The “New Masculinity”: Addiction Treatment as a Reconstruction of Gender In Puerto Rican Evangelist Street Ministries

Abstract

This article, based on ethnographic fieldwork including twelve months of participant observation and 428 interviews with 84 converts and leaders in Pentecostal ministries founded and run by former addicts in Puerto Rico, describes redefined masculinity as a treatment for addiction. Industrial disinvestment and resulting unemployment and drug trade in urban North and Latin America have led to narcotic addiction among Latino and African American men and attendant homicide, infection, and incarceration. Pentecostal-evangelical street ministries are prevalent in these regions. Their alternative vision of masculine honor and power addresses a cultural crisis of men’s social space. They replace the unachievable ideal of the male breadwinner with an image of male spiritual power. In place of the violence of the drug trade, they cultivate male domesticity and responsibility for the home. In place of a deleterious drug economy, they offer the social and cultural capital of ministry networks and biblical knowledge. Yet the trajectories of ministry converts reveal the limits, as well as the promise, of evangelist masculinity as a treatment for addiction. In the course of building leadership among their converts, the ministries create their own, internal hierarchies, fall short of the spiritual democracy they espouse, and lead to relapse among those left at the bottom.

Introduction

“The New Masculinity: no vulgarity, no discourteousness, a man who is a model for children, who gives kisses and affection, who cries when sad, is a hard worker, and never loses sight of his principles.”

-From a poster by the Mayagüez Baptist Church, hung outside of an addiction ministry for men in Puerto Rico.

Narcotics use is a major cause of mortality and morbidity among Latino and African American men in the U.S.; compared with white men, they are significantly more likely to be diagnosed with AIDS and to have been infected via injection drug use (CDC 2007, CDC 2009), to be arrested and incarcerated for drug charges (Mauer and King 2007, U.S. Department of Justice 2005) and to experience drug related violence (Galea et al 2002, Felson, Deane and Armstrong 2008).

Some authors cite structural, intersectional effects of ethnicity and social class to explain these disparities, but only a few examine the way that ideals and norms of masculine behavior relate to drug use and its consequences. These authors point to drug use as an effort to solve a crisis of masculinity among socially dislocated men lacking the skills and social networks to enter the legal workforce, and therefore lacking a respectable role and power within their families and communities (Singer 1992, Singer 2005). These men assert an oppositional identity by entering the narcotics-based informal economy (Williams 1989, Anderson 1990, Bourgois 1995, Duneier 1999), which then becomes the basis for further marginalization from the formal economy.

A significant discourse in international health ascribes high rates of disease and violence among low-income post-colonial men to their pathological masculinity (Tolhurst et al this issue). This discourse invokes the need for the theoretical framework of intersectionality (for example, of gender identity with race/ethnicity and social class) in research on the health of non-dominant men (Cole 2009, Bates, Hankivsky and Springer 2009, Dworkin 2005, Hankivsky and Christofferson 2008, Lyons 2009), yet the actions following from this discourse overlook the complexity of masculine identities. For example, many interventions (e.g. in HIV, domestic violence and reproductive health) make masculinity itself a point of intervention (Pulerwitz et al 2010, Verma et al 2006, Jobson 2010, Silvergleid and Mankowski 2005), with the idea that reformulating gender ideals can change the gendered behaviors that lead to high rates of disease among non-European people in low income zones (Basu 2004).

These approaches raise important questions about how gender, a culturally unstable category, interacts with addiction, also a culturally unstable category, variably defined as social, moral or biological. Addiction itself is gendered and gendering. In one of the few cultural studies of masculinity and addiction, Davis (1994) observes that for a Latin American man the label of addict derives from his inability to fulfill his role as family provider and his low stature in his community; while heavy drinking is socially sanctioned, alcoholism (defined as substance use that interferes with upholding social responsibilities) is associated with shame and moral weakness. The literature on women and addiction is more extensive, pointing to addiction as a way to cope with gender inequality (Forth-Finegan 1991), to gender-specific state regulation of alcohol and drug consumption reflecting views of substance use as (socially) pathological among women, compromising performance of femininity in their homes and communities (Campbell 2000, Nicolaides 1996), to women’s emphasis on relatedness and economic dependence on men as impeding their treatment (Amaro and Hardy-Fanta 1995), and to gendered treatment outcomes, such as in Therapeutic Communities (McCorkel, Harrison and Inciardi 1998). These bodies of work on women call for reciprocal attention to masculinity in addiction.

