Addictions: A Pastoral Approach for the Catholic Spiritual Director and Confessor

Saint Paul refers to a thorn in his flesh, a messenger of Satan that is his constant reminder of the need for God’s grace.1  Although many authors have discussed the nature of this thorn, there is no consensus as to its meaning. I have no greater insight into its meaning for St. Paul but can identify with having a thorn in my flesh. In contemporary terms, we refer to it as an addiction.

We don’t need “sample surveys,” universities or government agencies to tell us; our common experience in the United States tells us that the numbers are staggering for those addicted variously to illegal drugs, prescription drugs, gambling, eating, alcohol, internet pornography, sexual acting out. Addiction crosses all barriers: gender, age, socio-economic status, profession. Explanations regarding etiology, and therefore treatment of various addictions, vary. My purpose in this short article is not to offer an all-encompassing theory or treatment plan for addiction. Rather, it’s to reflect on my own experiential perspective in the hope that it may bring some direction to other priests either dealing with their own addiction or assisting others in counseling or in the confessional.

With me for many, many years, the power and influence of this “thorn” on my behavior ranges from the kind of annoyance one experiences with a flea bite to a constant and wrenching presence causing persistent distraction. Interestingly, at least to my knowledge, no one has suspected its existence in my life. Like so many with addictions, we are able to conceal them from most people.

Through my various academic studies — particularly in psychopharmacology, but more importantly in my own lived experience — I have come to the painful realization that all addictions, not only the obvious drug-related additions, alter the very chemistry and circuitry of the brain. It’s not just a “bad habit.” It’s a bad habit, as they say, on steroids. That euphemism only begins to express why these addictions are so intense and resistant to change. It also explains why no one intervention fits all. The brain is not reducible to mere chemicals and electrical circuits. This three-pound organ is unique and distinctive, responding to and shaped by various environmental experiences. How it perceives the world around it, how it responds to the world around it, is also unique and distinctive. A unique but integrative approach to addiction will address an individual’s biology, psychology, environment, and spirituality (bio-psycho-social-spiritual).

As with any approach to behavior, there is no one method that will apply to everyone in the same manner. But I do believe that a combination of the tactics that I describe below can be applied with some satisfaction to many, especially to priests and religious.

Medical intervention, psychiatric and psychological attempts to remove the thorn were less than satisfactory alone. Prayer alone seemed to increase my sense of guilt and shame. So, falling from the horse multiple times (or perhaps being knocked from the saddle to the ground), how have I managed to bring a sense of control and constraint to my life?

Prayer; meditation; confession, spiritual direction, accountability; developing and deepening a mature faith; medical consultation, psychological intervention are the sine qua non of my own stabilization (and that of the many individuals I have seen in pastoral counseling). Below, I will explain each of these factors and how they interact within an individual to offer some balance in one’s life.

We will see how the need for intimacy and the cure for isolation can be approached in prayer and meditation. Fear of facing one’s inadequacies and failures can be dealt with through the development of a deeper and mature faith in God. And the anguish that comes from the recognition of the duplicity of one’s life can be mediated, reduced or resolved by confession, spiritual direction and accountability.

At the outset, let me state unequivocally that this is NOT a program that is intended to replace any scientifically based treatment within which an individual is currently involved. These thoughts are intended to offer other priests an approach that they can prayerfully reflect upon when speaking to brother priests and to others within confession, spiritual direction and pastoral counseling. As it includes the Sacrament of Penance, I am particularly targeting our Catholic population, but these elements can also be adapted for other faith-based individuals. I believe each of these elements is essential for individual spiritual growth, some more than others during the lifelong experience with addictions.


Former novice master for the Oblates of St. Francis de Sales, Father Aloysius Gaffigan, a holy and saintly man, almost daily reminded his novices that as a priest, if you do not constantly pray, your life will have no direction and you risk losing the commitment you made as a vowed religious. Obviously, that advice applies to life as a diocesan priest as well.

