I’ve been using a new diagnostic category, though I haven’t seen it in the DSM-IV-R: Hunkered-downedness. Hunkered-down clients are a few inches shorter than their natural heights. They often look younger than their natural age. They can be appeasing. They can be hyper-vigilant. On the other hand, they can be somewhat dissociated. All of them have been a little depressed, some more than others. Their complaints may include procrastination, inability to make decisions, and general confusion. They have all been nice people, easy to be around. They are rarely assertive.

I do an intake with a genogram, paying special attention to attachment issues. All of these people had rigid or highly critical moms. When I explain, often at the end of the first session, that due to the history and current issues and presentation of the client that he or she has the "hunkered-down" diagnosis, they usually relax and agree. One person said, "You see me."

What to do? I usually ask them to think of a current interpersonal situation in which they are in this state, and then "float back" to the earliest time they ever felt that way. It’s usually sometime between 2 and 4 years old. It’s Mom, saying, "I’m ashamed of you." or "Stop it!" or similar words. The feeling is caved in, shame, inhibition. The cognitions are about being unworthy or unlovable or damaged goods.  If they can’t remember, I’ll guide them: imagine that you’re 2 years old. You’re exuberently dumping clothes out of drawer or banging pots. Mom shows up. Look at her face. Hear her voice. That gets them right there.

I use a combination of EMDR clearing with some Brainspotting thrown in, to clear the event. I’ve done up to six sessions on this event, alone, before it clears. During the last session of processing the "hunker", I watch the client’s body change. The neck becomes vertical, instead of horizontal. The shoulders come back while the chest sticks out. The chin comes forward. Today I saw a man stop looking like a boy. In a way, it was like the incredible Hulk, coming out of a little man’s body, except it was an incredible man. He felt it. I saw it. We install: I’m worthy, I’m lovable, I’m acceptable.

Then we finish the processing, by doing a body scan, and noticing the difference in this body. Then come back to a current "hunkering" kind of situation, and use the future template: dealing with the situation with the new body and new brain.

The next time, the clients come back and brag about their weeks. They’re different in many spheres: assertiveness, stick-to-it-iveness, decision-making. It’s very cool work.