Gendered patterns of substance use and gendered definitions of addiction reflect that addiction is laden with power inequalities. Narcotics trade generates an internal social hierarchy, with those at the top who sell but do not use, or use but keeping their use under control, claiming moral and psychological superiority (Hanson, Beschner, Walters et al 1985). The type of drug used, the method of use, and the source of income to pay for drug supplies also figure into hierarchies of social value within drug using networks; in various settings, drug users have described crack cocaine smoking as more stigmatized than cocaine sniffing, impersonal theft as more ethical than theft from friends or family, and sex-for-drug exchanges between acquaintances as more respectable than street prostitution (Inciardi, Lockwood and Pottieger 1993, Rosenbaum 1981). The drug trade itself is structured around a motif of dominance and dependence.

The dependence created by drug trade has roots in post-industrial economics. The formal economy of manufacture and export industries in Puerto Rican and American cities shrunk as manufacturers left for lower wage labor markets in Asia (Dietz 2003). A parallel economic system of illicit cocaine and heroin trade arose in place of the shrinking formal economy, with corporate organization involving narcotics production and processing in Latin America, large scale export, and distribution networks in North America and Europe (Bagley and Walker 1994, Joyce and Malamud 1998, Riley 1996). Venture capitalists in the drug market have had little difficulty recruiting dislocated urban workers as low-level traders and consumers, particularly men (Agar 2003, Agar and Schacht Reisinger 2002, Dei 2002, Bourgois 1995).

Puerto Rico, a U.S. possession since 1898 whose people are U.S. citizens, is experiencing widespread post-industrial dislocation of poor urban men. In the wake of U.S. manufacturing industries moving to lower wage regions in Asia (Dietz 2003), in the last two decades Puerto Rico has seen 60% of its population qualify for U.S. welfare benefits, and unemployment rates as high as 20% (Cockburn 2003, Chavez 1998, Buckley 1998). Puerto Rico’s employment patterns and federal subsidies have also led to a gender reversal in family economics. Men see higher unemployment than women due to preferential hiring of women by international industries in Puerto Rico; industries that note lower absenteeism, lower union membership, and acceptance of lower wages among women workers. Additionally, Puerto Rican women without jobs more easily qualify for public assistance through federally funded programs than men (Safa 1995). Excluded from legal industries and government entitlements, men disproportionately look to the illicit drug economy for income, with its violently enforced hierarchies of power (Bourgois 1995).

At the social margins defined by the drug economy, Pentecostal evangelist street ministries, run by men who are themselves former drug users, compete with the illicit economy for the labor and loyalties of displaced men. They are ubiquitous in poor urban areas of the U.S., and in Puerto Rico, one survey revealed three fourths of all substance abuse treatment centers registered with the state to be faith-based (Melendez et al 1998), with the majority of these Pentecostal (Hansen 2005). These addiction ministries can be seen as a social movement whose members create an alternative quasi-economic system involving its own forms of labor, professional identity, and rewards. Many of those struggling to survive post-industrial economic dislocation paradoxically turn to old time religion as a venue for social critique and cultural resistance. On an individual level converts speak of exchanging their addiction to narcotics for an “addiction to Christ,” suggestive of Simmond’s (1977) classic study suggesting that conversion does not involve a personality change, but rather the substitution of one set of gratifying externalizing experiences for another among people with underlying dependency. Yet addiction ministry converts collectively use a set of Pentecostal cultural frames and rituals to address what Saunders (1995) identified as a “crisis of presence,” an experience of alienation from self. In this formulation, Pentecostal mysticism and moral commitment enables converts to become “inner-worldly activists” (Saunders 1995 p. 336) in which they recreate their own histories, and “in the process, have regained a presence in history itself” (p. 337).

North American Protestants entered Puerto Rico en masse upon U.S. possession of the island in 1898, supporting temperance and prohibition; they identified widespread drinking among the rural poor as a sign of the moral depravity of Puerto Rican society. Abstention from substances, and other features of the Protestant clean living program, such as the priority of legal marriage and marital fidelity, were selling points for conversion among those who sought upward mobility (Martinez-Fernandez 2000). As in other parts of Latin America, Protestant conversion promised to affect male consumption patterns and public behaviors - for example, to reduce money spent on alcohol and extramarital liaisons - in ways that elevated the income and the image of their families (see Brusco 1995). Pentecostalism, one of the most mystical forms of Protestantism in Puerto Rico, espouses ascetic practices of regular fasting, periods of sexual abstinence, and in some churches refusal not only of alcohol but also of caffeine and over-the-counter pain remedies such as Tylenol, with the idea that denial of the corporal self through physical suffering strengthens the spiritual self (Hansen 2005). Male abstention through Christian temperance, therefore, has been a recurring theme in Puerto Rican society (Clark 1995).

