Loneliness and depression

Depression and loneliness are important clinical issues in those with addictive disorders. Many clients report turning to alcohol and drugs to seek relief from the severe pain of loneliness in their lives.  Depression, anxiety and substance abuse disorders (SUDs) are highly prevalent and co-occur in those with addictions. In one study, 44% of those with a history of comorbid alcohol use disorder and generalized anxiety disorders had a history of suicide attempts (Smith, J.P. & Book, 2010). In another study alcohol dependence was significantly more prevalent among younger and unmarried adults, men,whites, Native Americans, and those with lower incomes (Hasin, DS, 2007).

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The origins of loneliness that are uncovered include:

- parental divorce

- spousal divorce

- death of a parent or sibling

- loss of a sibling, including to a life of addiction

- repeated history of rejection

- fear of commitment and of marriage

- the trauma of being repeatedly used as a sexual object

- inability to find a trusting loving relationship

- severe social anxiety with low self-esteem.

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Nearly one third of persons with major depressive disorder also have substance abuse disorders and this comorbidity yields a higher risk of suicide and greater social and personal impairment as well as other psychiatric disorders (Davis, et al., 2013).  Heavy cannabis use may increase depressive symptoms among some users (Degenhardt, et al., 2003).

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A high level of childhood depressed mood was associated with an earlier onset and increased risk of alcohol intoxication,alcohol-related problems during late childhood and early adolescence and development of alcohol dependence in young adulthood (Crum, R.M.,2008). In a retrospective, blinded, case-controlled assessment of the drug and depressive history of depressed outpatients, alcohol dependence followed the onset of depression by 4.7 years and among poly drug users, cocaine dependence occurred 6.8 years after the first major depressive episode (Abraham & Fava, 1999). Alcoholism, in particular, is strongly associated with depression and suicidality (Galanater, Castaneda, 1985;Schuckit 1986). It also has been shown that opiate addicts have high rates of depression (Woody, et al., 1983).

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Since depressive illness is a major predictor of relapse (Pickens, 1985), the ability to resolve the anger associated with it can help substances abusers in their recovery and protect them from relapse.

Case Study on Loneliness

Antone had a fifteen year history of alcoholism which included several inpatient treatment programs. After several sessions he was able to acknowledge that he struggled with intense loneliness which had never been identified in his several rehab experiences. Next, he was able tore cognize very strong resentment toward former friends and family members as a result of his loneliness.

When asked if anyone in the past had hurt him, he recalled a painful relationship with a woman six years earlier. He believed that she had used him and then ended the relationship after having an abortion. His anger intensified when he began to recognize that he had become extremely fearful of vulnerability in a relationship as a result of her betrayal. At the same time, he uncovered anger with a narcissistic older brother who failed to support him.

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Antone began to recognize a pattern of drinking as a way to escape from his severe loneliness and its associated anger. He decided to try forgiving those who had hurt him in the hope that it would help with his alcoholism, his recovery, and his loneliness. He was given cognitive past forgiveness exercises in which he tried to think of forgiving the woman who had betrayed him so profoundly. Initially he found it difficult to forgive her. There were moments when he thought of getting revenge. His memories of her were so painful that he was reluctant to address them. After several months of struggling, he finally committed himself to forgive her because he realized that the pain was limiting his life. He realized how fortunate he was that she had left him, given her repeated pattern of selfishness. As his forgiveness deepened, he was surprised to feel compassion for her because he surmised that her extreme selfishness would probably limit her ability to ever enter into a healthy, loving relationship unless she changed.

In some ways he found it even more difficult to forgive his married older brother who was the father of several children whom Antone loved. He felt certain that his brother's extreme self-centeredness created the obstacle that prevented a relationship with the children. As he worked at forgiving his brother, he also came to feel some compassion for him.

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Antone's increasing ability to control his anger through forgiveness helped him significantly in his recovery from alcoholism and loneliness. The most difficult aspect of the work of forgiveness was that of making the commitment to forgive. He became more willing to trust a woman again as the influence of the past hurt diminished.

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Anxiety Disorders and Addictions

A lifetime history of social phobia, PTSD or generalized anxiety disorder (GAD) significantly predicts lifetime substance abuse dependence (R.D. Goodwin & Stein, 2013).  GAD has a high rate of comorbidity with SUDs (N.M. Simon, 2009).  In one study 46% of those with alcoholism met the criteria for GAD, with the onset of GAD occurring prior to the substance abuse in 67% of comorbid cases (J.P. Smith & Book, 2010). Alcohol use disorders and anxiety disorders demonstrate a reciprocal causal relationship over time, with anxiety disorders leading to alcohol dependence and vice versa ( Kushner, Sher, & Erickson, 1999).

