Psychosomatic Causes of Enuresis and Urinary

Urinary incontinence can occur at any age, often due to psychological reasons. The psychosomatic aspect of enuresis in children is a focus for many specialists, with recent studies yielding promising results. Timely detection of enuresis signs can lead to a favorable outcome. Ignoring symptoms can lead to unpleasant consequences.

Enuresis: Signs, Types, and Development Mechanism

Enuresis is involuntary urination during sleep or wakefulness, mainly manifesting in childhood. Modern medicine views enuresis as a life stage where a person learns to control their body, considering urinary incontinence normal until the age of three.

Causes of Urinary Bladder Dysfunction

Determining if enuresis has psychosomatic causes can be challenging for specialists and parents. During sleep, a child’s consciousness disconnects, temporarily breaking the link with reality. The child feels no need to empty their bladder, leading to inappropriate urination.

Occasional incidents shouldn’t be a concern, but regular recurrence warrants thorough analysis. A professional evaluation can help.

Types and Causes of Pathology in Childhood

Enuresis is classified by time of day:

• Daytime (severe form): The child is aware of internal and external happenings, thus should understand real-time events;
• Nighttime: The body relaxes during sleep, some control processes slow down, making incontinence more manageable. Enuresis can be primary or secondary. Primary occurs at night due to lack of control skills and usually resolves with age. Secondary enuresis occurs in children who had control but regressed due to various reasons. This type can be psychosomatic due to a disruption in the developed reflex.

Psychological causes of enuresis in children include:

• Nervous system overstrain;
• Excessive shyness;
• Psychological trauma;
• Fears;
• Nervous system disorders. Treatment of psychological enuresis focuses on identifying the root cause, as medications or surgery alone won’t remove the underlying issue.

Child’s Attitude Towards Their Problem

Although the issue primarily affects the child, the entire family is usually involved. The parents’ response strategy significantly impacts the child’s emotional state. Punishing or shaming the child can worsen symptoms, affecting everyone involved.

If parents ignore the issue, the child still senses something is wrong, potentially leading to fear, shame, and feelings of inadequacy.

Parents may experience feelings from inadequacy to anger and irritation. Concealing these emotions doesn’t help, as everyone understands and feels the unspoken.

Supporting your child is essential, but it won’t solve the problem alone. Diagnosing “enuresis” is appropriate after age four when control skills should be developed. However, if the child is under three, physiological factors may play a role, but psychological support shouldn’t be overlooked.

Types of Urinary Incontinence in Adults

Statistics indicate that about 1% of adults suffer from urinary incontinence. In most cases, the causes are anatomical, lifestyle-related, or pathological. Approximately 10% of cases in men and women have a psychosomatic factor.

Types of adult enuresis:

1. Stress-induced: Occurs during minor physical exertions such as jogging, coughing, laughing, or lifting heavy objects, without prior urges.
2. Urgent: Characterized by sudden urges and inability to reach the restroom in time.
3. Mixed: Combines symptoms of the first two types. Seeking a doctor’s consultation early can simplify and expedite recovery.

Understanding Enuresis in Children from a Psychosomatic Perspective

Enuresis can coexist with other illnesses, hence its categorization into complicated and uncomplicated. Understanding unintentional urination requires studying the child’s character and psycho-emotional state. The pathology takes on characteristics from either neurotic or neurosis-like progression.

In neurotic enuresis, the child is extremely sensitive and restless, often experiencing sleepless nights. The neurosis-like type is typical for children with a hysterical disposition, unconcerned about the illness. However, during adolescence, they might become introverted, reevaluate their situation, and become prone to neurosis.

Psychosomatic Causes

The emotional atmosphere in a family significantly impacts the formation of a person’s psyche. Systematic raising of voices and frequent arguments between family members can eventually lead to nervous system overstrain. In essence, enuresis is a reaction to stress, sometimes arising unexpectedly, but there is always an explanation.

