Latest / The STA Clinician Podcast / Ep235 'Healthcare For People With Learning Disabilities' - Reflection with guest Nicki Mansfield

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Ep235 'Healthcare For People With Learning Disabilities' - Reflection with guest Nicki Mansfield · The STA Clinician Podcast

0:00
Music.
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Episode 235 of the sports therapy association podcast
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my name is matt phillips creator of runshutlive.com and
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as always this episode is being recorded live on a tuesday
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on the sports therapy association youtube channel right then so here we are
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we have recorded live 234 episodes of the sports therapy association podcast
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now and they're all out there free for your education and your professional
0:39
development and listening pleasure.
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And we've decided, I say we, I've decided that it's time to take a pause from new weekly guests.
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And it's been on my mind for quite a long time because I'm just conscious,
0:52
I believe anyway, that I'm hopefully the conduit of some amazing information each week.
0:56
And it's got to say, I'm just guilty of putting another one on there because
1:01
it hasn't been enough time given to the previous one.
1:03
And that happened, that's been on my mind for quite a long time,
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probably two out of the five years.
1:07
And and with the last final episode of series
1:10
that we did of working with athletes with disabilities i thought brilliant
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this is it this is this is the pinnacle and now we're
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going to pause and we're going to have that magic word which hopefully is great
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clinicians you're all aware of which is reflect which is why what we're doing
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from now onwards for the unforeseen future don't know how long it's going to
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go on for that depends on you guys but we're going to be i'm going to be inviting
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you soft tissue therapist to pick one past episode that particularly affected your daily practice.
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And I'm going to invite you to come in to the show and have a chat about it.
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Now that sounds easy, doesn't it? Especially when you're just a gabber like
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me who goes on forever without thinking about what the next thing is going to be.
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But it does take confidence and it actually is a really pleasant experience
1:54
for people who've come and done it. It gives you a real sense of confidence.
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It's one for the bucket list. And also obviously it gives you a chance to talk
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about yourself, which is great for networking with other therapists,
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for collaboration, and also for clients
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as well. It's something you'll be immensely proud of, I promise you.
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And it's something where you can have clips of and all that sort of stuff.
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So if you are interested in being on the show, then obviously you need to have
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listened to the podcasts and you need to choose one. Let me put this on full
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screen for the people who joined us live.
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You need to have chosen one episode, which you feel has affected you in daily practice.
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And then you let me know about that. We have a chat. I just have to kind of
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like check you're not sort of inappropriate for the show.
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There's only about five people I think I can give that tag to.
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And then we do it. You come over half an hour or so, and we have a nice little chat.
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But essentially, it's about you and how that episode has affected your practice
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as a soft tissue therapist.
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So yeah hit me up on social media or matt at one check live.com or if you like matt at the sta.co.uk,
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just find me you know you can find me i'm the a team so do
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that it'd be lovely i've got my bookings up until mid-may so
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thank you to everyone who's signed up so far but if you're kind
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of umming and ahhing then let me know even if you're not very sure about it
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let me know and we'll have a chat a zoom call or something just to set
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your mind at ease because if you're a soft tissue therapist we want
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to hear from you if you work in healthcare if you're this kind of person who
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wants to help people then that's it that's the
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prerequisite for the show see it there you
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go right and talking about people who want to help other people in a wonderful
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way the guest kicking this off tonight is going to be the lovely nikki mansfield
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of triple m therapy a lot of you regular listeners will know nikki because nikki's
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normally the first through the door and in fact i'm sure we'll mention tonight
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about her discovery of the podcast and what it meant for her and that of stuff,
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because it's exactly what I hope in my dream is happening to listeners out there.
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And Nikki has chosen an episode to reflect on tonight, which is actually going
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to be, it was aired first on the 21st of February, 2023, which is lovely, a bit of nostalgia.
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It was episode 137, in which we had guest Alistair Beverley,
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the learning disability physio, talking about healthcare for people with learning disabilities.
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It's an amazing episode. And the other reason for this reflection series is
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not just to hear from Nicky, but also hopefully that will inspire some of you
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to go back and either re-listen to that episode or just maybe you missed it.
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Maybe you're new to the podcast and you just want some signs on where do I start with 234 episodes.
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And hopefully this will give you some ideas.
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And that's it. Right then. So we're going to try and keep it short.
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So if you have joined us live, just a few hires to people who have joined us live.
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Isn't it strange not seeing Nicky Mansfield's name there, first of all?
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I'm kind of looking, where's Nicky?
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So Charles Allen, thank you. You're the first thing to do, I think.
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So thanks for coming. If you do join us live, then we bring your name and question up onto the screen.
4:41
Hannah Tabrum. Hey, Hannah, how are you doing? Haven't seen you for a while.
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Hi, how are you? Tracy Marsh is in the house as well. Says, hi,
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all. Hope you enjoy the beautiful weather. Indeed.
