Practices

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.…

Run it in your head first, then act it out with someone safe, then do it for real. It is a preseason, and nobody thinks the preseason is cheating.

Each round adds a little pressure while help is still to hand. Imagining it stirs the fear enough to show whether your plan holds up. Acting it out…

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.…

One sign that the heat has come off a little: you can hold I am furious with you and you probably did not mean it in the same moment, without dropping either one.

In the middle of an argument that second thought is simply not available, and its absence is not a failure of character. It comes back as the arousal…

Some people are done with an argument in ten minutes. If the person you live with needs three hours, your quick recovery can look to them like proof that you never cared.

Say the mismatch out loud when things are calm, so that it is understood before the next row rather than argued about during it. If you are the fast…

Saying I need a break only works if you have agreed beforehand what a break means. How long it lasts, what the other person does meanwhile, and when the two of you come back to it.

Settle it on a calm evening. Twenty minutes, no following, no messages in between, and we sit back down at nine. Then keep the return time exactly,…

If someone close to you has become the person who chases you, that arrangement is wearing you both down, even on the days it works. It is worth naming out loud and changing on purpose.

Once a partner or a manager supplies all the pressure, nothing inside you ever needs to. They end up tired and resentful, you end up handled like a…

Before treating something as your failure to get going, check whether you ever agreed it was yours. A job that bothers one person and genuinely does not bother the other has not been agreed by anybody.

That turns a stuck task back into a conversation, which is where it belongs. Say plainly that the unpainted wall does not trouble you, ask what it…

Ask about food two generations back. What the parents were like about it, what the grandparents were like, what the rules were at the table.

Much of how a person eats was learned long before anybody mentioned a diagnosis, and a fair amount of the shame around it was learned in the same…

The scales worth using are the ones that ask about situations rather than symptoms alone. Home, school, work, and what actually happens in each.

A questionnaire counting how often somebody loses their keys will label half the population. What a diagnosis needs is evidence that the difficulty…

Executive function scales ask how the week actually went. That is often more use than an afternoon of testing in a quiet room.

Office testing happens in the best conditions a person will ever meet: no interruptions, someone sitting with them, a clear finish line in sight.…

Ask about the family properly: parents, brothers and sisters, children, then aunts, uncles and grandparents. Include drinking and drug use, in them as well as in the person sitting with you.

This tends to be the highest yield few minutes of an assessment, because the condition runs strongly in families. Relatives who were never assessed…

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…

The family history is not the warm up before the real assessment. Give it proper time and it will often tell you more than any single rating scale in the folder.

Walk through the family rather than asking one summary question about it. Who struggled at school, who could never sit through a meal, who changed…

If someone is about to send off a saliva kit to fill in the family history they never had, have a conversation first. These tests hand back more than health information, and they hand it back with nobody in the room.

A father who is not the father, a sibling nobody mentioned, a donor conception no one planned to explain: these arrive by email on an ordinary…

'I am disorganised' cannot be treated. 'The post piles up on the hall table until something ends up with a debt collector' can. Spend the time getting the problem down to something that specific.

Push for the particulars: which task, which moment, what was happening just before, what they did instead. Where you can, ask someone who was there…

Run the assessment yourself and watch while they work. Under real effort you will see the small movements, the tics and the overflow that never appear in ordinary conversation, and none of it reaches you if a technician or an app does the testing.

Sit where you can see hands and face. Note what happens as the task gets harder: the tongue that comes out, the leg that starts going, the free hand…

If your child is learning to settle, learn it alongside them rather than supervising. Parents who practise report less stress of their own and less flying off the handle.

Attention difficulties run in families, so the adult in the room is often working with much the same wiring at the end of a longer day. Practising…

When something is genuinely alive for the person in front of you, work with that. Whatever you had planned to cover keeps until a quieter week.

Teaching over the top of live feeling does not land, and it tells the other person that your agenda outranks their week. When there is heat, follow…

Phonological awareness is not one skill. Telling sounds apart, rhyming, breaking a word into its sounds and blending them back are separate jobs, and a child can be fine at one and stuck at another.

Before agreeing that a child needs phonics, find out which piece is missing. Ask them to say the sounds in cat, then to join up sounds you give them,…