Addiction

He Restoreth My Soul Chapter Two

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 chapter two, "What Is Addiction?" pgs. 7–12.

Ambiguous, Opinion and Tangential

It would be reasonable to expect that a medical doctor specializing in neurosurgery, in a chapter called, "what is addiction?" would include a well-informed, formulated, medically-sound definition and explanation of addiction. But the reader is void of any such clarity. Instead, Hilton interjects ambiguity, opinion and tangential reasoning, which has little to no relevance to addiction or porn as an addictive behavior. The inadequacy of this chapter is embarrassing, let alone completely baffling for a medical doctor to have authored.

Defining Pornography

Hilton presumptuously and arbitrarily defines pornography as, "anything that induces an inappropriate sexual interest for that person."

This statement is potentially one of the most blatant evidences of Hilton's ignorance and inexperience on the topics of addiction and pornography. Nonetheless, his lack of experience aside, as a trained medical professional, I am confused as to how he can assert this as a "functional definition." It lacks complete functionality. As mentioned in chapter one's response, he leverages familiar terminology within the LDS culture but fails to deliver substance. This is far from a functional definition.

First, "anything that induces an inappropriate sexual interest" is completely subjective, cultural, individual and familial. Who defines "inappropriate"? The bishop? A therapist? Parents? Society?

For example, a 19-year-old woman meets with me regarding her confusion regarding "inappropriate" sexual thoughts and behavior. For the last three years she had been concerned with particular thoughts and behavior, which she at first thought were normal and "appropriate." However, after talking with her bishop a few years ago, he expressed a heighten concern and took "preventive" measures to prevent the behavior from escalating.

Although the young woman wasn't spiritually concerned and was only talking with her bishop because she felt it was the right thing to do, the bishop’s response made her feel she was committing a serious sin. Now, three years later she is experiencing anxiety and spiritual confusion. What complicates this situation more is how her new bishop at college has responded to the behavior. The young woman said the bishop "was not concerned in the least" with her thoughts and behavior. In fact, he emphasized that it was normal and not something to be concerned about.

In another example, one young man sought treatment for his "pornography addiction" and "inappropriate sexual interest." This young man at 14 experienced a life transition when his parent remarried and the step parent moved in with a 16-year-old daughter. In his words, she was beautiful and he was experiencing "inappropriate sexual interest." At an age when his erections are unpredictable and frequent, it was difficult for him to keep his mind "pure." He had no desire to be inappropriate, and he didn't act out any feelings; in fact, he ended up locking himself in his room most of the time to avoid any potential "thoughts." Based off Hilton's definition, this young man is experiencing porn.

Many adolescence and adults believe they are experiencing pornography based on the subjective definitions of other people. One couple had an agreement to not go to either the beach or the gym. The wife expressed concern that her husband seeing other women in bikinis would trigger inappropriate thoughts. The husband had the same concern for his wife going to the gym and seeing men lifting without a shirt.

Second, Hilton fails to understand the contradictory nature of his opening paragraph when he further states, "Each person knows in his own heart what is a temptation for him, and that is the true test." What?! That is your functioning definition of pornography?! He just made a highly subjective statement of "anything that induces an inappropriate sexual interest" then leaves it up to the individual to determine what is inappropriate. Hilton's profound lack of understanding human nature, cultural influences and family dynamics on an individual is glaring. As you will discover, this lack of understanding feeds into every aspect of his book.

Third, it’s no surprise Hilton’s "functioning definition of pornography" is incoherent and unscientific because there is NO functioning definition of pornography.

If you ask a thousand people to define pornography, you'll get a thousand different answers. It is the only treated "illness" that has no specific definition of the problem or recovery. Mark Kim Malan, Ph.D. addressed this significant problem in A New Taxonomy: Scientific Misuse of the Term "Pornography", the following are extracts from his paper.

"Since the term ‘pornography’ has no agreed upon scientific definition, and since it has evolved into a term associated with pejorative bias, what terminology can scientists use to replace the term ‘pornography with a more accurate unbiased variable?

Efforts to answer this question led to examining not only the many various definitions of the term ‘pornography’, but also when it is used as various parts of speech. Such usage effectively expands and multiplies its definitions. Usually the term is used as a noun to define an object, for example when a photograph is called pornography. But also, it is sometimes used with an adjective to describe an object, usually in a pejorative way. An example would be the term ‘political pornography.’ A third approach is using the term to express individual subjective interpretation of an object. In this case pornography is modified into an adjective to describe another noun. The statement, ‘The Edsel, was simply a “pornographic automobile design”,’ would qualify as such an expression."

