Kamboj, S;
(2014)
Focus on bowel and bladder-control anxiety.
Anxious times
, 89
p. 7.
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Abstract
Most people can remember a time when they have been desperate to use the toilet and found one just in the nick of time. But imagine having this experience routinely, every time you went out. This kind of experience can create a tendency to experience unhelpful thoughts like “I need to get out of here or I will wet myself” and a general preoccupation with being incontinent. This is what happens to people who have bowel and/or bladder-control anxiety (BBCA). Their worst fear is that they will be incontinent in a public place. We have conducted one of the first detailed studies of bowel and bladder-control anxiety, which was published 2014, by our team at University College London. This preliminary study of 140 people with BBCA anxiety found that there was an equal split between people who mainly had concerns about bowel control (~40%) and bladder control (~40%), with a smaller proportion having concerns about both (20%). Fifty percent had actually had at least one episode of incontinence in public ‘since school age,’ so it may be that people begin to believe that a future occurrence of being incontinent in public is more likely. BBCA fears tended to develop in people in their mid to late 20s and the majority of sufferers (75%) were women. A majority of the respondents also reported experiencing panic attacks (78%). One particularly striking finding from our research was the tendency of people to believe that being incontinent in public was very shameful and disgusting. They believed that other people would be unforgiving and unwilling to help them. While it may be natural to associated body waste with disgust, and losing control with shame, it was the level of shame and disgust that was noticeable. Many people indicated that being incontinent in public was the most shameful thing that could happen to someone; that it made them a disgusting person. Our experience of treating patients with BBCA suggests that they often respond well to cognitive therapy. For other patients who have high levels of shame and beliefs about self-disgust, additional techniques might also be useful. One of our aims is to develop a more complete understanding of the condition, which will enable us to devise more effective treatments. We hope that our studies will provide the basis for future research to develop more effective treatment for a set of symptoms that has been neglected for too long.
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