Practices

The first day back is worse than the weeks before it, not better. Plan for that spike rather than letting it take you by surprise.

Anxiety climbs as the return gets close and peaks somewhere near the doorway, then it comes down, but only for someone who stays long enough to find…

If getting to the appointment frightened you, then you have already done the first hard thing. Walking in and talking to a stranger about yourself is the ladder, not the preparation for it.

Nobody watching later can see it. What they see is someone sitting there talking, and they miss the week of dread and the near cancellation. Say it…

Before you hand it over, read the original request again. Not your memory of it. The actual words.

Almost nobody enjoys this, which is why almost nobody does it. But work that is good except for the two things nobody remembered is the commonest…

When the thing is over, sit down for twenty minutes and go through it: what happened, what worked, what did not, what you will do differently. Put it in the diary, because it never happens on intention alone.

The monthly report, the school year, the audit. Write the answers where you will actually find them next time, and be specific about the point it…

Your body gets up in the morning and your mind often does not. Half a day can go by in a sort of waking dream, and whatever meets you in it gets the sleepwalker's answer.

So make waking the moment you decide something, before the day has handed you anything to react to. Thirty seconds on the edge of the bed will do:…

Take ten quiet minutes to decompress before you walk in the door.

Arriving already softened means the day's stress is not spent on the person you love.

If telling your doctor or midwife what you are using feels impossible, you can ask someone you already trust to pass it on for you, with your permission and in your words.

People often stay quiet with the very clinician who could help, because saying it out loud feels heavier than the problem does. Handing the message…

Before someone has said a word, you have often already decided what they are: only here because they were made to come, not really interested, wasting your time. That decision changes how the meeting goes.

The person sent by a court, or pushed into the room by a partner or a manager, walks in already read. Try starting the hour with nothing written: no…

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…

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…

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…

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…

Do not walk into a hard event and improvise. Ten minutes beforehand, work out what is likely to happen, what you will do about it, and how you get out if you need to.

If someone is coming with you, make it a shared plan. What the signal is when one of you needs air, who says what to whom, when you leave. The point…

When you cannot skip it, shorten it. Come for the meal and skip the drinks afterwards. Two hours of you at your best is worth more to everyone than five hours ending badly.

Decide the leaving time before you arrive and say it out loud on the way in, so that it is a plan rather than a walkout. Booking something afterwards…

If you are being assessed for attention, say something about your mood and your worry as well, even if nobody asks.

Anxiety and low mood sit alongside ADHD often enough that a thorough assessment will go looking for them anyway. But shame is quiet, and years of…