Addicted to Christ. Helena Hansen
retail (Agar and Schacht Reisinger 2002). The flooding of inner-city drug markets by drug cartels selling cheap Columbian and Mexican cocaine and heroin, and the disproportionate incarceration of blacks and Latinos from the War on Drugs have converged with unparalleled toxic effects on city neighborhoods (Singer et al. 1992, Bourgois 1995, Hamid et al. 1997, Agar 2003, Singer 2008), visible in “million dollar blocks”: geomaps showing the low-income, black, and Latino census tracts whose residents cost the state the most due to high rates of incarceration (Badger 2015). Yet, nothing in my clinical training prepared me to treat addiction as anything other than an individual biological and behavioral problem.
In fact, some ethnographers argue that biomedical treatment that lacks a social perspective actually perpetuates addiction. Philippe Bourgois (2000) describes methadone programs as tools of neurochemical discipline that consign patients to long-term opioid maintenance upon pain of withdrawal. Angela Garcia (2010) followed heroin-using New Mexican Hispanos in addiction programs that, she discovered, are structured around the expectation of relapse—assuring the chronicity of addiction that they claim to treat. Summerson Carr (2010), in her linguistic analysis of group therapies, found that clients are forced to learn a “script” of sobriety to meet the expectations of their therapists, deepening the gap between their goals and those of their treaters.
As Wanda at Victory Academy told me, she preferred Christian treatment because “In the ministry they don’t say once an addict always an addict.” In this way, ministries diverge from another well-known spiritual approach to addiction, that of Twelve-Step programs such as Alcoholics Anonymous. In both evangelism and Twelve-Step programs, uncontrollable drug use is the consequence of a lack of humility and the need to submit to a higher power. Both require personal re-formation based on principles of the Bible (among charismatic Christians) or of the “Big Book” (among Twelve-Step followers). This similarity is not coincidental. In the 1930s, Alcoholics Anonymous co-founders Bill W. and Dr. Bob were members of the Oxford Group, a Protestant evangelical organization. Early on, Dr. Bob told hospitalized alcoholics to give their lives to Jesus (Dick B. 2005). The founders later expanded their membership by making the twelve steps non-denominational, and referencing a Higher Power rather than God (Valverde 1998). Yet, the Twelve Steps remain classic Protestant liturgy: admitting one’s shortcomings, turning one’s life over to a Higher Power, making reparations, and carrying the message to others (Alcoholics Anonymous 2004). The language has been secularized, but the steps refer to confession, salvation, penance, and evangelization.
At the same time, Twelve-Step programs identify addictions as incurable diseases that require sufferers to attend meetings indefinitely for sobriety, with the lifelong threat of relapse. This discourse of addiction as a disease of the individual was the product of a cultural compromise struck in post–World War II United States, in which Alcoholics Anonymous and the medical profession appeased public resistance to alcohol prohibition by attributing alcoholism to individual vulnerabilities, rather than the properties of alcohol itself (Peele 1989).
Although Pentecostal street ministries recruit and convert on the basis of problem drug use, addiction is not the primary issue to be addressed through conversion. As one convert told me, “The problem isn’t drugs or alcohol. The problem is sin.” Street ministry sermons give equal time to adultery, promiscuity, jealousy, and egoism; they place addicted people on the same plane as all unconverted people who need to align themselves with the Holy Spirit. For them, sobriety is not a goal in itself, it is the result of conversion.
The Book of Acts mentions faith healing as a gift bequeathed to early Christians during the Pentecost, along with speaking in tongues and prophecy, so faith healing—including prayer and laying hands on the ill with the expectation of their recovery—is widely practiced in Pentecostal ministries. Yet, I never heard street ministers speak of healing addiction. They measure their success not by the number of converts who return to their lives as they were before substance use, but by the number who devote their lives to the ministry, who live on the ministry grounds, who complete missions to other parts of the island or to other countries, and eventually open new ministry homes. Unlike Twelve-Step programs, whose twelve traditions forbid them to own property in the name of the organization, street ministries own, rent, or squat on properties that are full-time residences. In street ministries, conversion means gaining a new address, a new vocation, and a new identity.
