Focus, starting, and ADHD

If cognitive behavioural therapy is the approach you keep being offered for ADHD, part of the reason is that it is easy to measure. It has good evidence behind it, and being the most studied is not the same as being the only thing that helps.

Structured, session by session approaches produce tidy numbers, so they get trialled more often and written up more often. That leaves quieter…

The change mostly happens between the sessions rather than in them. Catching a thought where it actually turns up, at the kitchen table or in the car park, is what makes a new one stick.

Make it small enough to survive a bad week. One thought written down as it came, and one line underneath saying what else might be true. If you have…

You are allowed more than one feeling about the same thing. Relief and grief when someone dies. Love for a job you would walk out of today. Neither one cancels the other.

A lot of the distress is not the feelings themselves but the argument over which one is the real one. Try saying both plainly, out loud: I am…

What you expect from a treatment shapes what you get from it. That is worth a conversation before you start, not months later when it has not worked.

If you are beginning something new and half of you thinks it is nonsense, say so. A doubt that stays unspoken tends to come out as a missed…

If rating a feeling out of ten means nothing to you, use something that does. Colour in bubbles, point at a picture, hold your hands apart to show how big it is today.

This began as an adaptation for children, swapping the numbered anxiety ladder for bubbles to colour in, and it is just as useful for anyone who goes…

Nobody tolerates something unpleasant for no reason. Before starting anything difficult, get clear about what you want on the other side of it, in your own words.

Something like: I want to sit an exam without being sick, so I am willing to practise feeling uncomfortable. The sentence has to be yours. A goal…

Setting out to get rid of worry altogether sets you up to fail twice, first at the worry and then at the failing. A kinder aim is to change how you sit with it.

Anxiety and ADHD keep close company, and for most people some background hum does not go away. What can change is what happens next: whether you…

When your child comes to you in a spin, the kind thing is to stay warm and steady rather than to promise that it will be fine. Reassurance settles the next ten minutes and feeds the asking.

It sounds cold and it is not. What your steadiness says is two things at once: this feeling is real, and I think you can carry it. Keep it short and…

If your only system for remembering things is your head, of course you are anxious. Nothing is safe in there and some part of you knows it.

Some people hold everything mentally because letting go of it feels like the thing will stop existing. The answer is not trying harder to remember.…

Ask everybody, at the start, what they use and how it goes for them there. Not only the ones who arrive with an obvious phone problem.

Two questions do most of the work: which platforms are you on, and what is it like for you on them. Asked early, without any warning tone, it makes…

You are already off your phone somewhere. In lessons, at work, in the pool, driving. That is worth more than it sounds.

It quietly disproves the sentence people say most often about this, that they can never put it down. They already do, most days, for hours at a time.…

For one week note three things each time: how you felt before you opened it, how it felt while you were in it, and how you feel twenty minutes after putting it down.

Most people find the before and the after are not the same, and that the middle was better than either. Usually one or two apps come out fine and one…

Sometimes the scrolling is not really about the scrolling. It is about the coursework, or the conversation, or the thing you have not let yourself think about since March.

You can usually tell by what happens when the phone goes. If the hours quietly move into something else equally absorbing and equally pointless, the…

Nobody is asking you to want less of a lift. The ask is to take some of it from somewhere that does not leave you flat afterwards.

Put that way most people will engage, because it is not a demand to become a calmer sort of person. Cold water, music that actually moves you,…

A young person on the sofa with their phone looks like nothing is happening. From the inside it is often the first hour all day that has asked nothing of them.

Both readings are true, and the argument is usually about which one gets said out loud. Naming the second one to a parent takes a surprising amount…

Before a phone gets taken away, it is worth asking what else goes with it. For a lot of young people the group chat is where their friendships actually live, and losing it leaves them alone at the moment they most need someone.

This is not an argument against limits. It is an argument for knowing what you are cutting. If the same device carries the friendships, the homework…

If therapy for ADHD did little for your thirteen year old, that is not a sign they were not trying. The self monitoring it leans on is still being built at that age, and it builds later in ADHD than in most.

The practical reading is about timing rather than willingness. Younger teenagers usually do better when the adults around them change the setup at…