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I A History of Insanities and Addictions Among Marginalized Americans The following two chapters describe how particular concepts of insanity and addiction have been incorporated into state-sponsored regimes for the management of homeless, impoverished, and culturally marginalized Americans.1 The net has been thusly cast for the simple reason that for most of American history, insanities and addictions have been found to afflict poor and culturally marginalized Americans in ways that are systematically different from the ways they have been found to afflict more prosperous Americans. However, they have been found to afflict poor and culturally marginalized Americans 1. A word concerning terminology. In the next two chapters I often refer to the following three related conditions: economic dependency, cultural marginality, and homelessness . Admittedly, these terms are drawn from my own time and place and are, in some sense, superimposed upon the activities of those who I discuss. This is particularly true of Chapter 2. In the eighteenth and nineteenth centuries, people empowered to administer the fates of very poor, deviant, and unattached Americans tended to make indiscriminate reference to the “defective, delinquent, and dependent classes,’’ or simply the “rabble’’ or “dangerous classes,’’ and to arrange public provision for them on an equally indiscriminate basis (Katz 1986; Monkkonen 1993; Rothman 1990). By and large, being assigned to this category required only having been found somehow disreputable and undeserving of the community’s collective forbearance (Matza 1966). This, in turn, has always been intimately related to assessments of moral solidarity and difference (Katz 1989). Hence, the images of vagrant, transient, and tramp, all of which bear the stigma of social “disaffiliation,’’ have been historically salient in descriptions of the rabble or undeserving poor. It is in this very general sense—of putative kithlessness— that homelessness has borne its enduring affinity with economic dependency, pathology, and cultural marginality more generally. The legacy of commingling poverty, cultural marginality, criminality, and pathology has endured, indeed thrived, despite the proliferation of taxonomic fads and their attendant designs for managing the variously described 15 16 Part I in essentially the same ways whether they were currently housed or not housed. Thus to have attended exclusively to those we would now call homeless Americans would have created a badly distorted image of their particularity. Likewise, my analysis is cast largely at the national level because procedures for diagnosing and treating insanities and addictions among poor and culturally marginalized Americans evolved according to processes that unfurled nationally. To have focused exclusively on the state or local level would have prevented my giving adequate attention to the fact that changes occurring at the state and local levels were largely dictated by nationwide social movements and/or federally articulated public policies. By and large my descriptions focus on the emergence, growth, and evolution of three relatively distinct social fields: the mental health industry , the alcoholism treatment industry, and the field of illicit drug control. To the extent these social fields have produced methods for managing those we would now call homeless Americans, their growth and development have been powerfully directed, though by no means determined,bypublicpolicymakersatthefederal,state,andlocallevels. Thus, of course, my social history of these fields cannot be adequately told without earnest attention to the ways they have related to, and figured in, broader state agendas. Most commonly, these agendas have concerned how membership in communities subject to a government’s administrativeauthorityhasbeenspecified.Hence,asIshow,considerationsofcollectiveidentity ,solidarity,andculturalothernesshavealways been paramount in determining if, when, and specifically how concepts of insanity and addiction have come to figure in the public government categories of “other’’ thought to comprise this most alien segment of the American population (cf. Hopper 1991; Grob 1994; Irwin 1985; Polsky 1991; Scull 1984; Simon 1993). In its contemporary sense, the expression “homeless’’ has encouraged some to think only in terms of certain very narrowly circumscribed manifestations or consequences of severe poverty—in a word, shelterlessness. However, the best research indicates there is very little that distinguishes shelterless Americans from the broader category of extremely poor, but housed, Americans (Burt 1992; Jencks 1994; Kusmer 2002; Rossi 1989; Snow and Anderson 1993; Wright 1989). Myopic attention to the literally shelterless, then, overlooks the much deeper and more enduring social processes at work here. Hence, the task I have set myself in Chapters 2 and 3 is to show how concepts of insanity and addiction have figured in the work of managing and accounting for that population that Hopper (1991) aptly describes as...

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