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From Treatment to Containment to Enterprise: An Ethno-history of Therapeutic Communities in Puerto Rico, 1961–1993

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Abstract

Unpaid work is now a central therapy in Puerto Rican therapeutic communities, where substance users reside and seek to rehabilitate each other, often for years at a time. Once a leading treatment for addiction in mainland United States, therapeutic communities were scaled back in the 1970s after they lost federal endorsement. They continue to flourish in Puerto Rico for reasons that have less to do with their curative powers than with their malleability as multi-purpose social enterprises and their historical co-option by state, market and family actors who have deployed them for a variety of purposes. Their endurance from the 1960s to the neoliberal present obliges us to recognize their capacities as what Mizruchi calls abeyance mechanisms whereby ‘surplus’ populations, otherwise excluded from labor and home, are absorbed into substitute livelihoods. Having initially emerged as a low-cost treatment, in a context of mass unemployment and prison-overcrowding they now thrive as institutions of containment and informal enterprise.

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Notes

  1. The first addict-led therapeutic community for addiction was Synanon established in 1958 in Los Angeles (Janzen 2005).

  2. Hogar literally means home or hearth, and the acronym CREA stands for Center for the Re-education of Addicts.

  3. A notable exception being the Delancey Street Foundation in San Francisco, see Wallace (1999).

  4. In September 1982, DSCA was attending 7383 clients in 48 centers, compared to 3414 clients attended in 69 private programs (DSCA 1986a, b:30–31).

  5. This was also the case in Puerto Rico’s smaller private programs, where most staff members were unpaid graduates (DSCA 1986).

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Funding

This research was supported by a grant from the National Science Foundation Cultural Anthropology Doctoral Dissertation Research Improvement Grant (1729646, awarded to Caroline Parker).

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  1. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA

    Caroline M. Parker

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Parker, C.M. From Treatment to Containment to Enterprise: An Ethno-history of Therapeutic Communities in Puerto Rico, 1961–1993. Cult Med Psychiatry 44, 135–157 (2020). https://doi.org/10.1007/s11013-019-09642-9

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