The Guard's Dilemma: Social Roles and Therapeutic Experience for Inpatient‐Guards in Tijuana's Community‐Based Addiction Treatment

Abstract

Over the past 30 years, Tijuana has witnessed a proliferation of non-biomedical, community-based drug treatment centers. Research on this industry focuses primarily on documenting their spread and describing institutional practices, particularly human rights abuses. However, ethnography attuned to inpatient perspectives shows academic responses (op-eds, articles, policy briefs, etc.) that generalize compulsory, community-based addiction treatment as completely unproductive often obscure inpatients' complicated experiences. I examine daily life and social roles in one all-female 12 Step center along Mexico's northern border to explore the claim by center administrators that inpatients benefit therapeutically from acting simultaneously as guards (inpatientguards). This ethnography of practice complicates academic discussions of compulsory addiction treatment by examining the labor the inpatient-guards provide and the meanings they ascribe to it, revealing the complexity of therapeutic experience and a path for global mental health to better understand community care. [addiction treatment, therapeutic process, total institutions, ethnography of practice]