What Should We Make of Personality Disorders?

What does the average pastor do when confronted with someone who exhibits troubling behavior that disrupts relationships and creates bedlam in the church? Unfortunately, because training for these types of issues is minimal, the response can create more problems. These types of inflexible thinking and behaviors have been placed into a modern category called Personality Disorders.

What is a personality disorder? Here is a definition from Chuck DeGroat’s book, Toughest People to Love:

Experts define a personality disorder as an "enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment." In theological terms, personality disorders reflect that long-term and chronic relational pattern Martin Luther describes as "homo incurvatus in se" – "people turned in on themselves (p. 46)."

Another way of defining these patterns is found in Allen Frances’ book Essentials of Psychiatric Diagnosis: Responding to the Challenges of DSM-5:

Our characters strongly influence our fate. How we see the world and respond to it very much determines how the world sees and responds to us. “Personality” is an enduring pattern of thinking, feeling, interacting, and behaving that is who we are; it provides the texture of our relations with other people. Personality Disorders cause vicious cycles of negative expectation and self-fulfilling prophecies. Normal personality traits become Personality Disorders when they are inflexible and make people unable to adapt to the needs of the moment. The diagnosis of a Personality Disorder is made only if the resulting problems cause clinically significant distress or impairment (p.131).

Note the emphasis on inflexible and unable to adapt. For someone with a personality disorder, their normal personality has been geared to see and do life through a single lens (schemas) which incapacitates them from thinking and behaving differently according to the situation. The cause is not fully known, but most say that it is a combination of biological and situational factors. Situational factors can include some kind of childhood trauma.

Frances offers a very simple but helpful diagnostic question to determine if you or another person suffers with a Personality Disorder:

“Do you have a style of doing things and relating to people that gets you into the same kind of mess over and over again?”

The DSM-4-TR has 3 clusters that I find more helpful than the more current DSM-5:

• Cluster A. Odd/Eccentric: paranoid, schizoid, and schizotypal personality disorders.
• Cluster B. Dramatic/Emotional/Erratic: antisocial, borderline, narcissistic, and histrionic personality disorders.
• Cluster C. Anxious/Fearful: avoidant, dependent, obsessive-compulsive personality disorders.

These were classified as Axis II disorders along with the developmental disorders. The most recent DSM-5 offers 12 different types of Personality Disorders:

1. Borderline Personality Disorder
2. Antisocial Personality Disorder
3. Narcissistic Personality Disorder
4. Histrionic Personality Disorder
5. Obsessive-Compulsive Personality Disorder
6. Avoidant Personality Disorder
7. Dependent Personality Disorder
8. Paranoid Personality Disorder
9. Schizoid Personality Disorder
10. Schizotypal Personality Disorder
11. Personality Disorder Due to Another Medical Condition
12. Unspecified Personality Disorder

Allen Frances also provides a basic definition and description of each that is worth considering. The ultimate goal is not to find labels for people but to understand them so that you might engage in skillful ministry.

The Implications for Local Church Ministry

It doesn’t take long to serve in a leadership capacity in ministry to see these traits in certain congregants. Statistics reveal that about 10% of the population fit the various categories of personality disorders. That means that leaders need to be exposed to and aware of these various forms of struggle. It is necessary to be aware of these issues because, unfortunately, it is not uncommon for these individuals to do great harm in churches, either as leaders or attenders.

In DeGroat’s book, he highlights four of the personality disorders that are most troublesome and are often the reason many leave the ministry (p. 46-47). They include Narcissistic, Borderline, Obsessive-Compulsive and Histrionic Personality Disorders. Below are DeGroat’s descriptions of each:

Borderline Personality Disorder: the volunteer who spent years praising and supporting you, only to viciously turn on you, sending critical emails to everyone in the church.

Obsessive-Compulsive Personality Disorder: the nagging parishioner who gives a lot but pesters you with daily emails asking for specific details about the organization’s accounting. She is unable to see her own obsessiveness or to realize that her emails cause you anxiety and give you heartburn.

Narcissistic Personality Disorder: the power broker who intimidates you after you challenge him in a marital counseling session, demanding to see your notes from each session and threatening to get a lawyer to investigate you and the church.

Histrionic Personality Disorder: the leader who seems to ooze drama and is a magnet for each and every crisis in your church.

To these four, I would add one more:

Antisocial Personality Disorder (psychopath/sociopath): We typically relegate this category to serial killers but antisocial congregants often do their “killing” in other ways. These individuals are very adept at pairing off with others to breed suspicion and mistrust within a church in an effort to “kill” a leader.

Wisdom and Love

The call of every leader is pastoral care that incarnates the love of Christ. This is to be combined with great wisdom. In Matthew 10:16, as Jesus prepares the disciples to go and do ministry, he says, “be as shrewd as snakes and as innocent as doves.” In other words, as you go about your work as a pastor be aware that troubled people are in your midst. Don’t be paranoid but wise. Don’t be antagonistic but be wise in the way you interact with everyone.

