Practices

You may not get to be a calmer person any time soon. What can change quickly is what you do in the twenty minutes after you lose your temper, and that is the part people remember.

Reactivity shifts slowly if at all, while repair is a skill you could be noticeably better at by next week. Go back sooner than feels comfortable.…

Tell your partner, on a good day, that the things you say at full volume are not a fair record of what you think. Not as an excuse. As information about how you work.

It changes what lands. If they know in advance that the heat is real but the words are unreliable, they can wait for the version that arrives twenty…

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,…

Sitting in a room with other people who lose their keys, cry at nothing and hate themselves for both does something no explanation can. You find out you were never the only one.

Groups also do encouragement better than a therapist can. When someone with the same trouble asks whether you managed the homework, it does not land…

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…

When someone says they feel restless inside, ask what the restlessness wants. Restless to move, or restless to do one particular thing until it feels right?

The two feel similar from the inside and point in different directions. With ADHD it is usually undirected: the legs go, the chair is wrong, you need…

A distracted person can be brought back with a nudge. Someone who has gone elsewhere cannot, and the difference shows itself in a couple of seconds.

Say their name, ask something simple, and watch what returns. Attention that has drifted comes back with a small apology and picks the thread up…

Try not to ask why. If the person knew why, they would probably have sorted it out already, and the question tends to land like an accusation.

Ask what happened just before instead. What was going on, what they felt, what came after, what sort of day it had been. Those answers can be worked…

If someone was adopted, or simply does not know their family history, say early and plainly that this is not a problem. It helps to have and it is not needed.

Otherwise the question lands as one more reminder of what is missing, and some people will spend the rest of the appointment feeling they brought the…

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…

While you are taking the family history, ask about seizure disorders and psychosis too, not only about attention. A family carrying other neurological or psychiatric conditions is worth knowing about whatever you end up concluding.

Keep the list short and ask it plainly: epilepsy, psychosis, learning difficulties, head injuries, anything neurological. Some of it will matter for…

Hypervigilance after trauma and ADHD scanning look much alike from outside. Often the honest answer is that both are present, and the real question is how much of each.

Watching that comes from threat is aimed at something and tends to switch on in particular situations. ADHD distraction is not fussy about where it…

Damage to the front of the brain can produce something that looks a great deal like ADHD: poor impulse control, blunted judgement, a person their family says has changed.

The nineteenth century railway worker who survived an iron rod through the frontal lobes is the standard illustration, and what altered in him was…

Not every bout of eating too much belongs to an eating disorder. Ask whether how the body looks is part of it, because that is where the two paths separate.

When bingeing comes out of ADHD it is often boredom, or the food simply being there with nothing stepping in to stop it, and the person is not…

When you need a date, hand people events rather than months. Was that before or after the holiday? Same year as the move?

Asking whether something happened between October and January invites a guess. Asking whether it was before or after a wedding, a house move or a…

Ask for a number first, then go hunting for exceptions. How is today on a scale of one to ten, and when was it last higher than that?

An assessment can turn into an hour of everything that is wrong, which leaves a person flatter than when they arrived. Exception questions do the…