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Transference-focused psychotherapy is a modified version of classical psychodynamic psychotherapy specially adapted for patients with severe borderline personality disorder. It is based on psychoanalytic principles, with an emphasis on object relations theory. A fundamental concept in this model is that the individual’s psyche is structured around internalized paradigms of interpersonal relations. The relationship experiences that are internalized will involve a specific representation of the self, a specific representation of the other (the object of the libidinal or aggressive drive), and an intense affect linking the two. In normal development, these representations are integrated with each other to form a well-developed, flexible, dynamic world adapted to external reality. However, this movement toward integration of the internal representational world does not take place in individuals with borderline personalities, who continue to experience life in a way that is based on rigid and extreme views of the self and others. The goal of transference-focused psychotherapy is to help individuals advance toward an integrated internal worldview through analysis of the patient’s ongoing experience of his or her relationship with the therapist. It is assumed that analysis of this relationship will bring to light the internal representations of self and other and the corresponding affects, related to unconscious desires and motivations, that underlie the individual’s extreme and discontinuous experience in life. The therapy begins with a specific diagnostic interview and the establishment of a treatment contract with the patient before the psychotherapeutic work begins. The first goal of the therapy is to engage the patient in the process of observing and gaining awareness of the representations of self and other that guide his or her perceptions of the world. The therapy then helps the patient to understand the internal forces that have kept these representations segregated from one other, and to integrate them into a more mature and coherent sense of self and other.