I always have the urge to go to the bathroom before I leave home, especially if I’ll be in a car for a long drive. It doesn’t matter that I went to the bathroom just twenty minutes ago. If I ignore the urge, I feel anxious.
My father used to ask us, his children, “Did you go to the bathroom?” just before we got into his car. If I didn’t take the cue and go “just to be safe,” he would complain, ridicule, and reprimand me if I needed to use the bathroom before his designated pit stop. I was just a kid.
I didn’t realize that my nervous system had been conditioned by my father’s strict rule.
Years later, I took a self-defense class for women. Men wearing ridiculously thick protective gear pretended to be sexual offenders and simulated attacks. The female participants then practiced kicking and striking strategically assigned target areas, just as we had been taught. We trained for several weeks.
At the end of the course, we shared our experiences. One woman said she always felt the urge to go to the bathroom after the simulated attack and defense exercises. She explained that it was exactly what she had done after she was raped. Her story made a deep impression on me.
Our nervous system doesn’t forget.
No amount of talk therapy would have eliminated my urge to go to the bathroom. The body remembers. The nervous system keeps score.
So how do I convince my nervous system that I don’t actually have to pee—that my bladder isn’t full?
Ironically, I learned the answer when I stopped taking an anti-anxiety medication cold turkey.
The medication had been prescribed on an as-needed basis. Over time, for various reasons, I began taking it every day. I didn’t realize I had developed a dependence on it. After the stressful period was over and I went on vacation, I stopped taking it. It was a very low dose, so I had no idea it could cause such severe withdrawal symptoms.
I woke up every hour from nightmares. Throughout the day, I felt a strong urge to urinate every hour, even though my bladder wasn’t full. After ruling out a urinary tract infection—I happened to be staying with a friend who was an infectious disease specialist—I discovered that urinary urgency is a common withdrawal symptom. Because benzodiazepines depress the central nervous system, withdrawal can manifest as an overactivation of the sympathetic nervous system.
If I couldn’t regulate my autonomic nervous system, I worried that I would reinforce the pattern and end up needing to use the bathroom every hour indefinitely.
So I told my nervous system that it was a phantom urge and that my bladder wasn’t going to burst. I held it for thirty minutes longer, then an hour longer. Each day I gradually extended the time before going to the bathroom. After several days, both my bladder and my sleep returned to normal.
One of my friends teaches nervous system regulation techniques for people with CPTSD. I understood the theory, but I hadn’t truly put it into practice. Now I understand how powerful those techniques can be.
I still have moments of anxiety, moments when I used to reach for a pill automatically. Now I see them as signs that my sympathetic nervous system has become unnecessarily activated. Instead, I calm myself with breathing techniques and wait for the activation to pass.
So far, it’s working.
Somatic Awareness 