As with any relationship, particularly an intimate relationship, communication is essential. The only way a couple learns about one another is by spending time with each other and by talking and listening to each other. It comes as no surprise that our relationship with God requires communication too. As a psychologist conducting psychological assessments for the marriage tribunal, I can say without equivocation that every couple I evaluated experienced significant communication shortcomings. Some began their relationship without mature and well-developed communication skills; some neglected to communicate when problems arose. At some point, communication took place only when necessity demanded. And at some point, only through an attorney.

Father Gaffigan pointed out that through prayer, we get to know God and Jesus Christ as intimate partners. Our basic need to connect deeply with Another is met in our loving celebration of the Mass, our prayerful reflection of the breviary, reflective Scripture reading, studying the lives of the saints, devotion to our guardian angel, meditation and contemplation.

Prayer is essential. But as addiction takes hold of the person, it sometimes leaves one thinking, “What’s the use? What’s the sense? My prayers are not being answered anyway.” And when prayers are said, they sometimes became a bargaining tool: “I’ll say these prayers but expect something in return.” When the answer I want doesn’t come (as I want it answered), the prayers begin to dwindle. Praying the breviary, if at all, becomes dutiful and mechanical. Even saying Mass can become perfunctory. This kind of communication eventually becomes as effective as the communication between the former spouses I assess who are seeking annulments.

When combined with the other ingredients discussed in this article, prayer can become one of the greatest vehicles to combat the loneliness that often results from addiction. As a priest, I am convinced that prayer is powerful, meaningful and efficacious. But as a person of some age, I know that prayer is not sufficient to solve the problems of addiction or even “bad habits.” Action is necessary. Pray as I might to rise early in the morning, if I don’t set at least two alarm clocks, one on the other side of the room, I remain in bed until my dog rouses me for a walk. Pray long and hard to lose weight, but as long as I continue my vodka and snacks at night, my waist continues to expand. We need to pray and act. Pray more, pray often, pray harder . . . and develop a strategy to change alter the targeted behavior. Below are some strategies that work well when combined with prayer.

For St. Francis de Sales, holiness is found in the struggle in life — not in achieving perfection in this world.2 That struggle — painful, gut-wrenching, distressing, and above all lonely — can bring us together with Jesus in a most intimate way. When we offer our pain to the Lord in the Garden of Gethsemane, in the crowning with thorns, the scourging at the pilar, in the carrying of the cross, in his embarrassment of being stripped of his clothing and in the nails driven through his hands and feet . . . we too cry out, “Remove this cup from me; yet, not what I want, but what you want.”

Eventually we learn that suffering can make us resilient, it can offer us strength. St. Francis de Sales reminds us that suffering and pain can help us to become more appreciative of the pain and suffering of others, making us more empathetic, more compassionate toward others. What a true gift for a priest. Salesian scholar Reverend Alexander Pocetto, OSFS, recalls how St. Francis de Sales reminds his readers, “Compassionate love exemplifies our solidarity with others and especially makes us realize our common human vulnerability, our mutual interdependence and our need to be with those who are suffering. It makes us see the interconnectedness of our lives.”3

One priest related to me that while there are many challenges to praying while in the throes of an addiction, prayer, even as an act of desperation, can also be a lifeline. It is the struggle that leads to holiness.


For centuries our Church has taught that meditation has multiple benefits. It brings us closer to God. It deepens our relationship with God. It is an active form of prayer in which we reach out to someone more powerful, more loving, more compassionate than we are. In meditation we set time aside from our busy day to be alone with God. We attempt to minimize distractions so that we can acknowledge that we are in the presence of our almighty God, the One who made us in love and to love.

Through the help and guidance of one’s spiritual director and confessor, one can be guided to meditate on certain spiritual topics that will, in Francis de Sales’ words, be helpful in rooting out of one’s heart both sin and the chief affections for it.

Topics for meditation and discussion can center on such passages as:

“Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.” (Isaiah 41:10)

“And you shall seek me, and find me, when you shall search for me with all your heart.” (Jeremiah 29:13)

“Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.” (John 14:27)

“When I saw him, I fell at his feet as though dead. Then he placed his right hand on me and said: ‘Do not be afraid.’” (Revelation 1:17)

Our Catholic form of meditation can be used to quiet our mind and body. Meditation can have the effect of calming the very same areas of the brain that are implicated in addictive behaviors. Meditation, in addition to bringing us closer to God, can reduce the intensity of certain feelings and thoughts that trigger the addiction cycle. Meditation can enhance one’s abilities to respond positively and effectively to the sights, sounds, feelings, and thoughts that in the past may have triggered the addictive response.

