<p>The current synthesis elaborates the principles of working with emotion in psychotherapy with personality disorders. We start with arguing that personality disorders are actually emotional disorders – in addition to interaction problems –, where the roots of the clinical presentations are to be found in the client’s emotional system. We then put forward a theory of change in clients with personality disorders, by using a multi-level conception of emotional change. Specifically, we define five clusters of emotional experiences that are of primary concern in clients with personality disorders. We elaborate on the role of the therapeutic relationship in the context of working with emotions with personality disorders. The main part of the paper lays out three specific treatment goals and ten emotion-focused therapeutic skills and methods to address in psychotherapy for personality disorders. Finally, our synthesis ends with specific clinical adaptations of an emotion-focused therapy for clients with personality disorders.</p>