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Some people who have been disappointed and hurt in important loving relationship resort to addictive substances to diminish their fears of being betrayed and their fears of commitment. This reaction is common when loving relationships end. The use of addictive substances as a means of coping with anxiety and work pressures is extremely common in our society.

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Adolescents and young adults from divorced families can manifest trust difficulties, fears of betrayal, and hesitancy to commit in relationships (Wallerstein 1991). They often resort to alcohol, marijuana, cocaine or other substances to cope with these fears. In Wallerstein's fifteen year follow-up of children of divorce, 20% of those in the study were drinking heavily (Wallerstein &Blakeslee, 2004).

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Study on Anxiety

Malcolm was a twenty-five year old single male who entered treatment for help with his cocaine addiction. He already had been to one inpatient treatment program, relapsing not long after his discharge. Malcolm was the third of four children and he grew up in a home with a weak passive father and an unaffectionate mother who attempted to control him. Although he found himself attracted to women, in his therapy Malcolm came to understand that he found it safer and more pleasurable to do his lines of cocaine than to risk becoming vulnerable in a relationship of trust with a woman. After several failures in attempting to overcome his cocaine addiction, he had hit bottom and was now highly motivated to work on his recovery and he subsequently was willing to examine all areas of emotional pain in his life.

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In his therapy, a great deal of anger with his mother was uncovered, as well as, much to his surprise, a profound mistrust of females because of the way he had been treated by her. He related, "I hated the way in which she tried to dominate my life, my friendships, my future, even my breathing." This discovery initially intensified his anger with his mother. However, he came to understand that the resolution of this anger was essential to establishing healthy friendships with females and to his recovery. He decided to try forgiveness because neither denying nor overreacting in anger was beneficial to him. A major difficulty in applying forgiveness was that his mother had not changed her controlling ways that reawakened his anger and mistrust.

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He decided for the forgiveness process to help him in his recovery and in his ability to establish healthy female friendships. Initially, in the work phase of forgiveness, Malcolm was unable to forgive his mother cognitively or emotionally. Instead he employed a modification of the 12 Steps program of AA and daily reflected that he was powerless over his cocaine addiction and intense anger with his mother and he wanted to turn them both over to God. He felt comfortable in this process because he had a strong spiritual life. His anger with his mother fluctuated significantly. There were times in the forgiveness process when he was unable to let go of his anger with her at all, especially when certain painful memories from the past emerged. However, he was determined not to be controlled by his past and, as he worked at giving up his resentment, he felt freer and less controlled.

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His struggle with trusting female relationships was a lengthy one but fortunately he was able to identify several trustworthy women in his life. The two year process of forgiveness proved beneficial in Malcolm's recovery from his cocaine addiction and it opened him to healthier friendships.

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Excessive Anger and Addictions

Substance abusers who grow in self-knowledge often identify their alcoholism and drug abuse as a type of rebelliousness against family members, employers, or society at large. Adolescents, in particular, discover that it gives them a sense of strength, freedom, and acceptance from other hostile, rebellious peers. Some, too, find that rebelliousness provides an excuse for avoiding responsibility or becoming dependent on others.

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Study on Excessive Anger

Henry had a sixteen year history of alcohol and later cocaine substance abuse. He had several inpatient hospitalizations for alcoholism and spent weekend time in prison because of several arrests for driving under the influence of alcohol. After a period of six months of weekends in prison he became truly motivated for the first time in recovery. The other incentive was that his wife had just given birth to their first child, a son. There is now ample evidence that marriage is associated with lower crimes rates (Sampson, Laub & Wimer, 2006).

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Henry had significant psychological insights into the profound anger and rebelliousness that influenced his substance abuse. He was fully aware that he had grown up in a large family with a powerful, domineering father who had ruled his family with an iron fist. When Henry engaged in moderate rebellious behavior as a teenager his father's response was swift and severe, grounding him for an extended period of time for even minor acts of rebellion. As an adolescent, Henry was fully aware that he derived great pleasure from drunkenness because, when he was intoxicated, his father had absolutely no ability to control him. Although he saw his present behavior as self-destructive, he had difficulty letting go of the deep resentment and bitterness he felt toward his father even though he realized that it played a major role in his struggle with alcoholism.