Finally, as pastors and spiritual leaders encounter troubled people, be aware of the fact that some are uniquely challenging. Mark Yarhouse has this to say in his helpful resource Modern Psychopathologies: A Comprehensive Christian Appraisal:

The pastoral or leadership team also needs to be fully informed about problematic behaviors so there will be no manipulation or conning (Miller and Jackson 1995). Processing (debriefing and defusing) strong feelings of ambivalence and confusion, even anger and intense frustration, is often necessary. Further education about personality disorders, coupled with good professional consultation, can also be helpful. Ideally, they can help the pastoral or leadership team attack the problem(s) rather than the person (which would alienate or isolate those directly affected). In the long run, such an approach is much more helpful than to spiritualize the problem or to offer religious interventions that are misinformed about the painful realities of rigid, inflexible patterns of relating (p.285).

In short, pastors, elders, deacons and leaders in local churches need to find those who can help them grow in wisdom as they pastor and shepherd the flock. This is a short blog raising big issues and questions. What would you add to this conversation? I would love to hear your thoughts.

Copyright © 2015 Timothy S. Lane

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Resources mentioned:

• Toughest People to Love by Chuck DeGroat
• Essentials of Psychiatric Diagnosis: Responding to the Challenges of DSM-5 by Allen Frances
• Modern Psychopathologies: A Comprehensive Christian Appraisal by Mark Yarhouse

What Does it Take to Survive and Thrive in Ministry?

5 Essential Ingredients: What Are They?

The old joke goes something like this, "For six days a pastor is hard to find and the seventh, hard to understand." While that may be funny on the surface, it belies a deep misunderstanding of what pastors do from day to day and week to week. It also reveals a significant lack of understanding of the life, pressures and expectations of someone in ministry.

Recently, I  re-read a helpful book on pastoral ministry entitled, Resilient Ministry: What Pastors Told us About Surviving and Thriving. (Bob Burns, Tasha D. Chapman, and Donald C. Guthrie, IVP Books, 2013)

Here is how the book came to be:

This book, based on seven years of research, seeks to answer these questions. Our research focused on gathering pastors and their spouses into peer cohorts, which met repeatedly in multi day retreats called Pastors Summits where we facilitated heartfelt discussions about the challenges of vocational ministry. This book presents the summary and analysis of those discussions in light of our literature research and experiences.

Based upon the discussions, the book identifies 5 areas that are critical for surviving and thriving in Christian ministry. Those five areas are:

• Spiritual Formation: personal growth in grace and maturity.
• Self Care: the pursuit of physical, mental and emotional health.
• Emotional and Cultural Intelligence: Emotional intelligence of oneself as well as others.
• Marriage and Family: spiritual and relational health with their spouse, children and extended family.
• Leadership and Management: sharing congregational leadership, building congregational community, effective administration, conflict utilization and responsible self-management.'

No Sour Grapes, Just Reality

As I pondered these 5 areas, I reflected back on my time in seminary and my days in pastoral ministry. Unfortunately, I can't remember when any of these five areas were emphasized in my preparation for ministry, nor my ongoing equipping while in ministry! While much of what I studied in seminary was essential to my work, so much was never addressed. In addition, there was little or no vision for ongoing development and growth once I found myself in a pastoral role. This was virtually missing at the local, as well as the regional and national level in my denomination.

As I reflected back on my circle of friends who have spent many years in ministry, they confirm that these critical areas are where most of their challenges and heartache lie. It is almost always the areas that caused many to leave.

A Way Forward?

If these findings are accurate, what does this say about our seminary training and ongoing support that is provided for those serving in pastoral ministry? I think the conclusions are obvious. But will we take them seriously? We can't afford not to.

For information about an organization that addresses these very issues, follow this link to the Institute for Pastoral Care.

Copyright © 2015 Timothy S. Lane

Doubts, Guilt and the Lord's Supper

A few weeks ago, a very close friend and I were traveling together. As we discussed a host of subjects, I ventured into more personal territory. I had noticed that he had stopped taking communion at church for the past several months. He is a convinced believer in Jesus, but for some reason didn’t feel right about partaking. Here is how the conversation went:

Me: So, can I ask you a personal question? (He said “yes”.) I don’t want to be insensitive but I noticed that you have not been taking communion whenever it is offered in church. I actually respect the fact that you are taking it so seriously and not participating in a flippant way. I am curious to hear why.
Friend: Thanks, I don’t mind you asking. I really don’t know why I haven’t been participating. Something just doesn’t feel right. I just don’t know……
Me: That’s fine. I wanted to make sure you understood what the Lord’s Supper is all about. I wouldn’t want you to miss out on something that is vital to your growth as a Christian. Do you still believe in Jesus and that he is your savior?
Friend: I do, but I am struggling to really believe that God loves me. After all, my life has been a real mix of trials lately……(to be continued).
____________________________
I have a lot of pastor friends who struggle to know how to “fence” the table well when serving communion. I have many more friends who struggle to know whether they should even partake from Sunday to Sunday. Many of these friends struggle with deep guilt whenever communion is served. Maybe that is your experience. It certainly was mine many times before I properly understood the purpose of Communion.

