Where beliefs about incontinence originate and their impact

How we respond to incontinence in ourselves or in other people is influenced by many factors including childhood experiences.

A big part of it relates to how we learnt to control our bladder and bowel as children. As a part of acquiring the skill to control our bladder and bowel, most of us are taught to avoid touching urine or faeces, our own, or others.

We are told urine and faeces are dirty and smelly, particularly faeces. We learn to associate the smell, sight and touch of urine and faeces with feelings of disgust. This shows on our faces.

We are often praised for gaining control of our bladder and bowel and are quick to feel a sense of shame if we have ‘an accident’. Shame and disgust are very powerful and deep seating emotions. So too is the sense of competence when we independently develop control of our bladder and bowel and can go to toilet on our own.

Social norms

There are also rules we learn as children about where and how to empty our bladder or use our bowels, and these rules differ depending on our gender. In many cultures, little boys are socialised to pass urine standing up and it is acceptable to do this in the presence of other boys or men, and even in public places.

By contrast, little girls are taught to pass urine in private, behind closed doors in toilets. These rules are called ‘social norms’. Most social norms are often so ingrained in society that we don’t even think about them. That is, until something undermines our ability to adhere to them.

Childhood shame

Responses to developing incontinence (‘an accident’) are highly individual and are likely to vary by gender. But the feelings of shame and disgust we learn in childhood often resurface. They can make us judge ourselves harshly and fear other peoples’ reactions and judgement. This, in turn, makes us tend to hide the problem from others, including from those who are closest to us and our doctor.

In fact, some people successfully conceal the problem for years, and it only becomes apparent when they develop dementia or need to depend on another person to help them with personal activities of daily living. Deep seated emotions and beliefs from childhood are likely to come to the fore when we are forced to depend on someone to help with personal care related to incontinence or bladder and bowel function.

We take our ability to reach and use the toilet, wipe ourselves or manage incontinence for granted. In fact, such is the value we adults place on our independence, that most of us decline help of this nature until a crisis.

Your task

The video in this Step features Dr Joan Ostaszkiewicz who is a registered nurse and a researcher from the National Ageing Research Institute. Joan is speaking about the basis of beliefs about incontinence and the effect of these beliefs on attitudes to adults with incontinence.

Take the time to watch the video and reflect on what you were taught about continence, incontinence or having an ‘accident’ as a child. Consider how this might affect your current beliefs and attitudes. Join the conversation to share your thoughts.