By Ali Van Kuiken
This is part of a series on the intersections between pastoral care and mental health.
Although I work in a specialized setting of a state psychiatric hospital, when speaking to church pastors I sometimes recognize behaviors and problems they describe as having similarities to those I witness in the psych hospital. Some of those are similar to people with Borderline Personality Disorder, some bring to mind folks who have experienced trauma, and still others remind me of the patients I work with who have either Antisocial or Narcissistic Personality Disorder. To learn more about how to provide pastoral care in a parish setting to those with these traits I interviewed The Rev. MaryJane Inman, BCC, Chaplain at Trenton Psychiatric Hospital. The Rev. Inman is a PCUSA ordained pastor and has been a chaplain for 24 years. She has many years of experience working with men and women with these traits and she shared her wisdom with me.
When I asked her for general tips, she noted the warning signs of someone with Antisocial Personality Disorder: they won’t take personal responsibility for their actions, they don’t show remorse, they have no respect for the law, and might even have fun “getting one over” on the law. However, someone who is Narcissistic simply believes the law doesn’t apply to them. Some signs of this in the church could be someone breaking rules or bullying others and showing no regard for them.
If you are noticing someone in your congregation with these tendencies, it is important to acknowledge what is happening and set boundaries. You need not take an all-or-nothing approach and immediately dismiss them from your church. However, it is important to see behavior for what it is and name what is unacceptable. At the same time, The Rev. Inman emphasized that although clergy can build on a person’s spirituality their “spirituality is not going to take away these other tendencies.” There is something about these people that is leading to this behavior; it’s part of how they see the world and operate in it. It is not the pastor’s responsibility to reform them. In fact, that may well be impossible. Instead what a pastor can do is: protect themselves and their congregation and the person in question through boundary setting, refer the person to other services if they are asking for that and if appropriate (such as anger management or substance use support group), and be forthright with the person if they are suggesting something illegal and you are not going to do it (for example if they suggest bribing someone you can state matter-of-factly “we’re not going to do that” and move on without shaming them).
When it comes to boundary-setting, The Rev. Inman emphasized safety and clergy protecting themselves during that process. Don’t meet with the person alone, she said, take someone from the congregation or wider denomination with you to that meeting. And depending on the circumstances it may be appropriate to validate the person’s gifts and abilities, even while setting boundaries around certain behaviors. One reason The Rev. Inman enjoys working with this population is because people with these disorders may be very charming and have a lot of social skills that people like and are drawn to. However, the person may use their gifts to manipulate others. This means the pastor needs to be wary and not get caught up in the person’s powers of persuasion. In any case where there is confusion or uncertainty about a person and their behavior, seeking an outside perspective can be helpful.
One of the difficult balancing points is holding in tension that this is the way people with these personality disorders see the world. And if we realize that about someone, we don’t need to feel bad ourselves about seeing them this way. And although we may not want to judge them we do need to hold them accountable. Even while not judging how someone got to this point, we do need to judge if someone is being dangerous or unhealthy. For instance, someone who has spent time in jail or prison may have PTSD from that experience and yet their trauma doesn’t excuse hurtful behavior toward others.
The Rev. Inman spoke about her personal experience being a chaplain to people with these struggles. She named that her setting of the psychiatric hospital has natural boundaries that allows her to be closer to these folks than a church pastor may be. She noted experiencing joy when getting to know some of these people and feeling compassion for those who have endured a rough childhood. She has also experienced disappointment when someone who is doing well becomes aggressive and has a setback. She has seen folks have a lot of forward and backward movement and as a caregiver that can be difficult to witness.
The Rev. Inman also shared an experience of feeling threatened by an individual she worked with for years and said it “shook me as a caregiver.” She had had a good relationship with this person and then “they got upset and projected onto me and I became a target for their anger.” The person couldn’t take responsibility so the pastoral relationship had to end. It was “scary and discouraging.”
Part of the challenge, according to the Rev. Inman, is that as spiritual leaders we don’t want to give up on people. We believe God can transform people. And yet that transformation is not magic, it takes a lot of work. Even given the immense challenges, the Rev. Inman shared that she still had hope for the person who had threatened her even when they stopped working together. Because although we can’t change how a person with these personality disorders sees the world, we can build up the ancillary things such as helping them get a job or work on anger management and substance use, and that can reduce the negative effects of these personality disorders.
In closing the Rev. Inman emphasized that even though it is not appropriate for a pastor to make a psychiatric diagnosis, it is always helpful to name the symptoms that you can see. That can be grounding and help you get perspective in a situation that otherwise might make you feel crazy. It can also help give you a sense of why things keep going wrong with this person. If the symptoms add up to someone being antisocial that can be good to know since that person may be dangerous. A person with Narcissistic Personality Disorder may have a lot of talents and do a lot of good, but it’ll be all about them and this can be difficult for clergy. The pastor may need to practice radical acceptance that this is how this person is. Or the pastor may decide to set a boundary and risk losing the person. Whenever an issue reaches this point, seek consultation. Don’t deal with it on your own.
The Rev. Inman wants young clergywomen to be empowered to own your truth about what you’re observing or experiencing, to set your own boundaries, even if these are different than the ones set by the congregation, and to seek consultation when working with people who are “stirring things up.”
For more information about personality disorders of various kinds, the Rev. Inman recommends reading the book Fatal Flaws by Stuart Yudofsky.
The Rev. Ali Van Kuiken is a chaplain at a psychiatric hospital in central New Jersey where she lives with her husband, toddler, and cat.
