The Substance and Pornography Addicted Spouse

         

"I do not do the good I want to do, but the evil I do not want to do," Rom 7:15.

Today we are experiencing an epidemic of substance abuse disorders, particularly related to opiods and heroin, as well as marijuana use. At the same time we are witnessing an epidemic of pornography and sexual promiscuity that are severely harming marriages, yonug adults, children and the culture and are contributing to the retreat from Catholic marriages.

This chapter addresses the current epidemics of substance and pornography addictions which severely harm Catholic marriages, youth and children.  Leading psychological conflicts that influence and drive addictions, which we have seen over the past forty years, are uncovered and their treatment described. The conflicts include: intense selfishness, loneliness and depression, intense insecurity with social anxiety, an obsession with pleasure and comfort, excessive anger and rage, overwhelming work stress,lack of hope about employment and marriage, serious marital difficulties, identification with addicted friends, fears of commitment, post divorce trauma in one's marriage or in a parent's marriage, despair and hopelessness and weakness in faith.

The hard work that is necessary to resolve these conflicts is described through growth in self-knowledge and the development of a healthy personality through an increase in good habits, virtues and stable relationships..  As in the AA program for treating addictive disorders, the benefits of role of faith are presented.

The Opiod and Heroin Epidemics

The severe heroin and opioid epidemics, described in a Wall St. Journal article, is responsible for the skyrocketing overdose deaths in this country which have more than doubled between 2000 and 2014. In 2014, 47,055 Americans died from overdoses, a fatality level that matched the AIDS epidemic's peak in 1995.

Extent of the Problem

Addictive disorders present a major threat to marriage, youth and family life.  Tobacco and alcohol use are by far the most prevalent addictive behaviors and cause the large majority of the harm. It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. (Growing, LR. 2015. Global statistics on addictive behaviors: 2014 status report. Addiction, 110: 904-919).

In 2011, more than 21 million Americans needed treatment for a problem related to alcohol or drugs, according to the National Survey on Drug Use and Health. In addition, addiction to marijuana and internet pornography are of epidemic proportions. 

Addictions are common, chronic and relapsing disease that develop through a multistep process.  The high 12-month prevalence rates approximate those of other mental disorders as well as chronic physical disorders with major public health impact (Merikangas & McClair, 2012). The impact of addictions on morbidity and mortality is high worldwide (Ducci & Gold, 2012).  Also, particularly troubling are high rates of overdose and death occurring among heroin addicts with younger users at greater risk (Degenhardt, et al, 2011).  An association with increased mortality has been also found among cocaine/amphetamine users. (Arendt, et al., 2011).

The use of anabolic androgenic steroids (AASs) has escalated in teenagers and is associated with increased violence. A side effect of AAS use reported is roid rage, characterized by indiscriminate and unprovoked aggression (McGinnis, 2004). AAS abuse appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood syndromes, and progression to other forms of substance abuse (Kanayama, Hudson & Pope, 2008).In a study of methamphetamine dependent adults, there was a five fold increase in the likelihood of psychotic symptoms during periods of methamphetamine use relative to periods of no use, with this increase being strongly dose-dependent (McKetin, Lubman, Baker, et al., 2013).

Relapse

Unfortunately, studies show that 60% or more of alcoholics and drug addicts relapse within a year of trying to overcome their compulsive behaviors. One reason for the lack of success in recovery is the failure to uncover and address the emotional and the personality conflicts from childhood, adolescence and adult life that drive such behaviors. Treatment should include work on resolving anger from life hurts, particularly in the father relationship, selfishness, loneliness, weaknesses in confidence and anxiety at each life stage. The importance of this approach was demonstrated in a study that showed approximately 70% of adult mental disorders begin during childhood and adolescence (Kim-Cohen, J., et al., 2003). Another study demonstrated that 46.9% of men and 31% of women with a narcissistic personality disorder also had a substance abuse disorder (Stinson, F.S., 2008).

While the twelve step programs are helpful to many people, they do not specifically focus on resolving anger from the family of origin nor on mastering selfishness and the other mood disorders that are so often present in those with addictions..  In a study of those who attended 12 step meetings, they were found to have more intense selfishness relative to general population samples.  Also, their selfishness remained elevated in spite of participation in 12-step meetings (Tonigan, J.S., et al, 2013).

