Practices

Ask it plainly. Do you think you are a threat to anyone you love? A vague anger problem turns into something workable the moment it has a name attached to it.

Then keep going, because the follow up questions carry most of the weight. Has there been any thought of killing someone, or of dying. What is in the…

Hurting yourself is not always about coping. Sometimes it is aimed at somebody else, and until you know which it is you cannot know what would help.

This is uncomfortable to ask about and it is not an accusation. An act can be a way through an unbearable hour, or a message to someone who has…

See what you made me do to myself. When self-harm is carrying a message like that, naming the message is not dismissing it, it is looking for the thing that could be said instead.

The question can be asked kindly and straight. Do you ever get angry enough with them to want to hurt yourself so that they feel it. People often say…

An act meant to be heard rather than to end a life can still end one. Whatever you believe about the intent, lethality is a separate question and it always gets asked.

The ways this happens are ordinary and awful. A method more dangerous than the person realised. The friend who was meant to arrive, arriving late. A…

When somebody's anger is filling the room, the bravest sentence available is usually the plainest one: you are frightening me right now.

It gives them a piece of information they almost never have, which is what they are actually doing to the person in front of them. It also puts…

Physically taking a refusing child should be rare, and only with a young child, two adults at home, two staff waiting at school, and a plan for keeping everybody safe.

It goes wrong easily. Someone gets hurt, a younger sibling watches it happen, and a child learns that the adults will use force, which is not a…

Sometimes the help you need is not insight. It is someone sitting with you while you sort out what actually happened this week and which bit of it mattered.

When anxiety is running at full speed, everything arrives at the same volume and nothing can be ranked. A bad week becomes one undifferentiated bad…

If most of the difficulty is happening at home, most of the work needs to happen with the household in the room. Otherwise the hour of good conversation gets quietly undone by Tuesday.

In a settled stretch, seeing the young person on their own with occasional family time is fine. In a crisis, turn it round: everyone together,…

When you are trying to reach a feeling, stay with the actual sentence that caused it rather than paraphrasing it into something milder.

She said you are too difficult. Said again, gently, it keeps the moment alive in the room instead of turning it into a memory being reported.…

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…

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…

Instead of stopping the worry, follow it all the way to the end. And then what happens. And then what. At each step, ask whether you could bear that.

Most catastrophes stop being catastrophes somewhere along the chain, and the place where you say no, I could not bear that, is the useful discovery.…

When someone says their heart races on their medication, ask whether it ever did before they started. It is the cheapest question you have and it usually sorts the answer out.

Go looking for the old settings: waiting to be called on in class, standing outside a room before a difficult conversation, three in the morning with…

Expect more anxiety, low mood, drinking and drug use in the young people coming through now. And expect the boys to say less about it, so go looking for irritability, trouble and substances instead of waiting to be told.

Ask parents what they are seeing rather than only what they have been told, and ask the young person directly and privately. Screening that rests on…

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…

Rolling or throwing a ball back and forth with someone is more useful than it looks when one of you has gone blank. It gives the body a job and the two of you a rhythm at the same time.

It works over a video call as well: ask them to fetch a ball from another room and bounce it while you talk. Say what you are doing and why, so it…

When someone tells you they have been hurting themselves, keep your face steady and stay curious. Alarm closes the conversation, and you need it open.

A visible flinch teaches the person that this is not something you can hear, and the next disclosure goes elsewhere or nowhere. It can also make the…

Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.

In practice this looks like smaller steps than a promise to stop: cutting the frequency, changing what is used, agreeing to wait ten minutes and do…

You can take someone's fear entirely seriously without walking through the frightening story with them. Say you can see how frightening it feels, and leave the plot alone.

It reads colder written down than it lands in the room. What the person needs is to feel believed. What they do not need is a second person weighing…

Run the same moment twice. The second time, change nothing except what you do with it, and let yourself not mind what the other person might be thinking.

Keeping the situation identical is the point, because then the only thing that moved was you. In a session that means the same silence and the same…