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Individuals with borderline and other personality disorders tend to enact their conflicts in potentially dangerous ways that can create serious difficulties in psychoanalytic psychotherapy. Transference-focused psychotherapy, or TFP, is a specialized, evidence-based psychoanalytic psychotherapy designed for these patients. This article proposes that the treatment arrangements in TFP play a central role in making an effective, specifically psychoanalytic psychotherapy available for these patients, whom analysts and psychoanalytic therapists might otherwise decline to see. Psychoanalytic here refers to a psychotherapy in which analysis of transference and the eventual development of a more mature, less transferentially affected relationship with the therapist are central to structural personality changes in the patient, although much else may occur. TFP shares the psychoanalytic assumption that the combination of new experience, emotion, and insight in transference analysis is central to change in therapy. After noting factors in patients and therapists that impede transference analysis and interpretation in usual settings, the article proposes that features of the treatment arrangements (or “treatment contract”) in TFP make transference analysis possible in a very structured psychotherapy. These features include enlisting the patient's initial agreement in arrangements to maintain safety for both patient and therapist and protecting the therapist's ability to interpret. The article describes how these factors allow focus on the transference relationship despite patients' tendency toward self-destructive actions, importantly enlarging the sphere of transference analysis to include an evidence-based psychotherapy for individuals with personality disorders.