Metapsychologies are essentially ontologies; that is, they are world-views and as such are ineluctably immersed in their time and place. They are neither right nor wrong, but, rather, relevant or irrelevant. An epistemological approach to the praxis of psychoanalytic therapy indicates that there are two striking clinical phenomena—the associative flow of data and the transferential enactment, or replay, of what is being talked about. All psychoanalysts must struggle with how to integrate these two clinical parameters into their metapsychological premises. It is suggested that the recent discovery of “mirror neurons” might provide a frame of reference. Elucidation and enactment may be two sides of the same cognitive process that leads to change.