A review and response to the book "He Restoreth My Soul: Understanding and Breaking the Chemical and Spiritual Chains of Pornography Addiction Through the Atonement of Jesus Christ" by Donald L. Hilton Jr., MD (Neurosurgeon).
This response addresses the Introduction to "He Restoreth My Soul", pgs. ix–xv.
General Thoughts and Impressions
While reading Hilton's book, the voice of Lemony Snicket would frequently enter my mind,
“Assumptions are dangerous things to make, and like all dangerous things to make — bombs, for instance, or strawberry shortcake — if you make even the tiniest mistake you can find yourself in terrible trouble. Making assumptions simply means believing things are a certain way with little or no evidence that shows you are correct, and you can see at once how this can lead to terrible trouble.”
As a clinician, father and husband with a profound desire to solve the "porn problem," I have spent my career and free time consuming every case study, research article, book, program and literature addressing porn and sex addiction both in the church and academia. Each study Hilton refers to in this book I have dissected and reread numerous times prior to reading his book. Not only am I well versed in the research, I routinely work with clients within the faith who struggle with out-of-control sexual behavior and pornography. Although this is a complicated emotional and spiritual issue and each individual is different, I am familiar what works and what doesn't work. Furthermore, I am aware of paradigms and treatment interventions that appear to work in the short term but have damaging long-term consequences.
Therefore, it is perplexing to me how Hilton, a medical doctor, has published a book full of assumptions and confirmations biases, especially considering such an important topic. I have no desire to question his integrity. In fact, I assume the best in that he has the desire to solve the "porn problem" too. However, his assumptions, conclusions and frequent use (and interpretation) of research are often off the mark, unsupported and sometimes hysteria that I can't help but wonder what he was thinking and how he thought this would be helpful. For someone not trained in medical science, regardless of the field of study, I could easily give a pass for authoring a book like "He restoreth My Soul." But Hilton is a medical doctor and uses his credentials on the book and throughout as a means to authoritatively back his statements.
Using his credentials adds weight to both his statements and a necessary backing to those statements. Using one's credentials, whether intending to act in that role or not, carries with it an important responsibility to accurately represent that profession and professional responsibility. Although each of are not excused from due diligence, the misuse of credentials can have lasting and harmful consequences. For example, when working with clients who dismiss sound therapeutic guidance and interventions, referencing the "science" from the neurosurgeon’s book "He Restoreth My Soul."
Furthermore, although I don't recall Hilton specifically stating that his book is a manual for leaders in the church, he has interwoven the LDS 12-step Addiction Recovery Program (ARP) throughout the book and frequently appeals to scriptural authority making it that "He Restoreth My Soul" has become a go-to book for bishops supporting their ward members. Again, this results in leadership dismissing sound therapeutic counsel for the "science" from a neurosurgeon’s book. Whether he intended it or not, Hilton has interfered with the health of a client.
If he simply published as a concerned member in the faith, providing his opinion, without any reference to his credentials, that might be one thing. But he's asserting authority and making scientifically false statements that ARE wrong and potentially damaging.
Due to the significant number of claims, statements and assumptions and popularity of this book, this review will address each chapter in its respective blog posts. The purpose of this review(s) has at least three goals: 1) provide hope, clarity and healing to those struggling with porn and out-of-control or undesired sexual behavior, 2) correct misinformation that prevents healing, 3) provide readers of "He Restoreth My Soul" a meaningful response to Hiltons assumptions.
Within his introduction, Hilton states his purpose for writing "He Restoreth My Soul" as a "response to what I regard as the primary threat to our peace as individuals, families, Church members, and as a society, culture, nation, and world." (pg. ix)
It's important for me to point out and give Hilton credit for stating this as his opinion, "what I regard" and emphasizing in the following sentence that these thoughts are his alone and not of the Church of Jesus Christ of Latter-day Saints. However, even with that "disclaimer," he establishes the premise of his book, which draws heavily on literature, research and scripture. His opinion is given as an absolute, not a thesis or hypothesis.
Ironically, Hilton emphasizes later in his introduction, "knowledge is power," though he seems to neglect essential facts. The very premise of his book is based entirely on opinion and not fact or knowledge. His opinion that pornography is the "primary threat to our peace as individuals, families, Church members, and as a society, culture, nation, and world." His belief that it's the primary threat is not only unsupported but oversimplifies the problem and prevents meaningful solutions.
