Allison McKimDissertation Abstract Therapeutic treatment is a common response to problematic individuals
and social relations, appearing everywhere from televisions talk shows to
prisons. In the criminal justice system,
these techniques are used to manage a growing number of offenders who are
required to participate in “alternative” correctional programs, such as
addiction treatment, in lieu of incarceration.
Here, therapeutic techniques connect the wellbeing of the self to larger
political goals such as crime control and to the production of good
citizens. Yet those without a criminal
justice mandate must seek treatment for often-similar problems in a sector of
the healthcare market that is minimally covered by insurance. The existence of therapeutic governance in such
divergent settings raises questions about how these practices are deployed in
different institutions. This dissertation examines how differently-structured therapeutic
institutions attempt to transform and normalize women. Using ethnographic data, I compare two
all-female, residential addiction treatment programs. One is a state-funded non-profit serving
criminal offenders who are mandated to treatment, and the second is a private,
for-profit program funded by health insurance and union benefits. I focus on three key dimensions of treatment,
1) how a program’s funding sources and relationship with the state shape the
pathways that women take into treatment and the structure of the program, 2)
how the program staff understands what is wrong with their clients, and 3) how
therapeutic techniques of normalization work in each institutional setting. I also consider how therapeutic personnel
draw on popular and professional knowledges about gender and race, such as women’s
self-help literature and traditions of “racial uplift” in black communities,
and how these bodies of knowledge make assumptions about women, family, and the
nature of addiction that produce similar tensions within each program. I argue that the programs’ different funding and referral sources
reflect a division within the addiction treatment field between publicly funded
facilities and programs competing in the healthcare market. This dynamic produces different client and
staff populations at each program, with the criminal justice program having
lower income and majority black women, but it also shapes the basic structure
of the treatment plans. For instance, penal-welfare
funding requires the criminal justice program to offer many concrete,
non-therapeutic services. Yet in
response to the coverage restrictions of managed care companies, the private
program must work in much shorter spans of time, and with less power over their
clients. To draw on all available
resources, the private program emphasizes substance abusing behavior and integrates
people into traditional, informal networks of social control, such as family
and self-help groups, while teaching cognitive strategies and moral techniques
for right living. On the other hand, the
criminal justice program uses introspective and confessional therapeutic
techniques that focus on the self and women’s gendered social roles. These prompt women to both reframe and
disconnect from their prior identities and relationships, especially family and
sexual partners, with the goal of fashioning a new self that is liberated and autonomous
from other people. Curriculum Vitae |
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