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Indeed. Cecily Hislop is beautiful in Cornwall. Always is, isn't it,
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Cecily? Especially with your presence.
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Sir Glenn Murphy, MBE, as well as loads of people walking up tonight.
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Nicky's fan people are here in force.
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Sarah Benson is here. Evenings is Sarah, sorry, Sarah Benson. Sarah Jones.
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And then Gary Benson as well, founder of the STA, is here as well.
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So thanks, people who are joining us live. And other people are coming through.
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But that is very much enough for me talking. So without further ado,
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we'll kick off the first of this new season series of Reflection.
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We're going to be reflecting on episode 137, Healthcare for People with Learning
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Disabilities, which was aired with learning disability, Physio Alistair Beverley.
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But with us to reflect is my guest for tonight, Nikki Mansfield of MMM.
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Music.
5:53
So civil um sorry i've mumbled up your triple m's but i'm just used to think seeing mmm so,
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we're just thinking chocolates exactly and thanks
6:02
so much for stepping up and being the first person i asked you and within
6:05
a second yeah let's do it it's great
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really kind of you because it's not simple it's not easy
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um but i'm sure you're gonna make it look easy for
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everyone so it's really kind of so for
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people who aren't aware of you um maybe let's start with you
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just letting people know where you are and what
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you do for living i am a soft tissue therapist qualified with lssm in 2000 i
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thought it's 2010 turns out it's 2011 so 14 years in i practice in st ives in
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cambridgeshire which is a small town not a large village as some people like to call it.
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And i have had clinics in harfordshire another one in another nearby,
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all town but covid kind of put an end
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to those so i'm back to a one practice clinic
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and back to just me after having had a couple
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of team members as well that i was training up hopefully one day we'll get a
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little team going again and then a few years ago i started also hosting cpd
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courses in person i do think that is in need of a lot of support the in-person
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cpd arena especially in our country.
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But taking a break from that for this year, just got a couple of health issues to focus my energy on.
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And if I'm honest, I was enjoying CPD hosting so much and getting so excited
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about it, I neglected my clinic a little bit.
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So this year is all about rebuilding my house and rebuilding my clinic.
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Thank you very much. Excellent. I appreciate that breakdown.
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It's great for listeners to have an idea that, yeah, you are a therapist and
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obviously we've all got different things going in our lives,
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but essentially your job is helping other people, which is what it's all about.
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And I'm sure there's a lot of people out there who are fortunate now that you
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are putting your efforts more into clinic now. So that's exciting as well for them.
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Right. Halifax is a bit happier. Halifax is content.
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So you chose episode 137 with the
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marvelous alistair beverly is there an episode i was
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like well i don't know i'll have a bit of a thing but this one it was
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it was the first thing it was the first thing i thought of is this is
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the listening to alistair talk was it's it's
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had a massive impact not just on my
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practice but on the way i deal with humans in everyday.
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Life as well huge impact right it's
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a big intro for this one okay now we're going to try and
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back that up with 20 minutes or so to half an hour of chat so
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it was entitled healthcare for people with
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learning disabilities how did
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you what first of all what made you want to
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watch it because obviously you saw it advertised on the STA and all that and
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then was it what you expected so I
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first started watching the STA podcasts in 2022
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and it was you advertising a series about business and
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I think i'd seen some advertised previously and
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thought oh that's not my that's not my specialty although
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maybe he was working with kids or something like that and i
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thought i've got a few and i saw the business one i
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thought oh that i'm always interested in the business side because we're business owners
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after all so i i watched the four episodes
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of that and thought i really like these podcasts i like they
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just seem really open and accepting and and
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that's a really good host as well but don't tell him I said that and so
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when your next lot came up and I saw subject item I thought I'm gonna watch
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that even though it's nothing to do my practice and so I carried on doing that
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and I was I was really enjoying learning about that thing that I thought was
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nothing to do with my practice but realizing just how much that I thought was that speciality or.
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Specialism actually applied to my practice anyway and so
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when this one came up I just thought well learning disabilities
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I don't think I work with anybody with learning disabilities I don't think anyone's
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ever been signposted in my direction definitely not my practice but I've got
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a lot out of the previous ones nothing to do with my practice why don't I and
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it's just I kind of spent the whole thing with my gob open just kind of going whoa,
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And then I've seen Alistair talk quite a number of times since.
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He's had another two podcasts with you. And I've seen him two or three years
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when in at Therapy Expo, had some chats with him as well.
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And then going back and reviewing the episode that we're going to talk about,
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it really kind of deepened and cemented my, you know, we do like reflective
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practice for our CPD logs.
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It was the perfect thing to do, to kind of fill in that little, what did I learn there?
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In your CBD logs, but also just in my brain, I just realized how far I'd come
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as a human interacting with other humans since I saw this episode.
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And this is what kicked it all off.
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That's amazing. And it's so nice hearing you say that because it's such an important
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word, isn't it, in our own business?
