Cardinal George Pell says not all victims of child sex abuse by clergy have suffered irreparable harm, but many did.
A victims' lawyer Cassie Serpell asked the cardinal if he acknowledged clergy abuse victims had suffered irreparable harm including long-term psychological harm.
Cardinal Pell replied: "Not all of them did but many did.
"I have read many of their stories. They're harrowing stories and I feel deeply for them," he told the child abuse royal commission from Rome.
"Many of them are life-long sufferers."
Cardinal Pell also said he deeply regretted the impact the abuse had on survivors' faith.
Ms Serpell said her client Julie Stewart had never stepped inside a confessional since she was indecently assaulted as a 10-year-old girl by Melbourne priest Peter Searson during confession in 1985.
Cardinal Pell said he deeply regretted that and that the abuse happened.
"Of course one of the other things I regret as a Catholic priest is the damage that these crimes do to the faith of the survivors, of the victims and their friends and family and generally throughout the society.
"I lament that."
The commission has heard police wrongly decided in 1990 that Searson, the Doveton parish priest, had committed no crime when he indecently assaulted Ms Stewart.
Ms Stewart later received compensation and an apology from Cardinal Pell through the Melbourne Response he set up as Melbourne archbishop in 1996.
