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This paper aims to demonstrate the confluence of thinking across several areas, in their critique of modernity, with potential solutions in the mental health field.

The paper uses case and organisational examples related to relevant theory and clinical practice to demonstrate relevant contradictions and paradoxes in “modernised” mental health care. This is based on the author's experience as a public sector psychiatrist specialising in “personality disorder” to lead a government programme of new service developments in the field.

Modern methods of management, focusing on measurement, prediction and control – in the service of efficiency and economy – are not sufficient to meet the needs of a population with high incidence of “personality disorder”. A major change of attitude is required, to an authentic biopsychosocial approach, including spiritual and other non‐verbal considerations.

Hitherto, research has not combined these elements in a way that has made it easy to capture and analyse them. New methodologies and paradigms may be called for.

Mental health care should not be considered an entirely rational process that can be measured and manualised; considerations of how to better manage complexity and uncertainty are urgently needed.

Destigmatisation and normalisation of mental distress and “illness” should occur.

The paper introduces two new terms to mental health discourse: “greencare” and “biopsychosocialism”.

Adults over the age of 65 who are diagnosable with personality disorder face numerous problems within current mental health service provision. These include a lack of diagnostic clarity and a lack of specialist personality disorder‐specific interventions. The authors present a pilot mini therapeutic community service for older adults diagnosable with personality disorder consistent with recommendations from NSF, NIMHE and NICE. Clinical experience suggests that positive outcomes demonstrated in similar services for adults of working age may be possible in this group and preliminary outcome results described in the article suggest a trend of clinical and functional improvement, and some economic benefits. This will need to be replicated and tested with a larger sample to confirm these findings.

The purpose of this paper is to describe the necessary primary emotional development experiences for healthy personality formation.

The paper is a critical synthesis of psychoanalytic theory.

Five experiences are judged necessary for health “primary emotional development”: attachment, containment, communication, inclusion and agency. These can be deliberately recreated in therapeutic environments to form a structure for “secondary emotional development”.

The ways in which these qualities of a psychosocial environment can be produced are described.

Failure to recognise the importance of these qualities of an environment can cause unhealthy, or frankly toxic, psychosocial environments in various settings.

This is the author's original work, and has relevance for all psychosocial environments.

The purpose of this paper is to introduce the “Quintessence” framework and its roots in TC phenomenology; to explain how each of the contributors to the conference is related to it; to pose questions about how the “TC movement” may use the underlying ideas in the future.

Adaptation of theoretical ideas to a conference structure.

As the necessary developmental experience for everybody, the quintessence principles are recreated in well-functioning therapeutic communities, and in the 2014 Windsor Conference.

As a theory that is becoming well used in the TC field, it needs more qualitative, quantitative, critical or philosophical underpinning.

Widely accepted as useful in TCs.

Has wider applicability.

Derived from condensation of numerous relevant psychological, sociological and systemic theories.

This is an appraisal of two workshop formats for people involved with, or interested in Therapeutic Communities (TCs). The paper aims to discuss this issue.

The author had the good fortune of being a staff member of two differently organised workshops, both of which aimed to help staff working in TCs with the role of staff member. The origin and structure of the two workshops are described in “Living-Learning Experience” (LLE) and “Learning from Action” (LfA).

This is followed by some observations and reflections made possible by the privileged position of the author's participation in both, within a fortnight of each other.

The two workshops could be considered a valuable complementary training tool.

The purpose of this paper is to describe some of the basic features of attachment theory, and explore how they relate to the development of the “social mind” and the work of therapeutic communities (TC).

The author describes the essentials of attachment theory in humans; and the development of both secure and insecure states of mind. The author will set out how insecure attachment systems are associated with deficits in mentalising processes which are fundamental to the activity of the social mind.

The author suggests how attachment to a TC can promote mentalising processes. The author draws on the work of other speakers in the conclusions about how to “grow” secure minds and societies.

This paper is a brief over view only and does not address attachment process to TC in any depth.

Attachment theory could help both service users and therapists who work in TCs understand some of the difficulties people have in engaging at the start. Attachment theory also gives a guide to what a “good enough” experience in a TC might look like.

There is little existing discussion of the application of attachment theory to TCs.