It comes from lots of experiences off-line. Then I did some reading (very little) about personality disorders, but with a concentration on Narcissistic Personality disorder and Borderline Personality disorder - an illness which will tear your heart out and barbecue it. And I've had a little experience, but not counseling experience, with histrionic personality disorder. (And I always have an MD pshrink as my backstop and referee. It's hard to keep one's footing without some professional homies.
Then I had a "flash": that chemically dependent people and personality disorder people are very similar, and both illnesses are very intractable, Even the best therapies have pretty lousy records.
But this was "seasoned" by my acquaintance with a recovering alcoholic who had "been working the program (AA)" for a dozen years, and was one of the most virtuous (as far as I could tell) and most spiritual people I ever met. So there is hope.
I'm working on whether one useful way to think about personality disorders would be to use the addiction metaphor in this way: PD sufferers are addicted to the reactions of other people the way substance abusers are dependent on their "substance".
And where "religion" plays into it is best exemplified by the great and unforgettable Cheech and Chong line,"I used to be all messed up on drugs, but now I'm all messed up on the Lord."
When I went up on the Psych ward in the Bullfinch Building at Mass General the patients glommed onto me. "Religion" (and in the US that usually means some form of Christianity) provides wonderful "cover and concealment" for various kinds of illness -- as do many of the "helping" professions, including being a clergy-dude and being some kind of pshrink.
You gotta pay attention. Back when I was smoking and taking care of a church while the pastor was on sabbatical, a lady who described herself as Spirit-filled stomped into my office, grabbed my cigarette out of my hand, and smashed it in the ash-tray.
Now whose needs was THAT supposed to serve? Of course, she could excuse it by saying she was a prophet and that was a prophetic "sign". Sounds good. But I'm not buying.
Then you have the ethical problem of when does "offering it up" become a kind of "enabling".
This is the kind of thing that keeps life interesting.
Man, ain't that the truth. I remember back in high school, the "Jesus Freaks" were all former dopers. They were trying to substitute one high for another.
My guess it that most of them have had quite a few more bouts with dope or other substances by this point in their lives. I hope not, but most likely the case all the same.