Ironically, as a major sugar producer until the 1950’s, Puerto Rico has been and continues to be a center of rum production, and has become a center of narcotics trade. As a U.S. possession, Puerto Rican customs procedures are minimal compared to those of other nations bordering the U.S. In the 1980’s when the U.S. heightened surveillance at the Mexican border, Puerto Rico became the main Caribbean transfer site of Colombian cocaine and heroin to the U.S. as well (Abel 1998). Puerto Rican men soon saw a rate of injection drug use-related AIDS higher than that of New York (CDC 2001), and a drug-related homicide rate higher than any of the United States (Booth and Drummond 1996, Abel 1998, Goodnough 2003). At the same time, Puerto Rican public funding for addiction treatment was lower than in any of the United States (CASA 2001), leaving a gap in services readily filled by Pentecostal addiction ministries. Puerto Rico, then, sits in a cross-current of narcotics trade flowing from South to North, and temperance based Protestantism flowing from North to South, fertilizing the ground for Pentecostalism, and its vision of a reworked masculinity, as a primary response to addiction.

Puerto Rican addiction ministries’ reformation of masculinity as the way out of heroin and cocaine dependence can be seen as a natural experiment testing the reworking of gender as an addiction intervention. In the case of ministries, however, the intervention is not initiated by State or non-governmental health agencies, but rather by formerly addicted, low-income Puerto Rican men themselves. This makes addiction ministries an informative study of agency; of the efforts of disempowered men to resist the consequences of hegemonic masculinity, such as narcotics trade in disinvested urban zones. It also illuminates religious practice as a strategy of masculinity making that is indigenous to working class neighborhoods.

Method

I report on twelve months of continuous fieldwork in Puerto Rico, and follow up visits over the subsequent two years (2001–2003), funded by the Social Science Research Council and designed to elucidate the cultural logics and social impact of Pentecostalism on narcotics dependent men entering addiction ministries. Fieldwork began with an on site semi-structured interview survey of the directors of fifteen residential centers run by Pentecostal addiction ministries, and snowball sampling of additional Pentecostal ministries leading to the positive identification of 57 addiction ministries across the island. Having established relationships with ministry leaders at two residential ministries in Southwest Puerto Rico on the basis of the initial on site survey, I undertook daily participant observation at those two ministries and 428 ethnographic interviews with 84 ministry participants and staff over the time period of the study, ranging from ten minutes to three hours each using purposive sampling over the subsequent eleven months. Sampling in the first three months was initially as inclusive as possible, with most ministry participants invited to participate. Those participants who consented to longitudinal interviews and who remained in the ministry more than a few weeks were re-interviewed on a weekly to monthly basis as new developments in their ministry role arose. Interview questions were generated inductively in order to confirm initial theoretical impressions based on observation regarding evangelical practices and beliefs regarding addiction, gender, and spirituality. As specific men in the study encountered changes in their circumstances and negotiated difficulties within the ministry and with family members, follow up interviews were conducted to assess the impact of these changes on their practices, beliefs, and investment in evangelical activities and identity. Ministry leaders were generally eager to include me in daily ministry activities because they saw my writing as a vehicle for their evangelist message. I also followed two women and six men, selected to provide contrasts in terms of their diverse ages, levels of education and roles in their ministries, over a three year period, initially maintaining daily observation of them for at least two hours inside of Pentecostal residential programs, and later weekly contact through home and neighborhood visits lasting at least one hour after they left the programs and moved back into their communities. I thematically coded and analyzed narrative data from field notes and interview transcripts using established ethnographic iterative techniques of continuous comparison, and grounded theory development, as well as triangulation with available secondary data such as health ministry records on treatment program leadership, enrollment, and Puerto Rican health policies with regard to addiction treatment. At weekly to monthly intervals I conducted confirmatory interviews with informants to test the face validity of my interpretations (Reeves, Kuper and Hodges 2008, Lingard, Albert and Levinson 2008).