Dr. Mark Kim Malan continues to explain in his paper,

"Historically the term ‘pornography’ has an unreliable history of usefulness as a scientific term. Instead, it is a social construct of the human mind. Its social use is vague, inaccurate and is often co-opted for use as rhetoric by those who use it to further their social or political agendas. Over time the term has taken on negative connotations, and is now, also used as a pejorative term, in expressions of disapproval. The term ‘pornography’ is like using the term ‘lemon’ to describe an automobile. It describes a negative quality of an object in the minds of many people.

Sexual scientists look ridiculous, at best, and unethical at worst, when we refer to therapeutic depictions of healthy sexual behavior as ‘healthy pornography’. To the public, who colloquially views the term as a pejorative expression, the term ‘healthy pornography’ becomes an oxymoron. To the public, it is a contradiction in terms. It is like hearing the term ‘healthy poison’.

The term ‘pornography’ has socially evolved over time into a negative term. It has become ‘sexy stuff’ with bad press. Now is the time for scientists to break a bad habit of using this socially biased, non-scientific term. As scientists we create problems for ourselves when we adopt unscientific terminology that has culturally evolved, and is loaded with cultural or moralistic bias. We handicap the social effectiveness of our research when we use such terms.

The term ‘pornography’ is not going to go away. The public, politicians, moralists and the press will continue to use it to promote their agendas. Replacing the term ‘pornography’ with ‘sexually explicit material’ is a step in the right direction, but still the problem remains of who decides what is ‘sexually explicit’. This term, like ‘pornography’ is a subjective interpretation of an object, or group of objects.

As a solution, I am proposing this taxonomy of objects and subjective human response, for use in naming, and specifically defining objects as scientific variables. Instead of using the term ‘pornography’, I suggest naming objects and the human subjective responses to them in a more specific and standardized way, using this taxonomy as a guide.

When others use the term ‘pornography’ in dialog with us, we can simply respond by stating facts: ‘The term “pornography” is not scientific. There is no agreed upon scientific definition. It is more scientifically accurate to talk about specific objects and how individuals subjectively respond to them’. It is our responsibility to teach the public to be accurate and think in scientific terms."

Defining Addiction – Wait what just Happened?

The reader is left to fill in a void as wide as the Atlantic as Hilton transition from a "functional definition" of pornography to a "structural definition" of addiction. Is he suggesting any and all pornography is a form of addiction? What is he saying? This is HUGE! Am I an addict?!

Nonetheless, Hilton fails again at any reasonable or coherent attempt to define "addiction." Instead, he quotes a "structural definition" of addiction, from what appears to be a random article in a journal published in 1979! "Addiction represents a pathological, yet powerful, form of learning and memory."  (Memory deficits associated with senescence: a neurophysiological and behavioral study in the rat)

First, this is in no way a structural definition of addiction. At best, it’s an outdated hypothesis describing the potential effects of hard drug use.

Second, literally no clinician refers to, defines or explains "addiction" in this way. Furthermore, this is completely tangential. Hilton is making a false assumption and unsupported conclusion that hard drug use is the same as porn use.

Third, Hilton confuses and uses "process (behavior) addictions," compulsion, chemical addiction and sin interchangeably.

"Applying this definition (structural) to pornography, addiction is simply a repetitive behavior which damages the person and others in his life and which the person is unable to stop." (pg. 6)

Aside from this being a poor and problematic definition of addiction, this more closely describes a process/behavior addiction. Or rather, an unhealthy habit. His statement, "addiction is simply a repetitive behavior which damages … " suggests habit and is also confusing in the context of the chapter and book. Is the action "simply a repetitive behavior" that causes damage? Or is it,

"The impaired thinking alters the belief system, and the acting out becomes the drug that reinforces the impaired beliefs … . [the] Brain chemicals and the adversary synergistically act in an unholy alliance of soul-searing destruction." (pg. 11)

This definition, also problematic and not how medical or professionals refer to chemical addiction, is more closely aligned with substance abuse.

