$46.95 / Perfectbound
ISBN: 978-0-615-35220-6
212 pages

Excerpt from the Book


We all control our bladders. How well is a matter of degree.

At the outset of this book, I want to emphasize that everyone, female and male, has at some point been in a panic to make it to the toilet. I also want to emphasize that everyone has had a bladder accident. Men tend to have fewer accidents, because the lines in their public rest rooms are usually shorter, and men are also built so that they can take advantage of alternative locations, whereas for women things are not that convenient. Since this book is directed to the incontinent woman (although it is useful for men as well), it is important for you to understand that you are not any different from the rest of the population; it is just that for women like us, the need to urinate is more frequent and immediate. Various conditions cause incontinence to develop. Whatever the situation might be, the end result is that we have lost much of our ability to control our release of urine.

“Micturition (urination) is a reflex action, which in a toilet-trained individual is controlled by the higher centers in the brain.”1 This reflex is initiated when the bladder fills with urine, which stimulates the stretch receptors in the bladder that signal the conscious desire to urinate. “Urination can be assisted by contraction of the abdominal muscles so as to raise the intra-abdominal and pelvic pressure and exert external pressure on the bladder.”

In young children, urination or micturition is a simple reflex action that takes place whenever the bladder becomes distended.3 As infants, we were not concerned about when or where we fulfilled our need to eliminate. Only when our primary caregivers decided it was time for us to learn control did the process of toilet training begin.

Toilet training is the process of learning how to recognize the body’s signals to eliminate and developing the physical skills of control so that we can wait until we reach a socially acceptable place to eliminate. From the time that we are toilet trained, we spend the rest of our lives controlling our bladders or trying to control them. Our conscious and unconscious attitudes towards our body’s elimination processes are formed in these early years. Toilet training can be easy for some children and very traumatic for others. The effect of the training depends on the individual child’s temperament, the attitude of the trainer, and the way that the task is presented.

Voluntary control of urination is normally developed during the second or third year of life.4 During our training, we learn to identify the feeling of wet and soiled diapers. We are taught that these conditions are not desirable, especially in social situations. We learn to estimate our social acceptability by observing the reactions of others concerning our control or lack of control when we are wet or smelling of urine or feces. At this early age, issues of self-image and even self-imposed isolation can arise surrounding the need to develop bladder control, and these issues can continue into adolescence and adulthood.

As developing children, when we do things over and over again, we do not consciously think of it as practice, but that is exactly what we are doing: We are practicing. Dr. Howard Bennett, a Washington pediatrician, advises children and the parents of the children who have bed-wetting issues that it takes practice to achieve bladder control. “If you pay attention to your bladder in the daytime, you’ll pay more attention at night,” Bennett says.

To regain bladder control as adults, we have to go through a form of adult toilet training. No matter how unappealing this may sound, it is true. Learning control of the bladder is the same as when we were infants: “Voluntary control of urination is accomplished by contracting the sphincter urethrae, which closes the urethra.”7 But as adults, we must approach the task of learning this voluntary control with a conscious attitude of purpose and with a desired outcome in mind.