This research was conducted with oral informed consent procedures due to the low literacy rate in the population studied, and with data storage techniques designed to safeguard the confidentiality of participants’ identities (pseudonyms are used below); these measures were approved by Yale University’s Human Subjects Investigation Review Board.

Findings: Christian Manhood as Treatment for Addiction

Addiction ministries draw on three main motifs as correctives to the crisis of masculinity and disempowerment uncovered by narcotics addiction. The first is that of democracy: the idea that through conversion, all men have equal access to spiritual knowledge and power. The second is that men to use addiction ministry networks as an arena to develop professional identities and pursue institutional advancement, often based on military analogies of “fighting in God’s army.” The third is a call for men to re-appropriate domestic space by re-entering their homes and families, having abandoned them as part of their addiction, and to claim patriarchal leadership in what has become a feminine domain of domestic control.

Democracy and Spiritual Power

Pentecostalism originated at the beginning of the twentieth century among African American, Mexican, and white worshipers who were protesting the rigid hierarchy of mainstream Protestant churches; Pentecostals looked to recreate the conditions of the first Pentecost following the crucifixion of Jesus. Worshipers at the first Pentecost were said to receive gifts of prophecy, faith healing, and speaking in tongues (spiritual language that would reunite the Tower of Babel) directly from the Holy Spirit (MacRobert 1988). Addiction ministries frequently refer to this principle of direct access to the Holy Spirit, insisting that through conversion and faith alone, any person, regardless of social standing, literacy, or drug use history, can commune with God through prayer and receive spiritual gifts, without ministers or other human intermediaries.

This concept of spiritual democracy has profound implications for the identity of marginalized men. As one ex-addicted man, a Vietnam veteran who became a pastor in a well-established addiction ministry after his conversion, put it: “When you accept Christ, you see things differently…I didn’t see myself as Puerto Rican. I didn’t see Vietnam. I didn’t see racism.” Through the principle of equal access of all to spiritual gifts, he was able to see himself as a privileged member of an imagined global Christian community (a la Anderson 1991), rather than a triply marginalized addicted, Puerto Rican war veteran.

The idea that converts have direct communion with God helps them to redress the stigma they internalized as addicts. The spiritual realm serves as an external source of validation for ex-addicts who meet suspicion and disgust in their communities; as one Bible study leader put it:

“(That we are) the body of Christ means everyone has a function. When we were in the street, people didn’t see the gold inside of us. [God] sees it. He knows that we have gifts.”

Here, converted ex-addicts not only have a function in their new community in Christ, but are people chosen by God, with a role in world history so sacred that ordinary people cannot even recognize it. In a twist of logic, the fact that converts stand apart from ordinary (secular) society and are rejected by it actually confirms their privileged position on a spiritual plane. For men who are at the bottom of a hierarchy created by forces of urban poverty, violence and hypermarginalization, the appeal of an alternative community in which they are visionaries, a community unified by spiritual forces that do not obey the laws of contemporary capital, is clear.

Evangelism as Profession

Addiction ministries mimic secular structures of male advancement and authority. Men who convert and detoxify from drugs in a residential addiction ministry start a curriculum of nine to twelve months with delineated Bible study and labor intended to indoctrinate them theologically, and to prepare them for progressive responsibility in the ministry. Such roles move from menial cleaning, cooking or construction jobs to supervising new recruits, to teaching Bible study and leading evangelical street outreach, to managing the residential programs themselves. Men in each level of this progression of roles have a title, such as kitchen manager, Bible study leader, or assistant program director, and these roles are often marked by uniforms (shirts embroidered with the name of the ministry). Program directors promote converts to upper level roles as a reward for productivity and obedience to ministry rules, and demote converts based on violations.

The ministries’ institutional hierarchy of advancement, ultimately leading to institutional leadership, is similar to that of secular Therapeutic Communities (TCs): it creates a system of well defined roles and incentives to address irresponsibility and lack of self-discipline (Casriel and Amen 1971, Weppner 1983). However, ministries’ emotive worship involving rhythmic music and “falling in the Spirit” (losing consciousness and lying on the floor in a state of communion with God) - as well as their Pentecostal emphasis on receipt of gifts through this direct communion with the Spirit (speaking in tongues, prophesy, and healing by faith), distinguish addiction ministries from TCs. They reveal a strategy of anointment and distinction of converts from members of secular society, as opposed to a strategy of normalizing converts to function as productive members of secular society. While TCs critique addicts as rejecting society, addiction ministries level an implicit critique of society by elevating converted addicts to the status of soldiers and visionaries in a war against spiritual corruption.

