The interweaving of subjective suffering and maladaptive behaviour in PDs leads to therapy having a double goal: reducing suffering and improving life quality. The aim of treatment should be to interrupt the circuits arising between metacognitive malfunctioning, problematic states of mind and interpersonal cycles, and stimulate often lacking social skills. In particular, to improve life quality requires patients to create new narrative scenarios with which to master wider areas of their relational lives (Dimaggio and Semerari 2001; Livesley 2003; Angus and McLeod 2004) and improve their metacognitive skills (Semerari et al. 2003a), so as to have a greater choice of possible futures and acquire new tools for understanding their preferences and desires, creating and maintaining intimacy and a sense of belonging to groups, steering the carrying out of tasks and correcting forecasts.