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Symptoms

The primary school pupil, let's call her Sarah, had an unpleasant symptom from which she suffered greatly. Since February 2023, she had not always been able to hold her urine - she had never had any problems with this before. She was generally able to hold in her pee for a very long time, but for the past six months, a few drops had often leaked into her underpants during everyday life. It was sometimes more, sometimes less - and often just a feeling or worry, even though nothing happened.

It usually happened when she was running, laughing or sneezing. And the worst time was always after she had been to the toilet. So when she had a wee, a few more drops would come out the next hour and end up in her underpants, which was very bad for her.

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Special program and conflict content

It was one of the special programs of the bladder sphincter - either that of the internal sphincter (entoderm, smooth muscles), the external sphincter (neu-mesoderm, voluntary muscles) or its innervation (ectoderm).

From the rhythm of the symptoms, we were able to deduce the SBS of the innervation of the external bladder sphincter. The content of the conflict is a “motor territorial marking conflict”, i.e. “I know where I can and am allowed to mark, but I can't manage to assert my right” - so it is about drawing boundaries with a lack of assertiveness.

During the conflict phase, there is a reduction in function, which means that the muscle does not close one hundred percent and urine is released in droplets - especially during exertion such as running, laughing or sneezing.

We explained the increase in symptoms after each visit to the toilet by the fact that the dysfunctional sphincter may close particularly poorly for a certain period of time following the maximum opening. Alternatively, urination could be a kind of temporary biological solution (she has now successfully marked her territory with urine), resulting in increased hypofunction because of the onset of the PCLA phase.

The new-mesodermal external sphincter muscle reacts to a “self-esteem collapse with its own urine”, which is quite a probable secondary conflict with incontinence and would have resulted in similar symptoms (“self-perpetuating vicious circle”).
Since the symptoms were always completely gone after a short time during the school vacations, it was possible to rule this out and find a clear lead in the direction of “everyday school life”.
An important clue was also provided by the mother's observation that the girl had the symptoms during one of the vacations when she was in vacation care, while they were completely gone after a few days during all the other vacations.

Cause

She was the center of a circle of friends consisting of four girls in her school class. The other three all wanted to be friends with her, but two of them didn't get on well with each other. One girl often teased or lied to the other, so Sarah had to protect the inferior girl or mediate between the two. Sarah always felt like she was being “tugged on” and found lying to one of them terrible because she was convinced that this was not something you did between friends.

In March 2023, there was a particularly bad argument in which one girl said to the other: “I wish you were dead!”.

In this situation, in which Sarah did not feel able to mediate and ensure peace between the friends (and parents involved), she experienced the motor territorial conflict where she was unable to assert herself so that everyone's boundaries were respected - and from where the symptoms started.

Since then, she always had to deal with the incontinence particularly badly when there were more arguments in her group. When they played together peacefully for a few weeks, the symptoms were reduced to a minimum.

In Oktober 2023, the three of us sat down together (Sarah, her mother and I) and carried out the 5BN analysis and discussed everything. Sarah cooperated wonderfully and we were able to get to the bottom of the exact causes. Based on her mother's notes, we were also able to validate exactly that the respective phases of conflict over the last few months correlated precisely with the respective intensification of the symptom.

The clearest thing was the complete disappearance of the symptoms a few days after the start of each vacation - with the one exception when Sarah was in vacation care, where the other two girls from her group were also.

Strategy and resolution

Of course, in this case it is difficult to find an external solution because it is almost impossible to avoid arguments between friends from time to time. The comforting thing was the prospect that she was already in 4th grade and would therefore be changing schools in the foreseeable future, which would almost certainly solve the problem, at least externally, as the girls would then no longer be together in this constellation.

Nevertheless, we thought about what she could do so that in future she wouldn't react so strongly with this SBS in these arguments, but would be able to remain much more relaxed.

One of the ideas we came up with was that she could get together with the losing girl and create a booklet together with the craziest sayings and actions of the other girl. A kind of “scrapbook” of the girl's stupidest actions. With the aim that they no longer feel emotionally attacked by it, but can secretly look forward to their actions every day so that they can expand their notebook together and create something “beautiful/creative/funny” from the “stupid”.

Sara was looking forward to putting these and other ideas into practice. In fact, it worked very well and the symptoms decreased significantly over the following months. It didn't completely resolve them, because she couldn't always avoid situations that caused her emotional distress. The symptoms were therefore still present in a mild, less stressful form until the end of the school year, but it was a good first beginning.

With the start of the new school year in a new school with other girls, the symptoms suddenly disappeared completely, as we had predicted - and have not occurred for more than nine months now.

Outlook

Of course, it is not impossible that similar arguments could occur at some point in her new circle of friends - which would be so similar in nature that the SBS would start again (lies, one picking on the other, her in the role of mediator).

In this case, you could see whether, in addition to new strategies on the outside, you can use therapeutic methods to bring about solutions on the inside.

Now that puberty is starting, their inner perception is also changing, so it is quite possible that the SBS itself would no longer occur in this case.