Treating Nocturnal Enuresis in Children

Elaborate with colours, feelings, voices and sounds so that once again you have your own script which has been at least half elicited from the child to feed back strongly to the child once they are in trance. In fact, my belief is that the child is already in an altered state at this point, (a state of strong internal focus) and this is the first run through of your therapy.

Go through the routine that you expect them to keep to, always eliciting and gaining agreement as you go along, eg Drink a lot of water during the day, go to the toilet and practise stopping and starting the flow, cut down on caffeine drinks, and make the last drink in the evening around teatime (obviously this depends on the age and the child’s bedtime, but discourage drinks just before bed.) As long as the child is drinking plenty of water during the day it will not hurt them at all. Before they go to bed each night, I ask them to run through a private video in their heads seeing themselves locking up the bladder door, getting the sentries in place etc. either sleeping through the night or having the sentries calling up the brain on their mobiles. If they use their mobiles they get the child to wake up and go to the toilet to unlock the bladder gate and empty the wee into the toilet where it belongs. They see themselves going back to bed and waking in the morning with a dry bed, big smile etc. (in other words feeding back everything that has previously been elicited from the child him or herself). Since the child will do this in one or two minutes or less, it is no hardship and the vast majority keep to doing it each night with no problem at all.

At last comes the time for a bit of overt trance work; choose whichever method you think fit, remembering that children often wriggle around and sometimes act out the movements as you talk. This is not always so, however, and sometimes they go into very deep and still trance states and display the signs you normally see in adults. At this point you more or less repeat everything you have already done getting them to watch the 'Kieran' channel on TV and intersperse indirect and direct suggestions. Although in general I agree with keeping the focus on beds being dry, I have also achieved good results at times from using the direct suggestion to 'stop wetting the bed', particularly where this is the stated aim of the child him or herself.

I talk about the different ways that children respond to the treatment; how some just decide to have all dry beds from now on; some decide to do it in a few days from now, and some do it gradually, a little by a little by a lot. I will do this both in and out of trance; the presupposition is always certainty that they will achieve their aim but there is leeway in the period of time taken to achieve it. In this way, disappointment is avoided without loss of confidence if they do not respond immediately. On subsequent visits, I check on how well they have been doing, always remembering to credit them with success where there has been even the smallest amount of positive response. If the response has been positive, I build on what has been done before with basically more of the same, plus lots of ego strengthening and congratulations. If there has been no response, I will ask questions to check what has been going on for them at school / at home during the week, whether they went through their private video routine each night (I get them to re-run it for me at the time so I can check that they were not giving themselves negative programming by mistake), whether they stuck to the no drinks at bedtime routine. I will then choose some variation on one of the following:

Always include some kind of ego strengthening and give as much credit as possible for any small amount of progress, even if that is being able to stay confident and in a good mood while he is doing things more slowly. Self-esteem always needs boosting;