A 2014 hopeful study was of 195 teenagers who were court-referred to a 2-month residential substance abuse treatment program. It found that increased daily spiritual exercises (DSE) was associated with greater likelihood of abstinence, increased prosocial behaviors, and reduced narcissistic behaviors, (Lee, M.E., et al. 2014). The absence of a strong spiritual component in the recovery program can be another important factor that predisposes individuals to fail to commit to abstinence and to relapse.

We will describe first describe origins and treatment of substance abuse addiction and then pornography addictions.

Substance Abuse

Substance abuse is a serious disorder, regularly associated with excessive anger. Annually, approximately 100,000 deaths in the United States are ascribed to alcohol abuse and alcoholism, making them the fourth leading cause of mortality after heart disease, cerebrovascular disease, and cancer (Stinson, 1992). Substance abuse disorder (SUD) is associated with social and psychological difficulties that give rise to anger in the user and others, including family conflicts, parental neglect, child abuse, social isolation, antisocial behavior, and unemployment (Kumpfer, 1993).

The optimal treatment of patients with substance use disorders requires an awareness of their other mental disorders. Research has shown that associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders (Grant, Stinson, Dawson, et al., 2004).

Marijuana Addiction

Cannabis use has increased significantly over the last three decades. Many individuals and even professional groups minimize the seriousness of chronic marijuana usage. However, numerous research studies demonstrate the damage done to emotional and mental health and to the brain by this drug. For example, it is well known that cannabis intoxication can cause brief psychotic symptoms like paranoia, while recent evidence suggests that heavy use of cannabis increases the risk for chronic psychosis like schizophrenia, (Luzi, S., 2008).

These most probable adverse effects of chronic marijuana use include a dependence syndrome, impaired respiratory function, cardiovascular disease, (Hall & Degenhardt, 2013), adverse effects on adolescent psychosocial development and mental health with poorer educational outcomes and an increased likelihood of using other illicit drugs, residual cognitive impairment and psychotic symptoms (Hall, 2009)

Below are many summaries of other studies which demonstrate the serious problems associated with marijuana use.

The association with depression, conduct problems, excessive drinking and use of other drugs shows a malignant pattern of co-morbidity that may lead to negative outcomes, Rey, et al, 2002. Another study revealed the possibility that cannabis abuse/dependence may make an independent contribution to risk of serious suicide attempt, both directly and through the possible effects of cannabis abuse on risk of other mental disorders, (Beautrais, A.M., 1999).

The results of this study confirm that long-term heavy cannabis users show impairments in memory and attention that endure beyond the period of intoxication and worsen with increasing years of regular cannabis use, Solowij N, 2002. One study on exposure-related structural abnormalities in the hippocampus and amygdala in long-term heavy cannabis users corroborates similar findings in the animal literature. These findings indicate that heavy daily cannabis use across protracted periods exerts harmful effects on brain tissue and mental health, Yel M, 2008, Arch Gen Psychiatry. 65:694-701. Cannabinoids appear to have profound and permanent effects on brain organization, connectivity, and geography when exposure occurs during critical periods in utero, early childhood, or adolescence, Science 2007,316:1212-16.

About one-third of the patients (N=73) used cannabis after hospital discharge. Post discharge cannabis use substantially and significantly increased the hazard of first use of any substance and strongly reduced the likelihood of stable remission from use of any substance, Aharonovich, E., 2005.

Five hundred and eleven persons with a first episode psychosis were studied. These individuals used three to five times more substances than general population. Also, substance use was associated with poorer social adjustment and a more acute mode of onset, Mazzoncini R, 2009.  Also, frequency of use prior to onset of psychosis indicated that progression to daily cannabis use was associated with an increased risk of onset of psychotic symptoms, Compton, M.T., 2009.

The serious health risks posed by regular marijuana use are underestimated or denied in the culture today.  Instead, they should be known by spouses and communicated to their children. 

High levels of anger in addictive disorders

The levels of anger and violence observed in substance abusers is far higher than the levels in the general population (Grisso, et al., 2000; Reilly & Shopshire, 2000). One relapse study showed that the predominant factor was negative emotion (Marlatt, 1985) and, in turn, negative emotion was positively correlated with alcohol dependence, trait anger, and depression (Zywiak, et al, 1996.) Anger has been described a driving force in addictive behavior and as a constant threat to sobriety (Nowinski, et al., 1999). Also, alcoholics who had urges to use after treatment had higher degrees of alcohol dependence, anxiety and trait anger than those without such urges (Litt, et al., 2000).

