The Difference Between Awareness And Consciousness

(Originally published September 4, 2008)

The leitmotif of every intellectual therapy is that awareness helps us make progress. I’ll grant that awareness helps; but being conscious cures. Unless we are able to achieve consciousness in psychotherapy, the most we can do is tread water, having the illusion of progress without its essence.

When it comes to measuring progress in psychotherapy, it matters whether one measures the whole system or only aspects of brain function. Awareness fits the latter. It has a specific seat in the brain— Awareness and consciousness are two different animals. “Aware” and feelings lie on different levels. Awareness is what we often use to hide the unconscious; a defense. Awareness without feeling is the enemy of consciousness. What we are after is the awareness of consciousness and the consciousness of awareness. Not the awareness of awareness. When the patient is uncomfortable during a session, therapists typically take the position that “More insights is what we need. She is not aware enough.” But it is not the content of those insights that helps; it is the fact of the insight—a belief system that aids the defense mechanisms to do their job. Yet, what lies on low levels of brain function is immune to any idea. We can be anxious and aware but not anxious and conscious.

Psychotherapy has been in the business of awareness for too long. Since the days of Freud, we have apotheosized insights. We are so used to appealing to the almighty frontal cortex, the structure that has made us the advanced human beings that we are, that we forgot our precious ancestors, their instincts and feelings. We may emphasize how our neocortex is so different from other animal forms while we disregard our mutually shared feeling apparatus. We need a therapy of consciousness, not awareness. If we believe that we have an id stewing inside of us, there is no proper treatment because the cause is an apparition—a phantom that doesn’t exist. Or worse, it is a genetic force that is immutable and therefore cannot be treated. In any case, we are the losers.

There is no powerlessness like being unconscious; running around in a quandary about what to do about this or that, about sexual problems, high blood pressure, depression, and temper outbursts. It all seems like such a mystery. The aware person or he who seeks awareness has to be told everything. He listens, obeys—and suffers. Awareness doesn’t make us sensitive, empathic, or loving. It makes us aware of why we can’t be. It’s like being aware of a virus. It’s good to know what the problem is but nothing changes. The best awareness can do is create ideas that negate need and pain.

Awareness is not healing; consciousness is. True conscious-awareness means feelings, and therefore humanity. The conscious person does not have to be told about his secret motivations. He feels them and they are no longer secret. Consciousness means thinking what we feel and feeling what we think; the end of a split, hypocritical existence. Awareness cannot do that because awareness has to change each and every time there is a new situation. That is why conventional cognitive/insight therapy is so complex. It has to follow each turn in the road. It has to battle the need for drugs and then battle the inability to hold down a job and then try to understand why relationships are falling apart. This also explains why conventional therapy takes so long; each avenue must be traversed independently. Consciousness is global; it applies to all situations, encompasses all those problems at once. The true power of consciousness is to lead a conscious life with all that that means: not being subject to uncontrolled behavior, being able to concentrate and learn, able to sit still and relax, being able to make choices that are healthy ones, to choose partners that are the healthy ones, and above all, to be able to love.

By and large, “awareness” is left brain, but that does not necessarily mean language. Conscious-awareness is right-left brain working in harmony. Incidentally, a study out by two psychologists at UCLA, Eisenberger and Liberman, found that people who experienced less discomfort had more pre-frontal cortex activity. (FOOTNOTE: N.I. Eisenberger and Matthew D. Liberman, “Hurt Feelings,” Los Angeles Times, Oct. 11, 2002, page A16) Again, higher centers are able to suppress and calm the lower ones. They also found both physical pain and emotional pain use the same pathways in the brain. In brief, pain is pain no matter what the source—emotional pain is physical. It is not just in our minds; it is not just psychological and cannot be treated on the psychological level alone.

We know that when there is awareness without connection during a session—it is known as “abreaction.” The vital signs rise and fall in sporadic fashion, rarely below baseline. This is what often happens in the pseudo primal therapies where patients are told what and how to feel. Here the vital signs do not move at all. It is why we measure vital signs before and after each session. We measured a new patient who had mock primal therapy. He went through early feelings that looked real. His vital signs never changed, indicating an energy release but no connection. So long as there is no connection, nor a shift in brain processing from right to left, there will be no commensurate change in physiology.

This is not to be confused with appropriate emotions where a person is expressing anger over an injustice or grief due to the loss of a loved one. Those are appropriate feelings, not neurotic.

The right limbic brain/brainstem is responsible for a great part of our arousal, while the left-frontal brain is the calming agent. When there is hyper-arousal due to brainstem/ limbic unfulfilled needs and memories, the left orbito-frontal cortex can help dampen that arousal and produce a false sense of calm. This is one key element in cognitive therapy. Indeed, as I pointed out, one reason for the development of the left brain was to help in the repressive process; keeping enough pain at bay to allow us to function in everyday life.

It is my experience that the wider the gap between deep feeling and awareness, the greater the unreality of the belief system; the more remote the feeling, the more far-out the belief system, and the more tenacious its hold on us. We had one patient who was fixated on aliens coming from another planet to attack her. After many lesser-strength feelings, she finally felt what those aliens were—her alienated feelings; unknown terrors that she converted into attacking aliens. She needed to justify or rationalize her fears. Because they were so monumental, her beliefs soared into the bizarre area.

Consciousness is the end of anxiety. Consciousness means connection to what is driving us. Disconnected feelings are what drive us constantly to keep busy. Their energy is found in the form of ulcers or irritable bowel, in phobias and the inability to focus and concentrate. They are the ubiquitous danger, shaping a parallel self—a personality of defenses and the avoidance of pain; a self stuck in history forever. In effect, there is a parallel self, the unreal front; and the real self, the one that feels and hurts. Thus, there are parallel universes that make up the human condition; one that feels and suffers, the other that puts on a good front. The latter, the front, is what most psychotherapy deals with: the psychology of appearances versus essences. It is navigating in the wrong universe.

Awareness means dealing with only the last evolutionary neuronal development: the pre-frontal cortex. It is the difference between the top level versus the confluence of all three levels, which is consciousness. Once we are conscious, we have words to explain our feelings, but words do not eradicate them; they explain. We are deeply wounded long before words make their appearance in our brains. Words are neither the problem nor the solution. They are the last evolutionary step in processing the feeling or sensation. They are the companions of feelings.

There are types of awareness that are important for our survival. Being aware of a healthy diet is crucial even in the absence of consciousness. But a therapy of awareness versus one of consciousness has an important difference in terms of global impact. In science we are after the universal so that we can apply our knowledge to other patients. A therapy of needs can apply to many individuals (we all have similar needs); a therapy of ideas usually can only apply to a specific patient. When we try to convince the patient of different ideas (e.g., “People actually do like you”), we generate no universal laws. It is all idiosyncratic. But if we address the feelings underneath, we can generate propositions that apply generally: for instance, pain when unleashed can produce paranoid ideas or compulsions. Or, the frontal cortex can change simple needs and feelings into complex unrealities, changing them into their opposites.

One cannot be aware without an intact prefrontal cortex. By contrast, there is no seat of consciousness. As banal as it may seem, consciousness reflects our whole system—the whole brain as it interacts with the body.