PhysioUpdate Q&A: Elaine Miller, a physio who uses humour to break down taboos on continence issues
In an exclusive PhysioUpdate Q&A, pelvic health physio Elaine Miller – who describes herself as a Fellow of the Chartered Society of Physiotherapy, an award-winning comedian and a recovered incontinent – answers questions posed by editor Ian A McMillan. Elaine is unapologetic if her no-holds-barred approach means she can successfully reach a new audience – even if she has ruffled a few feathers among her fellow professionals in the past.
Are physiotherapy and humour compatible?
Humour has long since been used in health. If you work in paediatrics or had a child in hospital, you’ll know the value of the Clown Doctors. Dr Patch Adams has been using clowning to huge effect since the 1970s and patient groups develop ‘in jokes’ that identify their ‘tribe’ and provide mutual support.
Dr Sophie Scott’s research showed that humour is a short cut for building bonds, and I think that’s especially true for therapeutic relationships. People who are funny instinctively know it works in some situations and not in others. I’ve seen physios use very dark humour to great effect – it’s a tool that can put patients at ease, motivate them or lift their mood.
It's fair to say that some of my professional peers were uncomfortable with my approach at first – something I didn’t mind as they weren’t my audience. I wanted to engage the 75 per cent of women who don’t seek help for their incontinence, and my colleagues already knew what physiotherapy could do for these women! Once they saw the show they understood and, thankfully, even laughed!
What advice would you give colleagues thinking of breaking stereotypes to reach a different audience?
You know your patient population backwards, so you know how to reach them, and that might not be through clinic. A caring profession should be thinking about how to get hold of the people who don’t realise we can help them, so, if you’ve got an idea that would work for outreach – try it, they need you!
Live comedy isn’t popular enough to change societal taboos, but everyone in the UK goes to the pantomime. So, I’m writing ‘Leaking Beauty', which I hope to take to geographically remote, culturally diverse and economically deprived communities [Elaine Miller]
What is a typical day at the moment?
Like everyone else, lockdown threw everything in the air. I was supposed to be touring the show and gathering data on whether it encourages help-seeking.
Live comedy isn’t popular enough to change the societal taboos surrounding pelvic health, but everyone in the UK goes to the pantomime. So, I’m writing ‘Leaking Beauty', which I hope to take to the geographically remote, culturally diverse and economically deprived communities which are pretty much missing from the data.
I am going to aim to do an ICIQ [International Consultation on Incontinence Questionnaire] on the audiences to look at prevalence and deliver evidence-based information in a bonkers way.
I’m having a lot of fun writing it and a lot less fun working on the grant application. I help with Pelvic Roar, do some consultancy, and have got the hang of teaching and speaking on Zoom.
Tell us about your recent activities in Australia
I was in Australia in February for the world’s best-timed Fringe – I left on the day of Brexit, landed as they got the bush fires under control and got home just before lockdown. My show Gusset Grippers won the Comedy Award – which is a big deal in the arts. Part of the prize is a fancy tour.
If the worst thing that happens to you in a pandemic is that you can’t go on a jolly round Australia then you don’t have any cause for complaint, but, still, I was gutted! Australia is a world leader in pelvic health, and I met with many organisations and clinicians when I was there. It was a wonderful experience: they are so giving of their time and knowledge.
I collaborated on a literature review with Monash University in Melbourne looking at humour as a health promotion tool. We have submitted revisions and hope it will be published. We found that if the person thinks the message is funny it can help retention and influence behaviour. If they don’t, it’s counterproductive. This is the first rule of comedy: ‘know your audience’! They are doing some very interesting work in perinatal health, and, fingers crossed, it won’t be long before I can get back for the next stage of their project.
World Continence Week runs from 21 to 27 July. How can physios get involved?
Join Pelvic Roar on Facebook, where we will be running social media and events. Have a look at what the World Federation of Incontinent Patients (@WFIP) and the International Continence Society (@ICS) are doing on Twitter. Tell your patients and colleagues that it is World Continence Week and they shouldn’t put up with their leaking! For more information, visit: https://www.pelvicroar.org and https://wfipp.org
You are lucky enough to be based in Edinburgh. Are you performing in the Fringe this year?
Yes, I’ve stayed in Edinburgh for a long time now. The Fringe is going ahead but the arts has been hit hard by lockdown. I’m hoping to do a run in the comedy club, but restrictions might be tricky. There are a number of vulva-shaped sites in the city centre, so maybe a pelvic health walking tour for this year?
Elaine Miller is currently on secondment from clinic and working on research, her book, podcast and pantomime.
For more information, visit: https://www.gussetgrippers.co.ukAuthor: Edited by Ian A McMillan