A: Schema for the five levels of emotional awareness model of Lane and Schwartz, Parallels in the hierarchical organization of emotional experience and its neural substrates. The shell structure is intended to convey that each succeeding level adds to and modulates lower levels but does not replace them. Although each model contains five levels, a one-to-one correspondence between each level in the psychological and neuroanatomical models is not intended. Lower levels with white background correspond to implicit processes. Higher levels with gray background correspond to explicit processes. B: Neural machinery characterized by neuroimaging studies on alexithymia. Alexithymics showed weak responses in structures of highly cognitive stages, such as the capacity to feel other’s emotional reactions (socio-affective processing), and stronger responses in primitive stages such as hypersensitivity to visceral pain (interoceptive aroursal). Consequently alexithymics experience inflexible cognitive regulation, owing to impairment of the emotional guiding system. ACC = Anterior cingulate cortex; vmPFC = ventromedial prefrontal cortex.