Theory should provide a focus for clinical work. A self psychological/intersubjective model provides a particular emphasis that can guide listening and intervention. Sustaining a focus on an individual's subjective/affective experience, and on emerging vulnerability, invites the processing of previously walled-off painful affect. This article underscores how a sustained empathic focus can be instrumental in the development of an increased capacity for affect regulation and the building of psychic structure in the context of couples treatment. This focus, particularly in working with couples, highlights, and often begins to heal, intersubjective differences and ruptures, leading to a deepening of intimacy in both individuals.