Why is it that the wonderful sacrament of the Lord’s Supper is so hard for many believers to enjoy? After all, the Greek word that is used to describe communion is Eucharist, which means “to give thanks.” Even the word “communion” is a good word. It implies that you are communing with God; relating to him; enjoying his company; reveling in his love and mercy for you.

I think the confusion and angst that many Christians experience may stem from the Apostle Paul’s exhortation in I Corinthians 11:23-32 where he strongly confronts the Corinthians for celebrating the Lord’s Supper in an unworthy manner:

23 For I received from the Lord what I also passed on to you: The Lord Jesus, on the night he was betrayed, took bread, 24 and when he had given thanks, he broke it and said, “This is my body, which is for you; do this in remembrance of me.” 25 In the same way, after supper he took the cup, saying, “This cup is the new covenant in my blood; do this, whenever you drink it, in remembrance of me.” 26 For whenever you eat this bread and drink this cup, you proclaim the Lord’s death until he comes.
27 So then, whoever eats the bread or drinks the cup of the Lord in an unworthy manner will be guilty of sinning against the body and blood of the Lord. 28 Everyone ought to examine themselves before they eat of the bread and drink from the cup. 29 For those who eat and drink without discerning the body of Christ eat and drink judgment on themselves. 30 That is why many among you are weak and sick, and a number of you have fallen asleep. 31 But if we were more discerning with regard to ourselves, we would not come under such judgment. 32 Nevertheless, when we are judged in this way by the Lord, we are being disciplined so that we will not be finally condemned with the world.

Verses 27-29 are startling. After reading these words, you might wonder if anyone is “worthy” to participate in the Lord’s Supper. But what is Paul really addressing? There are many things we could say about the specific context that Paul is confronting in Corinth. But one thing is clear. He does not want to erect a fence so high that needy sinners feel unworthy to participate.

Maybe I can share how I came to understand how to “fence” the table when I was pastoring a church full of both struggling sinners and sufferers. Here were a few things I would say:

Question: What does it mean to partake of the Lord’s Supper in an unworthy manner?

Answer 1: If you think you are worthy due to your performance, you come in an unworthy manner. The table reminds us that it is only in Christ that we are able to approach and commune with God.

Answer 2: If there is a known sin in your life that you are stubbornly unrepentant of or in denial about, you come in an unworthy manner. The table is for humble, repentant sinners.

Answer 3: Instead, if you believe in Jesus and are struggling with doubts, are feeling distant from God, experiencing weakness and fatigue in your faith, or you failed to obey God recently, you should come to the table to eat and drink!

Based upon this perspective, I shared the following with my friend:

The Lord’s Supper is using the image of your need for physical food and applying it to your need for spiritual food. If you were starving, weak, and unable to stand and someone put some food in front of you, what would you do? You would eat and drink to regain your strength. It is the fat and satiated who do not eat; not the hungry. The Lord’s Supper is a time to give thanks that God feeds the helpless and draws near to those who know they are hungry.

I don’t know if this registered with my friend or not. He thanked me for asking and then the conversation changed to a song that was on the radio. Yet the moment was not lost on me. It was a simple conversation with a brother in Christ where I was able to remind him of the utter grace of the Gospel. God’s love is wholly undeserved and yet freely given only to those who know they are not worthy.

The next time communion is served, ask yourself if you are hungry and thirsty for God's love and grace. If so, eat and drink to the glory of God!

Copyright © 2014 Timothy S. Lane

A Web of Care: External Resources

Here are five strands of external care (building upon the internal strands) that can be leveraged to strengthen the pastoral ministry in your local church.

It is important to note that there are professionals in various areas who may or may not attend your church. As best you can, know who they are and get a sense of how they might be utilized in ways that can strengthen your web of care. This will require humility and wisdom. If some of these people attend your church, get them to help you identify the resources available in your community.

Strand One: Specially trained counselors. If you have professionally trained counselors in your church, they can be a rich resource for helping you care for and equip other people. The obvious challenge is recognizing what models are most influential in their care. Make every effort to pursue them and begin a conversation that moves in the direction of mutual understanding and appreciation. Most professionally trained counselors have not been adequately exposed to Biblical and theological categories that are essential to distinctively Christian counseling. It is also true that many pastors and leaders have not had adequate exposure to helpful diagnoses and skills in discipling ministry with more complex struggles. Strive to bring these two together.

