Viewed from an evolutionary perspective, a personality disorder is not a disorder but an adaptation to early childhood unsafety. In an unsafe environment, the chance of survival is higher if you are vigilant to others. From that point of view, mistrust is a strength and not a weakness and therefore hard to change. The explicit effort by the therapist to see the world from the patient’s perspective, is an important way to restore trust. A warm, authentic and empathic attitude is of great importance. This eventually restores trust in the social world as a learning environment (epistemic trust) and erodes distrust. It is not what we teach patients that is most meaningful, but how we teach it. The therapeutic relationship has the potential to restore the capacity to learn from the social environment. Change is then accomplished by what can be learned outside the therapeutic setting, in their own social environment. Therapy will be more successful if the patient’s environment is more benign and if interventions take place in the context of the family and their own social environment. Because of the often tangible nature of social psychiatric interventions, they offer a unique opportunity to demonstrate the (good) intentions of the therapist, which facilitates the growth of epistemic trust. The F‑ACT PS approach adds valuable and tangible interventions, which psychotherapy alone can’t provide.