Borderline personality patients are commonly encountered in healthcare settings due to the high frequency of stress responses and chronic pain syndromes. Due to the high drama potential for these patients in theraputic relationships, their reputation is terrible among medical professionals. However, if a systematic approach to repairing the underlying defects in self-awareness, affect management and self-regulation of distress, progress can be made and symptoms reduced. The author has been using a self-regulation protocol for care of these complex and challanging patients for 30 years with some promising results.