Ministries also create an ethos of venture capitalism, directing converts to “win (men) for Christ.” Recruitment into the ministry can be seen as a pyramid scheme, with each man who builds a base of converts inheriting the expanding number of converts brought in by those below. An addicted man’s liabilities in the secular world of material advancement become assets in this inverted corporatism of evangelists; his past in the street becomes his credential for recruiting in the street, and his testimony regarding his prior wrongs becomes not a source of stigma making him un-hirable, but rather a sign that he is called to do God’s work. Evangelism provides value and status that can be re-applied to relations with worldly families and secular society.

Addiction ministries tap into a specifically masculine set of images by using military terms and analogies of war for advancement through their ranks. For example, when I first met the assistant manager of Victory Academy to interview him about the ministry’s residential program, he pulled out a large black binder and showed me workbook pages describing each of the spiritual steps that program participants completed in order to graduate. He explained that the curriculum prepares graduates for a great spiritual struggle: Reclutas (Recruits) are new initiates, just off the street, Soldados (Soldiers) are those learning to pray, Guerreros (Warriors) begin to evangelize on the streets, Vencedores (Victors) teach Bible classes, and Conquistadores (Conquerors) open new sites for the ministry. At his ministry, recruits demonstrate personal discipline by punctuality and precision in dress and speech, physical and mental stamina as entrained by hours of cleaning duty and Bible Study, as well as assuming a kneeling prayer position four to five times for half an hour each day. In fact, many in the Academy’s leadership, including the head pastor and two program directors, had careers in the U.S. military before their conversion. The professionalization that the Academy offers is based on a masculine model of self-development through rigorous basic training. Its image of spiritual warfare unifies converts against an exterior threat, and enhances the honor of men who talk of leaving drugs and devoting themselves to Christ as “living in victory.”

Spiritual warfare relates to a concept of spiritual power that involves strengthening one’s spiritual connection to God and strengthening spiritual perception, such as the ability to prophecy, by denying the body in fasting and abstinence. It involves enacting spiritual power by engaging in exorcisms of demons among new recruits in withdrawal; and the charismatic power to instill a desire for the Holy Spirit in new converts through personal testimony. It is this power that converts say they exercise, individually and collectively, to rid themselves and their communities of narcotics addiction.

Re-appropriating the Domestic Sphere

The cultural work of addiction ministries is to respond to larger economic forces that undermine the secular masculine performance of ex-addicted men by employing discursive and institutional techniques for alternative, spiritual masculine performance. This alternative performance draws on tropes of spiritual power and professional evangelism as described above. However, evangelist images of power and professional identity are not always accepted by their family members. Converts bump up against families from which they have been alienated, and in which women are primary decisionmakers and breadwinners. Converts are confronted with the dilemma that their growing spiritual authority in ministries is not matched by their status in their own homes. Their pre-conversion oppositional identity they has to be reworked after conversion for them to have a credible role in their families.

Ministries resolve the contradiction between the masculinity of the drug involved, indifferent male, and the masculinity of the responsible family man, through a life cycle view of male development: that men pass through stages of acting out male aggression and accepting male responsibilities. Such models of adult development are found in other parts of Latin America; Matthew Gutmann (1996) observed that men in Mexico City contrasted youthful binge drinking with the sober domesticity of middle age. In Puerto Rico, addiction ministry converts are not only reborn; they also mature into spiritual patriarchs. Ministry leaders speak about this spiritual maturation using analogies from child development. As a leader told me, when he explains Biblical concepts to new converts, he builds them up gradually: “First I give them milk, then milk and rice, then rice and beans, then meat.” Another leader paraphrased a Biblical verse, saying “When I was a child, I did the things of a child. Now I’m a man, doing the things of man.” As a pastor explained in a lecture on discipleship, the role of ministry leaders is to “support (new recruits) in a process of growth,” guiding them through the steps to spiritual development that will eventually make them collaborators.

Before conversion, ex-addicts in the ministries were trapped in a permanent male adolescence imposed by their local economy of post-industrial unemployment. They were unable to support their families through legitimate labor, and thereby meet the conventional benchmark of manhood. By framing conversion as a rite of passage in which rebellious youth learn from their errors and replace adolescent willfulness with wisdom, converts escape this trap by meeting an alternative, spiritual benchmark of adult manhood. Mentoring by Christian leaders enables men to truly become men, qualifying them for legitimate unions through Christian marriage, and then for fatherhood, preparing them to guide their children toward Christ. In fact, evangelical program directors usually determine when converts are ready to wed to their long-term domestic partners.