Meditation enhanced with easily learned stress-reduction techniques and thought-stopping procedures can contribute to improved self-control. Lacking self-control leads to impulsive behavior, the precursor to the addictive behaviors many times. Increased and improved self-control decreases the need for immediate gratification.

“Meditation,” according to the Catholic Catechism, “is a quest. The mind seeks to understand the why and how of the Christian life, in order to adhere and respond to what the Lord is asking.”4 In this meditation, we enter a special and a unique relationship with our Christ. In this relationship, Our Blessed Lord speaks to us. He offers to us, the Way, the Truth and the Life. The more we meditate and experience the peace that Christ offers us, the less we need the distractions that the addictions offer.

Developing and Deepening a Mature Faith

With addictions, and particularly when they develop early in one’s life, faith can be experienced on a very childish (not childlike) level. Even as an adult, one’s faith can be tinged and mixed with the “magical thinking” of a child and is experienced largely as fear-based and obligatory. St. Francis de Sales cautions his spiritual directees to love obedience rather than fear disobedience.5 This maxim frequently expects too much from someone in the early stages of addictions. But eventually, one becomes willing and able to love obedience to God’s desire for an intimate relationship with us.

Fear is very much an integral part of an addicted person’s life. Fear of intimacy, fear of loneliness, fear of failure, fear of one’s real or perceived inadequacies . . . these and many other fears result in high levels of anxiety. One’s very soul is disquieted. And the person engages in addictive behavior to quiet those intense feelings of angst. Sweet relief ensues. But the tranquility that results from engaging in the addictive behavior is short lived . . . very short lived. And the cycle of abusive, addictive behavior is repeated . . . and now strengthened.

One of the many common struggles for the addict: St. John the Evangelist tells us that faith in God means that we believe God’s love conquers all fear.6 But when one’s faith is based on fear, especially the fear of God, how can one “believe” that God’s love conquers all fear?

The answer for me came from St. Paul. Faith is powerful, but without love it profits nothing. Faith works through love and is made perfect in love. True love, Paul tells us, orients us to the Supreme Good.7 And that Supreme Good is Jesus Christ.

Our love of God and our love of neighbor . . . the two great commandments. Our faith grows as we love, and our love grows with our faith. Faith is not something that we produce by force of will; it is pure gift that God gives us, that we accept, and that we act upon. Then the maxim of Francis de Sales can be realized in our lives and we can respond to God’s command to love willingly and freely.

Incorporating these two great commandments in our emotional life has very practical results. How will I come across when I meet someone? Will that person see through me and recognize my flaws, defects and failings? Will my interactions with others expose my weaknesses and shortcomings? The answer to these questions is “Yes, they might.” That answer has always been fearful and anxiety-producing because my locus of control was always external.

Faith that God truly loves me, while struggling with and confessing imperfections and sins, has the effect of reducing interpersonal and social anxiety. Appearing perfect and projecting a false persona are no longer important. As mentioned above, St. Francis de Sales reminds us, holiness is found in the struggle for perfection, not in the attainment of perfection in this world.

A regular and meaningful prayer life within the context of a developing and mature faith leads one to greater acceptance of oneself as a child of God . . . even with the imperfections with which we continue to struggle.

It was most helpful for me to hear another priest say that in his experience, identifying, acknowledging, admitting and then honestly addressing fear was a major, if not principal key to his recovery.

Finally, we hear from Francis de Sales on friendship:

Love your neighbor with a great, charitable love, but befriend only those with whom you can be mutually supportive in virtue. The higher the virtues that you put into these relationships, the more perfect will your friendship be.

