HOW TO DEAL WITH PROBLEMS OF

BEDWETTING AND INCONSISTENT CONTROL

OF BOWELS AND BLADDER

Debra woke up one morning to find that her sheets were wet again. She just brushed it off and went on getting ready for school. Her mother walked into her room to see if she was up and noticed the giant wet spot on her bed.

 “Debra, honey,” she began, “you need to stop doing this. You’re nine years old and far too old to be wetting your bed.”

 “I’m sorry, mommy,” Debra responded, “I don’t mean to, honest. I’ll try to stop.”

Debra ran downstairs while her mother started gathering up the sheets to put in the laundry for the third time that week.

 

CONTROL OF BOWELS AND BLADDER:
 

Mrs. Lennon was reading her class a story to her class when one of her students, Dylan, interrupted.

 “Mrs. Lennon,” Dylan exclaimed, “Jasmine peed again!”

Mrs. Lennon put down her book and walked towards Jasmine while all the other children quickly scurried away. She noticed that Dylan was correct and that Jasmine’s pants were wet, as was the large wooden block she had been sitting on. Mrs. Lennon told her to go to sit at her desk while she telephoned her mother.

 “Mrs. Inglis, your daughter cannot control herself. I know there’s little that you can do about this, but can’t you call a doctor or something?  The other children tease her and I feel sorry for her.”

Mrs. Inglis apologized and said that she’d leave work and come pick her up right away. As she drove towards her daughter’s school, she wondered how she was going to deal with this problem; nothing seemed to be working.

DISCUSSION

There has been much discussion about the possible causes of enuresis and encopresis.  Although causes are important to delineate, we will limit ourselves, here, to dealing with the secondary effects of these problems on the child’s place in the family, interactions with parents and others and self-esteem.

No matter what its cause, bedwetting can have a disruptive effect on the whole household.  Parents are often awakened during the night to change sheets.  Mothers do multiple laundries each week.  Mattresses and clothing smell.  The house begins to reek of urine, etc.

This disruptiveness can damage the child’s relationships with parents and siblings who react with annoyance, disgust and/or anger to the situation.  Parents “try everything” and become exasperated and short-tempered and may spank the child for “forgetting to use the bathroom.”  They begin to assume that the child is “just trying to get our attention” or “trying to jerk our chains” or “get back at us.”  The problem snow balls.

The parents’ tasks in this situation are: 1) to find practical ways to limit the disruptiveness of this problem on the family and to normalize the home life again.  The disruptiveness has been getting in the way of constructive family relationships and has been monopolizing the parents’ attention (further alienating any siblings); 2) to relieve the child’s anxiety and some of the underlying cause for accidents; 3) to shore up the child’s own confidence and coping abilities to weather this storm.

SOLUTION

The most effective way to normalize the situation and minimize the disruptiveness is to deal with the bed-wetting or clothes wetting in a neutral, matter of fact and pragmatic but friendly way.   In Debra’s case, the parents talk with her at a peaceful time after dinner.  Debras’s mother explains that this bedwetting seems to be a bother to Debra and the family and the mother wants to minimize this and make sure Debra and her room stay fresh and clean.  Mother has some ideas about how to deal with it in a practical way.  She asks them to come into Debra’s room to see some new things and see if Debra likes this plan. 

 “Now that you are old enough and very competent at these things--when you wet your bed how about you get up and take the sheets and the rubber pad off the bed as quickly as possible so that your room stays clean.  You can put them in this plastic bin with a self-closing lid that Dad got for your room.  What do you think of that?”

Debra likes the idea.  Mother continues, “Then, you can then remake your bed, using the clean sheets and underpad stacked on this shelf in your closet.  We can put clean underwear and pajamas in there, too, and even a box of wipes, if you want, so that you can clean yourself off if you do not want to take a full shower in the middle of the night.  What do you think?”  

Debra thinks this is all right as well.

Then, when you come home from school I can show you how to use the washer and dryer.  You are really good with machines, so I know you’ll be able to handle this, and you can wash and dry your sheets and clothes while you play outside or watch t.v.  It’s easy, I’ll show you how.”

Debra liked the idea and helped her mother set up the sheets, clean clothes and wipes.  She wet the bed that night, and tried out the whole routine.  She particularly liked using the washing machine and dryer.  On the third night, the routine began to be less novel and fun and more work. 

But Debra liked the fact that her parents said encouraging things about how grown up she was for taking care of her own bedding and clothing.  In addition, she liked spending special time with them each day and helping her parents with the laundry and cooking. 

With her increased resourcefulness, her parents extended privileges to her, saying she was old enough, now, and that they trusted her to go to her friends in the neighborhood by herself and to stay up later in the evening.  She did not want to lose these perks, so continued to care for herself.

Gradually, Debra found ways to remind herself to use the bathroom before bed and to wake herself if she felt she needed to pee.  In addition, a friend invited her to a sleep over and she wanted to make sure that she would not embarrass herself by wetting the bed.  Within 3 months Debra’s bed wetting had almost completely stopped.