PubMed · 6234283
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J L Martindale. 1984. Subtle enablers.. https://pubmed.ncbi.nlm.nih.gov/6234283/
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While there has been interest in geographical variations in alcohol use and their implications for health, similar attention has not been given to geographies of alcohol treatment and recovery. This paper is concerned with exploring these geographies of alcohol recovery and treatment. Specifically, the paper uses the therapeutic landscape concept coupled with Foucault's concept of governmentality to frame a qualitative case study of a 'social model' recovery community in San Pedro, California. Analysis of the programs operating in San Pedro consisting of observation and interviews, demonstrates the complexity and contradictory character of such recovery landscapes. In particular, the governmentality perspective suggests that spaces created for alcohol recovery and support can be simultaneously understood as sites designed to govern the health-related conduct of individuals. Within programs, clients were provided with support and encouragement from staff and peers, but these same relations also made possible surveillance and the governing of daily routines. In the neighbourhood, program staff intervened to create 'healthy' spaces but these interventions also shaped the conduct of local residents and contributed to the spatial regulation of problem groups. While a focus on governmentality does not preclude recognition of the positive effects associated with therapeutic landscapes, it does provide an opportunity for further consideration of the complexities underlying such environments.
Alcoholics Anonymous, with its steady but nonspecific promotion of belief in a higher power and its emphasis on the group process, long held a near-monopoly in the outpatient alcohol recovery field, but its hegemony has now been challenged by two very different perspectives. The first is a nonspiritual approach that emphasizes the individual's capability to find a personal pathway to sobriety, exemplified by Rational Recovery. The second is a faith-based method, built on a religious understanding of alcoholism, of which Celebrate Recovery is a prominent example, based upon Christianity. Most communities offer a variety of approaches, so clinicians who are aware of these differences are in a good position to help patients make intelligent choices among the competing recovery philosophies.