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Unidad, Servicio y Recuperación: Twelve-Step Recovery in Civil War Guatemala, Part II

Updated: Aug 13, 2023

Editor’s Note: Today we finish our two-part series from Dr. Heather Vrana on the history of Alcoholics Anonymous in Latin America. Check out the first part here. You can find out more about Dr. Vrana and her work here

Treatments tell us about more than scientific understandings of ailments. They also reveal cultural and social beliefs. Injections of strychnine and insulin characterized treatment for alcoholism, addiction, and their related manias for about six decades from the late 1800s into the mid-20th century in Latin America. Incarcerated in a logic of addiction as disease, treatment was individual and invasive. Then, the twelve-step method—the 1960 Prensa Libre article called it the “gregarious exercise”—took over. Suddenly alcoholics and addicts could help one another without the risks and costs of hospitalization. While the civil war raged outside the doors, recovering alcoholics and addicts recited the Oración de la Serenidad.

One of the most intriguing, yet largely ignored, legacies of the civil war in Guatemala is the proliferation of twelve-step recovery groups like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Neurotics Anonymous (N/A) in every department, city, pueblo, and aldea. The previous blog post discussed the arrival of AA to Guatemala. This post addresses NA and N/A and how their proliferation fit within the nation’s complex and violent civil war. 

The first NA group in Guatemala began in 1989 when an American traveler visited an addiction treatment center where patients attended AA meetings. He convinced treatment center officials to permit him to host an NA group in the hospital and called it Grupo Ciudad Vieja. The turn to addiction from alcoholism sought to eliminate any addict’s excuse that AA was irrelevant to them. Groups extended nationwide through the 1990s, and with even greater rapidity as drug use and trafficking exploded with the end of the war. The year 1989 was also marked by numerous mass killings, abductions, and disappearances, including some of the war’s most infamous attacks on civilians. Meanwhile, the Bush administration struggled with Congress over how to handle military aid packages and training of the military and police. 

NA’s practices are, like AA’s, direct translations of their North American counterparts. Personal testimonies of recovery are formulaic: they offer little variation and seem to have no allowance for a distinct political, social, economic context. What do we do with this as historians? Is it the case that the 12-step model is universally effective across place—indigenous ejido, affluent suburbs, Wall Street, Akron’s Main Street, Calle Real—person—mozo, president, militar, comunista—and time—New Deal, World War, genocide? As I wrote in the previous post, I argue that textual orthodoxy in print literature and oral testimony provided legitimacy and the cover of apoliticism in a dangerous political context. 

In fact, a different fellowship by the same initials—Neuróticos Anónimos—responded more explicitly to tensions caused by the war. 

N/A was founded by a sober psychologist and educator, Grover B., in Washington, D.C. in 1964. Ten years later, it spread into Mexico and from there, throughout the Americas. Unlike AA and NA, N/A remains most popular among Latinx communities in the U.S. and in Mexico, Argentina, Uruguay, Brazil, Guatemala, and El Salvador. In contrast to AA and NA, N/A spread toward the end of the war and in the post-war period. Its literature framed mental or emotional illness as an inability to adapt to reality, which could be healed through discussion and community, still following the twelve-step paradigm. Although more difficult to date than AA or NA, it seems to have moved into Guatemala by the mid-1990s, according to a 2015 survey by Amilcar Salvador Arrecis that focused on adults aged 60 and older. In 2015, this entailed individuals born before 1955. Thus, for the adults surveyed, the vast majority of their lives had transpired under the cloud of revolution, counterrevolution, and civil war. 

N/A is distinct from AA and NA, though many of its members began in those fellowships. For Neurotics Anonymous, neurosis is not a medical or diagnostic term, but a broad way of signifying a failure to control one’s emotions. The N/A first step reads, “Admit that we are [or were, in some variations] powerless over our emotions and that we could not manage our own lives. Simply substituting “our emotions” for “alcohol,” a new fellowship was formed—one that sought to get to an underlying emotional shortcoming at the bottom of any number of addictions. Like AA and NA, N/A encourages individuals who think they might want to join to take a self-diagnostic test. If the individual answers four (or more) out of twenty-six questions affirmatively, then they are, indeed, a neurotic.

