Saturday, December 5, 2009

BedWetting Myth Busters

MYTH - Bedwetters are psychologically disturbed.

In earlier times, the collective wisdom of medical and psychiatric professions had it that enuresis was the manifestation of some underlying unconscious conflict the child was experiencing. In other words, bedwetters were consider psychologically disturbed. From a psychiatric or psychological perspective, children wet because they felt angry or guilty. Doctors believed that if you removed the symptom (wetting) with out treating the real problem (the underlying unconscious conflict), that conflict will surface in the from od another symptom or behavior problem.

REALITY - Children who bedwet are no more likely to show psychological disturbance than their nonwetting peers.

So it is not surprising that researches have found that treating enuresis with traditional play therapy, aimed at identifying underlying conflicts, is not very helpful in remitting the wetting. Further more, children who have stopped wetting actually feel better about themselves and display no substitute symptoms. If wetting were the symptom of an underlying psychological problem, then after wetting stopped, children would be expected to display another behavioral or emotional problem in its place. Instead, children who have stopped wetting show increased self esteem.

These notions apply to the majority of children who wet. Nevertheless, a very small minority of children with daytime wetting do wet in an angry, manipulative way, urinating right in front of their parents or in some obvious place (such as on the kitchen floor or in their parents closet), where the parent is bound to discover the wetting. For these children, wetting is usually a symptom of their physiological problems. Children who engage in such behavior certainly need a professional evaluation.

Enuretic children show no higher incidence of psychological problems than their friends who do not wet. However, psychological issues do interact with diseases and conditions such as bedwetting. Our emotional well being influences not only our vulnerability to wetting problems but also our progress towards dryness.



MYTH - Bedwetters are immature.

During toilet training, parents praise and encourage their child when he uses the potty, "Your such a big kid!" If the child does not achieve total bladder control when expected, parents or other may scold him, "Your still a baby." The wet child, and his siblings and friends, get the pejorative message that something is wrong with him. His parents, who naturally would like to take pride in how grown-up their child is becoming, may act disappointed or embarrassed. In our competitive society, when children do not achieve development milestones (such as walking, talking, or controlling their bladder) as quick as their parents expect, their parents may feel like failures or worry that the child is "slow" or preschool or grade school, she may feel immature compared to her peers because she still wets.

REALITY - There is no normal age for all children to be dry.

Some children are fully potty trained by three years old, and the majority of children have acceptable bladder control by age five, but remember, the age at which children achieve total bladder control varies according to each individual, the majority of children who bedwet are not developmentally delayed. On the other hand, a minority of children who wet have been diagnosed by their pediatrician or psychologist as "mental retarded". Such as children not only show delay in potty training and attaining dryness but also display significant delays in acquiring other skills as well intellectual deficits. Most such children, however, can get to dry.



MYTH - Bedwetter are just too lazy to get out of bed and use the toilet.

Older children who wet may be accused of being lazy or unwilling to control a simple bodily function. Their parents may ask, Can't you even get out of bed for a few minutes to pee at night?

REALITY - Think about it, who would chose to sleep in a cold, wet bed?

Children who wet often sleep so deeply that they don't feel, or sense the urge to urinate. Others may sense the need to void but, dream that they are at the toilet, and start to urinate not realizing that they are still in bed.



MYTH - All children outgrow enuresis.

As we have seen, many doctors offer the hopeful advice that parents should just bear with a wetting problem until the child outgrows it. We hear practically nothing about young and middle-age adults who wet.

REALITY - In fact, 1 to 3 percent of the adults population (excluding people who are elderly or neurologically impaired) Have enuresis.

There is anecdotal evidence that for some adults, stresses they experience (such as college exams, personal relationships, alcohol use, and service in the armed forces) are associated with a reappearance of a childhood wetting problems. Some people with this condition are so secretive and ashamed that they manage to hide the problem, with great difficulty, even from their spouses. So there is nothing magical about the aging process that cures wetting.



MYTH - Children wet because they come from dysfunctional families.

It's a notion as old as the problem itself, wetting is the family's fault. If a child wets, she must be showing the effects of living in an unhappy home.

REALITY - Psychopathology probably occurs no more often in families with children who wet than it does in other families.

Research shows that most wetting is not caused by psychological problem alone, although for some children who have been dry previously, family stress is associated with the onset of wetting. In addition, when children wet, their family's difficulties may prevent them from outgrowing or overcoming the problem. For example, its is common for two parents who are already in conflict over other issues to use the child's wetting as another battleground, especially if they disagree about the causes and treatment of the wetting. To spite the other parent, one parent might intentionally undermine the treatment program, for example, by allowing the child to go to bed without putting on the enuresis alarm. Others, less mundane behaviors may also occur. When families can begin to recognize and work around the obstacles they themselves place on the path to dryness, children are much more likely to benefit from treatment.



MYTH - Parents of children with wetting problems have failed to raise their children adequately.

Some parents come to us feeling ashamed that they have somehow failed, despite their best efforts, to potty train their children. At times their feeling have arisen because a spouse or another family member has blamed they parent for the child's wetting. These parents hear recriminations such as, "If only you did a better job....John wouldn't have this problem."

REALITY - Inadequate parenting rarely causes wetting problems.

As we have explained, wetting problems have many causes. Unfortunately, parents feel a great deal of unnecessary guilt because of their children's wetting.

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