I have a method that works for me, and I find it sort of relaxing. I can only quilt down, not across, or up. Alex Anderson is a left handed quilter I think? and she can use her thumb!! I just quilt for my own pleasure and sometimes I make a quilt that I like to hand quilt. I put no pressure on myself with deadlines, etc. I try to get consistent stitches. Sometimes they are smaller, sometimes, just consistent. It does take practice, but, I don't mind it at all.