Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Ask for the most frightening moment of their life, then the next one down, then the next, until there is a scale running from one to a hundred. You get the ladder you needed, and they get something they did not expect: fear comes in sizes.
Do it slowly and write it in their words rather than yours. Most people arrive believing anxiety is one solid block that either has hold of them or does not, and putting numbers on it starts to break that up before you have treated anything at all. It gives you a shared language for later too. 'That sounds like a forty' is easier to say than a paragraph of description.
Qur’an and Sunnah
'Suffering has truly afflicted me, but you are the Most Merciful of the merciful' (Quran 21:83). Job says the worst of it plainly and stays in relationship while he says it, which is roughly what naming the top of the ladder asks of a person.
۞وَأَيُّوبَ إِذۡ نَادَىٰ رَبَّهُۥٓ أَنِّي مَسَّنِيَ ٱلضُّرُّ وَأَنتَ أَرۡحَمُ ٱلرَّٰحِمِينَ
Remember Job, when he cried to his Lord, ‘Suffering has truly afflicted me, but you are the Most Merciful of the merciful.’
Qur’an 21:83read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A meta-analysis of cognitive behavioural treatments for adult ADHD found meaningful reductions in ADHD symptoms and related difficulties against control conditions, so structured psychological work has real support in this group. It pooled whole treatment packages rather than single techniques, which means it backs the general approach and not this particular exercise.
Knouse LE, Teller J, Brooks MA. (2017). Meta-analysis of cognitive-behavioral treatments for adult ADHD.. Journal of consulting and clinical psychology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Once fear has a scale, a frightening moment stops being the whole of it and becomes one point on a line.
When not to
Go gently if the worst moment turns out to be a trauma memory, because listing it is not the same as being ready to work on it.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
A reward that comes every time is easy to walk away from. A reward that turns up unpredictably is the one you cannot put down, and that is exactly how your phone is built.
Note who is a first degree relative and who is a second, instead of writing 'runs in the family'. Parents, children and siblings sit in one ring. Grandparents, aunts, uncles and cousins sit in the next.
Strategies for ADHD are visible. A timer on the table, a list on the wall, an alarm going off in a meeting. If someone has not yet made peace with having ADHD, each of those is an announcement, and it will quietly get dropped.