times of love or hate, peace or war, or simply in times of everyday living, human beings try to understand their own and others’ minds. They use an understanding of mental states – intentions, feelings, thoughts, desires, and beliefs – to make sense of and even more importantly, to anticipate, each other’s actions (Fonagy & Target, 1998). It is the reflexive use of such understanding to make sense of emotional processes that Fonagy and his colleagues refer to as mentalization. On the one hand, the process of making meaning of internal states serves crucial intrapersonal functions, for it provides the means to discover and give voice to vital aspects of subjective experience, and allows for deep and broad self-knowledge. This process, whereby internal experience, feelings and intentions are mentalized leads to the development of structures crucial to self and affect regulation.

Reflective functioning is the operationalized referent to the capacity to mentalize that can be scored in narrative. The capacity to mentalize emerges as a function of the caregiver’s attuned reading and modulating of the child’s internal state and heralds the ability of the child to understand himself as separate from the caregiver with desires, feelings, thoughts and wishes that are distinct from those of the other. That is, the child’s ultimate capacity to make sense of his internal experience depends upon his parents’ reflective capacities. Parental RF (Slade, 2005), as distinct from more general mentalizing processes, plays a particularly important role in the intergenerational transmission of attachment (Fonagy et al., 1995; Slade, et al., 2005). The benign and nurturing interaction with the caregiver also helps the child to regulate his own affect responses such that they become manageable, allowing the child and ultimately the adult to anticipate future affect experiences without fear of becoming overwhelmed and disintegrating. Self-other differentiation promotes the capacity to mentalize which, in turn, permits the individual to reflect on his own affect as well as that of others in such a way that he is afforded the ability to experience and communicate affect rather than impulsively act without understanding the mental state behind the action.

Where parental reflective capacities have been missing or disrupted, and early interactions with the caregiver have been thus misattuned, absent or hostile, the child fails to develop a coherent sense of self and agency such that future interactions with others are more likely to represent a frantic attempt at self-assertion and separation rather than a mutual interaction based on the non-threatening understanding of the other as separate and autonomous. This development may also lead to the individual’s inability to tolerate affect in an interpersonal context and to act out impulsively based on a profound disconnect between intention and action. In this scenario, the individual is left with a sense of mystery as to his own internal states and those of others, overwhelmed by the experience of intense affect, more likely to act impulsively and more likely to experience as threatening the separate intentions/desires of others, all of which increase the likelihood of interpersonal misunderstanding and conflict.

The RF scale was originally designed to score reflective functioning on the basis of the Adult Attachment Interview (AAI: George, Kaplan, & Main, 1984; 1988) narratives. It was later adapted for use with the Parent Development Interview (PDI) and Pregnancy Interview (PI). The scale measures an individual’s ability to reflect on his own as well as others’ mental states in narrative descriptions of behavior and reactions of self and other in an interpersonal context. Each passage in the interview is scored on an 11-point scale ranging from negative RF (-1) to Full or Exceptional RF (9) based on demonstration of criteria such as awareness and nature of self and other’s mental states, the recognition of limitations on insight and a capacity to demonstrate awareness of diverse perspectives. In arriving at an overall interview score, the rater takes into account the individual scoring of each passage as well as the quality of the entire interview.