A growing body of research in neuroscience and cognitive science indicates that core aspects of decision-making, evaluation, and insight are substantially driven by processes occurring outside of conscious awareness, challenging models that position conscious processes as the primary drivers of these functions. This article distinguishes between neural, psychological, and clinical levels of explanation and does not assume direct equivalence across them. Instead, neuroscientific findings are interpreted in terms of their implications for psychological processes that are more proximally related to behavior and therapeutic change. Consequently, this article examines the psychological implications of these findings, focusing on the role of nonconscious emotional and predictive processes in organizing conscious experience. The concept of “cognitive restructuring” is critically reconsidered, and the term “emotional restructuring” is introduced to emphasize the central role of unconscious affective processes in therapeutic change. This perspective is intended as a theoretical reorientation that repositions, rather than eliminates, the role of cognitive interventions. The article further argues that intuitive, creative, and nonconscious techniques—while long present in models of psychotherapy and marriage and family therapy—have not been adequately integrated into a coherent theoretical model grounded in contemporary neuroscience. Finally, it contends that insight is often better understood as emerging from nonconscious integrative processes, with conscious awareness reflecting their outcome. The clinical implications of this perspective are developed as a theoretically grounded, although not yet fully empirically validated, framework for understanding mechanisms of change in psychotherapy.