Emotional self-knowledge profiles and relationships with mental health indicators support value in ‘knowing thyself’

The primary aim of this study was to elucidate the association between pairings of self-awareness (high/low attention with high/low clarity) and mental health, using indicators of both positive (resilience, positive self-schema, and transcendence) and negative (depression, anxiety) outcomes. We hypothesized that those with both high would show better outcomes on all measures for mental health, compared to those with neither. Further, we supposed that those with high attention only would show worse outcomes than those with neither, a hypothesis that was based upon previous research, which suggests a ‘dark side’ to emotional awareness for those with high levels of attention³⁰.

Here we report partial support for our two hypotheses and discuss an interesting result regarding our exploratory analysis. Those with both high, compared to those with neither, demonstrate higher positive self-schema, resiliency and transcendence, but not higher self-esteem, lower depression or lower anxiety. Interestingly, the second hypothesis regarding high attention only compared to neither is supported for self-esteem, depression and anxiety outcomes, precisely on the outcomes that are insignificant for those with both high. These complementary results which partially support opposing predictions suggest the importance of clarity when attention is high, either improving positive indicators of mental health such as positive self-schema, resiliency or transcendence, or preventing impairment on depression, anxiety and self-esteem, which happens when attention is high but lacks clarity, but disappears when clarity is high as well. This is consistent with previous research that supports attention as the subfactor of emotional self-awareness susceptible to damaging mental health⁵⁵, particularly when it is not combined with a balanced level of emotional clarity²⁴. Further, it supports importance of clarity as a protective factor, thus logically affecting resiliency and transcendence, as we discovered, or attenuating the impact of high attention on symptoms.

In accordance with previous research, symptomatology (including low self-esteem) would be the expected result of a high, and especially imbalanced, level of attention to emotions. In daily life, this may be indicative of excessive awareness of feelings (i.e. ‘I am nervous!’) without further processing to integrate and understand emotions (i.e. ‘I am nervous because…’), rather than recognizing one’s emotions, applying the mental effort to understand them (clarity), and then moving on. Often referred to in mindfulness as being the ‘quiet observer’ or ‘peripheral observer’, this phenomenon consists of an ability to process and be aware of emotions (and indeed, all human experiences) from a place of detachment, allowing for deeper understanding and processing of emotions, which is likely aligned with emotional clarity. This suggestion is also consistent with previous research suggesting ‘overwhelm’ with the high attention pairing⁵⁶. Without a balanced level of emotional clarity to calibrate the harmful effects of emotional attention alone, it seems sensical that one may find themself in a negative feedback loop for distressing or harmful thoughts, which over time, may exacerbate and result in common mental health symptoms.

Comparing the differences between those with high clarity only and those with both high was presented as an exploration to see whether there were, in fact, differences between those with what could be considered ‘implicit self-awareness,’ or low attention to their emotions but an almost ‘default’ understanding of them, and those with both high.

When comparing high clarity only with both high, no differences appeared regarding any indicator. Because the clarity dimension is high in both profiles, and this is the protective dimension as supported by the literature, the lack of difference could be attributed to the similar level of the ‘active ingredient’ (clarity) of the two profiles in this sense. However, when we compared both profiles (with and without attention) with neither, those with high clarity only showed a positive association with mental health in two of the three cases in which both high did not. Specifically, when compared with neither, both high showed no differences regarding depression, anxiety, or self-esteem, while high only clarity, in contrast, was associated with significantly lower depression and higher self-esteem than neither attention nor clarity.

This suggests that, when compared with neither, the protective effect of high clarity depends on which element of mental health is being evaluated. Apparently, for more cognitive indicators, which correspond with positive indicators of mental health (i.e., self-schema, resiliency, and transcendence), more explicit reflection may be more helpful since both high is associated with more positive self-schema, higher resilience and higher transcendence when compared with neither, while high clarity only does not show this positive effect. In contrast, for more affective dimensions (i.e., symptoms: depression, anxiety, (low) self-esteem), high clarity only without attention could be better, possibly providing the more automatic and rapid response required in presence of emotional distress. This is consistent with the dual-process theory⁵⁷ which suggests that type 1 processing (automatic, contextualized, fast processing) is more efficient for evolutionary threats and is usually active when arousal is high, while type 2 processing (deliberate, reflective, slow processing), considered more productive and closer to normative standards, is the one contributing cognitive processes requiring reflection such as self-schema, ego-resiliency and transcendence.

When compared with the reference pairing neither, high attention only is harmful for symptomatology, but when clarity is introduced in tandem with attention, this impairment disappears. Then, when clarity remains and attention does not (high clarity only), symptomatology is, in fact, lower. This leads us to reflect on the imbalanced pairings, whereby one factor is high, and the other is low. High clarity only has beneficial associations with mental health indicators, while high attention only shows the poorest associations with mental health. Other studies suggest that imbalanced combinations of attention and clarity (e.g. one high, the other low) may provide opposite effects in the association between a risk factor and an outcome: while high attention only may strengthen the risk for psychopathology, clarity only appears to attenuate it. The current result further suggests that the effect of high clarity only (implicit awareness) could be less general than previously hypothesized, and in fact be beneficial for specific aspects of mental health (i.e. cognitive aspects) but not as much for affective ones.