Drug abusers have significantly higher scores on State and Trait Anger scales and are more likely to express anger toward other people or objects and have less control of their angry feelings than the general population (DeMoja & Spielberger, 1997). Also, subjective anger is an important correlate of alcoholism in depressed men and more closely related to alcoholism than antisocial personality (Lewis, et al., 1986).

Many therapists identify those with addictions as their angriest,most abusive, selfish and explosive patients. The strong resentment in these individuals can interfere with both inpatient and outpatient recovery programs and can play a major role in relapse(Gorski 1983; Potter-Efron, 1991; Daley, et al.,1992). Some in recovery relate that their sobriety is threatened because they lack an understanding of ways to cope effectively with their angry feelings . Many substance abusers relate that they drink to control their anger or to diminish their defenses so that they can more easily vent hostile feelings. 

The most difficult anger to resolve is that which arises from selfishness.  However, it is also very challenging to resolve the strong anger from hurts in the father relationship, particularly in men whose fathers were addicted.

Methods of Treating Anger in Addictive Disorders

Given the high prevalence of excessive anger in addictive disorders, anger treatment programs are increasing being viewed as an important aspect of recovery and have been demonstrated to have efficacy (Lin, Enright, Krahn, Mack & Baskin, 2004; Fernandez & Scott, 2009; Awalt, Reilly, & Shopshire,1997.) Although the cognitive-behavioral therapy literature recommends that alcohols become aware of their anger, learn to delay responding, and learn alternative assertive rather than aggressive responses, there are few data documenting the efficacy of this approach (Fernandez & Scott, 2009).

Reilly and Shopshire (2000) published a report of anger management in a relatively large sample of cocaine-dependent men and women. Their findings support the efficacy of cognitive-behavioral techniques (e.g. cognitive restructuring, relaxation training) in reducing self-reported anger and angry behavior. However, there have been few studies that have examined the efficacy of an anger management treatment.

One study that evaluated an integrated treatment for comorbid problem gambling, anger, and substance use found that participants in the integrated anger and addictions treatment reported significantly less gambling and less trait anger and substance use. (Korman, Collins, Littman-Sharp, McMain & Mercado, 2008).

The need for a specific plan to treat anger in the substance abuser is supported both by clinical experience and by research which reveals that feelings of anger have failed to subside after inpatient drug treatment (Powell & Taylor 1992).

Mental health professionals usually do not acknowledge or directly address the hostility in the substance abuser. Perhaps the therapists are hoping that the angry feelings, behaviors,and thinking will be addressed in the twelve step program.

The need for a specific plan to treat anger in the substance abuser is supported both by clinical experience and by research that reveals that feelings of anger have failed to subside after inpatient drug treatment (Powell & Taylor 1992).

The expression of anger in patients continues to be the method most often recommended by therapists. Yet, the limitations and dangers oft his approach have been described in the literature (Fitzgibbons, 1986, 1986;Tavris, 1989; Potter-Efron, 1991; Daily & Marlatt,1992). Unfortunately, many therapists are unaware of other anger management techniques available, and in particular, the use of forgiveness therapy which has received scant attention. Forgiveness, however, has been recommended as a way of working through past anger (Potter-Efron, 1991). In 2004 the first paper was published which demonstrated empirically the effectiveness of forgiveness therapy in the treatment of those with substance abuse disorders (Lin, W.F., et al. 2004.)

Finally, marital therapy is indicated when there is excessive anger in the addicted person related to the conflicts of living with a controlling, emotionally distant, selfish or angry spouse.

Benefits of Forgiveness

From our clinical experience, forgiveness can be highly effective in treating substance abuse disorders because it may help diminish angry feelings, thoughts, and behaviors in the patient. The ability to understand the causes of anger and maintain control over them, helps to stabilize the mood of substance abusers and facilitates their recovery. Forgiveness also can diminish the anger in the numerous other depressive, anxious and personality disorders associated with SUD. The healing of this anger is important because it can inhibit the recovery process.

Emotional Conflicts in addictive disorders

Numerous areas of emotional conflict can contribute to substance abuse and its associated anger. These include: selfishness/narcissism,loneliness and depression, strong insecurities, anxiety disorders with mistrust, work stress, modeling after an insecure and addicted parent,and and bonding with hostile or sociopathic peers. Additional factors can be antisocial and dependent personality disorders, unemployment,poverty and self-hatred.   Also, a heritable biological factor may play a role in the resentment in some addicts (Cloninger et al, 1981 and von Knorring et al, 1987).

