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

Is Worry Making Us Sick?

Any quick search in Google or Amazon will confirm what we all already know; worry is harmful to our bodies. Here are a few physical symptoms associated with worry:

• Difficulty swallowing
• Dizziness
• Dry mouth
• Fast heartbeat
• Fatigue
• Headaches
• Muscle aches
• Muscle tension
• Nausea
• Rapid breathing
• Sweating
• Trembling and twitching

You can almost get exhausted and anxious reading that list. All of these can be experienced to varying degrees depending on how severe your worry is. Most of you can probably identify many of these as you reflect on an anxiety-producing experience in your life.

Unfortunately, this is not the only way we are impacted by worry. If not addressed, it can have a bigger impact on your overall health. People who worry consistently are more prone to the following physical consequences:

• Suppression of the immune system
• Digestive disorders
• Short-term memory loss
• Premature coronary artery disease
• Heart attack

In light of this, it is not surprising when we discover the original meanings of the words we use today to talk about worry and anxiety. The English word “worry” comes from the Old English word meaning “strangle.” The word “anxiety” is of Indo-Germanic origin referring to suffering from narrowing, tightening feelings in the chest or throat.

Statistics reveal that nearly 20% of people living in the United States will experience life debilitating anxiety annually. That is nearly 65 million people! In 2008, American physicians wrote more than 50 million prescriptions for anti-anxiety medications and more than 150 million prescriptions for antidepressants, many of which were used for anxiety-related conditions. It is no over-statement to say that we have a problem of epidemic proportions.

What Would Your Doctor Say?

Physicians and counselors will tell you that diet, exercise, rest and some kind of meditation is a proven help when you are struggling with anxiety. Sometimes medication, when taken wisely, can be helpful. You can use your body to fight what is actually trying to undermine it. No one can deny that. But is there another part of dealing with worry that we need? While these things are important, we also need to know how to connect to God when our worries come. We need God’s grace even if we are going to pursue exercise and diet in a way that is most helpful.

Let’s consider the most fundamental aspect that must under-gird everything else we do when taking care of our bodies.

What Would Jesus Say?

Jesus lived at a time in human history that was very unpredictable and less safe than ours. It was a world in which worry was epidemic, too. In every instance where he encouraged people not to worry, he did so with compassion because he knew first-hand what it felt like to be a human being. In Luke 12:32, he spoke these encouraging words to anxious people, Do not be afraid, little flock, for your Father has been pleased to give you the kingdom. Those simple words sum up all that Jesus said over and over again. He commands them not to worry, but his command is one of encouragement, not shame. Let’s consider these simple but profound phrases:

Do Not be Afraid

Jesus knows that worry is a serious problem. He knows it is bad for you physically, as well as spiritually, and he gets right to the point because he loves you. His commands are always for your good. Whenever you are struggling with worry, it is connected to your relationship with God. The word “worry” that Jesus uses means “a divided mind.” Within the broader context of his teaching, Jesus says that worry happens when you try to love God and something in creation at the same time. As soon as you do this, you have begun to put your hope and security in something other than God. Anything else besides God is unstable (money, a relationship, a job, education, your own moral record, obedient children, your health). Do you see why Jesus is so straightforward? He cares for you. He knows that you can’t serve two masters (Matthew 6:24).

Little Flock

At the same time that Jesus speaks strong but encouraging words, he does so with a tone that is tender in its toughness, and compassionate in its candor. Don’t let this little phrase that Jesus utters evade you. Don’t miss those two powerful words: little flock. While Jesus challenges you to not worry or fear, he speaks to you as one who belongs to him, whom he is shepherding and for whom he laid down his life. You are unimaginably dear to him and loved by him. You are one of his sheep. Be reassured—he cares for you and loves you even as you struggle with worry, even as you forget him and his care, and give in to your tendency to worry. You may be prone to wander, but you will always be part of his flock.

For Your Father Has Been Pleased to Give You the Kingdom

If the promise of Jesus’ tender care is not enough, he adds something more! Your Father is not only going to care for you now, he is in the process and will ultimately give you His kingdom. Your future is certain and you can begin to experience it even now because His kingdom has broken into your life by the presence of the Holy Spirit. He is a deposit guaranteeing that you will get it all one day. So, right now, in the ups and downs of life, the stresses and strains of the uncertain future, let the certainty of your eternal future be what you cling to.

