Practices

Distant health warnings move almost nobody. The cost that lands is the one showing up this month: your memory, your marks, the work you know you could be doing.

So keep it specific and keep it near. Heavy drinking in the teens and early twenties shows up in memory and in school work, which is the exact ground…

What you tried at that age is a poor guide to what is in front of your child now. Cannabis today is far stronger than the same word used to mean.

The sentence that closes most of these conversations is I turned out fine. Try a different one: ask what it does for them, when they reach for it,…

Nicotine looks like the small problem next to everything else going on, and it is the one most likely to still be here in thirty years.

Most adults who smoke started as teenagers, and the earlier the start the harder the eventual stopping tends to be. So it earns a place on the list…

If a young person is using regularly, waiting to see whether they grow out of it is a gamble. Help early is nearly always cheaper than help later.

Families often hold off because raising it feels like an accusation. You can raise it without one: say what you have noticed, say you are not going…

Point at the body. 'Your hands went up just then', or 'you put your head in your hands', gives a feeling something solid to stand on.

Feelings argued about in the abstract go round and round. A gesture you both just watched is much harder to dispute, and it opens a door: what was…

When someone goes quiet and you can see they have gone inside, that is not your moment to help. Stay still and let the silence run.

You will feel the pull to summarise, to check they are alright, to bring the other person back in. All of it lands as an interruption. Give it a few…

When someone finally gets one true word out about how they feel, resist explaining it to them. Ask what that word is like from the inside and let them find the rest.

The temptation is to say the clever thing: of course you felt rejected, anyone would. It is often accurate and it usually ends the moment, because…

Watch for the swerve. Right after something tender gets said, along comes a story about a brother or a colleague or a thing from years ago, and the tender part quietly gets left behind.

Swerving is not dishonesty. It is what people do when a feeling gets close, and it works, which is exactly why it is so easy to follow along.…

If a conversation has wandered off and you have lost the thread, go back to the last thing that had real feeling in it, and go back using the words they used.

Not a summary of those words. The actual phrase: 'you said she has her standards and you will never meet them, and your eyes went red when you said…

You can say what an SSRI does in one sentence. It blocks the doorway that carries serotonin back out of the gap between two nerve cells, so more of it stays there for longer and is likelier to be picked up.

Worth being able to say plainly, because most people are carrying something vaguer and more frightening than that. It also sets a fair expectation.…

Serotonin syndrome comes from stacking, and the second agent is usually something nobody thought to mention: a migraine tablet, a cough medicine, a herbal remedy for low mood.

Triptans, tramadol, dextromethorphan, linezolid and St John's wort all count, as do other antidepressants. Someone who mentions in passing that they…

The standing side-effect list is sexual difficulty, less appetite, an unsettled stomach, disturbed sleep and headache. Sexual side effects are common, and almost nobody raises them unprompted.

So ask directly, and ask about sleep while you are there. People do not usually announce these things. They quietly stop taking the tablet and say…

If you know something about a person's history that the prescriber may not, say it. A past eating disorder or a single seizure can change what is safe to prescribe.

Bupropion lowers the seizure threshold, and in someone who is purging, restricting or very underweight that risk climbs meaningfully. The therapist…

You did not choose which things hurt you. Where you are tender was set long before you had any say in it, and the only live question is what you do with it now.

This is worth saying out loud between two people, because each usually thinks their own soft spot is embarrassing and the other's is obvious. Try…

Before telling someone what you have noticed about them, ask whether they want it. Do you mind if I offer something back to you? Then describe only what you saw, plainly.

Close attention is not neutral for a person who grew up being watched for a reason. Asking first turns being observed into something they agreed to,…

A calming skill handed over at the wrong moment reads as your anger is not welcome here. For someone taught as a child that their anger was unacceptable, that is the old prohibition arriving again in kinder clothes.

Let the anger be seen first. Say that it makes sense, that there is a reason for it, and only then offer anything that settles the body. The order…