Enuresis

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Enuresis is something that I am often approached with. This is a "lucky symptom" thanks to which parents, desperate to find medical help, sometimes on the advice of doctors, bring their children. Very often, if it were not for this symptom, no one would have noticed the difficulties that the child faces. But like any other symptom, enuresis does not in itself have a single meaning.

It means at least some kind of stagnation in development or regression. Very often, he himself is associated with aggressiveness and feelings of guilt. Sometimes persistence or return of bedwetting is a selective symptom for those children who cannot afford to masturbate. Since childhood masturbation is always associated with parental threats, colossal anxiety, shame and guilt.

It happens that a child unconsciously refuses to grow up so as not to lose the prerogatives of a younger age. This is why bedwetting may never end.

Only the study of the general emotional state of the child makes it possible to determine what obstacle he faced, finding the only possible solution for himself - enuresis. For this, as for other symptoms, there is no one psychotherapeutic attitude, because it would be aimed at the result, and not at the cause.

In certain cases, enuresis must be maintained for some time, necessary for the causes themselves to be eliminated, despite the parents' demand and the child's conscious desire. Otherwise, the refusal of this symptom, including in order to "please" the therapist and parents, may lead in the future to the formation of another symptom, possibly more dangerous.

In practice, there are cases when we get immediate and quick results without consequences in the form of character disturbances. As a rule, these are cases of enuresis in children with severe aggressiveness. But there are situations when it is necessary to minimize the importance of bedwetting, a symptom considered humiliating by all children. And it is important that parents trust both the analyst and the child.

Sometimes it will first be necessary to allow the child to have general aggressive behavior before asking him to sacrifice the local hedonism of the sphincter erogenous zones.

Work with children under 4 years old, those who are 6-7 years old and those who are over 8 years old will go differently. Since enuresis at different stages of development can serve as a protection against various conflicts that the child's psyche faces.

The symptom of enuresis is only of relative diagnostic value. From it alone, without knowledge of the accompanying emotional behavior, it is impossible to derive an understanding of the child's mental conflict, as well as therapy; in addition, when it disappears, the child is mostly still on the path to recovery, contrary to what parents think, for whom only the symptom itself causes anxiety, and it is enough for him to disappear for them to be satisfied, not knowing that this symptom is mutating in another, much more regressive, such as colitis, tics, stuttering, insomnia or psycho-motor instability with the threat of future unacceptable sexual or social behavior.

Based on the book "Psychoanalysis and Pediatrics" by F. Dalto