Practices

A rule that holds in your house and nowhere else is not really a rule. Children locate the unrestricted house within about a week.

So the awkward job is the useful one: a short message to the parents of the two or three friends your child spends most weekends with, agreeing…

Before sending anyone for hands on work, ask what touch has meant in their life. A massage table is a poor place to discover that touch brings something back.

The person delivering it is not there to hold what surfaces, and often has no training for it. So ask directly, ask about what parts of the body are…

If light touch makes you squirm but firm deep pressure feels wonderful, that is worth knowing about yourself. It is the same preference behind weighted blankets and a very tight hug.

Once you know it, you can arrange for it: a heavier duvet, a firm rather than gentle massage, sitting with your back against something solid,…

When a treatment is described as approved, ask what it is approved for. Magnetic brain stimulation is licensed for depression, and using it for attention problems is off label.

Off label is not the same as forbidden or useless, and it does change three things: how much evidence stands behind it for your situation, what the…

If several medications have failed, ask whether anyone else in the family had the same experience. A pattern of non response runs in some families.

It is a question that rarely gets asked and can save a year. If a parent or sibling went through the same list without success and then responded to…

The study most often quoted for magnetic stimulation in attention difficulties had eight people in it, and half of those on the dummy treatment improved too.

That dummy half is the interesting number. It tells you how much improvement can come from attention, hope and being taken seriously, before any…

The same treatment in two different clinics can go two different ways, and the difference is often the people. Kind, unhurried staff who explain things get better results.

So when you refer someone, or choose somewhere yourself, ask about that as well as the equipment. Do they remember your name, do they answer…

Telling someone what a treatment will actually be like improves how they respond to it. What it feels like, how long, what is normal afterwards.

Uncertainty makes everything sharper, so filling it in with plain description takes some of the edge off before anything starts. Do not oversell it…

Lead with what has evidence behind it. Save the thinly supported options for when the person brings them up themselves.

Mentioning something is a form of recommending it, whatever hedges you attach, and families will spend money and hope accordingly. If they raise it,…

If something is safe, affordable and it helps you, the fact that the effect may be mostly expectation is not a reason to stop.

The test worth applying is practical: is it safe, can I afford it, is it taking the place of something that works better, and would that money and…

Regular massage has been studied with restless, distractible children and teenagers, and their teachers noticed the difference in class as well as the young people noticing it in themselves.

The pattern in these studies is modest and repeated: short sessions, twice a week, over several weeks, with mood and behaviour improving rather than…

Aching shoulders and a bad back are not separate from finding it hard to concentrate. Pain takes up room in your head, and there is less left for anything else.

People who are restless tend to hold more tension and pick up more injuries, and then the pain makes the focus worse, and round it goes. So it is…

In placebo studies, people improve even when they have been told outright that the pill is inert. They also usually spend half an hour talking with someone who is paying attention.

That half hour is easy to dismiss as a detail of the study design, and it may be most of the treatment. Which is oddly encouraging: careful listening…

Reviews do not support acupuncture as a treatment for attention difficulties. Some studies of acupuncture alongside counselling have done better than dummy needling alongside counselling, which is a more modest claim than it first sounds.

The likeliest reading is that a warm, unhurried practitioner who examines you carefully is doing much of the work. Needles are very fine and harm is…

People who are sure they could never lie still for an hour tend to be asleep within ten minutes of getting on the table. Being unable to fidget seems to do it.

Worth saying in advance to anyone who is putting off booking. It is the same effect as a car journey knocking out a child who has not stopped moving…

The chapter a diagnosis sits in was decided by a committee, and the medicines did not rearrange themselves to match. When you are thinking about treatment, it helps to look past the name on the file to what the person is actually carrying.

Anxiety used to sit in one place in the manual and now sits in three, with trauma conditions and obsessive ones given rooms of their own. That…

If something helped one part of your anxiety and did nothing for the rest, that is not proof it failed or that you are beyond help. Different parts of this run on different machinery.

The sudden bodily kind and the grinding thinking kind are handled by different systems, and a treatment that reaches one may have very little to grip…

Nothing you take can act on something that is not there to be acted on. It is a plain limit, and it explains a good deal of the disappointment people carry about treatment.

A medicine travels everywhere in the body and only does something where there is something for it to work through. So the question is not whether a…

Something that settles a surge of panic within minutes and something that changes how often the surges come are doing two different jobs. A person can need both, and it helps to say which is which.

The fast option is a rescue. It works quickly, it is meant for the worst moments, and its usefulness is measured in that hour. The slower option is…

Sedatives are good at damping the body down and much less good at quieting a mind that keeps going round. If the trouble is chronic worry, being made drowsy is not the same as being helped.

This is one of the commonest mismatches there is: something sedating given for grinding worry, leaving a person tired, foggy and still worrying.…