Abstract
This article will first consider the relationship between the conscious, unconscious and physical triad of self. Second, the role of symbols and movement in the transmission of unconscious knowledge will be explored. Third, I will question whether unconscious knowledge can be created and transmitted before this knowledge has been consciously experienced. My personal experience will be presented as an example. Suggestions will then be offered to therapeutic practitioners for adaptations to practice when working with clients with chronic disabilities.
Keywords
Introduction
This article considers the transmission of knowledge, specifically facts and information, between the conscious, the unconscious and the physical body: ‘triad of self’ (Table 1). It specifically focuses on the creation of unconscious knowledge, the transmission of unconscious knowledge to the conscious world of what is known and how we can interpret symbols and movement to understand what unconscious knowledge is being communicated. This will inform the primary question, which is whether or not knowledge can be communicated to the unconscious before the conscious self has had any awareness.
Definitions of terms for the purpose of this research. These definitions were developed personally but are influenced by the definitions of Carl Jung.
Jung states ‘If unconscious processes exist at all, they must surely belong to the totality of the individual, even though they are not components of the conscious ego.’ (Storr, 1998: 212). Jung is suggesting that there are parts of the unconscious not present in the conscious ego but are still a part of the whole self. The ‘totality of the individual’ could be considered the triad of self.
Exploration of unconscious material not yet meaningfully considered is, of course, a central process of dramatherapy, but this process considers input from the triad of self, which has tangibly occurred. For example, a child experienced bullying while they were younger, this creates unconscious knowledge and the experience can then be made sense of consciously through dramatherapy processes. The primary experience of bullying then becomes accessible to the person.
This article, however, focuses on the development of unconscious knowledge which has not yet tangibly occurred. The primary question is defined as shown in the title of this article: Did my unconscious tell me about my multiple sclerosis (MS) before my conscious self had received the verbal diagnosis from a medical professional? My own experience will be presented to consider the transmission of unconscious knowledge of an undiagnosed and unforeseen chronic disability by analysing a personal dramatherapy experience and symbolic visualisation through a Jungian lens and using Laban Movement Analysis (LMA).
Jung (1963 in Jaffe and Jung, 1993), referring to his exploration of his unconscious, wrote that ‘. . . below the threshold of consciousness, everything was seething with life . . .’ (p. 202). He also suggested that by considering and interpreting symbols from the unconscious, through dreams, for example, he ‘. . . learned how helpful it can be, from the therapeutic point of view, to find the particular images which lie behind emotions. . .’ (p. 201). Jung (1963 in Jaffe and Jung, 1993) consequently proposed interpreting symbols as a means of consciously interpreting the unconscious self: ‘My hypothesis is that we can do so with the aid of hints sent to us from the unconscious.’ (p. 332).
Dramatherapy can aid the production and transmission of unconscious knowledge. Totton (2005) refers to Jung’s theory of dialectical relating, which considers the body conscious, unconscious and conscious and unconscious as part of the same system. Totton (2005) also suggests that you can ‘. . . invite dialogue between consciousness and the unconscious through movement.’ (p. 130). Chodorow (1999) in Totton (2005) further states that ‘. . . when movement is used in psychotherapeutic intervention, it activates both conscious and unconscious processes’ (p. 140). This highlights the importance of considering the role of the body in the triad of self when approaching it from a Jungian lens.
The unconscious as an academic subject will always have its limitations as there are many evolving and unknown factors to this entity. Understanding its relationship to the conscious and physical self can offer further opportunities for a client’s and therapists’ personal insight.
Methodology
Auto-ethnography and disability
Auto-ethnography aims to place the experience of an individual within their wider context to validate personal experience and consider it in relation to an ‘other’. This article considers my experience as a disabled person in relation to any ‘other’ person, as one person with MS may even experience their disability very differently to another. In the same way, the ‘other’ will later refer to the dramatherapist as an ‘other’ to the disabled client when considering clinical practice.
Auto-ethnography is an appropriate method for exploring the topic of disability as it can approach nuance (Kasnitz, 2020) and can respect the individuality of every disabled person’s experience: ‘Autoethnography . . . points to the sociocultural embeddedness of all human and social research, helping to show that researchers [with a disability] do not live outside of social reality’ (Polczyk, 2012: 178).
