Abstract
In the article we explain the use of agreements as a binding relation with a patient suffering from severe self-mutilation to a degree where it endangers the patient's life. The self-mutilation was a great stress for the nurses and caretakers in the ward where the patient was admitted.
The nurses' actions, i.e. the agreements in a binding relation, have attended to the patient in an exemplary way. Through this article we want to make this professionallity scientific. Agreements were used as a method to create trust and security in the relation. The accomplishment of the agreements is described to explain which qualities that lead to improvement for the patient. The nurse engaged in a very close relationship with the patient, and was therefore able to apprehend the stimuli that influenced the patient. The aim was to make the patient feel so secure that she understood what was happening, and that she did not mingle the past with the present. The patient was able to accomplish this by gaining confidence in an another person. By building agreements upon a binding relation where the patient's autonomy and needs were respected, and by making them explicit and plain, the agreements were carried out and evaluated.