Comments on the article by S. Zilcha-Mano et al. (see record 2023-80613-001). In this meta-analysis, Zilcha-Mano et al. ask a simple question, but one not easy to answer: Does a process variable (interpretation) improve outcome? They found that regardless of a variety of differences, the use of interpretations led to a positive outcome in the psychotherapeutic endeavor. Is the clinical observation that addressing painful emotions and trying to understand how a patient manages them demonstrable to be a common factor? This has to be systematically explored by evaluating the impact of experience-near interventions that address how patients protect themselves from painful affects at the moment it occurs in the session. (PsycInfo Database Record (c) 2024 APA, all rights reserved)