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

A Glass Half Full

When you look at this picture, do you see a glass half full or half empty? What about the way you view other people, especially other Christians?

I know, we don't want to be accused of going soft on total depravity, the reality of remaining sin and the temptation to exchange worship of the true God for something in creation. But we have more biblical categories to work with than those, as important as they are.

What about the following? We are made in God's image; the reality of the powerful work of regeneration and new life in Christ; the ongoing work of the Spirit of God in the life of the believer; the present intercession of Christ for his people; the bright promise of a changed life due to God's utter commitment to us? These biblical truths are equally important as we consider growth in grace and wise pastoral care and counseling with others. Let me make this very practical by sharing a counseling story with you.

John and Erin came to me for marriage counseling. They seemed like your average Christian couple, but that was not the case once I began to get to know them. Both of them had come from severely broken homes and had lived lives of confusion and self-destruction years before they had become Christians, met and married. Now they were telling me how hard it was for them to get along. They had several small children, were starting a business together and were trying to navigate ongoing extended family fall-out over a host of issues.

Here is what they saw and described:

• We are not communicating and getting along.
• We are constantly fighting with one another.
• We are not working as a team.
• We are such a poor example of a Christian marriage.
• We are doing the same thing to our kids that was done to us.
• Are we headed for a divorce just like our parents.
• Does God really love us in light of the way we are responding to one another?

As they shared their story, I began to see what they were not able to see. Here is what I saw:

• A married couple who were clearly professing Christians.
• A couple who wanted their marriage to last.
• A couple, though struggling to get along, were seeking outside help, again.
• John really cared for Erin and wanted to encourage her.
• Erin really care for John and wanted to encourage him.
• Both were involved in a small group Bible study with other couples.
• They were avid readers and listeners to podcasts that pointed them to Christ.
• They had been married 8 years.
• They loved their children and pointed them Christ.
• They served others within the context of their church.
• They longed to love their extended family well.

Those two lists couldn’t be more diametrically opposed to one another. Yet this is what is so typical when we are in the midst of a difficult season. There are two very different kinds of blind spots we can have in the midst of difficulty. One is to be in denial about our sin. Another is to be in denial about God’s grace at work in our lives.

Self-Examination

When most people consider the change process, they tend to start with the negative. What’s wrong with me? Why do I continue to do things that I should not do, and why don’t I do the things I should? The Apostle Paul struggled with this, too. In Romans 7:15 he says, “I do not understand what I do. For what I want to do I do not do, but what I hate I do.” In another place, Paul knew very well his own sinful tendencies. That is why, in I Timothy 1:15, Paul says, “Here is a trustworthy saying that deserves full acceptance: Christ Jesus came into the world to save sinners–of whom I am the worst.”

Paul was not afraid to speak candidly about his own struggles. He knew his own weakness and propensity to deal with the reality of remaining sin even though he was a Christian. No doubt, this ability to be honest about his own sin was grounded in the hope of the good news of the forgiveness of sins in Christ. You see how he connects the two in verse 15. Honesty about sin is equal to apprehending the work of Christ.

When you start to take a good look at your life, what is your tendency? Is it to think more highly of yourself or to beat yourself up? You are either blind so that you don’t see your sins and weaknesses, or you are preoccupied with your weaknesses, failures and sins so that you can’t see God’s present grace in your life. Paul is seeking to lead you in a different direction. He doesn’t want you to ignore either of these things. By doing this, you are more apt to see progress in your Christian life.

Ministry to Others

It does no one any good to go on ferocious sin and idol hunts in one’s life or the lives of others. Not only do they not help, they can seriously hurt people. Instead, we want to begin with marks of God’s work in our own life and in the lives of others. As I met with John and Erin, I had many opportunities to help them see where God was actually powerfully working in their marriage and family. It wasn’t a completed, pretty picture, but it was a masterpiece in the making by God’s grace.

Remember, if you are a Christian, you have God’s Spirit at work in your life. You can always find places where he is at work; just like John and Erin. And you can find ways that he is at work in others, too.