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Reflection reflection how we work with
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the patients and our clients what we could have done better what
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we what we did well you know positive and negative and
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yes it's great to hear that and so yeah we're going to reflect on
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this episode so the way we've done it is i is
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there's so much in the episode but you've kindly
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picked three areas which we're going to talk about which will
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make sense obviously we'll make sure that what we're talking about
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makes sense to people who aren't aware of episode but hopefully it
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will inspire you to go and watch the actual episode with
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Alistair Beverly and I'll remind you at the end which there
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is and there'll be a link in the episodes in the show notes so yeah the
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first one back with various facial hair changes it came up on my screen I was
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like oh yeah yeah yeah it's weird I've got like yeah six years I'm going to
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do a time-lapse change where it just comes and grows you just had your hair
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cut short again yeah let's not let's not you sent me,
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which, yeah, diagnostic overshadowing.
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Now, I'm pretty sure some people don't know what that is. So we better start
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off with what is diagnostic overshadowing. I have a definition.
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I've got a definition of Dr. Google just to make sure that I was saying it right.
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So diagnostic overshadowing, this is a phrase that smacked me in the face when Al was describing it.
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The definition of it is where symptoms of physical or mental illness in individuals
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with pre-existing conditions like autism or learning disabilities are incorrectly
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attributed to those conditions rather than being investigated as potential comorbid issues,
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potentially leading to delayed diagnosis and treatment.
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And unfortunately, in the tragic case of Alistair's own brother,
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who presented on a number of occasions to different healthcare professionals
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with clear signs of pain and chronic distress from how long it had been going on.
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His treatable condition of, I think it was a strangulated hernia,
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was completely overlooked due to his presentation of Down syndrome.
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And he sadly died of an entirely preventable condition or treatable condition
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so that so i mean that kind of thing it it hits you hard what kind of hit me
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harder was thinking well i've never heard of that my god i didn't know there's
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a word for that and then very quickly realizing,
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you're after you have heard of that it happens all the time this
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happens this assumption that this is
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because of that goes on all the time it happens
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it's been happening in my experience and then
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probably in things i hadn't previously thought of it's not
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it isn't just people with learning disabilities it's pregnant
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women perimenopausal women postpartum women there are men as well people like
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ptsd sufferers anyone with anxiety depression anyone with a chronic pain or
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especially a chronic fatigue syndrome have all had their other symptoms that need looking at,
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that need attention from the proper expertise.
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They've all had them overlooked because people have just gone,
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oh, it's all part of that.
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You know, it's, you know, or you're hypermobile. Of course your own sensitivity
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is higher. You know, here's some coding, you know, deal with it.
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So, I mean, I think what shocked me was I did it.
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It's a prejudice at its most basic it's a prejudice it it's born of fear and ignorance,
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and my as i said right at the beginning i thought
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oh there's a podcast episode about people with learning disabilities and
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since do me i've never seen a client with learning
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disabilities i don't suppose that they would be seeking me out anyway they
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would go to where you know where's where the
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expertise is is for that and so i'd done it i'd bunched
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everything that that person may be experiencing into
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the fact that they've got a learning disability so it
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is at its most basic it's a prejudice sadly like
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other prejudices it can be fatal so you just think of religion and for example
14:58
or different political stances but the great thing about the fact that it shares
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it's another prejudice is is we can overcome it education and exposure as alice said in that episode.
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We don't get to see, we don't get to treat, we don't get access to people with
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learning disabilities because we, I don't know, it's never part of our training.
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We don't get given those or taught those specific skills because all it comes
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down to, it's not because they're outside our scope of practice.
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They're well within our scope of practice if they've come to see us for an MSK issue.
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We just need to learn how to help them get access to our expertise.
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And it's i love the work that alistair does he
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does courses for people like us but he goes and talks
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like in the podcast and at therapy expo what i
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really like watching are his social reels
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so he like a lot of physios has undergraduate physios come and do their placements
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and he he invests an awful lot of his time energy passion in helping these young
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and mostly young i know and some are a bit, they're going to the profession a little bit older,
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but helping these people gain access to this larger than you would think cohort
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of people that need additional kind of ways of communicating or different ways of listening,
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need some adaptation in their exercises.
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And so they're getting exposure to it at a really early stage so that it isn't
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unusual when they come to practice.
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So they don't go and make the mistake of people like me and say,
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oh, that's not me other people do that so i really really admire the way that
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alistair does that if you've not checked out on instagram he's on tiktok he's
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all over tiktok as well but well he's he's he's so prolific he's actually in
16:53
here tonight listening to you so i hope that's not going to uh.
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Alistair is actually joined us this episode which is typical al he
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says hi all it's amazing here at these points i'm sat here taking notes and
17:05
learning thank you for featuring the episode a place to have you it's
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really nice to see but but nikki yeah a great summary really
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cool and you know what you check out his socials because
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they are they're just seeing the fun that he
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has with these graduates but you can see them just like kind of learning and
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you'll also get to see a load of cute videos of violet the poppy as well just
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so that as an extra bonus no it's a great it's a perfect episode to start this
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kind of reflection series on because it is And there's not just one out of these 234 we've done,
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but it is a classic example of how.