Theories for the Origins of Addictive Behaviors

A number of theories have been proposed and they include

1. The genetic or social theory - the earlier the onset of exposure to alcohol and drugs, them ore likely the individual will use;

2. Earliest psychological theory - the user did not receive adequate nurturing during childhood;

3. Psychoanalytic theory -individual uses to assuage guilt or criticism;

4. Cognitive-behavioral theory - no matter the stimulus, individual responds by using alcohol or drugs; with therapy individual can learn to break connection between stimulus and response;

5. Self-medication theory - when patients in studies were asked why they used, 75%said to help to deal with stress,to relax, to help with sleep, or to help forget problems; 15% said to get high.

Four Phases of Anger Treatment in Addictive Disorders

An examination of the typical problems and challenges faced within each of the four phases of the forgiveness process with case studies will be presented now.

Uncovering anger

In this phase of treatment, the challenge is not necessarily to identify anger because most substance abusers readily admit that they have problems with hostile feelings or impulses. Ascertaining with whom the addict is truly angry, however, can be a formidable task for several reasons. The first is because passive-aggressive expression can be the major hidden method of venting resentment in some addicts. it is important to recognize both passive-aggressive and active anger. Equally challenging is determining the degree to which the anger is caused by selfishness

The first step in identifying the true origin of the addicts' anger is to assist the person in the recognition of major disappointments in relationships throughout their lives. In our clinical work, the most significant anger arises from disappointments and hurts in the father relationship, but it can also develop from other relationships including spouses, mothers, siblings, peers and employers. If the alcoholic is involved with AA, the 4th and 5th step inventory can be invaluable in this phase when done with a sponsor or therapist.

The most common complaints uncovered against fathers are that they themselves were alcoholic or that they were too emotionally distant,critical, disrespectful, angry, controlling, narcissistic, or weak. Many addicts relate that they never expressed this anger directly to their fathers in childhood or adolescence, either because they feared him or they worried about losing the relationship with him as a result of their honesty. Rebellious behavior in the home, school, or community was an easier path to choose.

The most common conflicts uncovered against spouses were that they were emotionally distant, controlling, selfish, controlling or angry. Significant resistance can develop to identifying the role of marital loneliness in the addicted spouse. Reasons for this include a pop psychology incorrect view that no one else can be responsible for your unhappiness, fear of being honest with one's spouse, fear of the spouse's rejection or anger and fears of marital conflicts.

The Decision Phase

Addicted people in an inpatient treatment program often are unwilling to make the decision to forgive an offender because of ambivalence about their recovery or because of the benefits they derive from their resentment, including, in the case of males, the projection of a strong masculine image. One way to motivate such persons to decide to work on forgiveness is to present the negative consequences of storing up their hostile feelings. As the patient realizes that harboring resentment gives the offender a controlling influence in their lives, those in recovery programs are more willing to consider forgiveness as an option. As a further complication, patients can feel guilty about ways in which their hostile behaviors have hurt other important people in their lives including children, spouses and friends. This, too, can serve as a motivation to forgive.

The Work Phase

The fact that many addicts, whose parents had substance abuse disorders, can quickly identify and empathize with their parents,facilitates the work of forgiveness. The most challenging patients are those with physically and emotionally abusive parents because they often discover powerful impulses for revenge or violent thoughts and fantasies. When this type of strong anger emerges, many addicts feel powerless over their rage, but fortunately, their familiarity with twelve step programs can prove invaluable. In such circumstances they are asked to modify the first two steps and reflect that they are powerless over their rage and impulses for revenge and want to turn them over to God. Those with strong repeated anger attacks benefit from treatment with a serotonin re uptake inhibitor.

The ability to resolve anger from the past and the present has numerous benefits for those in recovery and reinforces the decision to employ forgiveness on a regular basis. Many substance abusers begin the work of forgiveness and relapse for a variety of reasons. Some of them need to hit rock bottom many times before they truly make a commitment to work on their recovery and on their resentment.

Anger management interventions for individuals struggling with substance abuse sometimes fail to address the significant early life conflicts that give rise to strong resentment. Therefore, the deep anger is never fully resolved and it often emerges under the influence of the addictive substance.

