As a result of the evolutionary pressure for survival, the brain relies on a number of non-conscious predictive neural mechanisms which allow for rapid, efficient behavioral responses to the environment. These predictive mechanisms enable the brain to recognize objects by sampling just a few sensory inputs, to anticipate what events are likely to occur and to prepare a response before events actually occur. Consciousness appears to play a role in the detection and correction of prediction errors. The author, a psychotherapist and psychoanalyst, proposes that this monitoring or oversight function of consciousness can be used to understand how conscious awareness facilitates change in the psychotherapeutic treatment of patients who repeat maladaptive patterns of behavior.