In many Spanish-speaking communities throughout major U.S. cities, people struggling with substance addiction turn to unlicensed rehab groups, programs offering therapy ranging from testimonies to intensive—and sometimes harsh— residential regimens. Of murky historical origin, these rehab groups borrow from 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.

In a This American Life broadcast, Ira Glass recounts the stories of addicts from Puerto Rico who say that police and municipal government officials on the island sent them to these rehab groups on the mainland, promising deluxe treatment programs. Many of these addicts ended up homeless after discovering, as Glass put it, “flophouses open 24 hours a day with group therapy going till late at night, sometime 10 or 13 hours straight.”

In this rehab style, documents are typically confiscated for safekeeping, and people live together in tight quarters for a period of weeks, receiving free room and board. There, standard treatment often consists of lengthy sessions that can include yelling and insults. Other reports describe additional shaming rituals at specific locations, including a groveling confession to a council 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 in these groups recover from their addictions, an outcome often attributed to strength of personal desire. But common “cult” stereotypes have also dogged these groups and led to 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. Although the phenomenon of brainwashing has been academically discredited, this “cult” narrative perseveres, and it’s attached itself to these unlicensed rehab groups largely because of their practice of confiscating participants’ documents.

But those who would further exoticize the rehab techniques may not be aware of relatively recent parallels between these groups’ shaming rituals and those of 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, in her memoir Through a Narrow Gate, the one-time nun Karen Armstrong recounts a special penance 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.”

Such practices have dwindled in recent years, out of concern for negative emotional consequences and an increased emphasis on developing personal independence. Even so, these rituals occasionally resurface—in the mid-1990s, for instance, the cloister of the famed televangelist Mother Angelica reinstituted the custom of public self-accusation.

Thus, some unlicensed rehab groups appear to have independently reinvented time-honored Christian methods, developed to help a person conform to some ideal: For monasteries, the ideal is a humble, Christlike person obedient to divine will; for rehab groups, the ideal is a reformed individual cured of his or her addiction.

Tellingly, rehab groups and monasteries both attempt their transformations within the context of all-encompassing environments—the “total institution” setting described by the sociologist Erving Goffman in his classic 1961 book Asylums. Personal identity is formed over the course of 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 may be 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’ potential for intra-group violence. Within the hermetic and socially intense context of a total institution, behavioral norms can form without checks and balances from the outside culture, and may shift more easily towards the harmful. Research indicates that large-scale violence of the kind found at Jonestown or Waco depends on apocalyptic, “us vs. them” ideologies in addition to isolation—but 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.

Recent reports of forced shaving as rehab punishment, therefore, should cause some apprehension—if true, they suggest that some locations are beginning to enculturate something even harsher than intense verbal encounters as part of their treatment. Although not inevitably violent, the social conditions necessary for greater harm are present, and the groveling and forced shaving plausibly indicate that some groups already permit more physical rituals that could very well escalate in the future.

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, the very environment that gives rise to their methods’ success might also allow their treatment regimen to spiral out of control, canceling out the positive outcomes to which many participants testify.


This article appears courtesy of Sightings.