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Henry had been in therapy a number of times during which the concept of forgiveness had been presented to him, but he admitted that in earlier phases of therapy he had only given lip service to the concept and had never truly made a decision to overcome his addictive disorder or to let go of his anger through forgiveness. He admitted that his reasons were that he enjoyed the sense of rebelling and that his anger helped him to feel that he was stronger than his father.

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The questions that the therapist repeatedly presented to Henry during his therapy was, "Why are you allowing your father to continue to control you' Why no let go of your anger with him and thereby break the control of the past'" Henry resolved to break the negative legacy passed on by the men in his family from one generation to the next and for the first time and he truly committed himself to try to understand and forgive his father. During the time when Henry worked at thinking of forgiving his father daily, his level of compassion toward his father increased and, in time, really felt like forgiving him. He also slowly grew in his ability to accept the pain of the past and came to believe that his father had, in fact, attempted to love him as much as he was capable of loving him, given his own conflicts from his family of origin. Henry related, "My father had a difficult life with many heavy responsibilities and he did the best he could given his family background."

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As his anger slowly diminished Henry grew in his ability to accept the pain of his past. As he continued forgiving his father, Henry's guilt from his rebellious anger diminished and his self esteem improved. For the first time, he was able to relate to his father in a positive manner.

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Antisocial Personality Disorders and Addictions

Studies reveal that 23% to 55% of children with Conduct Disorder develop antisocial personality disorder as adults (Robins, 1978; Robins & McEvoy, 1990) and, more than 80% of those who go on to develop antisocial personality disorders have an associated SUD (Reiger, Framer & Rae, 1990). Huizinga, Loeber and Thornberry (1991) recommend the simultaneous treatment of delinquency and substance abuse as more effective than a program focused only on one or the other. Forgiveness Therapy can be used with angry adolescent substance abusers to diminish their hostile feelings and impulses for revenge.

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Those with antisocial personality disorders can have childhood and adolescent experiences of profound betrayal or abuse. The response to this betrayal pain is intense anger which can lead to violent fantasies, impulses, and then destructive behaviors. In the treatment of anger stemming from antisocial personality, it is necessary first to uncover the intense rage from childhood and adolescence and to determine toward whom it is directed. Here the therapist will find value in exploring the depths of anger in all significant relationships by specifically asking if strong hatred, violent impulses, or a death wish have been entertained.

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Throughout the process, strong hostile feelings emerge toward a parent, abusive family member, or others with whom the patient had interacted. As a result of perceived benefits that these individuals experience from their intense anger, there is often a major resistance to the resolution of the inner rage and tendency toward violent behavior. Factors that influence the decision to change the method that has previously been used to deal with inner fury and to consider the use of forgiveness include: negative experiences with the law, a decision to stop acting like the offender, renewed commitment to family, or the emergence of guilt.

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For individuals with violent fantasies, impulses and behaviors, the release of rage can be facilitated by a process which begins with the physical expression of anger in a manner in which others will not be hurt; for example, the use of strenuous exercises, a punching bag, or breaking objects of little value. Men tend to be very comfortable with this approach to releasing their anger through their strength. Physical expression is followed immediately by making a decision to forgive offenders by cognitively relinquishing the desire for revenge. For some, the inner rage and impulse for revenge are so powerful that the word forgiveness cannot be used; this is particularly true in cases involving abusive fathers. As related in earlier in this chapter in discussion of the work phase and in Malcolm's case of rage with his controlling mother, the therapist can suggest that when clients cannot use the word forgiveness that they modify steps 1 and 2 of the 12 steps of AA and reflect they are powerless over their rage and want to turn it over to God or think that they want to let go of their desire for revenge.

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Other Personality Disorders and Addictions

In one study (Vaglum & Valgum, 1985) thirty percent of the female alcoholics met the criteria for borderline personality disorder. Forgiveness can be effective in diminishing the resentment and hostility in this personality disorder that usually arises from early and numerous life betrayals. The ability of borderline patients to control their resentment is of great value in the treatment of SUD.

Marital Conflicts and Pornography Use

As cited in the depressed spouse chapter of this book, research and clinical experience have shown that marital conflicts can contribute to depressive illness in spouses.  They can also lead to a compulsive desire to seek escape from marital stress through the use of pornography. 

