People who have been assessed as suffering from borderline personality disorder are notoriously difficult to treat or to help either within individual psychoanalysis or psychotherapy or within a hospital or day centre. The treatment milieu is most commonly that of a psychiatric day hospital. The purpose of this paper is to explore some of the therapeutic challenges in working with this client group, and then to look at what has been and is being achieved at Belle Ridley Day Hospital, a psychiatric day hospital run on psychodynamic lines which is based in the Waterlow Unit in North London.