Practices

When a medicine seems to be underperforming, look at what else is in the room before reaching for a higher dose. Anxiety, low mood and a wrecked sleep pattern can each blunt a good response or imitate a poor one.

Otherwise the dose climbs while the real driver goes untreated, and the side effects arrive without the benefit. Ask what a bad night actually looks…

Blood pressure on a stimulant is an individual matter. For most people it is a non-event, and where it does rise the answer is often a different stimulant rather than none at all.

No blood test or cheek swab will tell you in advance which one suits you. Finding out means trying, measuring and being willing to change, which is…

If the first medicine disappoints, that is information about the first medicine. Plenty of people who get nothing from one class do well on another.

Methylphenidate and amphetamine are not the same drug at different strengths. They work by partly different routes, so a poor result on one says…

Classes and clubs work mostly because somebody notices when you are not there. It is the being expected, more than the workout, that gets you out of the door.

A running club, a swimming group, a friend at the gate at seven. On the evening when you feel like nothing, an arrangement with another person…

Moving your body and being with people you like are the two most reliable things for feeling well. Doing both at once is not a trick, it is just efficient.

Each of them changes how you feel through the body, and neither depends on you having a good week. A walk with a friend gets you both. If you can…

Agree a short phrase to use at home. Saying I am having OCD worries tells a parent what is going on without handing them the worry to solve.

Once a parent hears the details they will nearly always try to help by answering, and answering is the thing that feeds it. A label gives them…

Headsets have become cheap enough to sit in an ordinary consulting room, and the use with the best backing is graded exposure. You can set the intensity exactly and repeat it as often as the person needs.

The value is in the control. A feared situation can be dialled up in small steps, run again the moment it stops being frightening, and ended without…

With some sensory routines, the part doing the work may be a parent's steady hands and full attention rather than the technique itself. Worth knowing, because contact carries into the rest of the day and a protocol does not.

Views differ on this and the research has not sorted it out. What follows practically is that a family who cannot keep the exact routine going has…

Before you practise something exposing with someone, say out loud what is not at risk. I will not think less of you, and nothing between us changes here.

It sounds obvious and it does a great deal of work. If the relationship really is on the line, then the discomfort is not symbolic and no amount of…

A good deal of what stings in a tense moment is what you imagine the other person is thinking. Sitting inside a silence and watching your own mind fill it shows you that plainly.

Practitioners run this on purpose. Half a minute or so of held silence, with the client asked to notice what happens inside them. Since nothing is…

Practice gets more useful when someone is really watching. It also gets harder, so agree that part before you begin instead of adding it once the person is already in the middle of it.

An audience raises the stakes in a way that makes the rehearsal more like life, which is exactly why it helps. It is also where consent gets…

Practise not needing the praise, not only the approval. If a compliment can lift you that much, the same dial is being turned when somebody criticises you.

The mirror version of this exercise has someone hold a flattering thought about you while you sit with it and stay level. It feels odd, because few…

If you have someone safe to do it with, ask them to say the thing you dread being thought about you, on purpose, while you practise staying level.

Home is usually where the anger actually happens, so practice that stays in a therapy room or in your head only goes so far. Agree the words…

The shape of the whole thing is simple. Find the judgement that stings, meet it, talk it through, meet it again with a different intention, talk it through, then mark that you did it.

The talking between rounds is not a break, it is where the moment turns into something you can use. Marking it at the end matters too. Saying plainly…

There is a steadiness worth aiming for: hearing someone disagree with you without either going off at them or going quiet and small.

Those are the two ways it usually falls over. Either the temper goes and the point is lost, or the confidence goes and you find yourself agreeing…

Who pays the bill does give a household some say. That argument weakens every year a child gets older, and it runs out entirely once they are an adult sitting in front of you asking for help.

With a sixteen year old at home on the family plan, parents setting terms is reasonable and worth saying out loud. With an adult, the same move…

Ask your child to show you their feed and explain it to you. You are asking to be taught rather than to inspect, and from the other side those feel nothing like each other.

Something shifts when the young person is the one who knows more. They slow down, they explain who these people are, they tell you which bits are…

Ask two questions and then sit with the difference. How much time on this would you like? And how much do you think is actually good for you?

Almost nobody gives the same answer twice, and the gap between the numbers is more persuasive than anything you could have told them, because they…

Try one hour with the phone away and out of reach, then talk about what came up. The hour itself is the information.

What surfaces is usually specific and useful. The twenty minute mark where the hand starts moving. The exact worry about what is being missed. The…

Fasten a time you keep missing to another person. Go up when your partner goes up. Ask a colleague to knock for you on the way to the meeting.

A person moving is much easier to notice than a number changing. Ask for it as a favour and keep it small and specific, because a vague request to be…