The Sober Self: Discourse and identity of recovering alcoholics in the Western Highlands of Guatemala

In this dissertation, I focus on how political, economic, and cultural histories influence experiences of alcohol abuse and alcoholism recovery amongst indigenous community members in Panajachel, Guatemala. My research goals were twofold: 1) to document and understand the political, economic, and sociocultural processes that impact the prevalence of alcoholism, treatment options and experiences, and sobriety attempts among Panajachelense problem drinkers and 2) to use this information to contribute to ongoing efforts to expand and improve mental health outreach to problem drinkers in the area. I combine ethnographic and epidemiological methodologies within a critically engaged phenomenological framework to document the enduring influence of discriminatory discourses on the lived experience of alcohol addiction and recovery in a historically oppressed population, namely the Kaqchikel Maya.

Utilizing ethnographic, epidemiological, and critical discourse analysis from data derived from fifteen months of fieldwork, I argue that national historical discourses that equated indigeneity with alcoholism continue to impact perceptions of alcoholic individuals at the local level. While both men and women are affected by alcoholism, national and local discourses typically focus on male drinking. Moreover, prevalence data I collected highlight how alcoholism disproportionately affects men in Panajachel. As such, the primary focus of this dissertation is centered on male alcoholic individuals in the process of recovery. I demonstrate how the phenomenological shift from an alcoholic identity to a sober self is influenced and constructed by historical political and contemporary social and economic processes amongst the Kaqchikel Maya in Panajachel. The difficult negotiation of sobriety arises from a state of disequilibrium between the external identity of "alcoholic" and the internal experience of the "sober self." The Sober Self is defined by a phenomenological shift in the natural attitude of the individual that radiates to those he is connected to within his lifeworld. Yet this transformation into the Sober Self is riddled with political, economic, and social barriers that define the experience of alcoholism and impede the process of recovery. Discrimination toward alcoholic individuals poses significant barriers to recovery. Additionally, available treatment models in the region do not meet the needs of the typical alcoholic Panajachelense.

The notion of the Sober Self expands upon emerging anthropological literature on self-transformation based in non-Americanized therapeutic processes for sobriety. This dissertation provides one of the first detailed portraits of the experience of alcoholism and recovery in indigenous communities within the Highlands of Guatemala. It builds upon previous anthropological work on alcoholism that limited discussion to the role of the church and Alcoholics Anonymous as primary mechanisms to achieve sobriety in the region. The work presented in this dissertation is meant to highlight the need for more comprehensive treatment programs in order to address the alcohol-related health, social, and economic issues found throughout the Western Highlands of Guatemala.