2 The body as a (muffled) sound box for emotion 49 certain impairments in emotional awareness, causing individuals to “get stuck” at a particular level. Five hierarchical levels or stages of development of emotional awareness are distinguished within this model. In accordance with Damasio's theory [10], the model asserts that emotional awareness begins in and with the body. The ‘lack of a physiological response to emotional stimuli’, as described earlier, has no place in the model. If there is no primary (physiological) emotional reaction, it is deemed out of place to still speak of a ‘limited level of emotional awareness’. For instance, in a similar way, when referring to the absence of brakes on a bicycle, it makes no sense to speak of ‘reduced’ braking capacity. Also fitting with the ideas of Damasio, what the model implies is that the conscious ‘feeling of the feeling’ only occurs in later stages of cognitive processing, although the model does discuss a more gradual course by describing five subsequent levels. The type of emotional processing that takes place per level corresponds to specific activations in different functional networks in the brain [8]. Figure 1. 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 backgrounds correspond to implicit processes. Higher levels with gray backgrounds correspond to explicit processes. Reprinted with permission from [8]. The basic order of the five levels within the Levels of Emotional Awareness model and their interrelationships running parallel to Piaget’s description of the stages of
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