This discussion considers personally-held theories as organizing principles that influence the ways in which analyst and patient co-create their interactions. In examining the clinical process Kieffer presents, I explore how the theories or organizing principles of analyst and patient might dovetail or conflict, contributing—at times—to increasingly rigid patterns of interaction and—at other times—to greater flexibility and understanding. Furthermore, this discussion explores Kieffer's central thesis about how enactments lead to therapeutic action.