Are you a counselor? Ever treated someone who dealt with antisocial personality disorder, borderline personality disorder, histrionic personality disorder or narcissistic personality disorder? Somewhere around 10 percent of the population falls into those categories, according to Dr. C. Jeffrey Terrell, dean of the College of Education and Human Services and professor of counseling psychology at John Brown University in Siloam Springs, Arkansas.
That’s why treating those four disorders — called Cluster B personality disorders — is the topic of the fall conference put on annually by Pathways Professional Counseling, with support provided by the School of Public Health of Samford University and The Alabama Baptist. The conference, set for Oct. 13, features Terrell as guest speaker and is designed to provide participants with the knowledge, skills and abilities to accurately identify and treat their most difficult personality disordered clients.
Pathways recently interviewed Terrell to learn more about his background and work with Cluster B disorders.
Q: Tell us about yourself and how you came into this field of work.
A: I have a long background in helping. I felt a calling early in life toward vocational ministry but wasn’t sure what that might entail. After earning a bachelor’s degree in music education from Samford University, I completed a master’s degree in biblical languages and later a specialty in counseling and pastoral ministries at New Orleans Baptist Theological Seminary. I also served as pastor of two small churches. But I ended up back in another master’s and doctoral program, this time in psychology. After graduation, it all came together when I became the president of a graduate school for Christian counselors.
Q: What are Cluster B personality disorders?
A: Personality disorders are enduring maladaptive patterns of behavior and cognition that affect every area of the person’s life. Cluster B disorders are the most dramatic and are often considered the most difficult problems to treat. Depending on whose research you read, somewhere around 10 percent of the general population has one of these four personality disorders, which is rather shocking. The numbers are likely higher in clinical settings, especially when clients have experienced early trauma and/or neglect. We all see these clients, but if you’re not aware of what you’re seeing, they will cause great difficulty to you, and they will not get better.
Q: What made you want to study more about personality disorders?
A: When I became president of a graduate school in Atlanta, somehow my practice began to attract more and more executives. C-level employees of major companies, entrepreneurs, managing partners and even some pastors made up an increasing set of my clinical practice. I began to notice that — though not necessarily diagnosable with a personality disorder — most of these people had personalities that had a significant amount of narcissism, and a few had more psychopathic personalities. Working to understand what was going on with these clients was the stimulus that led to more study. Later, I developed a graduate course on personality disorders and then began to do conferences and workshops around the country on the topic.
Q: What practical tools will participants come away with from the conference?
A: I tend to use a lot of video of clinical settings, mostly me working with individuals with these personality disorders. I find that seeing the dynamics in real life illustrates the nature of these disorders better than anything else. So the conference will involve a lot of application. We’ll discuss what you can expect from these clients in therapy and how to cope with your own feelings when working with these difficult personalities. When working with personality disorders, it’s critical to understand how the psychopathology got so severe so that you can be empathic with the client even as you work to maintain firm boundaries.
Q: How does your Christian faith inform your counseling practice?
A: There are times that clients come in and issues of growth and spiritual development are the predominant issues. Prayer and deepening biblical knowledge are very helpful with these clients. However, even in those times, we have to be careful to make sure we are tracking where the client is and how we can best serve. I believe that counseling is an incarnational practice — even if we never name the name of Christ, we are living as Jesus lived. When working with these dramatic, manipulative and erratic Cluster B personality disorders, most of the time it is better for our own personal faith to remain in the background and allow the Holy Spirit to do His work, to avoid giving the client something to try to manipulate. I had a female client with one of these disorders one time who attempted to use in-session prayer in a manipulative way to get closer emotionally, which would have been counterproductive at that point in her treatment. Balancing these demands can be tough, but it’s what we’re called to do as Christian counselors.
This conference is recommended for professional counselors, social workers, psychologists, marriage and family therapists, and students in these fields. CE credits are available as well for those who need to pursue credits. (Pathways)
For more information on this year’s workshop or to register, visit www.pathwaysprofessional.org/events.