With all of this in mind, allow the truth of God’s care for you to work its way into your daily life. We are to prioritize the kingdom by viewing everything through the lens of our faith. When you begin to live for God instead of the things of the world, you may find that your tendency to worry will lessen and your response to God and to the world, spiritually and physically, will change dramatically.

Copyright © 2015 Timothy S. Lane

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This is an adapted excerpt from Tim’s latest book, Living Without Worry, which can be purchased through The Good Book Company or on Amazon.

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

When Culture Feels Scary

When you reflect on the past month in the U.S. -- the recent SCOTUS rulings, racial tension and debates over immigration policy, to name a few -- do you find yourself pessimistic and fearful or optimistic and hopeful? Depending upon where you stand on particular issues, a wide variety of responses can be seen. For some, it may evoke celebration. For others, deep sadness. Some, anger, and for many, a great deal of fear. Yet, looking at our particular zeitgeist in comparison to what believers in the Old Testament and the New Testament faced has a way of providing helpful clarity as well as deep optimism. Yes, I said optimism! I am talking about deep biblical optimism, not pollyannish optimism.

In order to get some perspective, let’s consider one example from the life of the Apostle Paul. In Acts 18, we learn that he is near the end of his second missionary journey. He is leaving Athens and heading to Corinth. That, in and of itself, is worth considering. Paul’s time in Athens bore little fruit as far as we can tell. There was no successful church plant there that we are aware of. As Paul leaves Athens and arrives in Corinth, he says this,

I came to you with great fear and trembling (I Corinthians 2:3).

Prior to his time in Athens, Paul had experienced significant persecution for his work of spreading the gospel. The bottom line is this; Paul is struggling with fear as he faces opposition. He is a minority in the cities where he moves and preaches the gospel. He is outnumbered. People think he is crazy and narrow-minded. He is an outcast. His values are at odds with the culture he is moving and living in. Corinth, itself, was a challenging city. Not unlike many of our modern cities in the world.

It is within this context that Jesus speaks to Paul in Acts 18. Listen to what Jesus says and how it is very relevant for believers today.

9 One night the Lord spoke to Paul in a vision: “Do not be afraid; keep on speaking, do not be silent. 10 For I am with you, and no one is going to attack and harm you, because I have many people in this city.” 11 So Paul stayed in Corinth for a year and a half, teaching them the word of God.

The last phrase in verse 10 is a game changer as we ponder how we relate to our culture as Christians. Paul certainly hears words of encouragement that bring new strength and resolve to his efforts. Jesus promises to protect him and be with him in the midst of his work in Corinth. But Jesus goes another step. It is a positive statement that changes Paul’s perception of those he will encounter as he goes about his gospel work.

Jesus says that many of Paul’s present adversaries will be his future brothers and sisters in Christ. Not all of them will. Paul will experience ongoing persecution and rejection. That comes with the territory as we follow the King of a very different kingdom. Yet, as Paul relates to his current enemies with a tone and posture of grace, conviction, humility and tenacity, people will find hope and grace in the One whom Paul knows and proclaims.

How are we doing as a church in the 21st century within the context of our culture? Are we pessimistic or optimistic? Do we live in fear or in hope of the advancing kingdom of God; a kingdom of grace, mercy, forgiveness and joyful repentance?

What about your particular church? Do we see the cultural challenges of the day as opportunities for pastoral apologetics; a winsome and persuasive display of God’s kindness and call to a changed life?

What about you? Do your family members, co-workers and neighbors enjoy your company or hope you don’t show up due to your strongly held opinions and the way you express your convictions? Are you fearful and self-righteous?

Paul’s tone and demeanor shifted radically upon receiving Jesus’ counsel. It is the same counsel that you are receiving today. The King is on the move rescuing folks just like you and me. In fact, he wants to use folks just like you and me. We have an opportunity to be the church and represent our gracious King. This starts by building bridges and connecting with people; especially with those whom we may disagree.

Sound scary? If so, know that you have the same promises and encouragement from Jesus as Paul did as he moved to Corinth.

Copyright © 2015 Timothy S. Lane