Auto-ethnography is therefore a vital tool in ensuring the disabled researcher is included as a valuable member of the conversation, creating more inclusive research and giving disabled researchers a voice. However, as an author with a disability, I am vulnerable. People living with disabilities can experience discrimination from able-bodied people, and disclosing disability can have an impact on pre-existing relationship dynamics. When speaking to another dramatherapist with a disability online, I wrote the following message:
When you were saying you were fearful of speaking out about your experience immediately I just thought ‘gosh this is so my experience of being a disabled person in the world’. I feel like the world is not built for people with disabilities so when we speak out, it’s fearful that we will lose everything we have worked so hard to gain in a world not built for us. (Green, 2022, personal communication, 30 June)
It is important to include this conversation between two disabled practitioners as this exemplifies the ability to relate to another’s experience through exposure to personal narratives, and highlights the usefulness of an auto-ethnographic approach. However, ‘. . . the available literature on disability studies is mostly written from an “expert” vantage point in which non-disabled researchers share their findings about people with disabilities.’ (Polczyk, 2012: 177). This highlights the vulnerability but value in this auto-ethnographic approach and also solidifies the importance of intrinsically placing myself as a disabled researcher in relation to the able-bodied ‘expert other’.
Placing my experience within my social context: Living with MS in the UK
MS is a lifelong condition which affects around 130,000 people across the UK. The MS Trust (n.d) defines MS as ‘. . . a condition which causes damage to the nerves in your brain and spinal cord (the central nervous system)’. Your immune system attacks your central nervous system, ultimately damaging the ability for nerves to transmit messages effectively and can result in physical disability and cognitive and emotional difficulties. The ability of the body to repair itself is also impaired.
I was diagnosed with relapsing remitting MS (RRMS) in 2018. RRMS refers to a stage of MS where symptoms ‘flare up’ for periods of time. I experience physical disability such as imbalance and weakness of limbs, severe fatigue, headaches, breathlessness, pain, distorted sensations on the skin (e.g. pins and needles, ‘bugs’ crawling on your skin), emotional dysregulation, difficulty finding words, memory problems, loss of sensation, mental health problems and other infrequent symptoms.
MS and mental health
MS can be life-limiting depending on the level of disability. The unpredictability of living with a chronic condition and the symptoms associated can lead to poor mental health.
‘Studies have found that people with Multiple Sclerosis experience relatively high rates of anxiety and depression’ and ‘. . . the lifetime risk of major depression in people with MS has been estimated to be as high as 50% compared to 10% to 15% in the general population.’ (Jones et al., 2012: 1). People living with RRMS experienced the highest levels of anxiety. I also have co-occurring depression and anxiety.
Did my unconscious tell me about my MS?
Author’s personal experience
While training as a dramatherapist (Sesame) in 2015–2017, I had a strong resistance to the Laban Movement module. During this module, we would partake in a movement session led by a course lecturer with the aim of experientially learning how to guide our future clients in movement work as therapists. Every module would consist of me sitting in the corner or walking around the room in tears. One day, my lecturer encouraged me to try repeating a small movement. I chose to stand at the side of the room, face the wall, close my eyes and clench and unclench my fists while focusing on my breath. I kept breathing and clenching and unclenching my fists despite increasing internal resistance. After some time, I experienced a mental visualisation:
Planes. It’s wartime and there are planes soaring close to my face, the wings almost grazing my nose. This war is inside me and it is crashing. I can feel it vibrating through my body and my bones and there are ribbons soaring off the wings. They are dropping bombs: these bombs shatter but I can’t see them once they have fallen. I cannot see what they are destroying, but maybe I can. Maybe I can see dirt being thrown up from its resting place and maybe I can see the bombs create craters but also maybe my mind is filling this in because a bomb with no landing is scary: it’s a free fall. My breathing is heavy and it is still a rhythm but it is strong and seems like it should be faster. It is not, it is an anchor from which I hang and stay scarily close to the edge of the war zone. I feel tears streaming down my face and sense my lecturer coming near but I am stuck, her presence is acknowledged and I am briefly distracted but this experience is powerful. I cry and cry, the tears are so hot on my face and they are real. I clench and unclench and once the planes stop flying I begin to slow the clenching and blink my eyes open. I am stiff, I am rigid. What just happened to me?
