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PART 1:

1. the higher-ranking Vampires of the Sabbat (the "bad guys" in VTM) bear titles of clergy. Arlene De La Rosa is a bishop, hence Sam addressing her as "your eminence".

2. Arlene is a Sabbat vampire in a Camarilla-controlled city (for the moment, anyway). So she can't go around making bloodfeasts all over the place, or she'd risk being discovered by the "good guys". Because of this (and her age) she doesn't "feed" very often, making the struggle with the Beast within even more intense. The way it's been played out, she's been playing "polite and ladylike" for too long, and the Beast is screaming to get out, and it becomes the catalyst for this event.

3. On top of that, one vampire too many has tried to control her mind. More on that later, though...

PART 2:

the "voices in Arlene's head"...

First - Sergio (Archbishop of the city), referring to one of his "enforcers" (Juan) who suspected Arlene of conspiring with "the enemy" (the Camarilla prince of the city). They mention the fact that Arlene was not a Cammie vampire who turned, but was born and bred into the Sabbat.

Second - Vlad, the Priest of Arlene's pack, who was secretly conspiring to overthrow Sergio (using Arlene as a pawn in his personal chess game with the Archbishop).

Third - This was actually a composite of Juan (who respected Sergio only while he was within sight and/or earshot) plus another character--a member of Arlene's pack who constantly defied her authority, making her lose face among the higher rank (a "crime" punishable by Final Death).

Fourth - The prince of the city, to whom Arlene was indeed leaking information. He in turn would warn her of the plans of the Inner Circle, THE head honchos among vampirekind in the mythos of White Wolf Game Studio.

Each of these people had a hold on her mind in one form or another ("Blood bonds" are commonly used for a vampire to control a younger vampire's mind). As the clash happens and the layers of mind control are peeled, she'll discover what triggered this whole thing...

PART 3:

1. Raven, a vampire of the Ravnos clan (generally an independent clan, belonging to neither Camarilla nor Sabbat factions) was trying to find out which faction was in control of the city. She decided to mind-**** Arlene into telling her. This last attempt to manipulate Arlene's psyche "clashed", so to speak, with all the others, bringing all barriers down and revealing to Arlene's conscious mind what had remained part of her subconscious for most of her vampiric existence.

2. The creation ritual of a Sabbat vampire is designed to tear away their humanity and replace it with one of several "Paths of enlightenment", a religion of sorts which largely determines the conduct of a Sabbat character. One of these paths (which Arlene belonged to when she was made a vampire) is the Path of Caine (in VTM lore, the biblical Caine is the first vampire). Generally, characters have one path during their existence... unless something rather dramatically violent (violently dramatic?) should happen, then a Storyteller (the game master in White Wolf games) could allow for a change in Path if the background story is convincing and the event or events are played out in game sessions. Thus, Arlene's recent experience will gradually lead her to the Path of Power & the Inner Voice. [There's some debate among players whether the "Inner Voice" is instinct or an actual "voice in her head"; I chose the latter--although, in a way, it is the voice of her instincts.