The psychotherapeutic frame facilitates all technique and promotes cure. The frame’s fixed or static role has been emphasized, historically, and forms the basis for accepted practices of establishing a therapeutic setting and its ground rules. Once established, the frame’s static functions operate essentially on their own. However, the static frame alone is insufficient to manage certain acting out behaviors which can disrupt the therapy. The frame’s adaptive features can be used to detect and resolve such behaviors. The adaptive frame and its structure will be defined in practical terms that reflect its neurobiological basis in the procedural memory system. Case examples, including historical accounts, will help illustrate the adaptive frame’s use in the treatment of individuals with severe character pathology or early life trauma.