The concepts of multiple code theory and the referential process are examined in relation to levels of awareness and the sense of self as characterized in recent work in neuropsychology by Damasio. The juxtaposition of subsymbolic and symbolic systems in working memory, as this operates in the referential process, is central to both consciousness and the sense of self. The roots of pathology lie in dissociation within emotion schemas; this applies at different levels for all forms of neurosis. The goal of psychoanalytic treatment is integration of dissociated schemas; this requires activation of subsymbolic, including bodily experience, in the session itself, in relation to symbolic representations of present and past experience. Implications concerning repression, resistance, the primary process, the role of language in therapeutic change, and other psychoanalytic concepts are discussed.