Explain why the fact that affect blunting is typically not recognised by the patient themselves is clinically significant.

Because the patient usually does not notice or report a change in their own emotional expression, affect blunting is a finding that has to be actively observed by the clinician rather than elicited through the patient's own complaint — a patient will very rarely present saying 'I've noticed I show less emotion now.' This is part of what distinguishes it from an abnormal expression of emotion more generally, and it means the finding depends on careful, sustained observation across the whole interview, and often on collateral history from family or carers who have known the person over time, rather than on the history the patient volunteers unprompted.