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…

After years of feeling slightly outside every room, pulling back stops being a decision and becomes the setting you live at. Worth knowing about yourself before you conclude that you are simply not a people person.

If you are supporting or treating someone with ADHD, assume the connection has to be built rather than already there, and do not read the flatness…

Being far apart is not the same as being out of touch. What usually stops contact is the question of who starts it, not the miles.

Distance turns into disconnection when both people wait for the other one. It helps to fix a when rather than promising to speak soon. The same…

Moods travel. Laughter spreads through a group of friends, and so does contempt, gloom and low grinding cynicism. It is fair to think about which rooms you sit in.

This is not about cutting people off. It is closer to noticing that you leave certain conversations heavier than you arrived, and choosing to make…

Worry done on your own goes round in circles. Said out loud to one other person, it usually turns into a problem with edges, and sometimes into a next step.

The rule is short enough to remember at midnight: never worry alone. It does not have to be someone who can fix anything. A friend, a colleague, your…

Pulling back from things is easier. That is not the same as safer. The cost of a smaller life arrives later and quietly, which is exactly why it goes unnoticed.

It helps to be honest about the trade. Saying no to the party buys you a calm evening and charges you a slightly smaller world. Once or twice that is…

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.…

Fast, strong emotion is part of ADHD rather than a separate fault of character. It was in the original description, dropped for decades, and is being written back in.

This matters practically. Adults who react hard and settle quickly are often given a mood or personality diagnosis instead, and the plan that follows…

Often the feeling fits the situation perfectly and the size of it does not. You were right to be annoyed. The ten out of ten is the part that caused the trouble.

This is a useful thing to say to yourself afterwards, because it stops you throwing out your own read of what happened. Your sense that it was unfair…

The intensity that makes you exhausting on a bad day is the same intensity that makes you good company. Enthusiasm and impulsiveness run off one engine.

Worth saying, because a conversation about emotional control can easily become a list of everything wrong with you. The aim is not a flatter version…

Partners of people with ADHD tend not to name the lateness or the lost keys as the real injury. It is the size of the reactions. That is where the damage collects.

Annoying is survivable and frightening is not. If you are working through things in a rough order, the temper comes before the calendar, even though…

Being good at apologising is a real skill, and it loses value each time the same apology comes round. After a while what repairs things is something visibly different, not a better sentence.

So keep the apology specific and small. Name the thing, do not explain it away, say what you will do differently, and then let the doing carry the…

Self-restraint runs on a supply that stress uses up. In a week when everything is late and nothing has been slept on, you will react to things you would normally let go.

That is worth knowing because it changes what you work on. Instead of trying to be more patient at the moment of provocation, look at what is quietly…