Intense Addict Shaming: Possibilities and Perils

Is shaming through intensive and sometimes harsh therapy sessions at America’s unlicensed rehab groups cause for concern?Too little researched, these rehab groups are present in Spanish-speaking communities throughout major U.S

By David Mihalyfy|February 25, 2016

Is shaming through intensive and sometimes harsh therapy sessions at America’s unlicensed rehab groups cause for concern?

Too little researched, these rehab groups are present in Spanish-speaking communities throughout major U.S. cities and embedded within loose networks extending to Mexico, Colombia, and Spain. Of murky historical origin, they operate in the cultural matrices of Pentecostal Christianity and self-help culture, and frequently provide help to those unable to access more mainstream care. Often using the name and adapted logo of Alcoholics Anonymous, they are typically started and overseen by padrinos  (“godparents”) who are pastors, recovered addicts, or both.

As memorably detailed in a This American Life broadcast, Puerto Rican officials export addicts to the unlicensed rehab groups on the mainland with promises of deluxe treatment programs. Many of these addicts end up homeless after discovering, according to host Ira Glass, “flophouses open twenty-four hours a day with group therapy going till late at night, sometime ten or thirteen hours straight.”

Beyond that, generalizations are difficult because of the differences in practices witnessed in known locations. Some locations rely on AA-like testimonies, but others favor the “24 hour” programs on which initial Chicago-based reporting focused. There, documents are confiscated for safekeeping, and people live together in tight quarters for a period of weeks, receiving free room and board.
Reportedly, apart from folk remedies given to addicts when they go “cold turkey,” standard treatment consists of lengthy encounter sessions that can include yelling and insults. Secondhand reports of unclear reliability describe additional, location-specific shaming rituals that include a groveling ritual of confession to a “Sanhedrin” of sober peers, or punishment by shaving the head or eyebrows.

Perhaps surprising to those who would insist on a gentle approach to rehabilitation, some of the people recover from their addictions, an outcome attributed to strength of personal desire. Residence at the centers continues at first in conjunction with outside work and a nominal program fee. Other participants do leave before this time, but many recovered addicts and their families attest to the rehabilitative power of these experiences.

Unfortunately, common “cult” stereotypes have dogged these groups and led to undue suspicion of financial exploitation. Since the Korean War, alternative movements from Communism to the Hare Krishnas have been accused of brainwashing—namely, of imposing an alien identity on unwilling members who then become prey to a nefarious purpose to which they would not otherwise consent.

Although academically discredited, this “cult” narrative perseveres, and its overtones of manipulation have adhered to the unlicensed rehab groups. Because some administrators confiscate identification papers during residency, two half-known cases of identity theft and rumors of others have resulted in premature, blanket suspicion, although investigations have not yet occurred and the victims may have sold their own identities, a phenomenon known among cash-starved Puerto Rican addicts.

Furthermore, those who would exoticize the rehab techniques may not be aware of relatively recent parallels to these groups’ shaming rituals among a much less stigmatized group, pre-Vatican II Roman Catholic monastics. Prior to mid-20th Century reforms, purposefully humbling verbal and physical rituals were relatively common in convents across the world, as many popular, ex-nun memoirs relate.
For example, public intellectual and one-time nun, Karen Armstrong, recounts in Through a Narrow Gate her endurance of a periodic ‘chapter of faults’ requiring self-accusation before the assembled community, as well as a special penance à la Audrey Hepburn in which she was compelled to crawl beneath the table at mealtime to kiss the sisters’ feet with their “bunions” and “taste of boot polish.”
Although such practices have dwindled out of concern for negative emotional consequences and an increased emphasis on developing personal independence, opposite tendencies do occasionally surface, as can be seen in the mid-1990s reinstitution of public self-accusation in the cloister of famed televangelist Mother Angelica.
Some unlicensed rehab groups, then, appear to have independently reinvented time-honored Christian methods developed to communally assist the self to conform to some ideal: for rehab groups, the ideal is a drug-free individual, while for monasteries, the ideal is a humble, Christlike person obedient to divine will.

In this vein, attempts by rehab groups and monasteries to transform the self tellingly take place in all-encompassing environments that secure a centrally determined manner of life—the famed “total institution” theorized by sociologist Erving Goffman in his classic 1961 book Asylums.
All personal identity is worked out in a lifelong give-and-take conversation with society, Goffman asserts, but this process is accelerated in the regimented 24/7 milieus that range from mental asylums and jails to boarding schools and convents. Hence, the multi-week confinement of addicts in dilapidated buildings is not so much some inexplicably foreboding captivity, but rather a low-rent version of a long-standing approach to shaping character.

That said, this same social environment gives justifiable cause for concern, especially over the organizations’ often unrecognized potential for intra-group violence. Within the hermetic and socially-intense context of a total institution, behavioral norms can lack checks-and-balances from the outside culture and may shift more easily, including towards the physically harmful.

Although research indicates that large-scale violence like that at Jonestown or Waco also needs apocalyptic, “us vs. them” ideologies, total institutions like 24/7 rehab centers can produce smaller-scale violence. For example, two teenage members of upstate New York’s reclusive Word of Life Christian Church were severely beaten during a tribunal turned violent this past fall; one died from his wounds.
Thus, recent reports of forced-shaving as punishment at some rehab groups should cause some apprehension, since, if true, they plausibly indicate that some locations are beginning to enculturate as part of treatment something even harsher than intense verbal encounters.  Although not inevitably violent, the social conditions necessary for greater harm are present, and the leaders of these disparate groups are almost surely under-informed and thus under-vigilant

Ultimately, due to the absence of legal violations and to the ample protective space secured for religious freedom, America’s unlicensed rehab groups alone bear the responsibility of re-evaluating their methods, including the humiliations now largely abandoned by Catholic monasticism.
If proper caution is not exercised, however, the very environment that gives rise to their methods’ success might also allow their treatment regimen to spiral out of control and counterbalance all the positive outcomes to which so many participants gladly testify.


Mihalyfy, David. “America’s Unlicensed Rehab Groups: The New Religious Movements Behind the Media Coverage.” Medium. February 23, 2016. 

Not It!” Episode 554 of This American Life. Originally aired on April 10, 2015.

Melton, J. Gordon. “Brainwashing and the Cults: The Rise and Fall of a Theory.” CESNUR - Center for Studies on New Religions, December 10, 1999.

Armstrong, Karen. Through the Narrow Gate:  A Nun’s Story. Revised edition. St. Martin’s Press, 1981.

Arroyo, Raymond. Mother Angelica: The Remarkable Story of a Nun, Her Nerve, and a Network of Miracles. Doubleday, 2005.

Goffman, Erving. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Anchor Books, 1961.

Thomas Robbins. “Sources of Volatility in Religious Movements.” In Cults, Religion, & Violence, edited by David G. Bromley and J. Gordon Melton. Cambridge University Press, 2002.

McKinley, Jess, and Mueller, Benjamin. “Glimpses Inside Secretive Sect After Killing at Upstate New York Church.” New York Times, October 14, 2015. 

Image Credit: markara / creative commons.

David Mihalyfy headshotAuthor, David Mihalyfy, is a Ph.D. candidate in the History of Christianity at the University of Chicago Divinity School. Besides in Sightings, his work has appeared in Religion Dispatches, the jonestown reportInside Higher EdJacobin, and Counterpunch, and has received coverage in the Dish and blogs of the Chronicle of Higher Education and the National Review. He thanks the members of his Spring 2015 SAIC First Year Seminar on New Religious Movements for sharing their insights during the initial media coverage of the unlicensed rehab centers.


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