Overcoming Shy/Overtrained Bladders

-By BitterGrey

"It is a pain in the butt. ... I have to pee, but even after concentrating for nearly a half hour, I've been unable to. Why? I'm sitting in the school cafeteria. I don't know how deep the psychological training has been ingrained into me, but it's enough that I'm unable to relax enough to wet. Though the moment I'm outside, by myself, I'll be able to wet with no problems. " -LilDobe

When it comes to urinating, we have less control than we think. Far from helplessly wetting, there might be times when we can't pee, no matter how hard we try. Potty training focused so heavily on not wetting that now, sometimes we can't pee when we want too. The problem is most often felt in public restrooms, where it is called a "shy bladder" or parureseis. However, it may also be a problem for those starting to use diapers again. For me, the problem times were while walking, laying down, and driving.

To urinate, the bladder and two muscular valves, called "sphincters" need to work as a team. The external sphincter is consciously controlled, while the internal sphincter is not. They have been trained to hold on most of the time, especially when clothed or in bed. As a result, we need retrain them. They need to be taught that it is OK to wet diapers, etc.

The concept of retraining is simple: start in a situation where it is easy to wet, and move toward the situation that was giving you trouble, step-by-step. Each time you feel the urge to pee, confirm that everything is ready, encourage yourself to pee, and then praise yourself for your success.

Step one: Prepare

Of course, the first step is to prepare. Make sure the diaper is secure and capable, so it won't leak. Take extra precautions against leaks, both for emotional security and because you'll be peeing a lot during practice. For example, if you are training for beds, make sure your mattress is covered and clean sheets are on hand, so you'll be OK even if your diaper leaks. Leaks are a negative re-enforcement, one of the things that trained us to be dry in the first place. For males, you'll want it either up or down. Peeing straight into a diaper that is pressed against the head of the penis can cause a backpressure that hurts (or worse). Go over everything and reassure yourself that the diaper won't leak, and that it is OK to use. Next, drink extra water. This increases the urge and condenses training time.

Sip the water frequently over a period of time, generally not more than a liter an hour. Don't drink to the point where you feel sick. Drinking far too much water within a short period of time can lead to euvolemic hyponatremia, which can be fatal. In addition, don't let the urge rise to the point of being painful. This may drive urine back into the kidneys, damaging them.

Step two: Practice

Start in a position that you think you can pee in, and then move towards the difficult position step-by-step. For example, if you want to learn to pee laying down, start out standing, then pee a few times, sit on the edge of the bed, pee a few times, sit in the middle of the bed, pee a few times, and finally lay down, and pee a few more times. Each time, you'll want to...

• Before the peeing, reassure yourself that it is OK; that your diaper will hold, and will be warm afterwards. Remind yourself how much better an empty bladder will feel. (This is important, because doubts or anxieties will cause you to close off the external sphincter.)
• Count to twenty slowly while breathing in and out. Try to relax and let it flow.
• While peeing, enjoy the trickling sensation.
• After about three seconds, stop the flow gently. This way, you'll be ready to pee again shortly. Praise yourself for success and enjoy the feeling of an emptier bladder. (If there is any pain or soreness involved, interupting the flow may not work for you. It may be best to let your bladder drain.)

A few practice sessions may be needed. There is one detail that could be difficult...

Step two and a half: Getting the flow started

Counting and breathing doesn't work for everyone all the time. Here's a list of techniques that you can try. Use the ones that work best for you. Don't wait until it hurts.

• Dampen the front of the diaper slightly by pouring a little warm water down the front.
• Imagine yourself in the bathroom. "It's hard sometimes when I'm driving... naturally, but to 'let go' I sometimes visualize that I'm standing in front of the toilet, and tell myself it's 'OK' to go." -Rugger
• Visualize your bladder and sphincters operating, and enjoying the feel of the warm urine dribling over your genitals.
• Yoga-like relaxation techniques that involve tensing up, and then progressively relaxing. (An example is at the European Paruresis Association.)
• Stay in position, but do something else to give the bladder a chance to fill a little more (but not to a level that is painfull).
• Gently press on the bladder with your hand, just above the pelvic bone in front. Be careful not to drive urine back into the kidneys.
• Change to a slightly easier position, pee a few times, and work your way back towards the hard positions.
• Use a breath-holding technique, as described in the International Paruresis Association FAQ
  Since no devices are used, the breath-holding technique does not involve a risk of suffocation. However, it may involve other risks present in breath control. Freedivers hold their breath regularly and longer than required for this technique, but they are in exceptional physical shape. Done properly, this technique should not involve spasms or breath held for over one minute.
• Hypnois might also help. However, most files will be dedicated to giving up control. Those with shy bladders first need to get control before they can try to give it up.

Long Term Effects

Though it may take some practice, you should eventually be able to pee in the situations that gave you trouble before. Of course, how much practice will vary from person to person. Some will have to work at it for a while. Once the overtrained bladder is overcome, you'll be able to wet when you want. It will also give you the option of going on to use natural untraining techniques to eventually become incontinent, if you wish. Of course, this would involve wearing and using diapers 24/7.

On the other hand, if there is a long period without wearing diapers, there are some shy bladders that will revert: they get out of practice if they don't wet in problem situations often enough. Annoyingly, I'm slow to retrain, but quick to revert. It is best to be consistent. Choose when and where you want to wear diapers so that over time, your bladder will get used to doing what you want it too.

Email BitterGrey Level: Intermediate | Last Update: 22 Nov 2009 | First: 11 October 2002

Undrdog offered a suggestion about learning to wet in bed: "Starting standing up or kneeling in bed helps. Also, and this is strange, if you are laying on your back, lift your head up. I don't know why that helps, but it does. A lot of it has to do with just getting comfortable with the idea and trusting your diaper. It comes easier when you know you're in a thick diaper with plastic pants that won't leak.

	Related Topics: the International Paruresis Association