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A little snippet of information, a tiny bit of education and sharing done in
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the right way, not on a pedestal kind of talking down or shouting in capitals.
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Without going over the top, it can change your life and it can definitely change
17:51
the lives of everyone you come in contact with.
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And it's just information at its finest, isn't it? Something we're not,
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just because we don't know it doesn't make us bad or evil. It's just something
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we haven't considered before.
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And Alistair explains it wonderfully in the episode.
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So yeah, diagnostic overshadowing and it is, like you say, it's everywhere.
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I think Alistair is so quick to point out, even though speciality is working
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with people with learning disabilities, it can be applied just as much.
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I think he mentions to first-time mum, oh, yes, she's bound to be worried. It's the first one.
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And that is a classic example, which is very relatable. And you think,
18:21
oh, yeah, she's just, you know, she's extra hypersensitized to the pain when
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it could be something which is, should be diagnosed and should be looked at,
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could be totally unconnected to the pregnancy. So amazing.
18:32
Really cool. Okay. So diagnostic overshadowing, first point to take away.
18:36
I think that kind of leads into what you're talking about as well
18:38
the second section you mentioned was expertise versus
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marginalization yes so that
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was kind of applied to what you said we never see people for example it was
18:50
interesting because like john alice's brother had down syndrome alice is very
18:55
quick to say that down syndrome makes up a tiny tiny tiny tiny percentage learning
18:59
disabilities out there and in fact the biggest learning disabilities is the
19:02
ones which don't even get recognised because they haven't got a name.
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And it's people with a lower IQ, which is the definition of a learning disability
19:09
in the sense that it affects all of their lives, not just a particular moment
19:12
like trying to spell or trying to coordinate or something like ADHD or learning
19:17
disabilities that it affects all of their lives.
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But it doesn't mean they can't have mental health issues as well.
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It doesn't mean they can't have a learning difficulty as well.
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So it's good to clear those up.
19:26
But yeah, tell me more about this expertise and marginalisation then.
19:30
Yeah, yeah, you're right. So it's very much, I think it's an element of the
19:35
diagnostic, or rather it's born of the same place of diagnostic overshadowing,
19:39
where it's an assumption that we make.
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And in our cases, I think it's probably...
19:45
Usually made with like with the
19:48
best intentions we feel like it
19:52
requires some kind of expertise in people with
19:55
learning disabilities in order to help people
19:58
with learning disabilities whereas actually they've got
20:01
an msk issue if they're in your if they're in your clinic or they've
20:04
they've inquired about an appointment they've got an msk issue generally
20:08
neurological msk issue that we that
20:10
we deal with that we are the experts in and they
20:14
are so they are in the right place we we we're doing
20:16
people on a disservice to refer them back to an ld
20:20
specialist or a learning disability specialist so what
20:25
it occurred to me is i think al was explaining it
20:28
was not just msk there could be a there
20:32
could be a kidney problem there could be a cardio
20:36
pulmonary issue it could be like you just mentioned
20:39
a mental health challenge the the
20:42
breadth of range of comorbid things that a person with learning disabilities
20:48
may be suffering with is far wider or presents far yeah so it's far wider than
20:56
this this i mean i know there's lots of different types of learning disability
20:58
it's far wider than that the fact that they are learning disabled.
21:02
And I think I was guilty of thinking, well, I would refer to a learning disability
21:08
specialist and not thinking beyond that.
21:10
And I made it really, really clear that we've sent them back to somebody who is a jack of all trades.
21:17
They're not going to, I don't know about visceral injuries. I can't support
21:22
people. I can't support people with mental health.
21:25
And even with MSK, there's going to be things that I'm good at and things that I would refer on for.
21:29
And yet i would refer somebody back to
21:32
somebody who's got even less experience in all of those things than me so
21:35
where i was perhaps thinking with best
21:39
intentions i'm going to point this person in
21:42
the direction of somebody with expertise i'm actually
21:45
marginalizing them again like
21:49
they haven't got enough of that in their lives already so i
21:52
think it's incumbent on me as a soft tissue therapist as
21:55
a as if they've sought msk health to acquire
21:59
the necessary skills and understanding to
22:02
remove whatever barriers there are in place for that person to gain
22:05
access to my skills and expertise and having them with
22:08
the issue that they've bloody well come with you
22:11
know rather than kind of going oh yeah oh you
22:15
know i see i see your low back ache and shooting
22:18
pains down the back of your leg oh sorry you've got learning disabilities
22:21
straight away this this plan of the straight leg
22:24
raised testing my own testing and
22:27
pursuing you know a possible hypothesis of sciatic nerve pain all of a sudden
22:33
through this fear and this ignorance that i mentioned previously i've kind of
22:36
gone oh no you're best off in somebody else's hands whereas if that person hadn't
22:40
presented with a learning disability as well i'd have been you know come on
22:44
crack on let's get you sorted.