Also, take note of the unnecessary use of the adversary in this definition. This is a foreshadowing of the frequent misuses of the gospel to elicit fear. Hilton solidifies his ignorance regarding human behavior and the gospel with each similar statement. What value does he think he is providing by emphasizing "the adversary synergistically act in an unholy alliance of soul-searing destruction"?

Sin and the adversary's power is a function of our agency, not a biological impairment. This narrative of Satan and brain chemicals isn't unique to Hilton. It’s a popular pop-psychology idea adopted by inexperienced therapists and treatment organizations. For the purpose of drawing in the "religious" element of addiction, this topic is so convoluted and pervasive that I will need to address it throughout the various chapters. In short, this is a perfect example of men wresting the scriptures, mingling science, religion and the concepts of men. It’s damaging and destructive; ironically this misuse causes much unneeded "soul-searing destruction."

For example, a young man sat in my office with a blank look on his face. This kid was known as a model youth, charismatic, loving of the gospel and serving fully in his callings; however, as he sat and described the horrific despair and soul-crushing fear he possessed, one would have thought he committed the unpardonable sin, or murder. In his words, he was "evil." Why? Because he was "addicted" to pornography. This young man was on the verge of losing all hope. He is not alone; this is not an exception.

Although his porn use was habitual, it wasn't an addiction — far from it. But according to Hilton and his bishop, both untrained to provide this type of counseling, had nonetheless convinced this young man he was in danger of losing his salvation and being controlled/possessed by the adversary. After working with this young man, although his porn use was still being addressed, he returned to the joyful and hopeful teen he once was. By unlearning concepts like Hilton's statement, this teen is now on a path to recovery.

Habits, compulsion, chemical addiction and sin are sometimes overlapped. But they are NOT the same, these behaviors will be addressed why its critical to understand the difference for successful treatment. Hilton's failure and even neglect to define or adequately explain addiction is abysmal. Not a single reference to scientific literature, diagnostics manuals or research. He doesn't provide any clarity or insight in this chapter on "addiction". The reader is left to believe, whether they have had one "inappropriate" sexual thought or many, are addicts like those using hard drugs.

What does the medical field actually say about porn "addiction"? 

Hilton's beliefs are not only wrong scientifically, he is going against the teachings of our leaders. Elder Dallin H. Oaks has said,

"We recognize these different levels, we also recognize that not everyone who uses pornography willfully is addicted to it. In fact, most young men and young women who struggle with pornography are not addicted. That is a very important distinction to make—not just for the parents, spouses, and leaders who desire to help but also for those who struggle with this problem." (Recovering from the Trap of Pornography)

Elder Oaks embraced a more scientific and correct view of (1) inadvertent exposure, (2) occasional use, (3) intensive use, and (4) compulsive use (addiction). Hilton on the other hand doesn't believe in such varying degrees of use.

As for the scientific definitions, neither of the two official medical classifications and diagnostic manuals, the ICD-11 (International Classification of Disease, used as a coding manual in healthcare) or the Diagnostic and Statistical Manual of Mental Disorders (DSM 5 or the DSM-IV-TR) contain a diagnosis for porn or sexual addiction.

This is a critical fact that Hilton neglects to address in this chapter. Its very possibly why he avoided the topic at all.

The most recent addition to the ICD-11 allows for a classification of "Compulsive sexual behavior disorder." This is a critical distinction from "addiction."

"Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement." 6C72 Compulsive sexual behaviour disorder

Take note of the very specific language used in this classification, particularly to the last sentence: "Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement." Hilton's entire book is basing addiction on "moral judgement and disapproval about sexual impulses, urges or behaviours ... " An article about the ICD-11 explains compulsive sexual behavior disorder:

"Concerns about overpathologizing sexual behaviours are explicitly addressed in the diagnostic guidelines proposed for the disorder. Individuals with high levels of sexual interest and behaviour (e.g., due to a high sex drive) who do not exhibit impaired control over their sexual behaviour and significant distress or impairment in functioning should not be diagnosed with compulsive sexual behaviour disorder. The diagnosis should also not be assigned to describe high levels of sexual interest and behaviour (e.g., masturbation) that are common among adolescents, even when this is associated with distress.

The proposed diagnostic guidelines also emphasize that compulsive sexual behaviour disorder should not be diagnosed based on psychological distress related to moral judgments or disapproval about sexual impulses, urges or behaviours that would otherwise not be considered indicative of psychopathology. Sexual behaviours that are egodystonic can cause psychological distress; however, psychological distress due to sexual behaviour by itself does not warrant a diagnosis of compulsive sexual behaviour disorder.