If your mutual exchanges deal with knowledge, your friendship is certainly very laudable; it will be even better if they deal with the moral virtues such as prudence, discretion, strength, justice; but if they pertain to charity, the love of God, Christian perfection, then this friendship is truly precious and excellent: excellent because it comes from God, excellent because it tends toward God, excellent because its bond is God, excellent because it will endure eternally in God. Oh, how good it is to be loved on earth the way one is loved in Heaven, and to learn to cherish each other in this world as we shall do eternally in the other!8

Having a good, honest, virtuous friend with whom to communicate your struggle can be a huge help in moving toward and maintaining sobriety, in whatever addiction one has. Much like the confessor and spiritual director (discussed below), the good friend is someone who is loyal and accepting but is honest and truthful enough to let you know when you’re not being honest and truthful. That person may actually know you better than a confessor or spiritual director and may be able see various warning signs in your behavior that should raise concern: anxiety, depression, despair, disquiet, nervousness, arrogance, anger, etc.

Faith, love . . . hope! In talking with grade school children about Faith, Hope and Charity, I find that many of the children equate “hope” with making a wish: I hope I get a pony for my birthday! But many of us share the meaning of hope to mean that we have confidence that what God has promised us will be ours. The Greek word for hope can mean that one anticipates, often with pleasure. We have from Jesus the promise of the Holy Spirit. We have a realistic and reasonable anticipation that the Holy Spirit has come and will remain with us. He truly inspires us . . . he stirs, he motivates, he arouses — he breathes strength and determination into us when we allow it to happen. One priest said that he “only began to understand what hope means . . . not a definition, but the experience . . . when I realized and began to experience that God is doing for me what I could never do for myself.”

Fear-based faith increases and reinforces the cycle of addiction. And it is love-based faith that drives out the many fears the addict has lived with for years.

Faith, Love, Hope!

Confession, Spiritual Direction, Accountability

The elements of confession, spiritual direction and accountability are so interrelated that I’m going to discuss them within the same section. Individuals will choose how they may want to approach these three essential parts. The most important consideration is that they are well integrated.

Honesty, openness, truthfulness, authenticity with oneself are very difficult for the addict. These attributes require one to look deep within oneself. Honesty, truthfulness — these are necessary to accept and understand that one has a problem. They are important so that the person can recognize that he has lost the power to control his behaviors, his choices. And their opposites, dishonesty and lies, serve as a way to keep the addiction a secret, thus making one feel trapped. When one experiences the embarrassment and disgrace associated with dishonesty and lies, he triggers the addictive behavior, again sending the person into the vicious cycle of addiction.

Duplicity in one’s life causes guilt and shame. Duplicity adds to the intensity of the addiction. But facing a duplicitous life is not easy. It is a struggle. But the struggle is part of the path to holiness as Francis de Sales reminds us. The first step is honesty. And the kind of honesty it requires can be found only in the love of God . . . expressed and felt through the acceptance and love of others. Francis de Sales writes: “Nothing is so strong as gentleness, nothing so gentle as real strength.”9 In another place he writes: “We do not very often come across opportunities for exercising strength, magnanimity, or magnificence; but gentleness, temperance, modesty and humility are graces which ought to color everything we do.”10 These maxims are as important for the addict as they are for the confessor and spiritual director! Being able to bare one’s soul to another in humility and honesty is cathartic and freeing. Being held accountable allows one to continue to be free — even with setbacks.

Finding a confessor/spiritual director who is very compassionate, yet at the same time holds the person accountable for his thoughts and behaviors, is essential. But as Francis de Sales points out, “There are fewer men than we realize who are capable of this task”11 (of being a spiritual director). It would, of course, be advantageous if the confessor/spiritual director has some knowledge of addiction and addictive behaviors.

Many addiction treatment models recognize the need for a spiritual element in recovery. Spirituality helps a person to recognize (or develop) that there is an objective moral compass by which we can and should live our lives. Spiritual direction helps to bring one’s recognition of right and wrong into clearer focus without being condemning. This is done by recognizing that all spiritual direction is a triad, not a dyad. It always involves the Holy Spirit. And the Holy Spirit will talk to both the directee and the director. Spiritual direction always benefits from knowing that “where two or three are gathered in my name, there I am in the midst of them.”12

