Referring to Alessandro Cavelzani and Ed Tronick’s paper, the authors discuss the problems inherent in the application of theoretical tenets to clinical practice. They propose the idea that theoretical tenets tend to be associated to devotion to the theory of reference or to bedrock epistemic assumptions and that they may often generate self-referential outcomes. In particular, they delve into the issue of change in psychotherapy, starting from some questions about the theoretical tenets and their consequences on change, with special reference to Samantha’s case (presented here).