Rapid industrialization in Puerto Rico, leading to disproportionately male unemployment due to the targeted recruitment of women into low wage industrial labor, and later due to disinvestment of manufacturing from the island, has drawn social researchers to examine the ways in which labor patterns influence gender roles. Safa (1995) concludes that in Puerto Rico the image of the male breadwinner persists to the point that chronically unemployed men supported by employed women are still considered household heads, while their employed female partners are considered supplemental breadwinners. Safa and others, such as historian Martinez-Fernandez (2000) argue that major institutions such as private industry, the Protestant church and the Puerto Rican State have historically promoted ideologies of patriarchy within heterosexual marriage even when economic forces have created female-headed and female-supported households. While historians challenge the notion that the patriarchal ideal was ever predominant among working class Latin American families, pointing out that many poor Latin Americans have customarily lived in female-headed households (Potthast-Jukheit 1997), the complex reality of Puerto Rican families does not diminish the power of the patriarchal ideal as an ideal, as a cultural frame of reference. Addiction ministry converts covet patriarchal roles, seeing their achievement of patriarchal status as a major measure of success. As one ministry leader said:

“My daughters are proud of me. They say, ‘Daddy was a junkie, now he’s a pastor!’… I got the Lord. I teach my daughters. My daughters’ mothers, they see I got saved, I changed, I’m doing good. I got their respect. They come to me for advice on how to raise our daughters.”

Evangelist men, who have disqualified themselves from household headship during their addiction, use spiritual practice to restructure a less problematic social identity for themselves, which proves a useful tool to the extent that addiction is seen in moral, rather than in medical, psychological or social terms. Their identities are articulated primarily in terms of kinship, both fictive and biological, through their roles in their families, and a primary audience for their gender performance is their families. Adopting the “new masculinity” of addiction ministries, then, might be seen as a strategy for ex-addicts to insert themselves on a track to middle-class respectability by pursuing a spiritually-based, rather than economically-based patriarchy. Yet the following narratives of two men who became leaders in their ministries, but struggled with establishing a spiritual patriarchy, illustrates how precarious the strategies of the “new masculinity” can be. These two men are selected as case studies here because they demonstrate the two prominent modes of evangelism to rework ex-addicted masculinities that I observed in the field. Wilson illustrates the perils of reintegration into the domestic sphere in the context of a faltering local economy, and Juan illustrates the limits of cultivating an alternative base of spiritual power and an evangelist professional identity within the ministries, against the realities of marginalization from community and family outside of the ministries.

Wilson and the Precariousness of Pentecostal Patriarchy¹

Wilson was in his fifties when we met. A former hit man for a local drug-running mafia, he had killed a number of people to support his heroin addiction, and was sent to the penitentiary, where he was assigned to a ward known for its evangelism. By the time of his release, Wilson was considered a Christian leader in the ward. He enrolled at the residential addiction ministry Restoration House rather than going home on parole. He had been in many treatment programs before, including methadone for two years, but as Wilson put it, conversion changed his life. In the past he had gone right back to drugs, but this time, he said, “Jesus took the desire out of my heart.”

Conversion also helped Wilson to solve dilemmas of violence and retribution from his time on the streets:

“I had shot [a man] 21 times [in the past], he couldn’t walk because of it. [Since that] he became a Christian. We talked; I said I’m sorry – the Devil had me…I said ‘Forgive me.’ He said ‘No, forgive me, because I was looking for you to kill you…Jesus takes out the heart of stone and puts in a heart of flesh.”

After leaving Restoration House Wilson moved in with his parents, helping his father to sell hotdogs at a concession stand, and attending a local Pentecostal church every evening. Wilson stood tall outside that church, wearing the buttoned print shirts and khaki slacks favored by professional Puerto Rican men. Resting his hands on the belly overhanging his belt, he bellowed “¡En Victoria!” (In Victory!) at church brothers across the street.

Wilson spent most of his free time accompanying his mother, weakened by a heart condition, on trips to the grocery store or to visit her doctor. His sister, struggling with two children in a nearby housing project while her husband went on heroin binges, depended on Wilson for an open ear and soft shoulder. Wilson helped her to run the housing project’s award-winning youth dance troupe, driving his nephew and other troupe members to dance competitions across the island.

