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Therapeutic change involves integration of emotion schemas that have been dissociated. Two types of avoidant dissociation are distinguished: primary dissociation dominated by fragmentary emotional memories; and secondary dissociation involving initial encoding of more organized memories whose meaning is avoided. Reconstruction of dissociated emotion schemas occurs through the referential process which includes three basic components: arousal of the subsymbolic affective core of a dissociated schema in the treatment relationship; connections of subsymbolic processes to symbolic representations in narratives and interactions in the session; and reflection leading to reorganization of the schema. The role of enactive perception and embodied communication as underlying intersubjectivity in the referential process is reviewed. Variations in states of awareness associated with each phase of the process, in both analyst and patient, and their effects on therapeutic change are examined. Current work in cognitive science and affective neuroscience supporting this process model is reviewed. This formulation is largely compatible with Freud's early theory of recollection and “associative working-over” with new emphasis on subjective state and the relational context. Studies of the referential process provide a potential interface between investigations of psychotherapy process and basic cognitive science and neuroscience research.