Awareness and unawareness are fundamental concepts in Sullivan's interpersonal psychoanalysis, and they differ much from the Freudian and Jungian concepts of "consciousness" and 'unconsciousness". Sullivan feels that the "unconscious mind" is a metaphorical concept which Freud invented, and that its existence can no more be demonstrated than the existence of other metaphorical concepts. However, a person's awareness or unawareness of something can be objectively demonstrated by talking. If a person has a high degree of awareness of his/or her personality structure and how it was influenced by the experiences of his/or her early life, the individual may be able to say, "I am aware that the way I was brought up leads me to be very tense and often irritable when things go wrong in ways that undermine my self-confidence and self-esteem."

A person who is unaware of the nature of his/or her interpersonal experiences learns nothing from them.

The cause of unawareness is anxiety. Abrupt confrontation with the things the individual excludes from his/or her awareness usually makes a person feel anxiousness, guilt, shame, loathing of himself/or herself, or some other form of emotional discomfort.

A therapist's role is to participate as an expert in interpersonal relationships and emotional functioning by observing and helping a person who has problems in these areas; the therapist is not watching from the audience but is up on the stage with the client.