Although marginally employed, Wilson had become a different type of provider for his family. He showed physical signs of transformation too, he explained to me one day as we thumbed through a photo album spanning the twenty years. “See, I used to be so skinny. Now I have meat on my bones,” he said, pointing first to a shadowy snapshot from the 1980’s and then to his round belly.

A year later, he married a woman who he had known in the streets. A former sex worker, she struggled to stay off of crack. Her looks captivated Wilson. “She’s like a model!” He would say. He bought her a small house in a heavily drug-trafficked neighborhood near the beach and supported them both from the concession stand.

Wilson was determined to remain faithful to her through her bouts with crack; he called programs in all districts and found her treatment, not a small feat given the island’s lack of drug treatment programs for women. He enrolled his wife in a residential program two hours north of their home and visited her every Sunday, which was family visitation day.

I saw Wilson in his wooden bungalow during a visit to Puerto Rico the following year. He welcomed me warmly and helped me to climb the splintering boards that made up the staircase to his second story one-room apartment. From his balcony he swept his arm over the panorama of littered lots and gutted buildings across the street. He apologized for the broken hinges on the refrigerator, and the garden hose that he had strung up his stairs to create a shower, but insisted he was satisfied to own a home. The Southeast corner of his apartment was stacked to the ceiling with the bottled water that he sold on the street for extra cash to pay his mortgage. I asked about the empty beer cans below the staircase: Wilson pointed to two men pacing nervously in front of the house, and explained that they were homeless people that he allowed to stay downstairs in exchange for their protection of the property. They were into crack, he said, but he gave them the word of God daily.

There was a desperate quality to the success story he told me of becoming a Christian, entrepreneur, husband, and homeowner. He worked hard to hold the threads of male responsibility, but each of them tugged at him violently. Remaining a homeowner required him to live in a part of town that exposed him daily to drug dealing and violence. To maintain the property, he had to invite two crack users to live on the first floor of his home. To care for his parents, he had to commute to their house daily, a forty minute walk on foot, and his ten-year-old Jeep was unreliable. His wife worked hard on her sobriety, but visiting her each weekend required four hours of driving for his aging car, which had already had more than one breakdown. When his wife returned home, after a year of treatment, she and Wilson would both be trying to avoid relapse in an apartment that gave them a balcony view of daily drug deals. And Wilson had to contend with his church, whose membership was disintegrating over the revelation of its pastor’s extramarital affairs.

Juan and the Limits of Evangelical Authority

Juan, who was in the same ministry as Wilson, pursued spiritual power rather than domesticity in his effort to leave a life consumed by crack cocaine behind. A mystical man who spent hours a day in prayer, he was known for his biblical scholarship, his effortless citation of chapter and verse. He achieved local fame by exorcising demons from a new convert who hallucinated and screamed profanity during withdrawal. Juan coveted spiritual abilities, engaging other converts in talk about spiritual strong men that was reminiscent of idealized athletes:

“When you are with God, you get many powers. You know Randy Aisland? From the Dominican Republic? He is a man of God. He goes to a mountain to pray for a month, and when he comes down he sends his spirit from one kilometer away. He tells you what is on your mind, what you [will be] doing tomorrow.”

Juan was thirty-six that year, and re-enrolling as an undergraduate at the Inter-American University. Having arranged to commute to college from his dormitory at the ministry, he abruptly left one night. Converts at Restoration House were in shock; Juan had been counselor and spiritual medium for so many of the young men there. The director had even pulled me aside and asked if I thought Juan could be convinced to come back. He told me:

“The guys here, they’re just loco (crazy) for Juan!”

Juan had given me warnings of his departure:

“Sometimes it gets to be too much. Too heavy. I ask God, what you want me to do? You want me to help the poor people of Africa? God, I just wanna serve you. But my mother says she needs me. God, I will leave it all behind for you. My family, everything.”

Juan lost his own father at 12 years old, and did not have biological children, but had been fostering the younger men of the ministry. He had a reputation for being in-tune with God’s thoughts: he told others of their troubles before they said a word, he knew the names of people he had never met, and he saw angels visit him in prayer. People gravitated to Juan, the sage and psychic, for his cryptic parables and prophetic visions. His tattered sweatshirts and frequent fasts demonstrated his asceticism, and his sensitivity to the thoughts and moods of others instilled trust. Juan fit the image of Christ so often painted by preachers in culto: humble, eager to serve, omniscient.

