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Starting with the first works concerning therapeutic consultations and parent-baby brief therapies, considerations about early intervention have been aimed at complex clinical situations which do not belong, strictly speaking, in the category of joint psychotherapies. It was necessary to gradually invent other types of interventions for situations which can be defined as atypical. They often concern parents presenting serious personality disorders of the narcissistic or borderline type. These troubles expose the baby to serious neglect of his needs from birth onward and to relational distortions and psychological violence which affect his early development. Although many clinicians have concerned themselves with the consequences for the baby of pathological parental functioning, there has been less work describing the frameworks set into place in institutional therapy which these situations require. The complexity of the psychic functioning of these parents poses questions at several levels of the therapeutic space. Only a framework which combines flexibility and availability, in an effort of co-construction carried out jointly by several therapists, can allow for the establishment of a mother-child bond. We will illustrate this work by means of a clinical case which follows a mother from pregnancy until her child is 3 years 5 months old. We will describe the significant moments of the therapy by showing how the institutional therapeutic framework, a space which both contains and organizes, was able to accompany the mother-child dyad. Afterwards, we will give a more detailed description of the particularities of this atypical mother-child psychotherapy. Our clinical experience has taught us that a treatment program and pluri-focal therapeutic interventions are necessary when dealing with such atypical clinical situations.