Some of the common obstacles to the use of forgiveness in substance abusers include: the unwillingness to give up the addictive substance,the emotional high which comes from rebellious behavior, ambivalence about giving up the reliance upon strong anger for a strong masculine identity, narcissism, lack of a desire to be healthy, the need for acceptance from peers who are addicted, difficulty in changing the habit of employing the excessive use of anger when disappointed, and lack of a role model for forgiveness.

Deepening Phase

Addicted persons are often more motivated to make amends with those whom they have hurt and from whom they seek forgiveness as a result of their work on step five of the twelve steps of AA. Usually, these people find that in this phase their self-esteem begins to increase as a result of the resolution of anger from the past and their growing ability to deal with angry feelings in a healthy manner.

Selfishness in addictive disorders

Both clinical experience and research studies confirm that selfishness is strongly related to substance abuse if not its primary cause in many individuals. The addicted individual is often driven by a compulsive desire for pleasure that turns him/her in upon himself/herself, leading to a complete disregard for the well being of other family members. We recommend that selfishness be evaluated in all individuals with substance abuse disorders. The narcissism checklist on this web site can be helpful in evaluating this personality weakness.

A 2008 study of over 34,000 individuals (Stinson, F.S., et al)demonstrated that numerous disorders are associated (co-morbid) with narcissism, particularly in men. They include alcohol dependence, drug dependence, mood and anxiety disorders and other personality disorders. In this study 46.9% of men and 31% of women with a narcissistic personality disorder also had a substance abuse disorder. Also, 43.2 %of men with drug dependence had a narcissistic personality disorder and 22.3% of women with drug dependence.

In another study at Massachusetts General Hospital intense selfishness or narcissism was found to be at high rates in individuals with substance abuse disorders (Ronningstam, E. 1996). Those in treatment for substance abuse scored high on the narcissism and antisocial scales of the Millon Clinical Multi axial Inventory, (Matano,R.A. (1994).

The Diagnostic and Statistical Manual (DSM IV-TR) describes those with narcissistic personality disorders as having:

  • has a grandiose sense of self-importance
  • is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  • requires excessive admiration
  • has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  • is often envious of others or believes that others are envious of him or her
  • shows arrogant, haughty behaviors or attitudes

Other major symptoms include:

  • a sense of entitlement
  • a lack of empathy
  • a hedonistic pleasure seeking lifestyle
  • the use/treatment of others as objects, not as persons
  • irresponsible behaviors
  • a victim mentality

The Big Book of Alcoholics Anonymous describes the relationships between selfishness and alcoholism as follows, "Above everything, we alcoholics must be rid of selfishness. We must, or it kills us! God makes that possible. And there often seems no way of entirely getting rid of self without His aid. "We cannot reduce our self-centeredness much by wishing or trying on our own power. We have to have God's help."

"Self centeredness! That is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking and self-pity, we step on the toes of our fellows and they retaliate. So our troubles are basically of our own making. They arise out of ourselves and the alcoholic is an extreme example of the self-will run riot, though he doesn't think so. Above everything, we alcoholics must be rid of this selfishness, page 62."

The fourth step A describes taking "a moral inventory on our resentment, fear and sexual use of others which is all about ourself ish ness, which is our major problem."  Our professional opinion is that the selfishness in addictive persons should be evaluated by themselves and loved ones by completing a psychological measure of this conflict such as the narcissistic personality inventory or the narcissism checklist in the selfish spouse chapter.

Recovery from selfishness

Fortunately, the selfishness related to substance abuse can be resolved if the person is willing to work hard and grow in virtue.

In one study a significant decrease in the overall level of pathological narcissism was found, particularly in the area of interpersonal relations and reactiveness. At follow-up, 60% of the subjects had reached the cutoff score on the diagnostic interview, and40% remained unchanged. A high level of narcissism in interpersonal relationships was associated with absence of change at follow up(Ronningstam, E., et al. 1995.)

In the study of 37,000 adults over age 15 higher spiritual values protected against the risk of substance abuse. (Baetz, M., et al.(2006.) The author of this study stated, "Spirituality is dramatically important to avoiding a destructive pattern of alcohol and drug abuse."