His "regard as the primary threat" functions as the filter and lens through which he interprets every study, literature and personal experience. In science, this is referred to as confirmation bias.
"Confirmation bias, the tendency to process information by looking for, or interpreting, information that is consistent with one’s existing beliefs. This biased approach to decision making is largely unintentional and often results in ignoring inconsistent information. Existing beliefs can include one’s expectations in a given situation and predictions about a particular outcome. People are especially likely to process information to support their own beliefs when the issue is highly important or self-relevant." Britannica
Hilton acknowledges his confirmation bias by stating, "I began writing some thoughts after searching the current medical literature on the chemical aspects of sexual addictions and then focused on pornography addiction." He then further acknowledges his very limited and isolated experience with "addiction" was during a mandatory psychiatry rotation in a substance abuse clinic while a medical student.
Hilton is clearly stating here that 1) his confirmation bias led him to only read "chemical aspects of sexual addictions," and 2) those findings led him to adapt those findings or focus on porn addiction. Further, his limited experience wasn't as a trained therapist in psychiatry, but as a medical student in a substance abuse clinic addressing severe substance abuse. Despite his limited and filtered knowledge and experience with addiction, he concludes that "rat models of Parkinson's disease, which is a defect in one component of the dopaminergic system of the brain, just as addiction is an imbalance in another dopaminergic system."
He jumps to conclusions and absolutes are not only evidence of Hilton’s confirmation bias but are also misleading, incomplete, and wrong. Also notice how he draws on his limited experience studying rats with Parkinson's disease to alert the reader, "which is ONE component of the dopaminergic system." He compares and oversimplifies Parkinson to ONE component. Then he states absolutely, "just as addiction is an imbalance is an imbalance" of a DIFFERENT dopaminergic system. He not only concludes that dopamine deficiency is cause of addiction, but uses something scary like Parkinson's to heighten the reader's attention. (I'll address the fallacies of the dopamine claims in my review of chapter 2 "What is Addiction?")
The introduction is riddled with misinformation, scientifically and therapeutically erroneous statements. He also perpetuates unhealthy dynamics in relationships by warning for women in the church to be aware of these dangers so they can "be discerning in dating and eventually choosing a marriage partner." I can't tell you how many men have said women have left a dating relationship because the men have said they have looked at porn. Good men have resulted to hiding, lying or justifying their behavior because they are afraid the girl they are dating or their wife will leave them and view them as an addict.
Hilton in the "What Can We Do?" portion of the introduction reinforces these assumptions and absolutes, unhealthy and potentially dangerous suggestions. I will address each of these at length in the following reviews. But a few of the most troubling and uninformed suggestions I will mention here:
"Treat pornography and sexual addiction as a full addiction, and not from a behavioral/spiritual perspective alone."
This suggestion is an example of Hilton’s profound lack (or isolated) experience and knowledge on the topic of addiction and sexual behavior. As I will point out in forthcoming reviews, his definition of addiction is nonsensical first of all. But treating pornography as a "full addiction" could be compared to requiring brain surgery every time someone has a headache.
"Disclosure of each incident of viewing or sexually acting out is essential to obtain both repentance and recovery."
If one can't share with their spouse what they have viewed or sexual acting out, I assure you, the problem isn't pornography. As for confessing to a bishop of "each incident," this is not only ridiculous, but there is no support for this in church policy or doctrine. It also perpetuates the problem. Clients have routinely reported, "Oh well, I backslid. Since I have to tell the bishop I might as well make the most of this." This comment also sets the bishop up as something he is NOT. He is not a therapist; he is not an intervention specialist. Disclosing each incident is also not repentance; it's not measuring success or failure. Furthermore, how is an "incident" defined? By the bishop, by the individual, by the individual's spouse?
"Recognizing that many married men are secretly addicted, and have support groups ready to help them emerge from addiction."
Yes. Hilton is absolutely correct. At least with the "secretly." But not because of the lack of resources or support groups. Rather, because they are sick and tired of being told they are addicts. "Of course, that's what an addict would say." Right? Wrong. Most individuals who have a "porn addiction" are aware of it. They don't deny it. But they hide it because of how their support community reacts to them.
As I mentioned, there are many errors in the introduction. I never discourage someone from reading, but I would strongly caution the reader of "He Restoreth My Soul" to be wise and question these bold assumptions. I encourage the reader to question my review also, just as I encourage you to challenge Hilton. Challenge me. Look of the research in its full context and expand your experience and resources.