Careful attention must be paid to the evaluation of individuals who self‐identify as having the disorder (e.g., calling themselves “sex addicts” or “porn addicts”). Upon examination, such individuals may not actually exhibit the clinical characteristics of the disorder, although they might still be treated for other mental health problems (e.g., anxiety, depression). Additionally, individuals often experience feelings such as shame and guilt in relationship to their sexual behaviour2, but these experiences are not reliably indicative of an underlying disorder." (Compulsive sexual behaviour disorder in the ICD‐11)

The diagnostics manuals have written the diagnosis in this way for two reasons. First, there is little to NO evidence that porn/sex is an addiction. Second, writers of the ICD particularly have identified a growing trend of self-diagnosis and clinicians misdiagnosing patients. Any medical practitioner understands the great risks in misdiagnosis individuals, but this concept seems completely lost on Hilton.

In chapter six "It is a Drug," Hilton argues that porn/sex are not only an addiction but are exactly like a drug. I'll address those specific studies he quotes and his failure to understand the research. Even when the authors of the research specifically say its not like a drug.

Currently, there is an active scientific discussion about whether compulsive sexual behaviour disorder can constitute the manifestation of a behavioural addiction. For ICD‐11, a relatively conservative position has been recommended, recognizing that we do not yet have definitive information on whether the processes involved in the development and maintenance of the disorder are equivalent to those observed in substance use disorders.. (Compulsive sexual behaviour disorder in the ICD‐11)

(Additional information about CSBD: Compulsive Sexual Behavior Disorder in ICD-11)

A Special Form of Insanity and Circular Reasoning

Hilton, without defining addiction or a meaningful criteria for pornography has effectively pathologized each reader. Dooming each reader to a terminal mental illness, he then moves directly into a section he calls "A Special Form of Insanity," in which he leads the reader to believe they are experiencing yet another mental disorder as a result of their "addiction" and "sinful" behavior. But when you don't think Hilton could be any more reckless in his misdiagnosis and labeling individuals insane, he categorically judges addiction as the "very definition of selfishness, the ultimate contracture of perspective."

In words that can only be spoken by someone who hasn't worked with addiction, Hilton boils this complicated and complex issue down to a "basic problem in addiction is rooted in perspective. Pride, stemming from a lack of gratitude, allows the person to entertain desires that selfishly disregard the consequences visited upon not only the addicted one, but also upon his loved ones." Furthermore he believes "willpower" is the means to sobriety.

A few years back, a bunch of friends of mine were praising an individual for his financial prowess. They were impressed with his insights into and strategies for "playing the market" and improving wealth. Because of my background in finance, my friends thought I would also be impressed with this individual’s perspectives. Although this individual knew I had a career in finance and a strong knowledge of the market, his confidence preceded him. Not five minutes into his dialog, it was clear he didn't actually know what he was talking about. He used the right lingo but out of order. There were nuances in his communication that would sound impressive to someone without a financial background but complete garbage to someone trained in the field. Sure enough, he was attempting to set up a ponzi scheme of sorts, which would have wrecked my friends’ financial futures.

Hilton confidence precedes him too; he uses all the correct lingo, but confuses basic terminology and is dangerously reductive, which can harm the reader. He plays a dangerous game of circular reasoning, leading the reader to believe that if they are denying, they are addicted; it’s because they are sinning and experiencing a form of insanity. The solution is willpower through the atonement and to give up being selfish. I cannot image the lives this chapter alone has wrecked.

Finally, and again, in a tone of irony that is carried throughout the book, the only "expert" he draws on in this "addiction" chapter is Patrick Carnes who famously self-promoted as, "the acknowledged expert in a field that until recently didn’t exist," who made his living and fame off diagnosing individuals with a non-existent illness. Hilton follows up in the next chapter "The Money Trail."

See also:

He Restoreth My Soul Introduction

See also:

He Restoreth My Soul Chapter One

He Restoreth My Soul Chapter One

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 chapter one "Out of the Mouth of the Lion" pgs. 3–6.