A similar dynamic was revealed when analyzing results for self-esteem and self-schema, which, despite both falling under the umbrella of self-image, are positively associated with different pairings of attention and clarity. While self-schema was positively associated with both high, self-esteem was not and, in fact, self-esteem was negatively associated with high attention only, like the result with anxiety and depression. This result deserves further discussion.

Self-schema and self-esteem are neuroscientifically distinct¹⁰. As such, their associations with different combinations of self-awareness are not inconsistent nor entirely surprising. Self-schema indicates a more cognitive or controlled understanding of the self from outside (e.g. I am objectively successful) while self-esteem is indicative of how one affectively feels about the self from the inside (e.g. I don’t feel successful) and could be considered ‘affective’ and ‘automatic’. It is possible that complete emotional self-awareness (both high) favors a process considered ‘more cognitive’ (self-schema) but not necessarily more affective (self-esteem). In fact, some affective processes (self-esteem, depression) may benefit more from less attention than more clarity, which could explain the association of high clarity only with self-esteem, but both high with self-schema. Future studies with more thorough assessments of self-awareness dimensions should shed new light on these questions.

Like all research, this study cannot stand alone in its implications regarding the roles of attention and clarity of emotional self-awareness for mental health, as it does have some limitations. Most obviously, this research is cross-sectional. While some prior evidence suggests the developmental nature of attention to emotions and emotional clarity for developing or maintaining mental health, definitive judgment regarding the roles of these factors should only be made with substantial replication and ideally, longitudinal data. Further, though we chose to measure attention to emotions and emotional clarity using the TMMS-24 because this is the most widely utilized measure to assess this construct, the TMMS-24, along with the Levels of Emotional Awareness Scale⁵⁸ are the only two ways to assess attention and clarity regarding internal emotional experiences, and better instruments are urgently required to improve self-awareness assessment so that it is on par with similar concepts for others, like Theory of Mind and social cognition. Finally, we recognize that different schools of thought in emotional awareness research may refer to overlapping or nearly identical constructs by different names⁵⁹ and this could be a limitation of the present study.

Generally, our results supported that high levels of both attention to emotions and emotional clarity are beneficial in terms of positive mental health indicators, specifically self-schema, resiliency, and transcendence, and that those who have high attention to emotions but lack clarity to balance out this attention are typically worse off regarding symptomatology, showing more depression and anxiety symptoms. Given the adolescent, non-clinical sample, this knowledge has the potential to yield widespread effects when applied to community groups who have not yet experienced the onset of a mental health condition. In clinical practice, it may be particularly helpful to direct adolescents toward ‘knowing themselves,’ by paying attention to and fostering clarity regarding emotions, with the aim of eliciting lasting protective factors for mental health, all the while diminishing the negative ones.

In sum, the Ancient Greeks seem to have been correct–this investigation regarding the associations of emotional self-awareness pairings and mental health indicators shows value in ‘knowing thyself’. Nonetheless, findings suggest that ‘knowing thyself’ is a multidimensional concept; the benefits of knowing ourselves are specific to balanced versus imbalanced combinations of attention to emotions and clarity regarding them, and further depend on the aspects of mental health being evaluated.

While intervening before adolescents meet clinical criteria for mental health conditions is ideal, it is not always achieved. This new evidence stresses the importance of fostering emotional clarity no matter the stage of mental health symptoms, independent of the level of attention to emotions. This evidence suggests that in individuals with alexithymia, for example, strictly focusing therapeutic efforts on paying more attention to emotions would not yield as much success as focusing on emotional clarity, which is beneficial when paired with a high level of attention to emotions, and alone.

Further, considering the adolescent, non-clinical sample, this knowledge may have ripple effects when applied, particularly before the onset of psychopathology. Our findings provide new evidence for how pairings of attention to emotions and clarity regarding them could positively impact mental health. The protective effect of emotional clarity, sometimes paired with high attention (explicit and conscious emotional awareness), and others with low attention (implicit or automatic awareness) introduces new challenges in the training of the general, developmental population in this skill that is typically not the focus of child-rearing. While traditional cognitive skills like language and thought are thoroughly covered in public educational systems (i.e. before therapeutic intervention is strictly necessary), education on emotional self-knowledge falls short despite the 2000-year-old saying that we must ‘know thyself’. It is attractive to speculate that training new generations in emotional self-awareness or even self-knowledge in general could help to introduce natural resilience factors across development, thus leading to better socioemotional skills in subsequent generations. This could help to invert the cycle of emotional illiteracy that remains to be of much consequence in public education.