Copyright © 2015 Timothy S. Lane

Google Life

In January of 2010, my wife and I traveled to Kuala Lumpur, Malaysia to do some teaching in various local churches. Prior to going, I had no idea where it was. In order to get my bearings so that I could see just where we would be traveling, I got my tablet and opened Google Earth. Immediately, I was located in my home. Then I typed in Kuala Lumpur, Malaysia. Slowly the view of earth began to rotate. It seemed like it spun forever. Finally, it landed just over the country of Malaysia. I was pretty shocked. It took me half way around the world. I started rotating the earth and began to get a sense of where I would be traveling; what bodies of water and countries we would pass over to get there.

With that simple example, I started to draw some parallels between Google Earth and the process of Christian growth.

Destination

Sometimes, particularly when you are struggling, it is easy to lose sight of your destination. In the same way that I needed to get a sense of where I was traveling, the Christian needs to do the same. Why? Because it helps you calibrate your expectations for the journey. When the Bible talks about our ultimate destination, it does so by describing not just a place but a state of being. The Bible says that my final destination is a matter of character; I am being slowly transformed into the likeness of Jesus. That seems unlikely if I only have my current location before me. But that is what the Scriptures confirm. They say it in many places, but none is more obvious than I John 3:2,

Dear friends, now we are children of God, and what we will be has not been made known. But we know that when he appears, we shall be like him (Jesus), for we shall see him as he is.

The pages of Scripture are replete with promises of God’s good work in us to make us like Christ. Ephesians 4:23 says that we are to be made new in the attitude of your minds; and to put on the new self, created to be like God in true righteousness and holiness. Galatians 5:22-23 clarifies what that will begin to look like in this life when it describes the fruit of the Spirit,

But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control. Against such things there is no law.

When you are traveling, what happens once you get a bearing on your destination? You can calibrate your expectations so that they are not too high or too low. When I thought of the two twelve hour flights that I would have to take just to get to Malaysia, I calibrated how I needed to prepare myself for a long time cooped up in an airplane. I was able to pace myself, try to rest, keep fluids in me, and eat properly. This was going to be a marathon ride, not a quick jump from Atlanta to Savannah. Because I was properly realistic, I was more optimistic. It was a long flight, but the destination would be worth it.

When you think about the process of growing in grace, you must lift your head up and see where you are going. And when you do, you will see what a glorious destination awaits you. That, in turn, will give you hope as you battle your way, by God’s grace, to the finish line.

Copyright © 2015 Timothy S. Lane

Unanswered Prayers

Have you ever wondered why it feels like so many of your prayers go unanswered? How often have you prayed for something and nothing seems to change or happen based upon your clearly articulated requests? If we take a moment to look at the Lord’s Prayer in Matthew 6, you may have a better idea for why some of your prayers are not answered in just the way you wanted. Let’s start with some basics.

The Lord’s Prayer has six petitions. 3 “Your” and 3 “Our”. The first three focus our attention upward to God. 1) Your Name 2) Your Kingdom 3) Your Will. The second three focus our attention on our needs. 1) Our Bread 2) Our Forgiveness 3) Our Deliverance from Temptation.

9 “This, then, is how you should pray:
“‘Our Father in heaven, hallowed be your name, 10 your kingdom come, your will be done, on earth as it is in heaven. 11 Give us today our daily bread. 12 And forgive us our debts, as we also have forgiven our debtors. 13 And lead us not into temptation, but deliver us from the evil one.’

Seeing this order helps us as we think about what it means to specifically pray for our daily bread. We have to pray the “our” petitions in view of and through the first three “your” petitions.

When we are praying for “our daily bread,” it is easy to confuse our needs and wants. Daily bread has to do with the necessities of life, not the luxuries (that does not mean it is wrong to enjoy things beyond the necessities, but we have to be careful not to confuse the two in our prayers for daily bread). That is why we must start with the first petition, “Hallowed be Your name.” Whenever we hallow or make something ultimate in our lives other than God, we will begin to confuse our wants as needs. Hallowing God means we keep things in their proper place. When we don’t hallow God and make something else central to our lives, we will tend to pray self-centered prayers. James puts it this way,

You do not have, because you do not ask God. When you ask, you do not receive, because you ask with wrong motives, that you may spend what you get on your pleasures (James 4:2-3).