This excerpt was written as a reflection in 2022 for this research.
Conscious interpretations
Jung (1934 in Jaffe and Jung, 1993) defines consciousness as events happening outside of the self which are experienced and become a part of one’s self from their own perspective. He defines the unconscious as
Everything of which I know, but of which I am not at the moment thinking; everything of which I was once conscious but have now forgotten; everything perceived by my senses, but not noted by my conscious mind; everything which, involuntarily and without paying attention to it, I feel, think, remember, want, and do; all the future things that are taking shape in me and will sometimes come to consciousness . . . . (Jung, 1927 in Jaffe and Jung, 1993: 420)
Symbols
Jung highlighted the importance of considering symbols and images as communication between the conscious and unconscious self. He reported in his therapeutic practice to help ‘. . . the patients understand the dream-images by themselves, without application of rules and theories.’ (Jung, 1963 in Jaffe and Jung, 1993: 194), suggesting the value of the individual’s interpretation and how it may relate to their lives.
Symbols can be considered a mode of communication between the unconscious and the conscious self.
The symbols and images from the visualisation will be considered in relation to MS to analyse the potential of unconscious knowledge of chronic disability.
It’s wartime . . . This war is inside me . . .
MS is an internal war where your immune system attacks itself.
There are planes soaring close to my face the wings almost grazing my nose.
The closeness of the planes could indicate a closeness to the war, something right in front of my face but not quite reaching. MS was inside of me but I could not see it, even though it was there the whole time. MS can also be an ‘invisible illness’ as I am not visibly disabled.
I cannot see what they are destroying, but maybe I can.
There is uncertainty in this part of the visualisation as if there are two parts of me. A part that knows something and a part that does not, but they cannot quite communicate.
. . . maybe my mind is filling this in because a bomb with no landing is scary: it’s a free fall.
MS is an unpredictable condition, and your body and mind are constantly readjusting to compensate. You never know what is happening next but you try and fill in the gaps.
. . . these bombs shatter but I can’t see them once they have fallen.
There is a war happening and I know they are shattering but I cannot see where they go, potentially signifying an internal war. MS is an invisible illness, and you can often feel the symptoms but you are never aware of the impact on the inside of your body unless you have an magnetic resonance imaging scan, which is rare in my experience.
Laban and LMA
The visualisation will now also be interpreted using the LMA to consider the role of the body in the creation, transmission and interpretation of unconscious knowledge of MS.
LMA is a language developed by Rudolf Laban (1950), through which one can name and categorise physical movements to aid the understanding of the inner life of a person. Two categorisations found in LMA will be explored in relation to my experience:
Body: What we move . . . body awareness . . . shapes & gestures . . . Space: Where we move, spatial awareness, personal space . . . (Loutsis, 2016).
Pearson (1996) also writes of the role of the body in personal and unconscious experience:
The [non-verbal] knowledge resides partly in a connectedness with our physical energy as it flows from the centre of our being, by which I mean not only the physical centre of the body but also the psychic and spiritual centre. (p. 10)
The role of the body can play a part in not only the interpretation but also in the creation and transmission of unconscious knowledge.
I clench and unclench and once the planes stop flying I begin to slow the clenching and blink my eyes open. Effort actions: The clenching and unclenching of my fists lasted throughout the whole visualisation. They could be considered the effort actions of ‘pressing’ and ‘wringing’, as they were direct, sometimes flexible, strong, and sustained. Space: The clenching began to automatically slow down and stop when I went to open my eyes, bringing me back into the space with others.