Despite my biomedical training and my religious agnosticism, my own concept of addiction resonated with that of street ministers in unexpected ways. Where street ministers rallied to locate spirits, I saw a movement of people striving to relocate themselves. Where ministries made addicts into prophets, I saw social technologies of transformation. With the ministers, I wondered if the disease concept of addiction constrained the possibility of recovery. This paradox is highlighted by studies finding that defining addiction as a disease, rather than de-stigmatizing addiction as intended, can increase stigma against addicted people because the concept of disease casts them as irreversibly flawed (Pescosolido et al. 2010, Link and Phelan 2010).
My travels in street ministries required multiple ways of seeing addiction, and required holding the tension between a clinical gaze and ethnographic engagement. In a world where clinical medicine is dominant, where allopathic health care industries and pharmaceuticals represent the largest single sector of global industry (IMS 2012), I strove to understand strategies and ways of knowing that lay outside of biomedicine. How did conceiving of addiction as a spiritual disorder affect the possibilities for personal and social change?
PORTALS OF PENTECOSTALISM
By the end of the twentieth century, Pentecostalism was the fastest-growing religious movement in Latin America (Cleary and Stewart-Gambino 1997), having increased from 4% to 28% of the population between 1970 and 2005 (Pew 2006). In the early 2000s, Pentecostals were also the fastest growing Protestant denomination in the United States (Warner 2004). Pentecostals are characterized by the doctrine that any worshiper can establish direct contact with the Holy Spirit and receive its gifts as described in the biblical Book of Acts, including speaking in tongues, prophecy, and healing by faith. Pentecostalism gives ultimate authority to personal experience: to a communion with the Spirit that is available to all regardless of literacy, income, or previous knowledge of the Bible. As one worshiper in a Puerto Rican addiction ministry told me, “Pentecostals believe in personal sanctity, in long skirts and long sleeves. The experience of being saved is very clear, there is no doubt about the presence of God.”
Pentecostalism is not one denomination, it is a multi-denominational movement characterized by charismatic worship and a theology of gifts. Although many of the ministries I studied referred to themselves simply as Christian or evangelical rather than Pentecostal, I use the term Pentecostal because it describes a worship style that unites most of the street ministries in Puerto Rico.
Street ministries target beleaguered neighborhoods much like those of the early twentieth-century American cities from which Pentecostalism first emerged. Like the Azusa Street Mission of 1906 inner city Los Angeles, that unified African American, Mexican, and white American worshipers in what many historians identify as the first Pentecostal revival, contemporary Puerto Rican street ministries blend a clean-living doctrine of abstinence from substances and from sex outside of marriage, with an expressive worship style drawing on African and Latin American music and oratory, that is designed to elevate worshipers to a state of contact with the Holy Spirit.
The Pentecostal movement has deep roots in Puerto Rico, where Pentecostalism was well established by 1920, and produced several generations of Puerto Rican leaders and missionaries (Moore 1998). Notably, anthropologist Sidney Mintz’s classic 1950s biography of a Puerto Rican sugar-cane worker ends with the worker’s conversion to Pentecostalism (Mintz 1960).
Upon U.S. occupation of the island in 1898, the Catholic Church—which had been intertwined with the Spanish colonial government—no longer could exclude Protestant sects from missionary work on the island. North American Protestants rushed to missionize Puerto Rico, envisioning it as their portal to the rest of Latin America. Puerto Rico became a training ground for a Puerto Rican clergy who went on to found missions in the rest of Latin America (Milham 1951). Puerto Rico thus was evangelized earlier than its Latin American counterparts, due to its political and geographical proximity to the United States.
Early