Psychosomatic Causes of Enuresis in Children

Psychosomatic factors in childhood pathology may include:

• Stress (separation from loved ones, death, illness of a family member, family abortions, etc.);
• Anger (a way of expressing aggression towards the mother, e.g., as a reaction to parents’ divorce);
• Control (as a reaction to overprotection or strict prohibitions by a parent, the child symbolically defines personal space);
• Overexcitement (in mother-son, father-daughter relationships, e.g., as a result of not passing through the Oedipal phase of development for a girl).

Psychological Factors of Nocturnal Incontinence

Symptoms of nocturnal incontinence also have specific meanings. Enuresis, as a physiological process, is a way for the body to remain relaxed, allowing urges to occur unhindered. Since urinating in bed is socially unacceptable and shameful, enuresis is accompanied by a sense of shame.

In Childhood: If a mother gives attention to a child at night due to urinary incontinence, it’s an unconscious call from the child to the mother. This could indicate difficulties in separating boys and girls from a parent if the mother sleeps with the child or takes them into her bed after an incident. This reinforces a method of psychosomatic response: the child stays dry in bed with the mother but wets the bed when sleeping alone. The process is associated with fixation on the female body, anxiety, and excitement, which can later cause difficulties in properly relating to one’s body and feelings towards the opposite sex.

It’s important to understand that psychological work solely with the child in the context of nocturnal enuresis will be less effective. Psychotherapy for the mother or joint work of parents on their relationship can truly help. Supporting the child must be reinforced by the participation of interested family members.

Psychological Causes of the Disease in Women

Adult urinary incontinence can be related to disturbances in the psycho-emotional state. Psychosomatic causes of urinary incontinence in women include:

• Psychological trauma, severe stress, or fright;
• Psychological breakdowns in relationships with a tyrannical spouse;
• Childhood issues with very demanding parents;
• Strain from the fear of disappointing relatives;
• Dislike of men;
• Constant self-dissatisfaction;
• Fear of sexual contacts due to specific upbringing or physiological issues;
• Financial constraints.

These reasons can also lead to enuresis in men, but they are less susceptible to this ailment, and treating it is more challenging.

Treatment of Psychosomatic Urinary Incontinence

Before treatment, it’s essential to determine the cause of the disease. If enuresis is confirmed to be psychosomatic, involving all family members in the treatment is crucial. A psychologist greatly benefits from parents’ cooperation for a successful resolution.

Treatment Methods for Child Enuresis Psychosomatics

Firstly, consultations with various specialists are required: neurologists, endocrinologists, nephrologists, psychiatrists, urologists, or gynecologists. If no physical abnormalities are found, the disease is psychosomatic. Psychotherapy, sometimes accompanied by medication, can solve such a problem.

Proper psychological intervention is effective in resolving emotional issues. It helps to improve family relationships and positively impacts the child’s morale. Hypnotic suggestion is used if there are no negative factors in the family itself. Autogenic training is recommended for teenagers.

Treatment of Urinary Incontinence in Adults

In psychosomatic cases, patients are prescribed psychotherapy, antidepressants, psychotropic, or hormonal drugs. Positive results may appear within a week, but treatment continues for some time. Tranquilizers are also prescribed for neurotic forms of the disease. Sleep depth adjustment with calming sleep-inducing drugs may be needed.

Comprehensive Treatment of the Disorder

Resolving the issue requires identifying and eliminating the psychological cause of enuresis. Even adults often cannot understand their feelings independently. If tests are normal, seeking help from a psychiatrist or psychotherapist is advised. Physiotherapeutic procedures and a course of prescribed medications can quickly lead to positive dynamics.

Drug-Free Therapy

Again, it’s crucial to confirm that the problem is solely neurotic before starting specialized therapy. In addition to working with a psychologist, the treatment plan includes auxiliary methods such as hypnosis, autogenic training, hardening, acupuncture, diets, and physical exercises. Seeking professional help in time can aid your child and the entire family.