RRMS comes in waves, normally rendering me fatigued and unable to function in daily life. During the time when I had this symbolic visualisation, I also had frequent periods of passing out on the London Underground, waking up with no recognition of falling asleep and having missed my stop, as well as sleeping through multiple phone alarms to wake me up in the morning. I clench and unclench while the planes are flying, stuck in a state of making an effort, similar to exuding extra effort when I am stuck in a relapse. I am also stuck in a cycle during a relapse, moving between exhaustion, sleeping, being awake and then being exhausted again, just as I was stuck in a cycle of clenching and unclenching my fists. I then relax my hands when the planes stop flying, just as I can relax when a relapse moves into remission.
. . . sense my lecturer coming near but I am stuck . . . Body: I was unable to use my body as I wanted to and felt immobile. Space: My body could sense what was in the space around me. Relationship: I did not engage with my lecturer or the working relationship.
MS immobilises you, and often your body cannot do what you instruct it to. The reason I went to the doctor in 2018 (after increasing symptoms since 2015), which led to my diagnosis, was because my arm would not move in the right direction. I was present in the space, and I could sense my surroundings, but I struggled to have autonomy over my movements, and this isolated me from others in my surroundings. The immobilisation of the body which can be felt during periods of fatigue can also encourage introversion and withdrawal from others.
My effort actions could also have offered a sustained, firm and comforting movement and a sense of safety and consistency. Such as rocking a baby, the repetition could have created a sense of safety to allow for deep introspection. By closing my eyes to avoid relationships in the space, I was directed to look inside myself, even neglecting the working relationship with my lecturer. I also felt unable to use my body; however, the body was perhaps a stable container for internal exploration as opposed to engaging it as a form of introspection in itself. The fact that the movement slowed down as the visualisation faded could be an indicator of this.
. . . breathing is heavy and it is still a rhythm but it is strong and seems like it should be faster. It is not, it is an anchor from which I hang and stay scarily close to the edge of the war-zone. I am stiff, I am rigid . . .
The body can be used as a facilitator for unconscious and conscious exploration (Totton, 2005), as exemplified in the analysis above. My body was responding to the unconscious exploration and expressing emotion, offering immersion and realistic qualities to the experience through tears. The breath, however, seems to remain separate from the emotions and the experience and remained slow and steady, potentially facilitating the ability to remain in the process. By the end of the process, my body was ‘stiff and rigid’, possibly indicating a ‘freeze’ response or a coping mechanism to offer space for processing and realignment with reality.
Discussion
For this enquiry, it is vital to embrace an almost magical concept that our unconscious may hold knowledge which will not be experienced consciously until a future point in time.
Jung (1963 in Jaffe and Jung, 1993) reflects upon not dismissing dreams as communication, or ‘hints’ from the unconscious, which is important to consider when understanding symbols as a tool for interpreting unconscious knowledge:
Usually we dismiss these hints because we are convinced that the question is not susceptible to answer . . . If there is something we cannot know, we must necessarily abandon it as an intellectual problem. For example, I do not know for what reason the universe has come into being, and shall never know. Therefore I must drop this question as a scientific or intellectual problem. But if an idea about it is offered to me–in dreams or in mythic traditions–I ought to take note of it (p. 332).
This idea hints more towards knowledge not consciously considered, comprehended or known to the self but which could be accessed should the unconscious offer it. This article questions knowledge sitting outside the conscious experience but does not dismiss the power of the unconscious to hold this knowledge.
My experience exemplifies both dramatherapy and symbolic visualisation as facilitating communication between the conscious and the unconscious. It could be suggested that:
The body facilitates, supports and regulates unconscious exploration.
The unconscious projects symbols to the conscious self.
The conscious self can, in hindsight, analyse symbols and engage in meaning-making processes, taking into account Dienes (2008) idea of intuition and Jung’s (1963 in Jaffe and Jung, 1993) suggestion of the value of individual interpretation.
Engagement with physical space and movement within dramatherapy can be utilised to encourage introspection.
Symbols and images from dramatherapeutic experiences can be the language through which the conscious self can conceptualise experiences and develop conscious understanding.
Structural and judgement knowledge
With this triadic relationship in mind, it is important to consider that the unconscious and conscious is also made up of structural and judgement knowledge (Dienes, 2008; Dienes and Scott, 2005).
