Practices

Supplements are regulated as food rather than as medicine. Nobody checks strength or purity before a product goes on sale, and the main rule is that the packet cannot claim to treat a disease.

Most people assume the opposite, that anything on a pharmacy shelf has been through some kind of approval. Regulators here generally act only once a…

When researchers ran DNA testing on 13 herbal products, only 2 contained the plant on the label. Three had none of it at all, and several were padded out with rice, soy or wheat that nobody had declared.

The obvious problem is paying for something you did not get. The quieter problem is the undeclared filler, which matters a great deal if you avoid…

If you are going to buy supplements, look for an independent verification mark: USP Verified, NSF, or a product tested by ConsumerLab. It is the nearest thing available to the check that regulators do not carry out.

Those schemes test identity, strength, purity and how a product was made, and manufacturers pay to take part voluntarily. There are different tiers,…

St John's wort can cut the effectiveness of the contraceptive pill by around a third. If you take both, that is worth knowing today rather than finding out later.

It speeds up the way the liver clears certain drugs, so the pill is not the only thing affected. Warfarin, some HIV medicines, ciclosporin and a…

Some of these do have real evidence behind them. St John's wort has repeated support in mild to moderate depression, SAMe and methylfolate have reasonable backing as additions to treatment, and omega-3 has looked weaker in the larger and better run trials.

That last part is worth sitting with, because it is what usually happens. An early promising effect shrinks as trials get bigger and better…

If you want to use herbal remedies, two things carry most of the risk. Make sure whoever prescribes for you knows what you are taking, and buy from a source that has been independently tested.

That is a short list on purpose. Nearly all the harm in this area comes from an interaction nobody knew about or a product that was not what it…

Water, sleep, food and digestion are not the boring preamble to the real work. When those are running badly, everything else you try has less to work with.

It can feel almost insulting to be asked about breakfast when what you carry is so much bigger than breakfast. But a body short of sleep and short of…

Change the question you ask yourself. Not how badly do I want to stay calm, but what have I actually practised for the moment it starts.

Wanting is not a plan. Decide in advance the words you will use, the room you will step into, the person you will ring afterwards. Rehearsed things…

Behind calm that looks superhuman there are usually decades of dull practice. The practice is the part worth copying, not the headline.

Setting your worst moment against somebody else's lifetime of training only produces despair. Ask instead what that person did on an ordinary…

Stoics, Cynics, Buddhist teachers and your own grandmother were all working on the same problem: how to stay steady when life leans on you. You are allowed to use the version that is already yours.

You do not have to import somebody else's whole worldview to get a practice of steadiness. If sitting with a breath count feels foreign, a…

Have three or four openers ready before you need them. For what it is worth. Can I run something by you. You might not like this, so give me the benefit of the doubt.

When you are stirred up you will not compose diplomatic language on the spot, so the phrases have to be picked in advance and worn in. Say them aloud…

The early rungs do not have to be the real thing. A photograph, a video, or picturing it carefully with your eyes shut is a proper step and not a cheat.

This matters most when the real version is out of reach: the dog you cannot summon, the flight you cannot afford, the classroom that is thirty miles…

Rather than taking on someone else's routine, ask what actually makes you feel ready for a day, or better looked after. The answers tend to be specific and slightly odd, and they hold up better than anything prescribed.

For one person it is a shower before anything else. For another it is having the bag packed the night before, or eating something warm, or ten…

Being shown a breathing technique is not the same as being able to use one. Practise it while nothing is wrong, often enough that it runs without you having to remember the order.

At the height of fear the only skills within reach are the overlearned ones. Something demonstrated once in a quiet room will not turn up in a school…

Pick one picture and keep it. Shallow end, middle, deep end. Then the child, the parents and the school are all talking about the same thing without anybody needing the clinical words.

It makes the next step obvious instead of arbitrary. You are not being sent to the deep end, you are moving a bit further along the shallow end. It…

Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about.

Ask which one they would be willing to have a go at this week, not which one they ought to be able to manage. The answer usually sits somewhere in…

Before a step, write down what you will do when the fear arrives. Which breathing, what you will say to yourself, who you will speak to. Nobody invents a plan in the moment, they only follow one.

Keep it short and specific enough to be followed while frightened. It also gives you something to go over afterwards: what you used, what you forgot,…

No step happens without the person agreeing to it. Not ordered, not dragged, not talked round in a bright voice. Agreement is a condition of the thing working, not a courtesy.

Coerced exposure teaches two lessons at once: that the situation is dangerous, and that you are not safe with the people who arranged it. After that…

Try going into the next few minutes without deciding in advance what will happen in them. Curiosity in place of prediction.

A mind used to danger plans constantly, because planning once kept you safe. Sitting somewhere ordinary and letting the next moment be unknown is…

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…