Strand Two: Doctors and Psychiatrists. The physical body is complex. While doctors and psychiatrists are not omniscient, their training does provide insight into how the body influences the person. The same situation that exists with professionally trained counselors is true of doctors and psychiatrists. If you want a stronger web of care, do the same with them as you would do with the group in strand one. 

Strand Three: Social Workers. People in the helping professions, including counselors, can be a rich resource for the local church. Hospice care, those who care for the elderly, crisis pregnancy providers, suicide intervention, coroners, nurses, EMS, substance abuse and police officers are some of the many people who can play a role in very specific ways in the body of Christ. Often, they can be leveraged to do significant training for highly active lay people. Their experience and case wisdom is invaluable. Capture it for the good of others.

Strand Four: Every Member. One of the main aspects of a web of care is the daily relationships of each and every person in your church. As important as trained professionals are, there is no replacement for a person's daily friendships. These are the people who really know the person and are there around the clock. Every member in the local church should be equipped at some level to wisely care for those closest to them. You would do well to spend time equipping this group with basic skills for listening and a knowledge of where they can be helpful and where they may be over their heads.

Strand Five: Father, Son and Holy Spirit. It goes without saying that within the context of the body of Christ, there are many strands of the web of care that can be found outside of the local church. One aspect that can not be found or manufactured anywhere else is the presence of a personal God who is graciously involved and working His good purposes in every Christian's life. We do well to remember that the local church has a "resource" that no other organization or institution has; a gracious, personal redeeming God who has revealed Himself in the person of Jesus and works mysteriously through the Holy Spirit.

Finally, it is helpful to remember that the primary metaphor for the church used over and over again in the Bible is that of a body. There are many parts and each part is needed in order for the body to function well. As you consider both internal and external strands within the body of Christ, you begin to see how very important each strand is. You also see just how important it is for each strand to be connected wisely to one another. The strands cannot exist as parallel entities. It is the role of wise leadership to strengthen the interconnectedness of the various people who represent these multiple aspects of care. This will only happen if wise leadership encourages and facilitates this connection. Once it does, a web of care will emerge that will provide a more safe, secure and wise context to provide care for the people who attend your local church.

Copyright © 2014 Timothy S. Lane 

A Web of Care: Internal Resources

The other day, I was doing some cleaning in my basement. While working in a particular corner, I walked right into a spider web. My entire face was consumed. As I tried to get loose, pieces of the web kept sticking to other parts of my body; my fingers, arms, shoulders and even my torso! I could not get free of the web's embrace no matter how hard I tried.

Later that day, I was having a conversation with a fellow pastor about discipleship, counseling and pastoral care in the local church. In a serendipitous moment, I made a connection between my bad experience with the spider's web and a positive one as it relates to pastoral care.  When we think about caring for people within the context of the local church, the image of a web is helpful. We want to create a web of care so that people find it hard to hide, get lost, slip away or fall through the cracks.

I started thinking about the various strands of what that web would include. You see, a spider's web does it's job well because the spider spins many strands. A single strand will not suffice if the spider is going to catch its prey. Likewise, no single strand will suffice if the church is going to guard and feed the sheep. Here is a list of some of the strands.

Strand One: The Pastor. This is the first and most important strand, yet many churches think this is the only strand. When they do, people are not cared for. It only takes a congregation of 25 to overwhelm one pastor!

Strand Two: Spiritual Leaders. Any church worth its salt will have a number of spiritual leaders who assist the pastor and help provide stability for the people. If this is going to happen, it will mean that the lead pastor/pastors will have a vision and plan for equipping these leaders with interpersonal ministry skill.

Strand Three: Pastoral Staff. Most churches, even if they are small, have staff; a secretary, receptionist, nursery coordinator, children's minister, youth pastor and other assistant pastors. Every staff person must be adequately trained to know how best to help others grow in grace. Once again, it is the responsibility and calling of the lead pastors to provide this kind of training so that key staff are adequately able to know how to assist in the growth process of others.

Strand Four: Uniquely gifted lay-people. There are always a number of people who have gifts of mercy and are relationally strong in helping others with wise counsel. Often, they have gained these skills and character qualities through the hard knocks of life. You know who they are because people talk about how they have been helped by them. If this strand is going to be leveraged to the fullest, know who they are and create a natural but more formal connection with them and the other strands.

Strand Five: Small group leaders. In most cases, equipping for small group leaders has one of three legs missing. The two legs that are often present are: 1) training in how to lead a Bible study and 2) training in group dynamics and how to lead the group in discussion. The third leg that is often missing is what to do if an individual or couple approaches the small group leader after the meeting and asks for help with a problem in their lives. When small group leaders are given this third aspect of training, they become a vital part of the overall web of care.

Copyright © 2014 Timothy S. Lane