Today I am excited to get to chat about “personhood” with a dear dear friend, Helena “Dr.O” Orellana. We were classmates together during our graduate studies in clinical psychology, where she was a back-row dweller never at a loss for posing deep questions or providing sharp answers.
Helena has always been full of sincerity and generosity, and has one of the most stunning smiles on earth. Her laugh is infectious. Helena went on to pursue her doctorate and I’ve loved following her journeys on Instagram with her playful pup, Damsel. It was such a joy to reconnect with this gem.
So here we are! Welcome, Dr. Orellana!
Case Conceptualization 101
SA: You have a special interest in case conceptualization. In fact, your doctoral dissertation was devoted to it. Can you help our readers understand what case conceptualization is for a mental health therapist?
Dr.O: It means a couple different things, depending on the overall theory that you ascribe to. In general, it is the way you understand what’s going on [with a client or a patient] and how to help.
Here is a definition that I love by Tracy Eells (2010): “a hypothesis about the causes, precipitants, and maintaining influences of a person’s psychological, interpersonal, and behavioral problems.”
The last part of a case conceptualization is the treatment or goal… asking, “how do you help the person move away from what’s painful and limiting and impairing functioning towards flourishing, a fuller version of their life?” It’s like a story or a road map– where you’ve been, the bumps you’ve hit in the road, and where you want to go.
SA: Ideally this is done for every therapy patient or client, or “case.”
Dr. O: A parallel is the diagnostic process in medicine. You have all these symptoms and you want to know what’s the origin. Is it an allergy that is causing itchiness, for example? Or is the issue a combination of two things, maybe a vitamin deficiency and an allergy? That informs the treatment you choose. But [as the practitioner] you also have to take in other factors, like is the patient allergic to a certain medicine or is there a family history of a poor reaction to something?
This is kind of what therapists do when they conceptualize. They think about “what is depression and what do the symptoms look like?” and “what is the person’s history and other factors influencing how this reaction is expressing itself?” Depression for one person can look very different than depression for another. The therapist takes all of this [information] in, then different theories have different ways of prioritizing what to look for and paths that they would walk to help the person heal. Case conceptualization bridges the theory [of the therapist] and the individual person [client].
SA: This is so fascinating to me about therapy. Therapists with different theories could go completely different places with the the same patient, depending on the theory or theories they ascribe to.
Dr. O: Totally! Both in the immediate thing the therapist says to that person, but also in the whole arc of the sessions and treatment. There are trauma theories, for example, that say healing can happen in twelve weeks. Other modes of therapies would say there is no way you could heal something like trauma that fast.
Understanding the Person
SA: Now tell us about the CCMMP. What is it, and what is its purpose for Catholic therapists?
Dr.O: The CCMMP is the Catholic Christian Meta-Model of the Person. It is the culmination of a lot of time, thought, and work by the faculty at Divine Mercy University. It takes the wealth of knowledge we have about the human person, from Catholic theology and philosophy, and uses it to enrich the practice of psychology. This model outlines “what is the reality of the person?” The word “meta” means that this model can be applied with any other theory. In other words, therapists can use it to infuse the way they conceptualize with any other therapy theory or modality they choose.
SA: So the CCMMP is ALL about “the human person.” How would you summarize “personhood” for one of your students?
Dr. O: It’s a big one in philosophy! The classic definition from St. Thomas (which he took from Boethius) is, “a person is an individual substance of a rational nature.” The CCMMP’s definition of a person builds on this:
“The human person is an individual substance of a rational (intellectual), volitional (free), relational (interpersonal), sensory-perceptual-cognitive (pre-rational knowledge), emotional, and unified (body-soul) nature; the person is called to flourishing, moral responsibility, and virtue through his or her vowed or non-vowed vocational state, as well as through life work, service, and meaningful leisure; from an explicitly theological perspective (Scripture, Tradition, and Magisterium), human persons are also created in the image of God and made by and for divine and human love, and—although suffering the effects of original, personal, and social sin—are invited to divine redemption in Christ Jesus, sanctification through the Holy Spirit, and beatitude with God the Father. “
My favorite definition of a person, though, is by Von Hildebrand, a Catholic philosopher:
“Every man is a person in that his being is essentially conscious: he is a subject who enters into relations with others, who knows, wills, and loves. A person is a being who possesses himself, who does not simply exist but who actively achieves his being and has the power to choose freely.”
SA: I love that… “actively achieves his being.”
Dr.O: He goes on later to say that “the fullest expression of man’s personhood is found in transcendence.” A person transcending him or herself is distinctively human. Animals don’t do this. He is saying that every human being is a person, but you become more fully a person in the way that you engage in your life.