22:46
Excellent. Really well put. Amazingly well put. And it is something that has
22:50
to change society, isn't it?
22:52
But we can start helping that by, you know, changing our attitude a bit.
22:57
There will be a kind of a butterfly effect that will move on.
23:01
And then people who have got families, for example, and one of the children
23:05
or a parent or somebody is with a low disability, they won't automatically think,
23:09
oh, I have to take them back to the specialist.
23:11
They'll just think, I mean, as Alistair mentioned in the show,
23:14
there's fortunately now there are many more examples of people,
23:17
for example, with Down syndrome, but other low disabilities who are getting
23:20
involved in exercise. Hey, so guess what? They need massage.
23:23
Why do they go to a specialist to get some massage? They might tear their ACL. Exactly, yeah.
23:27
So um it's education but i
23:30
think as always if we all can make
23:32
a little bit of a change give different messages maybe in the literature
23:35
on our website maybe have some great photos of
23:38
us working with people with evident learning disabilities that
23:41
you can see it's not always the case but this is what it
23:44
should be isn't it we could help change perception everywhere
23:47
so it's yeah great points really
23:50
cool and and again just start changing in everyday lives alistair
23:53
says i mean i love this quote from him he's had to go now just uh
23:56
alistair popped in just say hi apparently it's violet's birthday today
23:59
so um he was just literally popping in to say thank you
24:02
and hi now he's gone off if you don't know who violet is yeah we're
24:06
not gonna that's gonna be a nice hook you have to go to tiktok's probably
24:09
i like his tiktok videos with violet but you can go to
24:12
tiktok yeah well you're one of those youngsters aren't you all right
24:15
thank you very much it's just a beard which makes me look over 30 but anyway
24:18
so yeah yeah you can start making a difference by Alistair points out I think
24:23
I made a quote of it here because it was just a classic Alistair filter off
24:28
because things need to be said but he said the thing about the.
24:35
I think i can't find these actual quotes but basically i'm not going
24:38
to do it justice but he said that people who refer to people with down
24:41
syndrome as angels it makes his blood boil that sort
24:43
of crap makes my blood boil and i think we all do it we see someone maybe because
24:48
we're just bought up with it i don't know it's just the ignorance but we see
24:51
somebody with down syndrome and he automatically we kind of look at them and
24:53
go oh bless them they're very smiley people they're so affectionate like a weird
24:57
form of like it's not even it's not positive discrimination is I think the dealing
25:01
mechanism was something that scares us.
25:03
It's as bad as kind of going, oh, they must be stupid.
25:07
Yeah, yeah, it's weird. But with no malintent, I think it's just really not
25:11
– because we don't see them.
25:14
We're not integrated with them. We move them away from society.
25:18
I can't remember what the statistic was for how many people there are with Down
25:21
syndrome in the country, but I think it's – Alistair made the point,
25:24
it's the same as the number of NHS workers. Yeah, we see loads of them.
25:28
We play football with them and do stuff. but when was the last time you actually had
25:31
a beer or you sat down at a table you know exactly exactly so
25:34
anyway yeah it's a massive point so we can start making a difference by not
25:38
looking at them and doing a sweet little smile or making that kind of comment
25:41
because that's part of the problem although it comes from a good place we
25:44
need to realize that they have like like
25:47
alistair says go to his website and see the blog he's got from al
25:50
and yeah have a look about you know the time that john farted at cubs or got
25:56
pissed at my wedding or beat up a bully at school oh yeah it was all sorts of
26:02
stuff and it and he just uses his way to show that people with learning disabilities
26:05
are still human and they've got every right to be a dick to do be nice yeah.
26:11
Brilliant okay and that kind of leads in nicely to the i love the way you've
26:15
packaged together nikki it's just i mean it's gonna be downhill from here i
26:17
don't know how we're going to keep this level of organisation up.
26:20
But yeah, the last one he said to me was, yeah, it goes on nicely to neurosensory processing.
26:27
So what's the link on from there now?
26:29
So really the link from there is.
26:32
So I've been seeing this cohort of individuals with learning disabilities as a small cohort.
26:40
And you've already said, so even if we're just talking about people with diagnosed
26:44
learning disabilities, as Alistair said in the episode, and as you've just alluded to there,
26:50
there's 1.5 million individuals in the UK with a diagnosed learning disability.
26:56
And there are also 1.5 million NHS staff members. And as he pointed out during
27:01
the podcast, I'm pretty sure all of us sitting here all see at least one NHS staff member.
27:09
I mean, it's the only discount I offer is for NHS staff, and I give it quite frequently.
27:14
And if we're seeing – so we're not getting an idea, a proportionate idea of
27:20
the population of people with learning disabilities. And that's just the ones that are diagnosed.