The psychological conflicts in one spouse that can result in a vulnerability to pornography use in the other include:

• controlling personality conflicts in the other spouse leading to a lack of respectful treatment resulting in loneliness, sadness and insecurity

• selfishness with a lack of cheerful self-giving to the marital friendship

• excessive anger leading to a loss of trust

• failure to see and affirm the God-given goodness in one's spouse

• lack of trust with resultant emotionally distant behaviors and criticism

• low self-esteem leading to isolating behaviors

• intense anxiety with irritability

• depressive illness with negative communication style

• lack of balance with failure to put one's spouse before work, children or others

• avoidance of the home and spouse

• poor communication skills with an inability to be more positive than negative.

Recommendations are offered for diminishing these common marital conflicts in other chapters on this website. Marital therapy is often an essential aspect of the recovery process.  However, not uncommonly, spouses who contribute to the problem because of their psychological conflicts refuse to participate in any treatment that would require their growth in self-knowledge.  Instead, they hold their spouses solely responsible for the pornography use.

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Medications in Rehabilitation

Disulfiram) and naltrexone have been of benefit to some individuals in their recovery from alcoholism.  In addition natrexone and methadone have demonstrated some value in opioid rehabilitation.

Twelve Step Programs and Faith

A major breakthrough occurred in the treatment of addictive diseases with the introduction of the spiritually based twelve steps of Alcoholics Anonymous. The admission of powerlessness and reliance upon God's mercy, love and assistance has been the foundation for recovery in countless numbers of addicted individuals. In addition the fellowship and friendships in AA and NA meetings has been invaluable in recovery.

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A mistake some addicted people make however is to base their spiritual lives entirely upon the 12 step groups. This action is often the result of unresolved anger with parents and loved ones which unconsciously undermines trust in authority figures and in the Church. In addition unresolved parental anger is often misdirected at the Church (see Paul Vitz's Faith of the Fatherless: the Psychology of Atheism.)

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In one study of 37,000 adults over age 15 higher spiritual values protected against the risk of substance abuse, (Baetz, M. et al. 2006/ Can J Psychiatry 51:654-61) The author stated that spirituality is dramatically important to avoiding a destructive pattern of alcohol and drug abuse. 

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Forgiveness Therapy

Forgiveness therapy has significant potential to helps substance abusers not only with their recovery from substances but also from the regularly associated psychiatric disorders particularly excessive anger, anxiety, depression, narcissism and low self-esteem.  One early study demonstrated its effectiveness with SUDs (Lin et al.,2004).  Participants who completed forgiveness therapy had significant more improvement in total and trait anger, depression, anxiety, self-esteem, and vulnerability to drug use than did the alternative treatment group.  Most benefits of forgiveness therapy remained significant at 4-month follow-up.  These results support forgiveness therapy as an efficacious model for residential and after work substance abuse rehabilitation.

Internet Pornography Addiction

The use of pornography on internet is having a devastating effect upon marriages, youth and families, indeed upon the entire Catholic community. In our clinical experience it is possible to address this problem effectively if the individual is willing to do the hard work and make the sacrifices that are necessary for healing.

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Dr. Peter Kleponis has given many conferences on this important topic and has written, an important book, Integrity Restored.

A webinar on the origins and healing of pornography conflicts are available on this site, www.maritalhealing.com/pornographywebinar.php.

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Dr. Peter comments on the emotional and character conflicts that influence pornography use and their resolution in the DVD,Blessed Are the Pure of Heart with Fr. Kevin Barrett, www.youtube.com/watched=i9tQ4n9PLzI. This DVD series is based upon Bishop Robert Finn's excellent pastoral letter on pornography and can be ordered at Family Land. 

Compulsive Sexual Behavior

Compulsive sexual behavior appears to begin early in life, to have a male preponderance, and to run a chronic or episodic course. It is also commonly associated with psychiatric comorbidity, typically mood, anxiety, substance use, and personality disorders. Further research is needed to better our understanding of the disorder and improve our ability to develop specific interventions. (Kuzma, JM, Black DW. Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatr Clin N. A. 2008 Dec;31(4):603-11.