Yet for all the trust he inspired in his young devotees at the addiction ministry, he admitted that the trust of his mother and eight sisters was hard to regain:

“Trust is the hardest thing to get back once you have lost it. Once you have lied to them they can never quite believe that you were out late because you were at church.”

Juan was an empathetic man who danced around the pain of intimacy. Selfless acts toward strangers came easily to him even before he accepted Christ: years ago, he accepted the blame in court for a car he did not steal in order to protect a teenager from getting a criminal record. Yet he fantasized about leaving his mother and sisters behind in order to bring God to the poor people in Africa. “When you have God, He is all you need. He is your family, and then you love everybody the same.”

Juan discovered in evangelism an image of Christ with which to identify as a sensitive male. As an evangelist, Juan was no longer a stool pigeon but rather as someone who gave selflessly. He was not a romantic failure but rather an ascetic. He did not abandon his mother and sisters but rather followed God’s call to love everyone equally. Juan adopted the mysticism and asceticism that he imagined Christ himself exuded. Material markers of male success, like the BMWs Juan had cleaned years before for local drug dealers, were rendered inapplicable to him as a Christian. Juan defined success as his capacity to channel the Holy Spirit in his thoughts and actions.

When I visited Juan a year later, I found him at his mother’s house, evading my questions about his studies at American University, and showing signs of relapse.

Juan finally admitted that he had not been registered at school for some time. According to Juan, his troubles began when he tried to transfer to the University of Puerto Rico campus in San Juan. His brother lived in San Juan and had offered Juan to stay in his house. But just after Juan arranged to transfer to the San Juan campus, his brother withdrew the offer of housing. His brother’s wife still saw Juan as an addict, and felt he would be a bad influence on their two small daughters.

It pained me to hear of Juan, who had been the first to bounce small children on his knee, being judged unfit for contact with his nieces. Juan seemed to relive the rejection as he described it; his eyes looked distant when he recited his brother’s words. The words hit him hard, despite Juan’s explanation to me the year before that “When you know the Bible, you look up instead of side to side. For example, [if] I wanna study, I don’t ask Mami. I ask God. I turn my life to [the] hands of God.”

Juan’s faith in his own conversion was not always matched by his family. And his family’s lack of confidence in itself seemed to undermine Juan’s resolve. As imbedded in an evangelist identity and hierarchy as Juan was when he left Restoration House, he still looked to his family for affirmation of his progress.

Discussion: The Limits of Evangelist Masculinity as Treatment Strategy

Wilson and Juan highlight the precariousness of the alternate masculinities carved out by intersectionally disempowered men. By virtue of the communities they target, addiction ministries confront not only masculine performance, but also deep problems of social, political and economic marginality that require structural approaches to affect change.

Evangelist addiction ministries represent a grassroots social intervention to stem the public health disaster of widespread narcotics addiction among economically displaced Latin American men. Hanging in the balance are the lives of converts, who face death from infection, overdose or homicide if they relapse. The wounds of family abandonment, and drug-trade related violence also loom in the shadows. The question of how far evangelism can go in maintaining sobriety, and of what evangelism means for masculine identity and power relations, are questions that demonstrate the irreducible relationship of political economics to health.

While addiction ministry conversion begins with a dream – of personal victory over addiction, of societal transformation, and of a place of respect for marginal men - it often ends in contradiction. Hierarchies created by the ministries’ emphasis on professional identity, advancement through paramilitary ranks, and assertion of a patriarchy over women, belie the democratic ideal of Pentecostalism. Ministry leadership is a function of the pre-existing skills and contacts of converts, such that spiritual capital accumulates to those previously endowed with social and cultural capital, falling short of the Pentecostal ideal of redistribution. The alternative “family in Christ” that ministries cultivate as a base of authority for men who are marginal in their homes conflicts with the ministries’ call for family reunification, and does not always hold up against rejection by families of origin. And the ministries’ devotion to an other-worldly, spiritual realm where spiritual power can bear fruit comes at the price of action on poverty-sustaining secular political economics that ultimately limit enactment of the dream.

This article makes a unique contribution to social science knowledge of medicine because it:

1. introduces a view of intersectional masculinities in evangelical addiction ministries to challenge the concept of altering gender norms as a health intervention

2. demonstrates the relationship between economic dislocation among working class men, power, domestic role and grassroots religious movements

3. links economic dislocation, power, domesticity and religion back to gender and health in the form of narratives of masculinity and recovery from addiction