27:27
What's really kind of hit home with Alice's work just over recent years is the whole kind of thing.
27:36
It's not just learning disabilities as in there's a name or there's no name to that thing.
27:40
It's not just a diagnosed thing. He helps people with all kinds of challenges
27:45
in processing neurosensory inputs.
27:49
And some of those have got a diagnosed learning disability and others don't.
27:54
So we all process sensory inputs.
27:57
There are loads of owners. We see things, we hear things, we touch things,
28:01
we smell things, we feel vibrations in things.
28:06
These inputs are all happening all the time, and most of us effortlessly filter
28:12
the unimportant stuff most of the time.
28:16
People with a diagnosed learning disability will tend to filter those less efficiently
28:21
in one or more of the senses.
28:24
And there's plenty of other reasons why some people might have difficulty filtering
28:29
some of those inputs, making it really, really laborious, hard work.
28:35
It takes a lot of energy and concentration to extract the bit that's important
28:39
or to figure out whether there is anything important there.
28:43
And there are strategies that people use to try and help themselves do that
28:47
so that it goes from kind of like an unconscious processing to what can I do
28:52
to get that information in.
28:53
The capacity for filtering that information, it's not constant and nor does
28:59
it only affect people with a learning disability or, you know,
29:04
as we're all learning much more about neurodivergence.
29:08
That's probably the biggie that we can all think of. And we,
29:11
I'm sure we all know people in our personal and professional lives who process
29:15
that information in different ways.
29:17
But people in pain chronic and acute pain
29:20
well their sensory processing is
29:24
affected people in with chronic
29:26
fatigue and even with acute sleeplessness or just like you know poor sleep for
29:31
i have insomnia for a couple of months at a row at a time like every year it's
29:36
pretty awful i i i get affected by it massively and so i've not got chronic
29:40
fatigue but but even just acute fatigue can do the same.
29:45
Perimenopause, massive one. Anxiety, stress, depression.
29:49
There's so many more mental health conditions and even physical conditions where
29:54
our ability to unconsciously filter some inputs out so that we can get the bit
30:01
that we need is massively effective.
30:04
To give a personal example of mine, I started perimenopause probably around 2020 in retrospect.
30:13
Effect um and over the
30:16
past two years i have started
30:19
getting vestibular challenges so i suffer from vestibular
30:23
migraines and they come along with vestibular it's
30:27
just kind of like an overload and then i started getting visual disturbances
30:31
as well and then auditory ones and i had a chat with actually with alistair
30:37
at therapy expo and because he gave lots of reasons why people might experience
30:42
challenges with neurosensory processing.
30:43
And he did a really good demo where he was getting us to memorize a story that
30:48
was on the screen, but then telling us jokes at the same time and standing on one leg.
30:52
So there was just more neural load.
30:55
And it was a really good example, but it also happened to coincide with one of my biggest flares of.
31:01
Overstimulation of the sensory inputs where
31:05
I'd reached a point at that point in the day because it's
31:08
a big room it's fairly very white bright bright lights lots
31:11
and lots of noise a lot of a lot
31:14
of different things trying to distract my attention and so I think by the time
31:19
Alistair was on on the second day I had my earplugs in which are a really good
31:23
strategy I have I'll have my eyes closed for most of it and then I also reached
31:29
a point where I can't hold my head up because I've I've got a cranial,
31:32
God, this sounds like a bloody list of things that are wrong.
31:35
I have cranial cervical instability because of my hypermobility.
31:38
So my spinal cord starts to get a bit impinged.
31:41
So I was kind of like in a little ball and hands on the hook.
31:44
And my friend's just got her arm resting on my back.
31:47
And the weight of that really, really helps kind of drown out some of the noise.
31:51
So I'm what I would have up until a few years ago called a high-performing person.
31:57
You know, I think I'm quite intellectual. I
32:01
enjoy a mental challenge I thought
32:05
I survived I thought I loved complexity and multitasking and
32:09
yet there are these times where things just become too
32:12
much and Alistair gave a really good example
32:15
of stimming so we're all kind of used to pen clicking or knee wobbling but he
32:19
played a video of somebody who if I had had that person in my clinic I would
32:25
have just panicked and thought I don't know how to help this person because
32:29
he was chucking stuff around and making non-verbal vocalizations.
32:34
And I would have just thought, oh my God, anything I do is just going to hurt this person.
32:38
And all he was doing was stimming because stimming helps quiet the noise.
32:43
It's like a conscious way of filtering out the crap that you don't need to hear.
32:48
And it was this realisation that this isn't a separate group of people. This is me, personally.
32:55
And it's all of us, maybe, at some point during our lives, depending on what
33:01
the life stress is and what's going on with your family and all these kind of things.
33:05
And it kind of just really, really hit home that I'd been carrying this prejudice
33:10
and that it possibly prevented people getting the care that they needed with me.
