One of Freud’s great insights was the discovery of psychic reality –
the concept that current experience is determined by mental
representations of past experiences. This insight was foreshadowed
in his early work as a neurologist when he coined the term “agnosia”
to refer to a failure in recognition due to an inability to
mentally represent and know an external object despite intact
perception. Although affect has been critical to psychoanalysis
since Freud and Breuer founded the field in the mid-1890s, the
clinical manifestations and the therapeutic implications of emotion
with and without mental representation has been a relatively
neglected area. The main thesis of our presentation is that the
distinction between implicit and explicit processes, which is
foundational in cognitive neuroscience, also applies to emotion and
the process of becoming aware of feelings, which is so central in
psychoanalytic work. Dr. Lane will begin by describing the
psychological model of “levels of emotional awareness,” which holds
that the ability to know one’s own emotions is a cognitive skill
like any other and that individual differences in emotional
awareness can be understood from a cognitive-developmental
perspective. Research on emotional awareness in normative and
clinical contexts will be summarized, including findings from a
recent study of psychodynamic psychotherapy for panic disorder. A
parallel systems-neuroscience model will also be presented
supported by neuroimaging research. It will be argued that our
growing neuroscientific understanding of emotion permits an
extension of Freud’s legacy and an advance in neuroscience by
applying the concept of agnosia to emotional awareness and deficits
related to it. Dr. Garfield will then discuss the model of
emotional awareness and the distinction between implicit and
explicit emotional processes from a clinical psychoanalytic
perspective. Case material will be discussed. Emphasis will be
placed on the clinical ph