In the era of peace and reconciliation, N/A took off, with members who gathered together in order to gain some control over their unmanageable emotions, which were framed as nothing more than a collection of symptoms of one’s innate egotism and an inability to love. Yet, anxiety, depression, fear, jealousy, sadness, trauma, inability to work, and anger seem to be reasonable responses to civil war. Though born of a middle-class white man from the U.S., it is easy to see why this mode of thinking would appeal to a diverse range of Guatemalans suffering the after-math of war.

Screenshot 2020-08-05 at 1.46.21 PM

Curve of Emotional Illness and Recovery, adapted from The Laws of Emotional and Mental Illness and used widely by Neurotics Anonymous

But what if the mutual aid principles of twelve-step recovery offered a radical practice? Were AA/NA/N/A groups ever the object of surveillance and political violence? What if groups were mistaken for guerilla cells and members for combatants? What if some of the many dead and disappeared who had no clear connection to the left were actually recovering alcoholics? To what point did members guard the anonymity of their fellows? Under torture, even? And what of the claim that AA, NA, and N/A groups were apolitical? To be apolitical in the civil war was, to be sure, a political stance in itself. And were they really apolitical? Did the left or the right ever try to recruit from within “the rooms”? Might a murderous state benefit from the dulled senses of a drunk and, therefore, the sharpness of sobriety bring forth political anger at inequality? (I am not aware of a single instance of military or paramilitary oppression of a twelve-step recovery group, though I find this hard to believe. Once it is safe and ethical to return to Guatemala, I will conduct additional interviews with members of twelve-step groups to interrogate this further.)

Historians of Central America have not yet addressed disability or addiction as outcomes of civil war trauma. Most historians and anthropologists of the period have invested a fair amount of energy in historical memory, human rights, and truth and reconciliation practices in the post-war period. For many years, focusing on death counts and the disappeared more than citizens who survived the war has made sense. One outcome of this focus, however, is that we have little understanding of disability in the region. This is the focus of my current book project, Righting Wrongs: Guerrilla Medicine and Disability in Cold War Central America.


The number of private in-patient and out-patient treatment centers has increased dramatically in the last few decades since the end of the war. As many as two hundred new Pentecostal rehabilitation centers have popped up in Guatemala City’s metropolitan area. They tout logics of individual transformation that are about—in the words of Kevin Lewis O’Neill—“getting the fuck out of here.” These centers do not follow the twelve steps nor offer group therapy, nor do they keep patient records like case histories. Contrary to the social gospel of the Catholic Church and Liberation Theology, the logic of Pentecostal and Charismatic Christianity (to which as much as 60% of Guatemalans ascribe) demands the captivity of the will. Abducted on the street by center inmates called cazadores, drug users are often held against their will in dingy and haphazard centers. If AA and NA were the recovery models of the civil war and N/A the model of the peace and reconciliation era, then these exemplify what Julie Gibbings and I have called “post-peace Guatemala.” 

This brief account of AA, NA, and N/A in Central America has addressed a few key questions in the new global history of twelve-step recovery. Why and how did groups spread so widely? What did group members find in the rooms of recovery? How does this history connect with broader national and international histories with which we are more familiar? As a partial answer to these questions, I have argued that orthodoxy in print literature and practice provided an apparently apolitical outlet for the personal impacts of political turmoil before and during the civil war. Meetings offered mutual aid that was largely unfettered by surveillance and political repression at a time when that was hard to come by. I have also sought to model how transnational and global approaches strengthen the subfield of alcohol and drug history and, too, our understanding of the Cold War. Indeed, one of the most quietly pervasive legacies of the Central American Cold War was a set of twelve steps, a group of equals, mutual aid, and the admonition to get one’s feelings under control.


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