33:15
I can't think of any examples, but I certainly know that two,
33:20
three years ago, I was not as well educated on neurodivergence as I am.
33:25
And thankfully, we all are becoming now.
33:27
And then I deal with everyone different. My best mate, so my neurodivergence
33:33
is more towards the autistic end of the spectrum. I need details. I like plans.
33:37
I take things quite literally, but I don't have the things. So I'm really good
33:41
at reading emotional responses.
33:43
And so it's like some dials are turned up, some are down. my sister
33:47
and my best friend they won't mind me telling you and
33:51
one of my best friends that was at therapy expo with me they see
33:54
it last year they're all massively down the adhd
33:56
end of the spectrum and because we can talk about
33:59
it in an informed and open way now we
34:04
can find strategies between us to help so that
34:07
we don't stress the other one with our opposing kind of
34:10
needs and we work ways of
34:13
just just this openness just
34:17
this i've taught them this is what i need and
34:19
they've taught me this is what we need it just opens
34:23
the possibilities and if i can do that with a client if i can identify oh those
34:29
lights might be a bit bright i'm going to turn those down or offer a ifm like
34:34
wobble chairs like this and i sit on a wobbly chair as well which can be really good for stimming.
34:41
If we can make our environments more accessible and inviting.
34:46
Then perhaps that's how we gain the exposure.
34:49
Because the education seems accessible to us. There are people like Alistair Buffer in it.
34:54
There's a lot more education in the general field for things like neurodivergence.
34:58
But in terms of the exposure, as he talked about in the episode, how do we get.
35:04
These people in front of us and that's what
35:06
i've been pondering this week is how can i yeah how people
35:10
know that this is a place where they are welcome
35:13
and can get help and i think it's like you said on your website you know
35:16
photos photos of people who look
35:19
a bit different i thought in your accessibility part of
35:22
the website include not just i've got
35:25
a ramp and extra wide doorways you know
35:27
that's for your physical disabilities include things specifically
35:31
to do with the more learning related disabilities
35:34
things like i have detailed
35:37
written instructions on how to find where my
35:40
place is and not to come early well not
35:44
everybody likes written instructions so i could put a video on there of
35:47
me walking from the street and getting there well there's lots of little things
35:49
i'm really if anybody's got any ideas
35:53
of how to help therapists gain
35:56
a greater exposure of these people
36:00
that need our help i'd be really really open open to hearing it because i really
36:04
really want to make an effort to to to help guide people towards the help that
36:09
they need it might not be with me but i might be able to decipher that it isn't
36:13
me i think that there's the answer to the question you pose it's it's collaboration
36:17
it's talking to each other.
36:19
And and finding ways that work for other people and also i think just we can
36:24
try and fill a website with all these ideas what we think might help but just
36:27
how making it clear that have you got particular need or do you want to talk
36:31
about something with me where i can make your visit more pleasurable and understanding
36:36
then you know blah blah blah and just invite people to that conversation.
36:40
So no amazing like a section for carers and things on your website something
36:43
yeah it's just showing people who are already a bit nervous if they have if
36:48
they have heard on the grapevine oh this person seems to work with everybody
36:51
and it's not going to turn me away they're just going to see on the website. Yeah, it's true.
36:55
And once you've got them on the end of a phone or on a Zoom call or something,
36:58
that's it. That's the biggest hurdle.
37:00
You can talk and use your beautiful kind of openness and coaching.
37:04
And I love the way you talk about strategies as well, which you can.
37:08
You can work through with your friends of helping each other
37:11
because that's exactly what coaching and we should be doing with our clients and
37:14
patients isn't it finding strategies together rather than saying you
37:17
need to do these exercises and then wondering yeah great work
37:20
right look it's 8 41 so we're going
37:23
to round it up a little bit there yeah we did pretty well
37:26
actually 8 40 was the goal i think you were taking a bit of a a punt
37:29
uh experimented with a new short and sharp episode by getting
37:31
me on first well it's like we said at the beginning if we
37:34
get to 8 40 you know with you we can do with anybody so i
37:37
mean that was our agreement's
37:40
true gary benson has said gary benson founder of
37:43
the sta said what nikki said earlier resonated with me the episode
37:46
really taught me about how i view people not just those with disabilities but
37:49
all humans and gave me the ability to look from other perspectives which
37:52
is what it's all about isn't it and i think that's the beauty
37:55
of life we should celebrate the differences um because that's how
37:58
we we we can interact and help people we just got recognized and
38:01
we're all different cecily hislop has said
38:04
i was lucky to have a volunteer who has ds
38:08
when i managed a charity shop i wouldn't have been without him although
38:11
he always beat me in an arm wrestle okay exactly
38:14
and charles allen as well has commented hi nikki
38:18
we take referrals from nhs norfolk ecch and i have to totally agree with all
38:23
of what you're saying thanks charles for sharing that very cool brilliant and
38:28
and what i'm hoping this is a classic example everything i hope would happen
38:32
with a reflection series like this, where we're listening to somebody like Nikki.