Patience with clear guidance. Patience with recognizing that a person with an addiction may be prone to relapse. Patience without judgment. Patience as the person with an addiction grows in respecting himself and others. Yes, patience while holding one accountable is very important. Patience as the person with an addiction learns how to share his fears and apprehensions, his desires and above all his struggles. For many with addictions, this kind of safe environment has yet to be found. Many search for this safe environment for many years. This is the opportunity that a confessor or spiritual director can make a real difference in a person’s life. Addictions are very obvious examples of St. Paul’s letter to the Ephesians where he tells us that we are spiritually dead. And the kind of spiritual life that we need can only come from Jesus. This is the awakening the addicted person needs to experience. It takes time; it takes prayer; it takes effort; it takes compassion . . . it takes patience. Paul is very direct when he writes in the letter to the Ephesians: “You were dead in the trespasses and sin in which you once walked.”13 And the addict feels spiritually dead because of the multiple transgressions and failures. He can feel the newness of life that Paul writes about with the grace of God and assistance of a gentle, humble guide and confessor.

Priests, like everyone else, don’t have all the answers to the complex issues of addiction. Recognizing the various and complicated components of addiction, we should recognize that simple answers are not sufficient to respond in a spiritually or emotionally helpful way. Telling an addict that he will get better if he “only prays more” should be met with the response, “Have a good day, Father,” and the person quickly turning his back on you and walking away.

If you recognize that you are ill-equipped to deal with addictive behaviors and people who are struggling with them, be honest. Listen compassionately and actively to the person and then refer him, saying something like “I know someone who can help more than I can. I can put you in contact with him. Please know you will remain very much in my prayers. I’d be more than willing to keep in touch with you.” Even though you are referring the person to someone else, it should not be done in a way that leaves the person feeling unfairly judged, condemned, or humiliated.

Medical and Psychological Consultations

Some individuals can benefit from medical and psychological interventions. Some addictions are much more chemically based than others and withdrawal can be a serious medical issue. It’s always helpful if the person with an addiction has a physical evaluation to be certain any underlying medical or physical issues are addressed. The same is true of psychological aspects of the addiction. Some issues are best dealt with in cooperation and consultation with medical/psychological personnel. This has to be done with the permission and authorization of the directee.

When seeking medical and psychological opinion, it is wise to know the person to whom you are referring the directee. Assuming your directee is Catholic, it would be advisable to work with others who share our Catholic perspective. I have repeatedly suggested to members of the clergy to have a current and active list of contacts readily available, including psychiatrists, psychologists, clinical social workers, nurses, counselors, and marriage and family therapists. When a penitent or directee comes to us, that’s when they need help — not weeks later when we have finally found and contacted an appropriate referral.

Medication is not always necessary or even suitable. We certainly don’t want to take away one addiction and replace it with another. But sometimes the medication can be used to assist the directee in “taking the edge off” anxiety and depression. Sometimes the anxiety or the depression is so severe, the person needs intensive therapy or even hospitalization.

One reason the cycle of addiction is so strong and difficult to break is because it is a disorder with biological, psychological, social and environmental factors that influence both its development and its maintenance. In addiction terms, repeated exposure to addictive behaviors or addictive substances causes certain neurons to communicate in a way that couples liking something with wanting it. This causes us to search the behavior or substance out. Relief is only temporary, and the desire returns.

Even thinking about the behavior can set the chemical cascade in motion, often causing the person to seek out the drug/behavior. Many believe that only drug-related addictions have a chemical or physical component to them. This is not accurate. Pornography, gambling, spending . . . all share a chemical cascade that is released in the brain when the thoughts of these behaviors are triggered. Much study has been given to the neurobiology and neurochemistry of pornography addiction. Brain imaging studies has repeatedly shown that when pornography becomes compulsive, it activates the same underlying brain networks as alcohol and other drugs. Similar studies are underway in gambling and spending.

This is why prayer alone to alter the behavior may ironically and unintentionally begin the surge of neurotransmitters and other natural chemicals to flood the brain. Prayer and an additional ingredient is important to impede the trigger of these brain chemicals.

It is important for confessors and pastoral counselors to be aware that there are many risk factors that have predisposed many people to developing addictions and PTSD. Many of these risk factors (experiencing dangerous events; being injured physically or emotionally; childhood trauma; circumstances of helplessness or extreme fear; history of mental illness) occurred in early childhood and adolescence. These complicated and complex issues may need to be addressed by medical and psychological practitioners.