Obstacle - Collective Identity

Chapter one is only three pages. In those three pages, Hilton leverages a "collective identity" or "collective behavior" to signal safe passage to his readers. This safe passage is critical to the LDS community. Within our culture, we are leary of "outside" sources in general, but especially those regarding sexuality or issues involving sexuality. The sanctimoniousness in which we address sexuality is both beautiful and hindering. Our view of sexuality is beautiful because of our connecting it to eternal progression. It’s hindering because we perceive external (those outside the faith) experts as a threat to that sacred sexuality.

Therefore, because Hilton is generally unknown among the faithful members of the church — he is neither a General Authority or an "official" resource for the Church of Jesus Christ of Latter-day Saint — he signals to the reader that he is a safe source by using language, analogies, scriptures and conclusions the collective identity already agrees with.

In social psychology there is a concept referred to as collective behavior:

"Collective behaviour, the kinds of activities engaged in by sizable but loosely organized groups of people. Episodes of collective behaviour tend to be quite spontaneous, resulting from an experience shared by the members of the group that engenders a sense of common interest and identity. The informality of the group’s structure is the main source of the frequent unpredictability of collective behaviour....

The U.S. sociologist Robert E. Park, who coined the term collective behaviour, defined it as “the behavior of individuals under the influence of an impulse that is common and collective, an impulse, in other words, that is the result of social interaction.” He emphasized that participants in crowds, fads, or other forms of collective behaviour share an attitude or behave alike, not because of an established rule or the force of authority, and not because as individuals they have the same attitudes, but because of a distinctive group process." Britannica

Hilton's appeal to the collective identity isn't inherently bad. Knowing your audience and connecting with the culture of your audience is good communication. However, when that appeal is used to perpetuate unfounded claims and assumptions, it’s contributing to a systemic problem. Whether he intended it or not, his leveraging a collective identity and backing it up with his credentials creates unchallenged buy-in within the community. 

Wresting

Hilton leverage the collective identity with a simple recipe:

  1. Identify a concept the particular community already agrees with: "Porn is evil."

  2. Quote a from a scripture or prophet/apostle that vaguely supports identified concept.

  3. Share a miraculous/captivating story/analogy that emphasizes concept.

  4. Provide vague non-solution that is often in the form of the "atonement".

1.

Hilton isn't sharing anything new to the intended community; however, he is feeding into the fear and panic of the "porn epidemic." He capitalizes on the readers’ fears by conveying the idea that no one is safe, and if we all are not vigilant, the dangers of porn will, like a lion "[grab] them by the spiritual throat and [strangle] the life out of happiness, joy, companionship, learning, love (both romantic and platonic), spirituality, reason, and life itself." He later references pop-psychology jargon, that if exposed to porn "even the sexual self being ruined and consumed as the chemically altered brain is left to crave what can never be fully satisfied." These statements are deeply problematic, untrue, divisive and communicate a confusing message of despair and hopelessness.

2.

Hilton's use of 1 Peter 5:8 is ironic. Hiltons's use of scripture here is referred to as proof-texting.

"Many Christian ministers and Christian teachers have used some version of the following humorous anecdote to demonstrate the dangers of prooftexting: "A man dissatisfied with his life decided to consult the Bible for guidance. Closing his eyes, he flipped the book open and pointed to a spot on the page. Opening his eyes, he read the verse under his finger. It read, 'Then Judas went away and hanged himself' (Matthew 27:5b). Finding these words unhelpful, the man randomly selected another verse. This one read, 'Jesus told him, "Go and do likewise."' (Luke 10:37b). In desperation, he tried one more time. The text he found was: 'What you are about to do, do quickly.'" (John 13:27) Wikipedia

Also refer to "Proof-Texting is a Bad Habit that we Need to Break".

Throughout his book, Hilton assigns his own meaning to the particular passages he quotes. As for 1 Peter 5:8, he fails to emphasize the "sober" concept that Peter was conveying in "Be sober, be vigilant; because your adversary the devil, as a roaring lion, walketh about, seeking whom he may devour."