38:36
Working clinician, hopefully this does open up channels for collaboration.
38:40
And hopefully all of episodes do.
38:42
The idea of getting a clinician from the shop floor who has to speak,
38:45
who's going to talk and open themselves up to what they do and the highs and
38:48
the lows, and that will help other people to reach out.
38:50
So Nikki, with that in mind, if people do want to contact you about some of
38:54
the things you've talked about tonight, then what's the best way of them reaching you?
38:58
I would say message me on Instagram at Soft tissue, Nicky.
39:03
Okay, we'll make sure that goes into the notes. And if they don't like Instagram
39:06
or don't use Instagram? Then I'm just Nikki Mansfield.
39:09
Just look in any of the massage forums and I'll probably have chipped into a
39:13
conversation somewhere. I do enjoy those.
39:16
We don't want quantum debates, conversation.
39:19
And obviously as well, we'll do our guest. My business page on Facebook is Mansfield
39:24
Massage and Movement, but I haven't updated that since I took this hiatus in hosting.
39:29
So you won't find much, but by all means, go and have a look.
39:32
Tell me where I can improve it.
39:33
But yeah, just on the SCA members page, on the Hands On Hub page.
39:39
You get around, don't you? You're there. I do get around.
39:43
And we're all better off conditions for it. Wicked. Okay, that's fantastic.
39:48
And obviously, we can get you in contact with Nicky through us as well.
39:52
So if you listen to the show and you want to go through me, like Matt at the
39:55
SCA.co.uk, then we can do that as well.
39:58
If you can't find Nicky, then just let us know. we should also thank
40:01
as well the person who stimulated this show tonight alistair
40:04
beverly the ld physio we'll make
40:06
sure that links to his website appears on there
40:10
as well but basically it's just the ld physio.com the ld
40:12
physio.com and also on instagram and tiktok
40:16
and definitely want to look at the visuals because yeah the
40:19
the images and the videos just say a thousand words it's
40:22
amazing the stuff he puts out there really is yeah they stimulate
40:25
shoot almost starting a physio degree just so i can go and
40:28
be an undergraduate it is is one of those
40:30
things but things you can change so quickly anyway right
40:33
that's amazing um thank you so much nikki it
40:36
was brilliant it's exactly what i wanted this the new series to be so thank
40:39
you so much for your time my pleasure we're going to be back next week i've
40:44
decided it went so well tonight that we'll continue i was going to pull the
40:47
plug but no we won't and next week i'm very pleased to see let's just bring
40:51
it up in the screen if i can for those of you like the visuals and,
40:55
get the right badge. I think this is the one we're going to have in the clinic,
41:00
Shannon Byrne from Rebound Injury Clinic in Dublin.
41:04
Let's put this on a solo so you can see it.
41:06
And Shannon, fantastic therapist as well, is going to be reflecting,
41:10
oh, we're going way back to July, 2021 to episode 60. We're going to like double digits.
41:16
She's going to be reflecting on episode 60, which was working with West End
41:18
Pro Dancers, recorded with special guest Liz Bailey.
41:22
I know the backstory to this one. And I know why Shannon has picked that episode and it's brilliant.
41:28
I've got shivers down my spine just listening to it.
41:30
So I really encourage therapists to try and join us live if you can.
41:35
If you can't, then please leave a review on the podcast because all this information
41:39
only gets out there if you leave a rating or review. Otherwise, it kind of disappears.
41:44
If you just put a rating or review, Google picks it up and it will appear when people put in,
41:50
neurodivergence or people put in autism or oh by the way autism day tomorrow
41:53
people don't forget to wear a splash of clothing or something but um yeah just
41:57
just please rating and reviews,
42:00
just a splash it's something obviously splashy but yeah so do try and join us
42:04
live if you can because it hopefully it will hearing another clinician is hopefully
42:08
going to really start some debate that'll be next tuesday april the 8th on youtube
42:13
or there is a link if you prefer on facebook always recommend youtube if you
42:16
can it's just a bit more reliable right nikki thank Thank you so much.
42:20
Really enjoyed having you. You're welcome. I think it's a great idea. I appreciate it.
42:23
Thank you. No, it's really cool. You've definitely set the benchmark very high.
42:26
It's exactly what I'm hoping this is going to lead to. So thank you.
42:29
And thank you for people who joined us live as well. As always,
42:32
Hannah Tabram has said, excellent job. Nikki, no pressure.
42:36
Hannah's going to be joining us. Looking forward to that as well.
42:38
There's a few names in here. I know people have said yes already. So yeah.
42:42
All right, people. Until then, as always, take care of each other.
42:46
I always finish the show that way since we came out of COVID.
42:50
But just think twice about the person down the street who maybe you thought
42:53
you knew what they were going through, but maybe you didn't.
42:55
So, yeah, just let that linger and we'll talk about it again next week.
42:58
Music.