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Mental Health: The Unthought Known

By James Gairdner


As the world emerges from the ravages of the coronavirus, the inconvenient truth is that its legacy will be with us for some time. Not least the significant cost in individual mental health, where on a global scale instances have rocketed. A global analysis of data published in the Lancet refers to 204 countries and territories, that revealed an additional case load of 76.2 million in major mental disorders (MDD) and 53.2 million in anxiety disorders. To put it closer to the context of the United Kingdom, the numbers are no less troubling with significant increases across the total population led by a 27% increase or 80,226 more referrals in under 18s. At the time of writing this, 1.6 million people are on NHS mental health waiting lists. The Royal

College of Psychiatrists says NHS services are struggling to cope with the demand, leaving Adrian James, the president of The Royal College of Psychiatrists, to conclude: “The extent of the mental health crisis is terrifying, but it will likely get a lot worse before it gets better. Services are at a very real risk of being overrun by the sheer volume of people needing help.”


Having lived through 18 months of lock-downs and uncertainty, I empathise with a desire for this all to be over and long for the days when international travel was easy, and the world less restrictive and crowded spaces filled, for my own part, with less trepidation. On a personal note one of my children is one of those currently sat on a waiting list. However, I was reminded recently of the “unthought known” a phrase coined by (Bollas, 1987) to represent those experiences in some way known to the individual, but about which the individual is unable to think.In object relations theory, a preverbal awareness of one’s early experiences of important objects (e.g., parents, siblings), that is indescribable in words but that nonetheless influences one’s later thought and behaviour.


Diamond (2008) suggests that these “unthought knowns” can exist in organisational life, “where as members of a cooperative system, we are tied together emotionally and cognitively” (p.351). The unthought knowns represent significant truths that are known but cannot be thought about or talked about with others in any meaningful way. It strikes me that “cooperative system” may be extrapolated to include society where the long term and highly inconvenient consequences of the pandemic may represent this “unthought known” which it may be uncomfortable for us to consider.


It follows that those who directly represent the effects of the unthought known have themselves to be made invisible. In addition, just as the issue cannot be thought about, neither can the solution. This leads to an underinvestment in the systems that would support them. Could this also explain the stock response from government when confronted with such issues to see the panacea in large sums of money? To triage, even hold at arms length, rather than seek to acknowledge or even understand.



"It strikes me that “cooperative system” may be extrapolated to include society where the long term and highly inconvenient consequences of the pandemic may represent this “unthought known” which it may be uncomfortable for us to consider"

Self-evidently the consequences for those put out of sight maybe devastating, so perhaps now more than ever it may be important for society to find a way to sit with that which it is difficult to acknowledge. At the very least this may mean that those who suffer and those who care can feel heard, which in itself may prove cathartic. How might we create spaces to sit where we can sit with this discomfort rather than seek to put it out of sight and move on? This feels important not least as Jung suggested because“everyone carries a shadow and the less it is embodied in an individual’s conscious life, the blacker and denser it is[…]if it is repressed[…] is liable to burst forth suddenly in a moment of unawareness […] At all counts, it forms an unconscious snag, thwarting our most well-meant intentions” (Jung, 1970). It will out, the question I guess is when and how we wish this to occur?





 

References:

  • Datta, A. (2021). Women at receiving end as Covid-induced mental health crisis looms large . Available: https://www.business-standard.com/article/current-affairs/women-at-receiving-end-as-covid-induced-mental-health-crisis-looms-large-121110301599_1.html. Last accessed 31 Jan 2022.

  • Bollas, C (1987). The shadow of the object; psychoanalysis of the unthought known. New York: Colombia university Press.

  • Diamond, M (2008). Diamond M; Article Title: Telling them what they know. Organizational change, defensive resistance, and the unthought known; Journal Title: Journal of Applied Behavioural Science, 2008, Vol.: 44, Pages: 348-364

  • Jung, C (1970). In: Collected Works (11), paragraph 131.

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