In 1951 the anthropologist and psychoanalyst George Devereux wrote "Reality and Dream," on his analysis of an American Indian patient. In the prologue to the book, he summarizes his approach as such: "Whatever happened between Jimmy and myself on the personal level happened between two men of good will and concerns only us: it concerns two men united in a quest for common sense and common decency by their common humanity, whose cornerstone is the individuality of each of us." (p. xxxiv) Although his statement may appear in stark contrast to the richness of cultural description seen in Joe Gone's article (2010 [this issue]) on the potential of integrating traditional healing and psychotherapy, Devereux sees enormous diversity in cultures; therefore, an interest or an investment in an aspect of culture (such as the healing process) does not in and of itself tell much. Rather, it is the "meaning or the culture's ethos" (p. 73) that is informative. It is a nuanced view of the functioning of culture that Gone utilized to compare two Native American healers to understand the healing process. Gone is able to elucidate the dilemmas faced in developing an indigenous psychotherapy, or counseling method, by comparison and contrast between a medicine man and an American Indian psychotherapist. It is this interplay of seeking to find the human without separating the person from his or her culture that defines much of Gone's attempts to build a theoretical structure for developing an indigenous psychotherapy. In this commentary, the author focuses on a number of issues that Gone raises that he thinks are critical for Gone and others to move to the next stage of systematically identifying the processes and structure for a psychotherapy that comes out of this land, this earth, and its First People in a place called America. His sense is that Gone has identified many of these elements in his previous writings and in this extensive comparison of approaches to build a theory for an indigenous approach to psychotherapy and counseling. For the majority of his commentary, the author reflects on what he thinks are the bedrocks of Gone's theory that could guide the development of a practice. He also comments on it from his own experience of many decades of working with Lakota healers.