Bed-wetting or nocturnal enuresis is the unintentional passing of urine at a time when the bladder should already have control. Standard treatment through the NHS is through GP surgeries which use specialist nurses. These usually are there for really young children and are limited use to older ones who know they have a problem but just don’t know how to control it.
The condition as solution focused therapists see it, lies not just with the bladder control, but the sleep pattern. The person is sleeping too deeply, which means the signal being sent from the bladder to brain to wake up and empty is not being detected.
This sleep behaviour appears to fall into two categories from my experience:
Late sleep cycle wetting
When the person may wake after 2 or 3 cycles and goes back to sleep deeply again and has ignored the full bladder message. This condition can be related to symptoms of depression. Just the continuous cycle of bed-wetting can spark this depression, so focusing on what helps, relaxation and working through how they feel about things can often help. Along with body alarms that you can set to a clear sleep pattern, can alert the person to getting up and emptying the bladder before going back down into the deep sleep.
Early sleep cycle wetting
This is when the person is bed wetting in the first 90 minutes. This is often linked with sleep walking condition in the slow wave sleep cycle, called NREM parasomnia disorder. American research has found that activity during this cycle is linked to lack of self esteem, and cases I have seen have been mostly in young men on the verge of pubity that find fitting in with the “in crowd” to be difficult. Watches that vibrate the person awake can be still helpful here, but focusing on building self esteem appears to be more effective.
One key element here is blame. No one is to blame, it’s just one of those things. Older children and adults who are bedwetting are not doing it for fun, or spite and all would happily wish it away. So the things you can try yourselves before going to bed are:
- Make sure you’re winding down for the day.
- Don’t watch TV as you go off to sleep, the blue light from the TV can have an effect on melatonin.
- Read a book or a magazine to help you drift off
- Listen to relaxing music or a relaxation CD
- Wake yourself up properly when you come out of a sleep cycle and make sure you go to the toilet – the signal can take time so making the trip can help things along. You could use a vibrating watch to wake you if you’re away on camp or sharing a room.
- Have a bath an hour or so before bed time this can help the sleep.
- Keep a journal to find times when it’s better and times when it’s worse. Quite often being very energetic and tiring oneself out can add to later bed wetting.
- Start to feel better/good about yourself, this will help change the brain chemistry and help make the sleep patterns lighter.
Solution focused therapy for Bed wetting
Allowing the child or adult to understand what is driving the bedwetting and to focus on the times it’s not happening, can help a person to move forward and not feel so bogged down by the stress and the guilt the problem creates. With the cases I have worked with, each individual had a different cause and a different outcome they wanted to work on. Several children made the discovery using the CBT activity sheets that doing too much made them over tired and that was the time they wet.
Another difficult case where the child would not talk until the fourth session told me he found it difficult to mix at his new school as the children were all superficial (a deep one there). He didn’t like to make small talk which is why it took 4 sessions to get an answer! Each one of them have understood what was going on, came up with their own solution.
Hypnotherapy for Bed wetting
Hypnotherapy works well for bed wetting as it allows the client to relax, focus on what they can do to achieve a positive outcome and to give post hypnotic suggestions to allow them to be more aware when they may wet.
I used to find that I dreamt awkward situations that would wake me and I’d find myself needing the toilet. I helped some clients to develop awkward dreams themselves to help force them awake.
CBT for bed wetting
CBT forms can be utilised to find out what is actually happening during the day, to determine when they wet at night. Activity sheets can help pinpoint activities, thoughts, feelings and help a client understand the processes that underlie the problem. Once this has been established, then SFT can help them move forwards.
Mindfulness for bed wetting
If a client is feeling stressed about the bed wetting, the more they are likely to wet the bed, so mindfulness can help reduce the worry and to allow the client to feel calm, confident and focused. Depending on the influences of stress, whether it’s school or work, I can tailor make the mindfulness programme to meet their needs.
Case Study of Bedwetting
Joshua had just turned 12 and was in his first year of High School. He had been wetting the bed the past year and was worried about staying at friends houses or going to scout camp because he may wet there. He had been to the GP and had fights with the nurse because she suggested he was doing it on purpose!
Desperate the family turned to me, as I was local, but Josh’s face was a picture when I explained it could be he was just sleeping too deeply. His mum did say he took ages to wake up in the morning. So we set ourselves some small tasks to try. 1) to keep a journal of everything he was doing. 2) No TV, computers or phones at least an hour before bed, he could read, but nothing too scary.
Josh loved golf, so he decided to read his golf magazine before turning the lights out.
A week later he was back, we looked at the diary one thing stood out to me – activities. On the days he had after school activities he wet the bed. At the weekend too, he’d played several rounds of golf – more wetting.
He wasn’t happy about this though because he wasn’t very academic, and the only thing he loved was sport. I suggested that now might not be a good time to do so much, but as he grew and became stronger and fitter, he’d be able to play much more sport.
Over the next few weeks, by lowering his anxiety over wetting and by cutting one or two sporting events out, Josh found a balance. I also found a watch that had an alarm that vibrated. He had said on a number of occasions that he awoke about 3am, but went back to sleep again. He then wet the bed shortly after. I suggested he try to get up and go to the toilet, perhaps the journey there would wake him up more, and it did. So his parents bought him the watch, so he set it for 3am and every morning he would get up and go to the toilet at this time. This stopped his wetting altogether and it gave him the confidence to go to sleepovers and scout camps.
Penny Ling is a widely experienced hypnotherapist who has worked with everyone from top executives to stroke victims since 2007. She has been editor of Hypnotherapy Today Magazine and is a supervisor and mentor for members of the AfSFH and NCH.
Read Penny’s inspiring story “How I beat all my phobias”, or find out more how hypnotherapy could help your problem by downloading “How Solution Focused Hypnotherapy can help with life”. Feel free to send Penny a message here.