Substance abusers who have narcissistic personality conflicts regularly manifest very strong anger and rage. These individuals are commonly encountered in drug and alcohol treatment programs and have been reported to respond poorly to individual psychotherapy ( Washton,A. M., 1995.) However, some of the patients do respond to a treatment protocol which challenges them to act more responsibly, to give themselves more fully to others, and to employ forgiveness rather than ventilating their anger whenever they feel upset. This approach to treating the narcissistic personality is developed further in a case study in chapter

The treatment process is very challenging because their substance abuse is an important part of their compulsive, pleasure seeking lifestyle. Some, however, do become motivated to change from their narcissism. The major factors that influence such a decision include an understanding that happiness comes from giving oneself, an awareness of harm to the self, feelings of emptiness and depression, fear of losing a loved one, job or college education and the emergence of guilt.

Narcissistic personality traits predispose these individuals to impulsive angry outbursts and violent behavior when their needs are not being met or when they are not the center of attention. Forgiveness is taught as an alternative method for coping with their anger and as a way to reach beyond themselves to other people. While supporting the appropriate expression of anger, forgiving and understanding are recommended when the patient feels upset with others as the first step in dealing with anger. The narcissistic person is asked to reflect upon trying to be more patient and understanding with others and to act in a more mature and responsible manner. Also, past forgiveness exercises are employed that concentrate on parents or other important persons who facilitated the development of their narcissism. Because forgiveness involves the giving of a moral gift to others, the narcissistic person learns to focus on care for others.

Other actions which help overcome this weakness are:

  • admitting powerlessness over this personality weakness and turning it over to God
  • trying to give cheerfully to spouse, children, parents, friends, neighbors, etc
  • stopping using others
  • working on friendships with those who are not narcissistic
  • forgiving those who may have enabled narcissism/failed to correct it or modeled it
  • trying to stop being the center of attention

The selfish spouse can experience significant healing and more fulfillment if a commitment is made daily to engage in the hard work of growing in the following virtues:

  • generosity
  • responsibility
  • temperance
  • courtesy
  • kindness
  • orderliness
  • love
  • self-denial
  • humility
  • service to others
  • patience
  • solidarity
  • manliness with an understanding of being a protector and a leader
  • forgiveness
  • meekness
  • self-control
  • faith

The following aspects of the Catholic faith are beneficial in the serious struggle to overcome the serious personality conflict of selfishness:

  • a daily examination of conscience on self-giving and other virtues
  • the use of the sacrament of reconciliation
  • meditation on becoming more loving and giving like Christ
  • spiritual direction
  • reception of the Eucharist for growth in all virtues, especially love
  • reading and studying Pope John Paul II's books, Love and Responsibility and Theology of the Body
  • prayer for healing of this weakness

The chapters on the selfish spouse/relative and child, www.childhealing.com, offer additional suggestions for dealing with the character weakness of selfishness.

The fourth step of AA in which the person tries to make amends can also facilitate the healing process if a request is made to loved ones for forgiveness for all the harm caused by the selfish and addictive behaviors. Finally, since substance abuse is often associated with using others as sexual objects, many who are in recovery benefit from participation in 12 step groups for sex addicts in addition to attendance at AA meetings.

Weakness in Confidence

Substance abusershave been noted to have low self-esteem (Dorard, Bungener, Corcos, et al, 2013; Washton, A. M. 1995). Many alcoholics relate using alcohol as way to cope with their insecurities. Some recognize that alcohol decreases their anxiety which then helps them to feel more confident. Those with low self-esteem often have significant amounts of anger with parents, siblings, peers, employers and significan others who failed to help them develop confidence or who damaged their self-respect. In many men the failure to experience a loving, affirming father relationship is the major conflict which contributes to strong feelings of insecurity and anxiety. 

The hurts in the father relationship are a major source of the strong anger seen in those with addictions. 

However, those with low self-esteem can also have significant amounts of anger with spouses, mothers, peers, siblings, employers, and significant others who failed to treat them with respect. 

Sadly, many men with controlling wives who find far more comfort drinking with their friends than they do in the marital friendship. In such cases resolving anger with the controlling spouse and trying to help the controlling spouse grow in more respectful behavior are essential.

Case study on confidence

Seth, a twenty year old college student, entered a drug and alcohol inpatient treatment program for mixed addiction of alcohol and cocaine. Prior to his hospitalization, Seth was in treatment for his addictions and for intense social anxiety. He felt that people were always looking critically at him and he dreaded any kind of embarrassment. His extreme social fear interfered significantly with his college life. Not only was he afraid of participating in class, he found himself needing to drink or use drugs before socializing with his peers. When he drank, he related that he felt very confident and did not fear being rejected.

