Incontinence and your emotions

Incontinence, whether slight or severe, can affect you emotionally as well as causing practical problems. It can affect the way you see yourself and the way you think other people see you.

Why does incontinence have such a strong effect on our feelings?

There are many reasons, some of them simple and some of them complicated. Understanding why incontinence effects you so deeply can help you to feel better about yourself and to tackle your bladder or bowel problem more positively.

Are you the only person with this problem?

Bladder and bowel problems and incontinence are very rarely discussed and so it is easy to feel that you are the only person that has such a problem. Yet statistics show that you are likely to know others with similar problems - and who also probably think they are alone. Those who confide in friends or family have normally find that their problem is accepted in a sympathetic and matter-of-fact way ... and also that very often the person they are confiding in knows of someone else who has a similar problem. Immediately they feel not quite so alone.

Will everybody know that you have a continence problem?

You may be worried that others will notice that you are wearing a pad or a leg bag or that your incontinence causes an odour that others will notice. This is rarely the case. Others will not notice the slight bulge that a pad or a leg bag sometimes causes for the simple reason that they are not looking for it. As well as this, most are far too caught up in their own thoughts and conversation to notice such things!

Ask yourself this: before you developed a bladder or bowel problem did you ever notice anyone else wearing incontinence aids?

Probably not ... and yet, as has been pointed out already, the numbers show that you must have been in the same room as other incontinent people often.

Urinary incontinence should not cause a problem with odour. Urine should not smell strongly when it is fresh. Wash well daily and change wet pads or clothing frequently to prevent odours from occurring. Faecal incontinence causes more of a problem but with proper protection, good personal hygiene and changing promptly after a leakage many problems can be avoided.

Will others think less of you if they know about your problem?

It may be useful to turn that question around and to ask yourself whether you would think less of any of your friends if they became incontinent. Imagine that it is a friend or family member who has this problem: you would want to do anything you could to help - and you would probably hate to think that they may have been hiding such a problem from you out of shame or embarrassment.

Sharing your problem.

Incontinence is an embarrassing problem and you may want to keep it a secret. But by doing so you are cutting yourself off from the support of family and friends that you would call on when you have any other problem. For some people, keeping their bladder or bowel problems a secret can become so important that they end up not going out and not having visitors - cutting themselves off from those they love most.

Sharing your problem with close family or friends means that they will understand better why your behavior may have changed recently and it will enable them to help when they can. Remember that people want to help those that they are close to. Often the help they can offer is simply being there for you, being willing to listen and able to understand when you are unhappy or frustrated. Telling a few close friends or relatives about your problem can make things easier in other

ways. Because they know about your problem they will understand when you have to go to a toilet frequently or when you take slightly longer than you used to - they can help you to plan for this and can “cover up” for you.

Taking control.

Once you have decided who to tell, plan when and where to meet and what you are going to say. You will have to explain the nature of your problem and why it has happened and discuss how it affects you. Think about how much you want to tell each person : you are still entitled to your privacy. Think about how the person you are talking to might be able to help and tell them.

Just as it is important to share your problems and receive the support of others, it is not essential to tell anyone and everyone. Choose carefully who you want to share this part of your life with.

Taking this approach can help to put you in charge of your incontinence, rather than it being in control of you.

Why does incontinence affect us so deeply?

Even though it is remarkably common, incontinence itself is a taboo subject. It is associated with infancy or with the loss of faculties, which can sometimes accompany old age. As such it is often unhelpfully regarded either as a subject for cruel jokes or as shameful or degrading. Few people can remember actually being potty-trained as children, but the importance of becoming “dry” and “clean” and “grown up” is impressed upon us at that time and remains with us.

Most people will remember the reaction of other children to anyone who “had an accident” at school or who was known to wet the bed. Some people remember better than others because they were the ones being laughed at or teased by the others. All these things stay with us right into adulthood. The importance placed on becoming dry, not having accidents and not wetting the bed in childhood can cause problems later in life. When any of us becomes incontinent even to the slightest degree we can immediately become embarrassed, even ashamed.

Another reason for the taboo, which surrounds incontinence, is that it involves the genital area. This means that it gets mixed up with taboos, which surround the sexual organs, especially amongst older generations. For everyone, young or old, the need to wear pads or a catheter or to have an ostomy changes the way we think of ourselves. For those who are active sexually, or who want to be, this can be especially difficult (there is a separate leaflet available about this).

What can be done?

Remember you are not alone. Do not worry that others will think less of you because you have a bladder or bowel problem. Imagine that it is a friend or relative who has the problem rather than you: ask yourself whether you would think less of them, or whether you would want to support them. Consider sharing your problem: do not push away from you those who would want to help.

Take control of the situation.

How do you see yourself?

If you sometimes feel very low or think about yourself in a negative ways, try this exercise, which helps many people to see themselves in a much better light. When you are feeling low, it is hard to see hope anywhere or good in anything. This is a very simple and surprisingly effective way of reminding ourselves of the positive things, so easily forgotten when your spirits are low. Wait until a time when you are not feeling low and sit down with a pen and a piece of paper.

Write down, in separate lists, good points about yourself and bad points also. Think about the following:

• What do others think of you?
• What are you good at?
• What have you achieved - remembering that family and home-based achievements are just as important as any others?
• What type of person are you?
• Who have you helped?
• What relationships are important to you?
• What goals do you have?

Do not worry if you find it easier to think of more bad points than good at first - that is quite normal, because it is always easier to be critical of yourself than it is to praise yourself!

Gradually, perhaps over a few days, think of more good points than bad. It can help if you try to think about how friends and relatives think about you rather than just thinking of yourself from your own point of view. You could even ask somebody close to you to help. Keep this list of good points and bad somewhere safe. When you are next feeling low, upset, frustrated or worried read through the list and it will help to remind you of the way things really are rather than only being able to see the worst in yourself. If you often feel low because of your continence problem, remember that you can ask your doctor whether it is possible for you to talk to a counsellor or a psychologist for further help.