Practices

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…

There is a route the calming nerve takes through you: eyes, then jaw and mouth, then throat and neck, then shoulders and chest, then belly. You can visit each stop in turn and simply notice what is there.

Give every area a moment before you move on. Soften around the eyes, let the jaw hang, sigh the throat loose, feel the chest lift, then rest a hand…

Talking is not the only door in. Exercise, massage, acupressure, yoga, tai chi and the rest go at the body first and let the mind follow, which is the opposite direction from most therapy.

That is why they sit well beside talking work rather than competing with it. If words keep circling the same ground, changing what your body is doing…

Body based approaches have been linked with better physical and mental health, easier relationships, and in some settings lower use of painkillers and psychiatric medication.

That last one tends to interest the people holding the budget, so it is worth knowing if you are trying to get this kind of work taken seriously…

Take a few photographs of your bedroom, then look at them later and circle whatever has to change or go. Seeing the room in a picture shows you things you stopped noticing years ago while standing in it.

The list is usually short and dull: the light on a charger, the pile of unfinished things on the chair, the television, the clock you keep checking.…

Two ideas will let you judge most claims for yourself. In a good trial nobody involved knows who got the real treatment, and a study of five people can be swung by one of them having a good month.

Researchers want their treatment to work, and that hope leaks into how they rate what they see, which is why the person handing out the pill and the…

Programmes built on crossing the midline or on balance and inner ear work do not appear to beat ordinary exercise. If movement is what you are after, movement is available free.

These packages come with a theory about why they work, and the theory is usually where the confidence comes from rather than from the results. What…

Massage may well leave you calmer, and calmer is worth having. It is not a treatment for ADHD, and the two are worth keeping in separate boxes.

Living with ADHD is stressful in a measurable way, so anything that genuinely lowers that load is doing real good and deserves a place. The error is…

Do not write off simply sitting with someone. When researchers looked into why dummy treatments helped, one of the things they kept finding was half an hour of a person's full attention.

Thirty minutes of someone listening properly to your difficulties is not filler around the real treatment. Across the talking therapies, who the…

A ramp does nothing for someone's legs, and it gets them into the building. Timers, visible clocks, a shorter task list and a calendar somebody else keeps do the same job here.

Accommodations are not treatment and they are not pretending to be. What they do is take the parts of the work that live inside a person's head,…

One social approach does have a real evidence base behind it, and what makes it different is who delivers it. Parents do the coaching, in the middle of actual play with actual friends.

In practice it looks small and ordinary. You set up a play date, you stay within earshot, you give a nudge before things tip over, and afterwards you…

Coaching for adult ADHD comes down mostly to one thing: a standing appointment with somebody who will ask how it went. That sounds thin until you have tried keeping a plan alive entirely on your own.

A coach is not a therapist and does not need to be. They hold the horizon you keep losing and the fortnight that has quietly gone by, and they make…

Mindfulness for adult ADHD is promising and thinly researched at the same time. If it helps you, that is worth having. It is simply not yet in the same bracket as medication or practical therapy.

There are only a handful of studies, mostly small, and few of them set mindfulness against another active treatment rather than against not much.…

A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.

Optimising is unglamorous and often the quickest thing available. Was the dose ever adjusted upwards, and on what basis. Does the cover reach the…

If the prescriber, coach or therapist is not delivering much, say so and ask for someone else. Working around poor care quietly is the thing that convinces a couple this is simply as good as it gets.

A dose never revisited, or a therapist who has never worked with ADHD, sets a low ceiling. The trouble is that the ceiling gets read as the person:…

Sleep, food and movement will not cure anything, but they lengthen the fuse. Bad moments still arrive, and you handle them differently when your body is not already running on empty.

This matters more here than it sounds, because ADHD tends to wreck exactly these three and then the wreckage feeds back into the flare ups. Late…

When something feels unbearable to risk, follow it downwards. If that did happen, what would it mean, and what would happen after that?

Keep asking gently, and stop when you reach something that is a statement about the person rather than about the situation, such as it would prove I…

One psychiatrist took up a dance class in lockdown, three times a week, at something he was frankly not good at. Being bad at it was the reason it kept working.

A repetitive session on a machine asks very little of you once your body knows it. Something with steps to follow, in time with other people, keeps…