Dienes (2008) discusses the difference between structural knowledge and judgement knowledge. If the conscious self is exposed to a series of information, the unconscious self can then develop structural knowledge, built on patterns. Structural knowledge then informs more conscious judgement knowledge: ‘When structural knowledge is unconscious and judgment knowledge is conscious, the phenomenology is that of intuition’ (Dienes and Scott, 2005: 23).
Diene’s (2008) research on structural and judgement knowledge can also be applied to this triad to identify the body as a potential contributor to unconscious structural knowledge. Unconscious awareness of physical changes in the body not yet considered by the conscious self, such as heavy legs or increased fatigue, could have created unconscious structural knowledge leading to unconscious judgement knowledge of an MS diagnosis. Conscious experiences, such as awareness of pain or increased doctor’s appointments, will also have contributed to structural unconscious knowledge.
I suggest that my unconscious received and held information from my conscious and physical self, which was developed into new information and judgement knowledge about my chronic disability. Dienes and Scott (2005) suggest that
Presumably, conscious structural knowledge leads to conscious judgment knowledge. But if structural knowledge is unconscious, judgment knowledge could be conscious or unconscious. (p. 339)
This judgement knowledge of chronic disability can then be communicated back to and interpreted by the conscious self through dramatherapy and symbols.
Considerations for practice
I have suggested that my experience was an example of unconscious knowledge being created, transmitted and interpreted between the triad of self, but the interpretation of the mental visualisation was not fully realised, as I was not aware of my MS diagnosis (Diagram 1). I consequently reached conclusions relevant to past experiences of physical surgeries to interpret the war-like images. I argue that this interpretation did offer therapeutic merit, but the visualisation remained very present in my conscious, and I frequently thought about it. Once I received my MS diagnosis, there was a very prominent moment of realisation and almost relief when considering the diagnosis in relation to the visualisation (Diagram 2).
Author’s experience of visualisation before MS diagnosis.
Author’s experience of interpreting the mental visualisation once a diagnosis of MS had been received.
Diagrams 1 and 2 visualise the difficulty in processing chronic disability when there is a difference in conscious and unconscious knowledge. The cycle in Diagram 2 can be described as a more fulfilling process while the cycle in Diagram 1 continues to move without acknowledging the impact of a chronic disability in a fulfilling way.
The creation of unconscious knowledge is usually presumed to have been, at one time, experienced in an aware state by the client. This awareness of their previous experience can support interpretations of unconscious materials. Some unconscious knowledge may be available. The client is not yet aware of this material and is therefore unable to effectively interpret and make meaning. This is a key overarching consideration for future practice for therapeutic practitioners: We need to consider awareness which is emergent, in its infancy, and not yet known and, for many reasons, is not available to the conscious mind. Avoidance and denial are good examples of defences used to protect oversensitive or traumatic experiences. Watermeyer (2006) suggests that people push what they fear down in to their unconscious, and this can include fear of disability, which can be seen as fear-inducing within society. This may have been a reason why I avoided Laban experiences during my training, and it must be considered as to what information is missing, which may facilitate avoidance of movement exercises for the client.
This article encourages thoughtfulness and consideration of how symbols experienced imaginatively or through the body manifest and inform the triad of self. Care must be given to how clients may acquire new conscious knowledge through this triadic relationship. These considerations can provide a vehicle to further reveal the experience of ‘disabled people’s [clients] bodyminds in their own spacetime’ (Kasnitz, 2020) and help to understand disability.
The benefit of this article lies within considering the presence of unconscious knowledge not yet consciously experienced and how it may present itself within a client’s dramatherapy process, whether they are aware of a chronic condition or not. The triad of selfsharing knowledge can offer integration of self and a sense of security to process disability and the mental health problems which may be associated with a chronic condition. Once the conscious interpretation of symbolic material feels appropriate, the connection between the conscious, unconscious and physical self can be examined from a position of shared internal knowledge. The emotions associated with chronic conditions can be overwhelming and lead to mental health problems such as anxiety and depression, and the longevity of the circumstance can feel like a dead end. Dramatic distance, symbols and unconscious knowledge can offer more cathartic exploration different to verbally describing similar experiences and feelings repeatedly for a lifelong condition. The therapist should remain aware of the potential of unconscious knowledge not consciously considered and encourage symbolic investigation to promote integration of self.
