Madness and chaos in the culture of a therapeutic community

Jonathan Stephen Roger Leach (Department of Health and Social Care, UK Open University, Milton Keynes, UK)



The purpose of this paper is to explore the perceptions of staff members working in a psychiatric therapeutic community in relation to ideas of “madness” and “chaos”.


The paper is a qualitative study based on oral history group witness seminars.


The findings indicate that many of the participants experienced working in a therapeutic community as both exciting and unsettling; some found themselves questioning their own mental health at the time. Despite a sense of “madness” and chaos in the life of the community, there was also a feeling that it provided a containing environment for some very disturbed patients.


This study is unusual in drawing upon staff member’s perceptions of their own relationship to “madness” in response to being involved in the life of a therapeutic community.



Leach, J. (2019), "Madness and chaos in the culture of a therapeutic community", Therapeutic Communities: The International Journal of Therapeutic Communities, Vol. 40 No. 1, pp. 16-24.

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