Help or Hindrance?
On the back of World Continence Week from the 21st to the 27th of June we have seen a massive campaign on social media to bring awareness about issues regarding continence. Be it the maintenance of continence, the causes and treatments of incontinence, or even the campaign for the provision of bins in male toilets.The campaign has been fantastic in the promotion of the awareness of many pelvic health concerns.
However, one of the phrases I kept seeing crop up last week is “common but not normal”. This phrase was first brought to my attention back in 2019 on a course with Antony Lo. It was the first time I heard someone express their sentiments about being classified as “not normal”- and they weren’t positive. Since then it has really gotten me thinking. What do people mean when they say this? And, importantly, how do people feel when they hear it?
First and foremost, what do we actually mean when we say “common but not normal”?
Does placing an individual into a metaphorical box of “not normal” help or hinder? What do we even mean by normal? What is normal for the individual in front of us? What is their background, their medical history, their context? Humans are natural and organic and will express differences to each and every other individual in the world, be it from nature or nurture.
What if normal was a spectrum, and we each had our own range, our own limits of normal? What if that range varied based on the context of what was happening in our life? What if that “normal” varied based on the time of your menstrual cycle? Might these differences still be classed as “normal”? What would that mean for our classification of “common but not normal”? When we talk about normal, should we be talking about the norm based on what society has told us we “should” experience, or what is normal for the individual? Who am I, as a physiotherapist, to judge what your “normal” even is.
What is our intention when using the phrase and are we actually achieving it? If the intention is to provide hope, have we achieved that? If the intention is to urge someone to seek help? Have we achieved that? If someone thinks they are an outlier and abnormal, are they then going to express their concerns with their healthcare provider? Or are they more likely to sit with it longer, hoping eventually they might become “normal” again. Is our language augmenting their feelings of isolation and ostracisation; feelings that are already potentially quite high given the stigma and taboo associated with incontinence.
What if we rephrased it to “common, but something that can be helped” or maybe “common but does not have to be endured”. Not as catchy, but more helpful? Maybe? How else can we use our language to encourage people to seek the help available to them without compartmentalising them into a category of normal or not? We need to encourage both men and women with incontinence to talk. To seek help. There is help available to you should you need it. And I strive to create a space where people can discuss these symptoms and concerns with no judgement, in a safe environment.
And what of the people hearing this about their bodies. To be told you don’t fit in and that what you are experiencing isn’t normal. Maybe it is something you have experienced before. Does not being normal suggest you have done something wrong? Does it suggest you should feel shame or guilt for not conforming to societal norms?
Do you even need to strive for normality? What is normal to you and your own body? Are your symptoms of incontinence new, are they bothersome, are they something you would like help with? If so, are you aware of the services that can help you? What if the symptoms are not bothersome, and they do not impact your quality of life? What if you are already aware of the help available to you, but it is not something you feel you need help with, what then? To me, that does not define you as normal or not? Ensuring you have the autonomy to decide what happens with your body, to decide what feels normal or not to you, is important to me.
We want to promote pelvic health physiotherapy to improve the quality of life of the people suffering from such symptoms as leaking. But what if our language isn’t encouraging, but instead instilling fear and stigma? Pelvic health concerns are so often associated with feelings of shame, embarrassment and sometimes even guilt. What is our language doing to impact these feelings? People don’t remember what you said, or what you did, but they do remember how you made them feel.
How can we promote a healthy lifestyle, healthy habits and good pelvic health without demonising variations in individuals? How can we use our language to let people know there is help available should they want it. But also leave a positive S.C.A.R ensuring people know that they are Strong, Capable, Adaptable and Resilient despite what symptoms they might be currently enduring; help them to see that this might not be forever, just for now?
If you are someone suffering from leaking, be it from the bowel or the bladder, be you male or female, know that there is help available should you want or need it. I strive to create a safe space for people to talk about these concerns without judgement
Know that there is hope.
And know, importantly, that you are not alone!Leave a reply