Being prepared for a possible medical or psychological emergency or referral is wise. Research individual physicians, psychologists, therapists, and treatment centers in your area whose treatment approaches are consistent with our Catholic principles.


Addictions alter the brain. It would be easy to say to yourself, “Just stop it” if the addiction were only random bad choices. It’s not a weakness of character; it’s not an inadequacy of willpower. It’s a function of the brain’s chemistry and wiring. Bad chemistry and bad wiring. How it got there is complicated. How we control it is also complicated, but more easily accomplished if we approach it with proven methods. Many of these methods have been taught and used for centuries within our Church. Many of the best spiritual directors, among them St. Francis de Sales, have given us some excellent principles by which we can manage addictive behaviors in our lives.

With a greater understanding and application of the neurosciences, anatomy, physiology and psychology, spiritual direction has become for some the integrating principle for dealing with addictions.

Addictions will continue to be a struggle. But we do not have to struggle alone. Our road to holiness, like the Road to Emmaus,14 can be enhanced and even thrilling by walking that road with the Lord. In addition, when our sadness and the burden of addiction are shared with a companion — a companion who has experienced addiction too — it can promote your own healing as well as healing power for the other who is struggling to break from the power of addiction.

  1. 2 Corinthians 12:6–7, New American Bible (Washington, DC: United States Conference of Catholic Bishops, 2002).
  2. Saint Francis de Sales, Introduction to the Devout Life, trans. John K. Ryan (New York: Image Book, Doubleday, 1972), pp. 1415.
  3. Alexander Pocetto, OSFS, “Compassionate Love and Salesian Spiritualityin Studies in Salesian Spirituality (Center Valley, PA: De Sales University, 2003).
  4. Catechism of the Catholic Church (U. S. Catholic Conference, Washington, DC, 1994), §2705.
  5. Letter from Saint Francis de Sales to Saint Jane de Chantal, 14 October 1604 in The Classics of Western Spirituality, ed. John Farina, (Mahwah, NJ: Paulist Press, 1988), p. 122.
  6. 1 John 4:18, New American Bible.
  7. 1 Corinthians 13:3, New American Bible.
  8. Introduction to the Devout Life, pp. 177-179.
  9. Letter from Saint Francis de Sales to Saint Jane de Chantal, 24 June 1604, Letters of Spiritual Direction.
  10. Introduction to the Devout Life, pp. 117–118.
  11. Saint Francis de Sales, Selected Letters, translated with an Introduction by Elisabeth Stopp (London: Faber and Faber, 1960), p. 104.
  12. Matthew 18:20, New American Bible.
  13. Ephesians 2:1–2, New American Bible.
  14. Luke 24: 28–29, New American Bible.
Fr. Anthony J. Pinizzotto About Fr. Anthony J. Pinizzotto

Fr. Anthony J. Pinizzotto, PhD, is a priest of the Diocese of Arlington (VA). Ordained for over 40 years, he holds advanced degrees in theology, psychology and psychopharmacology. Assigned to St. Agnes Parish in Arlington, VA, Father continues to work as a consultant in Clinical Forensic Psychology.


  1. Thank you father. Your article helped me immensely.
    I am an addict as well. Started with sugar and progressed based on availability.
    I have taken my issues to confession but rarely find help. In my mind addiction is not a sin since we cannot control our own selves. I believe Thomas Merton called addiction the Sacred Addiction.
    Addicts displacing the love of God for a temporary high. I can only imagine what the love of God truly feels like compared to the life of an addict. Your article has given me some great thoughts and ideas to use to give myself more to God’s love. I have used meditation quite a bit, but like many things become complacent over time. May God bless you and all who struggle with the ball and chain of a prisoner. Freedom is available through the substitution of love for whatever it is we crave.

    Rev Patrick

    • Avatar Anthony J. Pinizzotto says:

      Rev. Patrick: I believe it’s important to take the adage of St. Francis de Sales to heart: take the person where he or she is and with gentleness and humility, help that person move forward. Within that context, even a setback can actually be a spiritual movement forward as the person picks himself up with grace and determination to do better.
      Thanks for taking the time to respond.
      Fr. Tony Pinizzotto