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The Origins of the Compulsive Use of Pornography

In our clinical experience the most common emotional and character conflicts which influence this difficulty are:

• Selfishness

• Loneliness and sadness

• Marital conflicts with a controlling, angry, critical, selfish, emotionally distant or negative spouse

• Confidence weaknesses

• Excessive sense of responsibility with lack of balance in life

• Poor body image

• Social isolation

• Mistrust and anxiety in relationships

• Excessive anger

• Guilt and shame

• Lack of self-giving to others

• Difficulty in receiving love

• Disordered priorities

• Excessive sense of independence

• Boredom with contraceptive sex

• Lack of acceptance by peers, particularly in adolescents and in the adolescent stage of development

• Lack of sense of fulfillment

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If you have this struggle, what do you think are your conflicts'

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Damage to Marital Love

Pornography harms marriages and families in numerous ways including:

• a belief that fantasy is better than authentic love

• growth in selfishness - the major enemy of marital love

• failure to understand and appreciate the beauty and sacredness of marital love

• lack of refinement in self-giving to the romantic aspect of marriage, to the marital friendship and to the intimate relationship

• Diminished communication with one's spouse with harm to the marital friendship

• Damage to the wife's ability to trust and then to to experience pleasure with her husband which upsets him

• severe sadness, anger, mistrust and insecurity in the victim spouse

• harm to marital intimacy

• disordered view of beauty, goodness and sexuality

• increased vulnerability to adultery

• increased risk for marital separation and divorce

• weakened spiritual life

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Warning Signs of Pornography Use in Marriage

• neglect of the marital friendship

• neglect of the romantic aspect of the marriage

• loss of interest in the intimate relationship

• increased tendency to isolate

• increased irritability

• decrease in positive, loving communication

• increased viewing of pornography in the home

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Response to Pornography Use by Offended Spouse

• describe the betrayal pain that is identical to that of marital infidelity of sadness, anger, fear/mistrust and insecurity/loss of confidence

• attempt to do so without excessive anger which is only possibly by a process of forgiveness

• give a correction and demand change

• insist that he know himself, work to overcome the conflict and meet with a third party as a couple

• challenge spouse to be loyal to the marital vows to be true to and to honor.

Damage to Young Men from Pornography

• involvement in a fantasy world that undermines the ability to relate to young women in a healthy way

• interferes with the development of a healthy personality

• harms the ability to understand and want to make a loving commitment in marriage

• fosters the hook-up culture

• results in sexual obesity

• can lead to severe loneliness, depression, weak confidence and social anxiety.

Personal Sharing of Harm from Pornography Use by a College Student

A single man wrote about the damage caused by his compulsive use of pornography through his adolescence, “I would most certainly agree with the damaging effects of pornography. In my own personal experience, I have recognized above all else an extreme tendency to emotionally and socially turn inward as a result of the sexual, emotional, and spiritual brokenness resulting from post-porn addiction. Out of pain and fear, I have found it harder and harder to open myself up to others and act in a Christian manner. It can be aptly described as a selfishness and obsession associated with focusing on my own pain and a desire to remedy it.

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This disorder has made it extremely difficult to see the beauty in others and merely appreciate life. I have low confidence and it is harder to serve and give of myself to others. My social life has also been affected, although I push myself to do what I must to endure and succeed. I have no desire to date, and social anxiety permeates my interactions with others. I am confronted with a greater depressive and anxious condition in light of my body's absence from the porn. These described conditions represent the damaging effects of many years of pornography addiction on my physical, emotional, spiritual and sexual well-being.

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It seems a lot of the following conditions such as shame, despair, fear of commitment to a loving relationship, weakened spiritual life are the result of guilt. I felt that early on and throughout my addiction to pornography. The world one becomes enmeshed in when addicted to pornography is pure fantasy, devoid of self-giving love, and without any of the true emotional ups and down of real relationships (Its a one- way road). These characteristics played a powerful role in damaging my own perception of what a wholesome relationship is and created a purely sexually and selfishly focused view of relational feeling and bonding, devoid of the beauty in my partner and care for her. Returning to the focus on guilt and spiritual brokenness, it is so true that pornography addiction creates these conditions. My relationship to God suffered as I felt more and more unworthy to confront him in prayer. Sadness and despair followed and now although I am tying to overcome, my sexual condition has made it even harder to pray or feel God's presence."