Isolating verse 8 from the context of Peter's message would lead any reader to believe we SHOULD be fearful of the "roaring lion." However, Peter’s message was quite the opposite. "Be sober" is a message of hope, love and grace. Peter is teaching about God's grace through the Atonement. We are safe, inspite of the "roaring lion," to be vigilant and observant how the fear of the lion will rob us of our joy. Let’s read this verse in context:

"6 Humble yourselves therefore under the mighty hand of God, that he may exalt you in due time: 7 Casting all your care upon him; for he careth for you. 8 Be sober, be vigilant; because your adversary the devil, as a roaring lion, walketh about, seeking whom he may devour: 9 Whom resist steadfast in the faith, knowing that the same afflictions are accomplished in your brethren that are in the world. 10 But the God of all grace, who hath called us unto his eternal glory by Christ Jesus, after that ye have suffered a while, make you perfect, stablish, strengthen, settle you. 11 To him be glory and dominion for ever and ever. Amen." 1 Peter 5: 6-11

How should believers live, believing in a real devil — a spiritual enemy with an agenda to bring harm to Christians? Peter's answer to that question begins this verse: Be sober-minded. Be alert. It's the third time in this letter Peter has urged his readers to be clear minded (1 Peter 1:13; 1 Peter 4:7). It matters that we are paying attention, with serious minds, to what's going on in our lives and in the world around us.

"Peter writes that there is danger beyond the physical persecution some of his readers were facing. There is a deep agenda, far beyond that of the powerful men who might inflict that persecution. The devil, not the men or women who might harm us, is the real enemy of a Christian believer.

Our enemy the devil desires to devour us, to cause real and lasting harm. The Greek word here is katapiein, literally meaning to "swallow," or to "drown." Peter has made it clear that our place in eternity with our Father is secure. The devil cannot take that from us, but he does seek to damage our faith. He wants fear to shake our submission to the Father, and lies to distort our understanding of God's goodness. Since He cannot touch the believer's soul, Satan seeks to leave us as weak and ineffective servants of our King.

In the next verse, Peter will describe how to fight that enemy. Notice, also, what he doesn't tell Christians to do. He doesn't say to live in fear. Nor does he say to live as if the reality of the devil is unimportant. We are not instructed to ignore the devil, nor to cower in the shadows." BibleRef

3.

Ironically, Hilton's focus is on the fear, the devil, the hopelessness, the loss, the damage. Unfortunately, he continues to misuse Peter's lion analogy, convincing the reader they are not safe, to hyperventilate before shadows. This does not create a clear and sober mind, let alone an informed mind. It creates panic and fear, and turns power over to the devil — exactly what Peter was warning us not to do.

Additionally, Hilton reinforces his faulty interpretation of the scripture by quoting non-experts on the subject. Although President Hinckley has perceived a potential danger that seems to be associated with pornography, both Hilton and Hinckley's comments oversimplify the complexity of the problems and fail to address the root issues involved in "damaging hearts and souls."

In Hilton's reference to a professional in chapter one, he not only quotes the therapist incorrectly, he again takes it out of context and misrepresents the intent of the therapist. In quoting Mark Haney, Hilton claims "pornography addiction" is what leads a teenager to experience "isolated agony."

First, "isolated agony" is nowhere in John Mark Haney's article "Teenagers and Pornography Addiction.”

Hilton, although vague in his misquoting Haney, the misquote leads the reader to believe pornography is what creates the isolation. This is false and NOT what Haney stated.

"Normalize the Issue: Many teenagers who are developing compulsive pornography problems do so in agonized isolation, often believing that they are perverts and alone in their actions. It can be helpful for the professional to educate them on the prevalence of the issue while still clearly communicating the dangers so they don’t trade their isolation for an ‘oh well, since everyone is doing it …’ idea, for that is common too."

Hilton's careless and self-serving misquoting and changing of context is reckless. Haney's only use of "isolation" is in a section educating the reader to "normalize the issue" with teens, recognizing that teens "often [believe] that they are perverts and alone." It is NOT because of the pornography, but because of the lack of education and clarity (sober thought) on the subject. This is a HUGE misrepresentation and is foreshadowing of Hilton's carelessness throughout the book.

Second, it seems like Hilton didn't even read the "Teenagers and Pornography Addiction" article.

"Some critical cultural, religious, and socioeconomic factors with pornography and youth warrant mention. Some cultures have much broader parameters surrounding what is considered appropriate with sexuality, while cultural norms within other groups make the topic almost unmentionable. Therefore, practitioners must attempt to educate themselves about cultural mores. ... Similarly, approaches to spirituality and religion can have a profound impact on a teenager’s sexual development, and not always in the way that a parent intends. For example, some youth who come from rigid and legalistic religious backgrounds that wrap sexuality in shame and guilt, try to forcefully repress their desires, which causes them to unconsciously bond with the same profane elements they are trying to ignore. When they act on these repressed desires, the resulting shame and self-loathing just perpetuates the cycle."