Treating Nocturnal Enuresis in Children - 2

Elaborate with colours, feelings, voices and sounds so that once again you have your own script which has been at least half elicited from the child to feed back strongly to the child once they are in trance. In fact, my belief is that the child is already in an altered state at this point, (a state of strong internal focus) and this is the first run through of your therapy. Go through the routine that you expect them to keep to, always eliciting and gaining agreement as you go along, eg Drink a lot of water during the day, go to the toilet and practise stopping and starting the flow, cut down on caffeine drinks, and make the last drink in the evening around teatime (obviously this depends on the age and the child’s bedtime, but discourage drinks just before bed.) As long as the child is drinking plenty of water during the day it will not hurt them at all. Before they go to bed each night, I ask them to run through a private video in their heads seeing themselves locking up the bladder door, getting the sentries in place etc. either sleeping through the night or having the sentries calling up the brain on their mobiles. If they use their mobiles they get the child to wake up and go to the toilet to unlock the bladder gate and empty the wee into the toilet where it belongs. They see themselves going back to bed and waking in the morning with a dry bed, big smile etc. (in other words feeding back everything that has previously been elicited from the child him or herself). Since the child will do this in one or two minutes or less, it is no hardship and the vast majority keep to doing it each night with no problem at all. At last comes the time for a bit of overt trance work; choose whichever method you think fit, remembering that children often wriggle around and sometimes act out the movements as you talk. This is not always so, however, and sometimes they go into very deep and still trance states and display the signs you normally see in adults. At this point you more or less repeat everything you have already done getting them to watch the 'Kieran' channel on TV and intersperse indirect and direct suggestions. Although in general I agree with keeping the focus on beds being dry, I have also achieved good results at times from using the direct suggestion to 'stop wetting the bed', particularly where this is the stated aim of the child him or herself. I talk about the different ways that children respond to the treatment; how some just decide to have all dry beds from now on; some decide to do it in a few days from now, and some do it gradually, a little by a little by a lot. I will do this both in and out of trance; the presupposition is always certainty that they will achieve their aim but there is leeway in the period of time taken to achieve it. In this way, disappointment is avoided without loss of confidence if they do not respond immediately. On subsequent visits, I check on how well they have been doing, always remembering to credit them with success where there has been even the smallest amount of positive response. If the response has been positive, I build on what has been done before with basically more of the same, plus lots of ego strengthening and congratulations. If there has been no response, I will ask questions to check what has been going on for them at school / at home during the week, whether they went through their private video routine each night (I get them to re-run it for me at the time so I can check that they were not giving themselves negative programming by mistake), whether they stuck to the no drinks at bedtime routine. I will then choose some variation on one of the following: Always include some kind of ego strengthening and give as much credit as possible for any small amount of progress, even if that is being able to stay confident and in a good mood while he is doing things more slowly. Self-esteem always needs boosting;		More formal hypnosis using a 'convincer' coupled with strong direct suggestions; New visualizations of different desired outcomes, eg. always being woken up by the sentries to go to the toilet rather than sleeping through the night. Little girls may prefer fairy godmothers, fairy princesses, etc., watching over them when they sleep, sprinkling magic dust or magic spells; Dreams where they speak to someone who looks just like them who has found a way to get over the problem; Swish Technique; Metaphor. Where there is sudden onset, there is an obvious need to uncover the cause and help the child deal with the feelings; expressing and acknowledging their feelings may be sufficient in itself, dispelling fears, reassurance that a previous negative experience is unlikely to happen again, allowing the expression of anger, encouraging the child to grieve the loss of a person / animal / home / friend / role in the family, explaining that some events which have occurred must be told to an adult and that they themselves are not to blame. There are so many ways of dealing with the above that they require a separate article and will not be dealt with in more detail here. It is important to be aware that there are cases where there is no progress and it is vital for the child to understand that for some reason this may not be the right time for it to happen, but they should be reassured that their inner mind is working on the solution and will surprise them by sorting out the problem in its own time, in its own way. This is clearly of the greatest importance because otherwise there is a danger that an already low self-esteem can plummet even further. They can be told about other clients who have responded in the same way so they are reassured that they are not the only one. Of course there may be many reasons, only a few of which are listed below, for lack of progress: Insufficient rapport with, and lack of trust in, the therapist; Lack of skill of the therapist; Lack of neuro- physiological maturity despite chronological age; An organic problem which has not been diagnosed despite medical investigation; Lack of support from the parents, practically or emotionally; An emotional factor of which you are unaware; Pressure (either regarding this problem or some other problem) from parents, grandparents, siblings, school; Minor ill treatment by some significant person in their lives or even serious abuse; An unconscious need to rebel against a parent; A need to get more attention; it may be that too much attention is being given to another sibling; The child may not be particularly receptive to hypnosis. We may never know exactly why any one individual fails to respond and I believe it is important to accept from the outset that in some cases hypnotherapy is not the treatment of choice for an individual client. It may be that they should be referred to somebody with more experience, referred for further medical investigation or for psychotherapeutic help or it may be that they merely need more time to develop. The latter can often be the case with nocturnal enuresis. Having said that, most children respond easily, get excellent results and are a delight to work with.
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