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Damage to Young Women

According to the American Psychological Association, the culture can be infused with sexualized representations of girls and women, suggesting that such sexualization is good and normal. This leads to girls and women feeling bad about themselves: there is evidence that sexualization contributed to impaired cognitive performance in college-aged women, and related research suggests that viewing material that is sexually objectifying can contribute to body dissatisfaction, eating disorders, low self-esteem, depressive affect, and even physical health problems in high-school-aged girls and in young women

In addition to leading to feelings of shame and anxiety, sexualizing treatment and self- objectification can generate feelings of disgust toward one’s physical self. Girls may feel they are ugly and gross.   APA Task Force on the Sexualization of Girls (2007) www.apa.org/pi/women/programs/girls/report.aspx .

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The American Psychological Association (APA) quotes D.L. Tolman’s Dilemmas of Desire: Teenage Girls Talk about Sexuality(2002): “in the current environment, teen girls are encouraged to look sexy, yet they know little about what it means to be sexual, to have sexual desires, and to make rational and responsible decisions about pleasure and risk within intimate relationships that acknowledge their own desires. Younger girls imbued with adult sexuality may seem sexually appealing, and this may suggest their sexual availability and status as appropriate sexual objects.”

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According to the APA, “A culture can be infused with sexualized representations of girls and women, suggesting that such sexualization is good and normal.” This leads to girls and women feeling bad about themselves: “there is evidence that sexualization contributed to impaired cognitive performance in college-aged women, and related research suggests that viewing material that is sexually objectifying can contribute to body dissatisfaction, eating disorders, low self-esteem, depressive affect, and even physical health problems in high-school-aged girls and in young women. “In addition to leading to feelings of shame and anxiety, sexualizing treatment and self-objectification can generate feelings of disgust toward one’s physical self. Girls may feel they are "ugly” and “gross” or untouchable.”

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Damage to Girls

Melinda Tankard Reist’s article, The Pornification of Girlhood, describes the severe damage caused to girls by internet pornography and the influence of pornography in our culture, Quadrant Magazine, July 2008 - Volume LII Number 7-8, www.quadrant.org.au/php/article_view.php'article_id=3983.

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Dr Lauren Rosewarne in her 2008 book Sex in Public: Women, Outdoor Advertising and Public Policy, highlights how the signs and symbols of pornography are now enmeshed in popular culture: “While pin-up images are prohibited in a workplace, outdoor advertisements, which may contain references to pornography, are freely displayed...pornography can be interpreted as being one of the most potent contemporary influences on advertising...such advertisements are helping normalize pornographic images by displaying them in places where they are unavoidable and thus encouraging the acceptance of them. This process is known as mainstreaming... explicit sexual expression has become naturalized.”

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Girls are “being invited to see themselves not as healthy, active and imaginative girls, but as hot and sassy tweens on the prowl”, write Andrea Nauze and Emma Rush in Corporate Pedophilia: Sexualization of Children in Australia (2006).

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Pornography has become the sex handbook for many boys who are fed distorted images of women who are reduced to sex toys and masturbatory aids.

Damage to Children

A extensive recent study of hard core adult pornography, www.moralityinmedia.org, shows how it contributes to the sexual exploitation of children The results reveal:

• For many perpetrators there is a progression from viewing adult porn to viewing child porn.

• Perpetrators use pornography to groom their victims.

• Children imitate behavior they view in adult pornography with other children.

• Children raised in one-parent households are more likely to be sexually exploited.

Damage to Spiritual Life

The Catechism of the Catholic states, "Pornography consists in removing real or simulated sexual acts from the intimacy of the partners, in order to display them deliberately to third parties. It offends against chastity because it perverts the conjugal act, the intimate giving of spouses to each other. It does grave injury to the dignity of its participants, since each one becomes an object of base pleasure and illicit profit for others. It immerses all who are involved in the illusion of a fantasy world. It is a grave offense. Civil authorities should prevent the production and distribution of pornographic materials." Catechism of the Catholic Church, 2354

Bishop Paul Loverde's pastoral letter on pornography describes the spiritual damage caused by pornography, "This plague stalks the souls of men, women and children, ravages the bonds of marriage and victimizes the most innocent among us. It obscures and destroys people's ability to see one another as unique and beautiful expressions of God's creation, instead darkening their vision, causing them to view others as objects to be used and manipulated."

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"Our natural vision in this world is the model for supernatural vision in the next. Once we have distorted or damaged that template, how will we understand that reality' Those who engage in such activity deprive themselves of sanctifying grace, destroy the life of Christ in their souls, and prevent them from receiving Holy Communion until they have received absolution through the Sacrament of Penance .... The human person progressively builds or destroys his or her character by each and every moral choice." Paul S. Loverde, Bought with a Price: Pornography and the Attack on the Living Temple of God, (2006), www.arlingtondiocese.org/documents/BoughtPrice_F.pdf.

