Unrecognized and taboo

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The nocturnal enuresis (nocturnal enuresis) and the daily bed-wetting (enuresis diurnal) is one of the most common childhood diseases. 10-20% of the 5-year and 3-5% of the 10-year-old children suffering from this pathology. (Heinemann and Hopf, 2012, p 245) is often shameful the topic and will be negotiated and tried to solve, because it is rarely noticed in the environment, especially if the bed-wetting at night only happens within the family.

School trips or overnight stays at friends become problems as the child and the parents are confused about how to deal with the bedwetting. Shame is often too large, that child may feel betrayed sometimes by the parents. In other cases, bedwetting is trivialized, perhaps because the parents einnässten as a child as well, the symptoms disappeared by itself or because the child is still small. Often then diapers are used.

The causes of enuresis can be very different. In addition to organic and genetic causes, is often clear that an emotional disorder (eg anxiety, depression), an extreme stress or a developmental disability is a priority. Therefore, a detailed diagnosis is essential.

The theories for the treatment of enuresis are of various kinds, many successes have been achieved by direct behavioral changes are sent with a reward system, a bell mat to the toilet, for example, keeping a diary. These are behavioral therapeutic approaches. Psychodynamic approaches attempt to gain from illness of enuresis to understand (eg go back to sleep in parent's bed) and to address these with the family and the child. In some cases, children do not dare to use the school toilet for fear of enclosed or to be annoyed. Other children are disgusted by the toilet or are too engrossed in the game and seem to forget that their bladder is full.

Even in this short blog will show how diverse is the theme and how different the schools deal with these. In the next blog will be about the treatment with sand play therapy in enuresis.

The author Daniela Penkwitz is educator, graduate päd, child and adolescent therapist iA you concerned for some time with "enuresis". In practice, she leads groups as well as individual modules on this topic.

Multimodal Therapy

Montag, 2. Juni 2014