Seth was the second child in his family and grew up in a home in which he felt comfortable. He had enjoyed a close relationship with his mother, but did not feel particularly close to his father, although he liked him. In the first grade Seth began experiencing strong rejection by his peers because of his inability to play sports. He was regularly the victim of intense criticism and at times ridicule by other children throughout his elementary and middle school years. Due to his extreme sensitivity and shame over this peer ridicule he never informed his parents of the daily emotional trauma he experienced at school.

The high school years were much better for Seth. He was not a scapegoat, but his anxieties were of such an extreme nature that he had great difficulty trusting in interpersonal relationships. Also, he began to drink excessively during these years.

Seth recognized that he had regularly misdirecting the anger meant for his peers at his family, particularly his mother. He also realized that the hurt he experienced from his peers when young made him extremely fearful of being rejected as a young adult. His decision, after several month of therapy, to work at forgiving his peers from his childhood years was based on the hope that this would help with his recovery and diminish his excessive anxieties that interfered with his college life.

In re framing and understanding, Seth tried to view his offenders as children and teenagers who were themselves troubled by excessive anger and possibly by a dislike for themselves which they were misdirecting at him. His pain was so intense from his peer experiences that he was not able to experience any compassion or empathy toward those who hurt him. Also, he had great difficulty absorbing and accepting the pain because of its profound nature.

Seth was a strong young man who made the intellectual decision to let go of his anger to help his recovery even though he did not feel like it. Many days he felt that he really wanted to strike back, but saw intellectually that revenge was ultimately useless and would only harm him. He felt benefit from reflecting on an old Chinese proverb that "He who seeks revenge builds two coffins."

As Seth continued the forgiveness process and felt stronger in dealing with his addiction, he experienced a diminishment of his insecurities and over the course of several years he slowly felt more comfortable in peer relationships. As he grew in the ability to separate his childhood peers from his young adult peers, his trust increased and his compulsive need for alcohol or drugs to relax with his peers decreased. He also benefited from regular physical workouts during which time he would imagine expressing anger at those who had hurt him in the past. Developing a better body image was beneficial to building his self-esteem.

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.)

Nearly one third of persons with major depressive disorder also have SUDs 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 and depression are associated and marijuana may increase depressive symptoms among some users (Degenhardt, et al., 2003).

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).

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. Clinical experience has shown that loneliness is one of the major factors influencing the development of depressive disorders in substance abusers. We have treated many married women,who are very lonely in their marriages and whose husbands are often not home for dinner, begin drinking late in the afternoon in an unconscious attempt to seek comfort.

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.

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.

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.

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, withthe onset of GAD occuring 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).

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.

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).

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.

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.

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.

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.

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.

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).

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.

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.

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."

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.

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.

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.

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.

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.

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.

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.

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.)

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 destructve pattern of alcohol and drug abuse. 

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 particulalry 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, anxiey, 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.

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.

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.

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

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

1.

2.

3.

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.

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

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.

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.

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."

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 .

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.”

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.”

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.

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.”

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).

Pornography has become the sex handbook for many boys. It is not often noted that pornography is detrimental for boys, who are fed distorted images of women'Xwho they are and what they want. Women are reduced to sex toys and masturbatory aids. And men are portrayed as predatory and masterful, never as gentle and considerate lovers.

The American Psychological Association makes the vital point that “asexualization practices may function to keep girls ‘in their place’ as objects of sexual attraction and beauty, significantly limiting their free thinking and movement in the world.”

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."

"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.

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.

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.

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.

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.

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.

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.

A John Paul II Institute for Studies in Marriage and Family, Patrick Williams, wrote in an excellent paper on this topic, “When beauty is recovered as purity and goodness, the person rejects pornography because there is no longer an attraction to it.  The force of true beauty is great and can, even if slowly and imperfectly, replace the corrupt understanding of beauty.  This requires openness to the saving power of God to transform the heart.  The realization of a true understanding of beauty restores the sight of man to overcome his concupiscence, to overcome his use of the other as a mere body.  John Paul II knew this well when he quoted Dostoyevsky, ‘beauty will save the world.’”Pornography and Beauty:  The Understanding of Psychology and the Thought of Wojtlya/John Paul II, 2007,   Pornography and Beauty,

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 savour 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.

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.

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.