Educate clients on the conscious, unconscious and physical self
When working with clients who identify as having a disability, there may be a resistance to movement work or accessing the unconscious through dramatherapy. The wishes of the clients in the space should be respected, but conversations could be had to educate the client on the benefits of exploring the relationship between the conscious, unconscious and physical self and the knowledge which can be accessed. The client can then have an educated choice in having the opportunity to gain knowledge which is not yet conscious.
Use the body as a facilitator and informant
From my experience and exploration, the body can be a facilitator to support communication between the conscious and unconscious self. The body can also be a factor in informing unconscious knowledge. Practitioners should therefore offer clients with disabilities the choice to bring awareness to the importance of the body in the therapeutic process as a means of unconscious exploration. LMA can be helpful for clients to offer less confrontational ways of using the body, thus providing an aesthetic distance to support exploration and gain understanding.
Be prepared for the acquisition of knowledge
Practitioners should prepare for the possibility of the acquisition of unconscious knowledge not yet consciously aware to the client. The significance of the physical self in this triad can be of importance when working with clients with chronic disabilities as their experiences of relationship to their body and the power of these conscious realisations may be extreme and/or life-changing. Chronic disabilities are lifelong by nature, so this knowledge may be heavy and something that the client has to permanently live with.
These considerations for practice are also applicable to clients who do not identify as having a physical disability but who have experienced physical trauma, such as refugees or clients with eating disorders.
Limitations
The limitations of this article have already been outlined when discussing auto-ethnography. The individuality of auto-ethnography narrows the scope of this research but can hopefully contribute to a wider body of research considering the triad of self and unconscious knowledge when working with differently abled clients, or as a differently abled therapeutic practitioner.
This article is also focused on simply one visualisation which contributes to a hypothesis limited by the aforementioned difficulties of working with the unconscious. However, the contribution of this work as an auto-ethnographic offering is necessary to introduce the voices of disabled practitioners and people to research in a research base currently dominated by writings of the able-bodied experts, ‘others’ to disabled practitioners. While research focusing on unconscious bias towards disabled people is also easily accessible, the experiences of physically disabled clients and their unconscious processing needs to be contributed to. It is my hope that this limited contribution adds to a pre-existing research base, such as Dunn and Burcaw (2013) and Toombs (1994), and leads to reducing the gap between the disabled practitioner/client and the ‘other’.
I interpreted my visualisation after diagnosis, potentially resulting in the interpretation of symbols or movement being analysed to suit a pre-determined meaning of chronic disability. On the other hand, Jung’s belief in the individual placing their own meaning on their symbolic experiences and Dienes’ (2008) concept of intuition as structured within the unconscious from structure and judgement knowledge support my belief that this interpretation is valid. I did approach many other routes of interpretation, but I experience a bodily sensation of affirmation with this interpretation which confirms my personal conclusion. I am also limited by my initial claim that conclusions regarding the unconscious can never be fully proven.
Conclusion
This research aimed to answer a primary question of whether unconscious knowledge can be communicated to the unconscious before the conscious self has had any awareness, further defined by my question, ‘Did my unconscious tell me about my MS?’.
I proposed that unconscious knowledge could be created and transmitted through the triad of self before a person becomes aware of any conscious experience of this knowledge. As seen in the personal example, I had indicators that led to structural and judgement knowledge which aided my unconscious to intuit a more serious chronic disability than my conscious mind had considered. The concepts of structural and judgement knowledge may help to understand how this unconscious knowledge could have been created before a verbal diagnosis was ever received, due to the cues the unconscious received from the conscious and physical selves.
This article aims to consolidate specific ideas to gain a new perspective and contribute to pre-existing narratives of disabled practitioners and clients and hopes to inspire readers to relate this to the potential experiences of differently abled clients. The overarching benefit of exploring the unconscious should be to further curiosity. Jung’s suggestions of unconscious knowledge existing external to our comprehension aid this curious stance.
Footnotes
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