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Internet Pornography Healing

The recovery plan we have found to be effective includes:

• self-knowledge

• growth in virtues

• friendships/peer support

• protection of the home

• 12 step group for those with addictions

• spiritual plan

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Chapters on this site that address selfishness, sadness, anxiety, marital love and sexuality, marital anger and controlling conflicts can be helpful. We also offer a pornography webinar on this site. Some individuals have found 12 step groups, such as sexaholics anonymous, of great benefit.  In our practice men have reported being strengthened by participating in a biweekly teleconference in which anonymity is maintained by using first names. Finally, we encourage our Catholic patients to go to the sacrament of reconciliation on a weekly basis to the same priest if possible and to receive the Eucharist as often as possible.  We have seen that the power of these sacrament regularly strengthens individuals to fight against this powerful addiction.

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Some patients also benefit from the use of SSRIs (serotonin re uptake inhibitors) which decrease anxiety, sadness and anger.  The side effect of these medications of a diminished sexual drive and performance is one of the few beneficial medication side effects.

Parents have attempted to protect their children in high school and college from pornography by placing a program on their lap tops such as Covenant Eyes which sends a weekly report to the parents of the web sites visited. Some college students have been warned that if regular pornography use is found that they will lose their financial support. Those struggling with internet pornography have been helped by having the weekly report from this program sent to a good friend.

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Books that are helpful with this conflict include The Social Costs of Pornography, Clean of Heart, Every Young Man's Battle Guide, Theology of the Body for Teens, The Truth and Meaning of Human Sexuality and Theology of the Body for Beginners , The Courage to be Chaste and the website, www.pornharms.com.  We also recommend The Weight of Smut, Mary Eberstadt, First Things, June-July, 2010, Not Your Father's Pornography. Jason Byasse, First Things, 2008. the addiction chapter and the marital infidelity chapter on this website.

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We have found that teleconferences for men with internet pornography addiction in which anonymity is maintained by using first names are very effective in the treatment process.  In these teleconferences the emotional causes of the conflict are addressed and the twelve steps are employed.  A number of articles that demonstrate the benefits of telepsychiatry are available at Medline, the web site of the National Library of Medicine and the National Institutes of Health, www.ncbi.nlm.nih.gov/pubmed .

The Role of Faith

Priests can help in addressing the pornography epidemic by communicating the beauty and sacredness of sexuality in the sacrament of marriage, by warning of the dangers of pornography and compulsive masturbation, by strengthening Catholic fatherhood, by considering developing support groups for parishioners with this conflict that could be based on a teleconference and by criticizing permissive parenting and the contraceptive mentality.

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For Catholics working with a confessor/spiritual director is important in the treatment plan.  Spiritual directors can assist individuals to grow in trusting the Lord has plan to protect them from loneliness and to strengthen their male confidence.

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John Paul II's wisdom from Letter to Artists, no.16 is helpful in the struggle against the pornography epidemic, He wrote,“Beauty is a key to the mystery and a call to transcendence. It is an invitation to savor life and to dream of the future. That is why the beauty of created things can never fully satisfy. It stirs that hidden nostalgia for God which a lover of beauty like Saint Augustine could express in incomparable terms: ‘Late have I loved you, beauty so old and so new: late have I loved you!’”. John Paul II, Letter to Artists, n. 16 (1999)  A true appreciation for love and beauty can contribute to healing the present pornography epidemic.

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The writings of John Paul II on marriage, family life, love and sexuality, including The Role of the Christian Family in the Modern World, Love and Responsibility and Theology of the Body, are important in purifying the Catholic family of the negative influence of moral relativism and the sexual utilitarian philosophy, both of which contribute strongly to the present pornography addiction epidemic.

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Reasons for Hope

The field of positive psychology that employs the use of forgiveness and other virtues has significant potential to help those with addictions, not only with their recovery from compulsive behaviors, but also from associated disorders. The ability of addicted persons to learn how to overcome selfishness, grow in confidence, address loneliness and anxiety and resolve and control excessive anger is essential in their recovery and in protecting them from relapse. Faith can play an important role in the recovery process. 

References in this chapter can be found at the National Library of Medicine web site, PubMed.