Practices

There is a difference between being disappointed with how things are and having given up on how things will be. The second needs a different level of care.

Disappointment still has a future attached to it: this is bad, and later might not be. Hopelessness has closed that off. If you hear someone move…

The worst symptom is not always the one that costs the most. Ask what actually stops you doing things, and start there.

Someone might rate their racing thoughts as the worst of it and still be turning down every meeting because they go red in the face. If you are…

When someone is genuinely distressed by what happens on their phone, treat it as a reading of their anxiety rather than as a complaint about screen time.

For a lot of people, younger ones especially, the phone is where most of the social risk now lives: being left out, compared, watched, judged.…

Listen to the tone, not only the content. Sorrow and flat negativity about someone's online world can be the clearest reading of their mood you will get.

If most of a person's social life happens online, how they talk about it is a fair guide to how they are. Weariness, bleakness, no pleasure left in…

When a young person seems impossible to satisfy, the complaining is usually a symptom rather than ingratitude. Saying that plainly to a parent changes what they feel.

Parents worn down by years of grumbling often arrive carrying a resentment they are ashamed of. Naming the negativity as part of an illness gives…

Treat the whole of social media as poison and you will never hear anything true about it again. Some of what happens there is genuinely good for people.

Drawing, making things, finding others who share an unusual interest, keeping up with people who live far away: none of that needs fixing. What…

Parents see an adult sized person and assume adult sized judgement. It helps to say out loud that the wiring is still being finished well past eighteen.

The look of the young person is doing the arguing, and it is very persuasive, so only a plain statement will counter it. Say that the parts used for…

Once the surge is up it takes something like a quarter of an hour to drop, and nothing sensible said inside that window will land. Give it the time first.

This is the point where a parent, a partner or a friend reaches for reasons, and the reasons make it worse. Keep your words few, stay nearby, offer…

Pulling away from people sits upstream of a good deal: low mood, social fear, and the slow shrinking of where someone is willing to go. Whatever the eventual label, getting a person back into contact is rarely wasted work.

You do not need the diagnosis settled before you start. One regular arrangement with one person, at a fixed time, somewhere easy to reach, does work…

When you assess a young person, take a reading of the adults as well: what they understand about the world their child lives in, and how comfortable they are in it.

A good deal of what arrives as the presenting problem is really a mismatch. A parent reads something ordinary as alarming, or something serious as…