Whenever we confuse our wants for needs, our prayers will become self-centered. They also will not be about his kingdom but our own.

When I was a young parent, I would find myself praying that God would change my children. On the surface, that doesn’t sound all that bad. In fact, it can seem pretty godly. But whose kingdom was driving that prayer? Sometimes it was God’s, but many times it was my kingdom. “God, change my childrens so that my life won’t be so difficult.” “God, change my children so my reputation is not harmed.” Those prayers sound like I am praying with my own pleasures in mind.

What about you? What seemingly good things are you praying about, but sometimes with your own pleasures and glory in view, not God’s? “God, work in my spouses’ life.” “God, make this week’s sermon really good.” “God, make everything at work go just right so that I can relax a little and enjoy an early retirement.” “God, take this struggle with temptation and sin away so that I can be free.” “God, remove this suffering from my life so that I can really glorify you.”

What are you praying for today? Are you praying at all? Take a careful look at your “Our” petitions and examine them a bit more closely. You might find, as I have, that your perspective needs to be aligned more clearly by hallowing God and his kingdom more than your own.

If you find that difficult, remember that Jesus prayed, “Not my will but your will, Father” so that we might be rescued from the tyranny of our self-centeredness.

Copyright © 2015 Timothy S. Lane

Epidemic Worry

Worry is an epidemic. 1 in 5 Americans struggle deeply with anxiety. That is nearly 65 million people. And when I say struggle, I mean in a debilitating way. It will impact their ability to function at home and on the job, and it will impact their relationships in significant ways. Not only do they have difficulty dealing with others, others will not know how to respond and help them.

While there are many ways that an anxious person needs help, it is no coincidence that within the broader context of Jesus’ teaching on worry in Matthew 6:25-34, he also teaches his disciples to pray in Matthew 6:9-13.

In Matthew 6:25-34, Jesus says don’t worry about things like food, drink and clothing. If we are not to worry about food, drink and clothing, what are we to do?

25 “Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes?26 Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? 27 Can any one of you by worrying add a single hour to your life?

28 “And why do you worry about clothes? See how the flowers of the field grow. They do not labor or spin. 29 Yet I tell you that not even Solomon in all his splendor was dressed like one of these. 30 If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you—you of little faith?31 So do not worry, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ 32 For the pagans run after all these things, and your heavenly Father knows that you need them. 33 But seek first his kingdom and his righteousness, and all these things will be given to you as well. 34 Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

In Matthew 6:9-13, Jesus calls us to pray for “daily bread.” Coincidence? Not at all.

9 “This, then, is how you should pray:
“‘Our Father in heaven,
hallowed be your name,
10 your kingdom come,
your will be done,
on earth as it is in heaven.
11 Give us today our daily bread.
12 And forgive us our debts,
as we also have forgiven our debtors.
13 And lead us not into temptation,
but deliver us from the evil one.

We are called to pray for these things and expect God to provide them; sometimes in “miraculous” ways and often in “ordinary” ways. Either way, they are gracious gifts from the Father. As James says, “Every good and perfect gift is from above, coming down from the Father of heavenly lights, who does not change like shifting shadows” (James 1:17).

So you see, Jesus tells us there is another, better way than worrying. Simply stop and acknowledge your utter dependence on God for everything and ask him to provide for your needs. Your daily bread. Bread, not dessert! Necessities, not wants.

When was the last time you found yourself actually praying for things that you tend to take for granted? Food, drink, paying the bills, good health insurance, giving to others?

When was the last time you said something like this,

“Dear Father, I do not take for granted that there will be food on the table tonight. Rather, I come to you and acknowledge that unless you provide, I will go without. I acknowledge that even the skills I have to provide for my needs come from you. Thank you. I pray not just for my own needs but for the needs of others as well. Give us today, daily bread.”

While I don’t want to oversimplify the struggle with anxiety, Jesus does call us to a life of childlike, dependent prayer.

Copyright © 2015 Timothy S. Lane