Practices

Put something small at stake and you turn up more. Groups that charge a token amount get better attendance than free ones, and the same trick works on yourself.

It does not have to be money. Book the class you would have to cancel a day ahead, tell a friend you will meet them there, pay the small deposit. The…

If cognitive behavioural therapy is the approach you keep being offered for ADHD, part of the reason is that it is easy to measure. It has good evidence behind it, and being the most studied is not the same as being the only thing that helps.

Structured, session by session approaches produce tidy numbers, so they get trialled more often and written up more often. That leaves quieter…

The change mostly happens between the sessions rather than in them. Catching a thought where it actually turns up, at the kitchen table or in the car park, is what makes a new one stick.

Make it small enough to survive a bad week. One thought written down as it came, and one line underneath saying what else might be true. If you have…

You are allowed more than one feeling about the same thing. Relief and grief when someone dies. Love for a job you would walk out of today. Neither one cancels the other.

A lot of the distress is not the feelings themselves but the argument over which one is the real one. Try saying both plainly, out loud: I am…

What you expect from a treatment shapes what you get from it. That is worth a conversation before you start, not months later when it has not worked.

If you are beginning something new and half of you thinks it is nonsense, say so. A doubt that stays unspoken tends to come out as a missed…

If rating a feeling out of ten means nothing to you, use something that does. Colour in bubbles, point at a picture, hold your hands apart to show how big it is today.

This began as an adaptation for children, swapping the numbered anxiety ladder for bubbles to colour in, and it is just as useful for anyone who goes…

Nobody tolerates something unpleasant for no reason. Before starting anything difficult, get clear about what you want on the other side of it, in your own words.

Something like: I want to sit an exam without being sick, so I am willing to practise feeling uncomfortable. The sentence has to be yours. A goal…

Setting out to get rid of worry altogether sets you up to fail twice, first at the worry and then at the failing. A kinder aim is to change how you sit with it.

Anxiety and ADHD keep close company, and for most people some background hum does not go away. What can change is what happens next: whether you…

When your child comes to you in a spin, the kind thing is to stay warm and steady rather than to promise that it will be fine. Reassurance settles the next ten minutes and feeds the asking.

It sounds cold and it is not. What your steadiness says is two things at once: this feeling is real, and I think you can carry it. Keep it short and…

If your only system for remembering things is your head, of course you are anxious. Nothing is safe in there and some part of you knows it.

Some people hold everything mentally because letting go of it feels like the thing will stop existing. The answer is not trying harder to remember.…

Some of what you believe about yourself is not a distortion. Things really did go wrong, often for years. What can be argued with is the conclusion you drew from them, that this is simply what you are.

Try separating the record from the verdict. The record might be missed deadlines, jobs that ended badly, friendships that faded. The verdict is 'so I…

A reward that is far off has almost no weight in ADHD. Tying the task to something you actually care about gives you a reason that does not depend on the payoff arriving soon.

So instead of 'I should file these', try 'I want to be someone my family can rely on, and this is part of that'. The other half of this approach is…

Worry does two things at once. It makes the problem bigger than it is and it makes you smaller than you are. The second half is the one that usually goes unchallenged.

After years of being told you get things wrong, a low estimate of yourself does not feel like a distortion, it feels like the evidence. So argue with…

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.…

When someone has gone flat, the question is not what they ought to be doing. It is what still has any life in it for them, however small or unimpressive, and then how to get more of that.

Activities handed out from the outside do not lift much. Someone who brightens talking about their car, or a cousin, or a game has just given you the…

If you run a group for people with ADHD, keep it to about five or six, or bring in a second facilitator. Past that you spend the session keeping order instead of doing the work.

The limit is not really about behaviour. It is about how many people one person can genuinely track while also holding the thread of the session.…

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…

Try not to talk the worry through in detail, even with someone kind. Going over the specifics feels like sorting it out, and it is closer to watering it.

Mental review and asking for reassurance are the same move in different clothes. Both give a short drop in distress and a stronger pull next time.…

When the words for feelings are not there, ask for a number instead. How much did the handwashing take over this week, one to ten, is a question someone can answer on a bad day.

A number asks far less of a person than a description, which matters when putting feelings into language is hard for them, and you still end up with…

Agree a short phrase to use at home. Saying I am having OCD worries tells a parent what is going on without handing them the worry to solve.

Once a parent hears the details they will nearly always try to help by answering, and answering is the thing that feeds it. A label gives them…