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After expressing my appreciation to Heather MacIntosh and highlighting her article’s significant contributions to the field, I comment briefly on some of the implications of her methodology and findings. I then elaborate on her summary of the history of the application of self psychology (Kohut, 1971) and intersubjective systems theory (Stolorow, Brandshaft, and Atwood, 1987) to couple therapy, highlighting the key contributions of both theories and describing the current state of the field.