ABSTRACT
This chapter focuses on the dynamics of the therapeutic community as an evolutionary path. The movement of therapeutic communities in Italy has had, as its precursors, some brave psychoanalysts who, since the end of the 1960s, have created innovative experiences and more humanising units within traditional psychiatric hospitals outside the cities where numerous inpatients were living in alienated conditions and cut off from civil society. The Italian Mental Health Act of 1978 brought reform to the psychiatric system in Italy which led to the closure of all the asylums. The emphasis is on participation and experiential encounter, on reflection on clinical and organisational aspects of the community, and on dialogue among peers aimed at quality improvement and change. The cultural climate of democratic renewal has been fuelled by the commitment of many pioneering psychoanalysts and phenomenologists united by a bio-psychosocial model.
