I’ve always wanted to help people.” My medical school application essay opened with those words, and when I came to Baltimore at age twenty to start my medical training, I was dead-set on helping people in Africa. After two years of attending church in the Sandtown-Winchester neighborhood, though, I fell in love with the community, so my wife and I decided to move into the neighborhood in 2009. I admired the work my church there was doing to deal with the poverty, racism, and institutional neglect Sandtown was known for. (It became even more well-known for these ills in April 2015 when Freddie Gray suffered his fatal injury here.)

I helped to start a community mental health program with the church while also participating in other ministries. After finishing my residency, I found a great job at a community health center that allowed me to balance vocation, family, and advocacy. Our fellow church members, poor as they were, joined forces to bless the even less fortunate by sending us overseas to a maternity and pediatric hospital in South Sudan.

In my work in Sandtown, it felt good to be helping others as I had always wanted to do, loving my neighbor in word and deed. Yet I felt unable to help myself.

I remember the day my hands started to shake as I walked the two blocks from my main office to our satellite location. This other office, I knew, had unfiltered, unprotected wireless internet, and simply thinking about the ease with which I could access pornography there made me feel nauseated. I reached in my pocket for my phone to call a friend and community leader, Elder, as he is known in Sandtown.

Though I knew I had a problem, I justified my half-heartedness in the battle for purity by holding up the good works I was trying to do.

“I just need you to pray for me. I’m feeling really tempted,” I said.

“I will pray for you, brother, but I want you to think about our community,” he said, as he nearly always did when I called.

Like many other young do-gooders, I began my ministry work full of idealism and quickly met the harsh realities of inner-city life. The church that Elder started several decades ago works closely with mine, guided by the same principles of Christian community development pioneered by the civil rights hero John Perkins, and we often shared our frustrations about addressing the issues that have made Sandtown infamous. Helping people here isn’t easy, and for a long time, “thinking about the community” meant thinking about my failures and shortcomings. Sure, I’d had some successes over the years, but I’d also learned how persistent the stigma and shame of mental health issues could be in a community like ours, and how devious Satan could be in destroying the lives of the people I was investing in.

The struggle I was experiencing the day I called Elder mirrored what I’d seen my neighbors go through in dealing with their own mental illness and addictions. I found myself making the same excuses about getting help I’d heard them make, yet I was still faster to recognize their pride than my own. All the same, I worried that neither they nor I could ever get better, and I felt ashamed that my desire to love my neighbor did not extend to the people on my computer screen, or to my wife, to whom I had vowed to be faithful. While I had struggled with pornography since I was a teenager, in the course of my time in Sandtown, I’d begun using it more and more – a response to my anxiety about how much good I was really doing in my efforts to help the neighborhood. In effect, I was asking pornography to cover up my inability to be the perfect Christian social justice advocate. Though I knew I had a problem, to myself I justified my half-heartedness in the battle for purity by holding up the good works I was doing (or trying to do). My addiction held such power over me that I had grown accustomed to hiding the depth of my brokenness even from myself.

Like most people, I far preferred to offer help than receive it. But my decision to reach out to Elder turned out to be a game-changer. After I confessed my sin in our Bible study, he invited me to meet more regularly with other people from the neighborhood to help conquer my addiction. As I submitted to his spiritual direction and let myself be accountable to him, he helped me to see a different way of relating to the neighborhood. He shared many of his own struggles and feelings of inadequacy, and by doing this, he modeled how I could think about my community and pray for my neighbors in a way that expected God to work regardless of my efforts. When I reoriented my heart toward loving Christ first, it was much easier to see that my self-perceived failures could not stop his work in redeeming his people.

Most decent addiction programs recognize the need for a holistic approach, in part because it’s so clear how the barbed hooks of addiction embed themselves in a person’s mind, body, spirit, and community. The importance of good friends, stable work or hobbies, regular exercise, a good diet, and spiritual discipline is routinely emphasized by practitioners and therapists who understand how a patient’s day-to-day life differs from the few hours a week they spend together. Still, despite the many psychiatrists and pastors who appreciate this reality, I often hear from patients how a trusted authority breezily denied or ignored either the biochemical or the spiritual dimension of their illness. What’s more, despite noble exceptions, not enough recovery programs recognize how poverty puts the recommended practices of self-care out of many addicts’ reach.