For me this is so helpful as a psychologist because mental health issues and illnesses can really subdue, or wound, or cause us to not be able to live in a fully human way. They block that ability.
Thinking Like a Therapist
SA: Please show us what all this looks like in practice! Perhaps pick one of the core truths about the human person and then share how you could use it for guidance in a therapy session.
Dr.O: Well this is a dead give-away for what my theory is [that I ascribe to], what I think is important. I come back to the relational. The reality that people need relationship and that they are formed by relationships.
SA: Quick note to readers… See the CCMMP Part VII. “INTERPERSONALLY RELATIONAL” . Here it is discussed how “Humans are naturally social, with inclinations and needs for family, friendship, life in society, and other interpersonal relationships.”
So you can take someone, for example, who grew up in a challenging home environment. How they learn about themselves, and how they experience the world and other people, is fundamentally shaped by the early relationships they experienced. So in a home where there was a neglect of needs, the person might understand themselves as somebody who should be dismissed or doesn’t matter. That’s a very painful belief that can shape the way this person interacts with others. In therapy, I try to think, “Is this person’s ability to relate wounded? How has it been wounded? And how has the muted expression of their relationality part of what I’m seeing now?”
For someone who is lost in life, who is highly anxious, who doesn’t really trust themselves and is really suffering, I think about how might that have been shaped by early relationships. Then that shapes how I interact, because therapy is a relationship. It’s one of the most powerful parts of therapy. We can talk about our relationship in a way that creates new patterns. My focus is on giving them new experience in relationship, one that can be talked about. [I could say], “you know, I noticed after I said that, that you seemed very nervous, and I can see that your leg is bouncing and your eyes are darting around– I’m wondering if you’re feeling anxious right now.” My experience of the relationship is informing the words I use to help [the client] talk through what they’re experiencing.
SA: I’m definitely hearing your preference to Interpersonal Theory and Psychodynamic Theory come through!
Let’s Get Personal
SA: Tell me! How has utilizing the CCMMP affected how you understand your own person? How has it made a difference in your personal life?
In psychology, more than other sciences at the graduate level, you become so involved. Internal reflection is such a part of your own growth as a therapist and as a person . It is in a way that an architect or an engineer doesn’t have to [engage with their learning material]. As a therapist, you have to be very aware of yourself in the room, and very mindful of your own flaws and how your wounds might be affecting your relationship [with the client]. It requires at times a painful amount of vulnerability. For me, the model has been there throughout this process of learning about myself and growing as a woman. It has been like a chorus, a refrain. I think clients sometimes can underestimate just how much of a gift they are to their therapist. Seeing how the model is true in their lives helps me see it is all true for me too.
In Real Life
SA: How can understanding the concept of personhood and the core truths of the human person enrich the life of the everyday woman? For instance, a friend or sister who isn’t a therapist doing case conceptualizations, but is intentional in her own personal growth and relationships?
Dr.O: All of us long to be known in relationship, but also to [be known to] ourselves. I think that especially as our lives change, like moving from being a single woman to a woman in relationship, to becoming a mother, etc., all of these profound changes can lead us to be confused about who we are. Just when we think we’ve figured it out or have a grip on it, suddenly something changes, and we think, “ugh I feel so lost here.” Lost to ourselves, lost to others. In some ways, this model helps us become more known to ourselves. Not entirely or perfectly, but it expresses those core truths that can be anchors in times of transition or times of feeling lost. [These truths about who we are] help us stay afloat in choppy waters, and also can give us a sense of the horizon, so we can know where to navigate to.
SA: This can be hard work . It reminds me of intentionality, a theme I have been exploring a lot lately, and that I hope to explore more at the place she made. I am really fascinated by the process of living with purposeful decision- making based on all these truths [the CCMMP], what we know are good for us. In my own life when I am intentional, it makes such a difference. I am curious how intentionality is a part of your life?
Dr.O. One thing right now in this new role as teacher and supervisor is allowing my students’ views and own strengths in how they were created to heal, come through. I really want to help foster that, versus the temptation to tell them “well, just do it this way [with their own clients].” I am trying to hear them and to be intentional with my words, and not to overly emphasize what fits me but might not fit them [as a therapist].
SA: This reminds me of how I am trying to interact with my daughters. I want to honor that they see the world differently, to take a pause and receive their perspective before impulsively saying, “no, this is how I want to do it.” That pause sounds like a simple thing, but it’s not easy!
Thanks so much for sharing, Helena. I just love who you are so much and am sincerely grateful you took this time to be with us.
Dr.O: This is such a great project!
Sign up here for more posts like this and a library of free resources for intentional living.
Leave a Reply