Some Observations on the Psychological Factors in Urination and Genitourinary Afflictions

In the recent accent upon what has been rather unfortunately designated psychosomatic medicine, the afflictions of the urinary tract have received rather scant attention. A priori this might seem to be surprising in view of the close connections of the urinary and genital functions.

On the other hand, it has long been recognized not only by psychiatrists but by some pediatricians and others that functional disturbances of urination could be closely dependent upon emotional factors. From the physiological standpoint urination serves the simple purpose of periodically discharging accumulated urine. From the psychological standpoint, however, urination has many other meanings, conscious and unconscious. Space precludes any attempt to catalog all of these, but, following a scheme proposed in my book, Man Against Himself, I think it is possible to point out certain erotic values and certain aggressive values in urination to which self-punitive values are added when pathological disturbances of function become evident.

The Erotic Component in Urination. There can be little doubt but that the act of urination is one of the child's early expressions of sexual excitement. For the child, as for the aged, the passing of urine is the closest physiological approximation to genital activity which is physically possible and of itself this suggests a reason for the polyuria of childhood and old age ordinarily explained on purely anatomical grounds. That bed-wetting gives way to masturbation and nocturnal emissions, that pride and satisfaction in urinating becomes more maturely genital activities and satisfactions, that compliance with parental regulations in regard to urination are replaced with the regulation of sexual activity in deference to social attitudes, are matters of common knowledge. It is thus logical that in the neuroses, where infantile satisfactions are sought for and accomplished