4.

After a confusing message of hopelessness and fear, Hilton's solution is the atonement, but he doesn't actually talk about the atonement. In just two paragraphs, he demonstrates his lack in doctrinal understanding and his mockery of those who have embraced the atonement without reprieve. He confuses agency, sin, transgression and biological limitations.

Somehow he is under the impression that women experiencing pornography is limited to chat rooms. This is complete ignorance, and potentially another misreading of the "Teenagers and Pornography Addiction" article.

Hilton suggests homosexuality is a similar issue as pornography and an addiction. Is Hilton suggesting reparative, conversion or aversion therapy?

Hilton's leveraging a collective identity is irresponsible and mitigates readers from identifying and questioning his inconsistencies and double checking his references.

See also: 

He Restoreth My Soul Introduction

He Restoreth My Soul Introduction

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.

Introduction

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.

Chapter 1: "Out of the Mouth of the Lion"

ARP Fails Women Support Groups

Anonymous Question Series:

Q: "Why does The Church's ARP program assume that men are addicts and women are "related to addicts"? It is SO difficult to find a women's support group."

A:

The quick answer: as an Church culture, we have done a poor job at identifying and providing women resources.

(This is a great question and will be a little difficult to answer concisely, for me. This has been a topic of GREAT interest and equal concern for me, so much so that I have taken up the opportunity to write about it. I am over 100 pages into a book I hope to complete by the end of this year that addresses this issue and other related topics and their solutions. Additionally, Kathryn Kirk and I have attempted to fill this gap with "LDS Women Struggle Too" Blog and Group. But because of our Church culture, it is very hard to get the word out.)

However, I can't "blame" The Church nor the "culture" for not meeting the needs of women adequately in this regard. Many do, and I value the frustration around the topic. But this issue is NOT limited to The Church. "Addiction," especially sexual related issues, have historically been a "man's issue”. With the exception of AA (or "Friends of Bill"), which had its beginnings in 1935, support groups for non-substance abuse only started in the mid 1970s and were predominately male focused. Additionally, medically and psychologically there is NO standard definition or diagnosis for sexual-related "addiction." Sex (porn and sexual related issues) addiction was a “self-diagnosis” of subtenancy abuse individuals who felt they wanted a separate AA meeting to address their "problems with love." It was also a "sign" to their spouses that they were doing "something" to address their cheating behavior. It is interesting to note that because there was NO medical definition of sex addiction it was entirely — and still is today — self-diagnosed. Here's the kicker; because there was/is no medical definition, the criteria for sex addiction was entirely driven by white male middle class individuals:

"Sex addiction is overwhelmingly focused on male sexuality, given that 90-95% of alleged sex addicts are male. In the paraprofessional side of sex addiction, the online bloggers and activists who promote the ideas of porn addiction are also consistently white males, typically of middle class or above." —David J. Ley, Ph.D, Sex Addiction's Diversity Problem

As a result of white Christian middle class males defining sex addiction, the majority of addicts are in that demographic ... the epitome of confirmed bias! As such, the “solutions” have been entirely developed around solving it for the white Christian middle class male — not only making a perceived issue worse than it really is, but entirely neglecting the needs of other demographics.

The Church has been modeling what the professionals have been doing; therefore, they have mirrored support groups for males of our faith and have lectured repeatably to men in priesthood meetings, while entirely ignoring or being unaware that about 50% of those who struggle with porn and sexual issues are female. This is while NOT one word is spoken about it in Relief Society or the General Women's Conferences. Fortunately, the Brethren are recognizing that the old approach isn't working, and they haven't lectured the men in priesthood for the last few conferences.

Back to your specific question. There are support groups, but they are hard to find. Kathryn and I have tried really hard to promote our free online group, but it is very hard to spread the word. I also wonder if The Church should be involved with support groups. The success rate is ridiculously poor ... at best 10% for support groups or 12-step programs in general. I believe the success rate in our church support groups and 12-step programs also mirror the secular groups. Unfortunately, our view that something is better than nothing is keeping the status quo.

This isn't a solution, but hopefully it helped you understand the complicated dynamics of the issue. You are always welcome to reach out to Kathryn or myself for further support. If you would like a support group, we are eager to support an effective, solution-based approach. Spread the word and we will provide.