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The purpose of this paper is to present a facet of enuresis which is not commonly discussed in the analytic literature. Most of the analyses of incontinence focus on the relationships of guilt, shame, and aggression and on the relevance of pride to the urethral function. Significant portions of the writings in the area also concern the relationship of fire-setting tendencies to enuresis, male-female differences in unconscious castration anxiety, and the curative effect of puberty on enuresis. Representative of the commonly held notions is the thesis of Michaels,16 titled “Enuresis in Murderous Children and Adolescents,” which elaborates on Glover's11 assertion that enuresis is a psychosomatic equivalent of psychopathy, in that both of these phenomena are expressions of an inability to hold tensions. These tensions need not be exclusively aggressive, as is evidenced in the conclusion of Pierce et al.17 that disturbed children utilize enuresis to discharge aggressive and sexual tendencies.
The aim of this presentation is to speculate on the somato-psychic components of enuresis, specifically as they are mediated by cognitive factors. The concepts we shall examine include overcontrol and reaction formation, and we shall also consider the reported negative effects of retention training. From this vantage point, many of the patterns often seen as resulting from the above-noted dynamics will be explained comprehensively.
A general formula for the psychoanalytic interpretation of the dynamics of enuresis is that a repressed (hostile or sexual) drive is partially satisfied through wetting. The concomitant shame and guilt feelings are indicative of the superego components countering the aggressive impulses. There are, however, several facets of the syndrome which do not fit into this framework. We shall review briefly the relevant theory and point out the inadequacies, and then show how the syndrome is more comprehensively understood if we consider “overcontrol.” In exploring