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The importance of reflective awareness for clinical practice is generally well recognized across a variety of therapeutic approaches. Psychodynamic approaches traditionally also recognize that defense mechanisms provide major impediments to reflective awareness. Recently, however, the neuropsychoanalyst Mark Solms proposes that the dynamic unconscious can be understood in terms of the nondeclarative cognitive unconscious. One consequence of Solms’ proposal is that there is no possibility of lifting repression because nondeclarative content is simply incapable of becoming conscious. This paper addresses whether the dynamic unconscious can be sufficiently addressed by the cognitive unconscious. Cases of anosognosia (denial of illness) are discussed in the context of satisfactorily addressing the complexity of psychodynamic phenomena. This paper contends that while the cognitive unconscious provides an important addition to psychoanalytic thinking, the cognitive view does not adequately account for the dynamic unconscious. The paper proposes retaining the concept of the traditional dynamic unconscious and acknowledging the distinction between motivated and nonmotivated impediments to reflective awareness. Clinical implications of the conceptual distinction between motivated and nonmotivated impediments are further considered.