The question arose when I ran across the following remark by Tim Robbins about Susan Sarandon:
So when you work with someone you trust it's easier. I've directed Susan three times and each time it gets easier and easier. And you know one of the things I love about her? She really has balls. She has the courage to be unsympathetic—and there are so few people who do that.
Clearly, really here does not mean actually, and yet I don't hear any prescriptivists complaining about this usage.