Practices

The thing your obsession keeps circling is usually something you care about a great deal. Contamination worry sits on top of wanting people safe, and harm worry sits on top of never wanting to hurt anyone.

This is worth saying out loud, because most people carry these themes as proof that something is rotten in them. Read the other way round, the theme…

What the thought is about matters far less than what happens next. Germs, illness, something too silly to say aloud: the machinery running underneath is the same in each case.

Chasing the content puts you in a game that cannot be won, because the moment one worry is settled the next turns up wearing different clothes. The…

Notice how when one worry is finally settled, another takes its place. That pattern is the thing you are actually dealing with, more than whichever worry is currently in the chair.

Most people work this out for themselves long before anyone names it. Naming it still helps, because it gives you something to watch that is bigger…

Some worries are perfectly reasonable, and settling them still will not settle you. Someone living where the storms come can build the kit, check the kit, and find the worry has quietly moved on to something else.

This one is worth testing on yourself, because it removes the argument that you would be fine if only the fear were irrational. The probability was…

Fears of doing something terrible, of hurting an animal or a person, are not treated by moving closer to the act. Nobody should be walking you up a ladder towards the thing you are terrified of doing.

These thoughts sit at the far end from wanting. They horrify you, which is exactly why they stick to you. The work goes on what you have decided the…

Plenty of people quietly believe that thinking about something bad makes it more likely to happen. It has a name, it is a known part of this condition, and having the belief does not make you dangerous.

Hearing that it is a documented feature tends to do more than any argument about probability, because arguing about odds is a game the doubt plays…

If you are stuck on whether having a thought makes you a bad person, that question is a symptom and not a case waiting to be settled. Name it as scrupulosity and let it stand unanswered.

Debating your moral standing is where this gets its fuel, and every reassurance you win, from a friend, an imam, a search at midnight, buys less time…

It can help to give the parts of your brain jobs. The front of your head is the manager, the memory system is the librarian, and the alarm is a security guard who is good at his work and far too keen on it.

The point is not accuracy, it is having language you can reach for quickly. Saying the guard is overreacting again gets you further than trying to…

If stopping the ritual is out of reach for now, do it differently every time. Different order, different hand, different room, as long as it is never the same twice.

Compulsions take a lot of their grip from exactness, and disturbing the shape loosens that grip while you are still allowed to do the thing. It also…

When obsessions start early and dig in deep, ask gently what anxiety looks like elsewhere in the family. Often there is an undiagnosed parent, and often that parent is helping in ways that keep the whole thing running.

None of this is about blame. A parent who checks the locks for their child, answers the same question fifteen times, or arranges the evening around a…

If the urge to arrange has to go somewhere, point it at something that can actually be finished. A kitchen drawer ends. A desk you keep re-sorting never does.

The ending is the part that matters. Finishing leaves you with something real to have done, which competes with the small relief that compulsive…

If this has been going on for years, medication is often part of what helps, and it usually needs a longer run at it than people expect. Starting low and building up slowly is the normal way of doing it.

The slow build is there to keep side effects bearable through the first few weeks, which is where most people quietly give up. It helps to agree with…

There is no brain scan, EEG trace or blood test that can tell you whether someone has ADHD. Anything sold as an objective biological test for it is promising more than the science can give.

Group differences do exist, including in the theta to beta balance, but a difference that appears when you average hundreds of people cannot identify…

Balance difficulties do turn up more often in ADHD, by something like half again. That is a fact about company, not about cause, and it does not turn balance training into a treatment.

Plenty of things could sit behind a link like that. More falls and knocks, more risk taken, or genetics feeding both at once. Working on balance…

Protocols that spin a child in a chair or tip them backwards and forwards to train balance do not improve ADHD. What they mainly produce is a dizzy child.

There is a cost beyond the wasted afternoons. Something unpleasant that was introduced as treatment teaches a child what treatment feels like, and…

The amount in a capsule can vary from bottle to bottle, and sometimes between capsules in the same bottle. Undeclared fillers have been found in them too.

This matters most when you are trying to work out whether something helps you. A good month followed by a flat one may be two different products…

Kava can damage the liver at a high enough dose, badly enough that some countries have banned it. Herbal is not a synonym for gentle.

The unnerving part is how quiet liver damage is. Someone self medicating anxiety with kava can be accumulating harm and feel nothing at all until it…

Vitamin C cannot really be stockpiled, since the excess leaves in your urine. A, D, E and K are stored in fat, so a large daily dose keeps adding to itself.

Vitamin D is where this bites at the moment, after a lot of people started taking big amounts on their own during the pandemic years. If you are…

Omega supplements thin the blood, so they usually do not belong alongside warfarin. Bruising easily is often the first thing anyone notices.

One clinician worked out that her husband's bruising came from taking omegas on top of his Coumadin, and it settled once his doctor told him to stop.…

If fish oil gives you those horrible repeats all afternoon, that is a fixable problem rather than a reason to stop. Keep the capsules in the freezer, ask about an enteric coated version, or try a flavoured liquid.

Sticking with something usually fails for small unglamorous reasons like this. Someone with a sensitive palate will not last four weeks with an…