
Most toileting programs emphasize behavioral techniques, relying heavily on external reinforcements like praise, stickers, and rewards. However, this focus on external motivators often overlooks the critical internal factors that support successful toileting.
Enter interoception. If you’re not familiar with it, interoception is the sense within our bodies that allows us to experience internal sensations—such as a racing heart, a growling stomach, a full bladder, tingling potty parts, or wet skin. Understanding these body signals is essential to understanding what’s happening inside us and what our bodies need to stay regulated.
By enhancing body awareness through targeted interoception activities for toileting, we can help people of all ages gain better agency over their bathroom habits. It’s encouraging to see more professionals and caregivers becoming familiar with the role interoception plays in successful toileting, whether it’s urination or defecation—let’s just call it successful peeing and pooping.
By incorporating interoception into toileting programs, we can help make the experience more intuitive and effective for everyone.
How Can Interoception Improve Toileting?
Let’s start by breaking down how interoception works for many of us who experience independent toileting and regulation. For many, they notice specific sensations within their body. These sensations are different for everyone. Over time, as we repeatedly experience our unique sensations, we learn to assign meaning to them. In other words what do these sensations mean uniquely to me?
For example, we might learn that a certain pressure feeling in our low belly area means we need to pee, and that becomes our drive to get to the bathroom in time. Similarly, when it comes to pooping, we may notice a particularly full and tight sensation in our bowels and come to understand that it means we need to poop. The sensations then serve as a signal, motivating us to find a toilet so we can eliminate it safely and effectively.
Essentially, interoception allows us to notice what our bodies are uniquely feeling, and understanding these internal signals is key to regulating our toileting needs. It is different for all of us. How your body feels when you need to pee or poop is likely distinct from the way my body feels. We are all valid in our unique interoceptive experiences.
The Problems with Most Toileting Programs
Unfortunately, most toileting programs don’t incorporate interoception. Instead, many tend to be very externally oriented and compliance-based, focusing on surface behaviors—like counting the number or frequency of successful toileting attempts or unfortunate accidents—without acknowledging the underlying factors contributing to toileting progress. Simply giving a child sticker after sticker won’t magically develop the interoception and other foundational skills they need for successful toileting.
In other words, if there are deeper issues hindering toileting success, they don’t improve just because of a reward. By shifting the focus of a toileting approach to building these underlying skills, including interoception, we can help individuals learn to notice and interpret the unique signals from their bodies, forming a crucial foundation for independent toileting regulation.
Incorporating The Interoception Curriculum can be a game-changer for addressing toileting difficulties. This publication stands out because it actively teaches individuals to recognize and interpret these bodily signals, laying a strong foundation for increased self-awareness and confidence. See the difference our interoception resources can make in all areas of life!
How Interoception Helps Parents
One of the most frustrating but amazing parts of parenthood is realizing your child is their own person. You see your child have their own opinions, thoughts – and, sometimes, very complicated and difficult-to-describe feelings. Struggling alongside your child to understand and communicate is emotionally exhausting, but interoceptive training can help! But you don’t need to take my word for it. Read it in Dani’s words:
“When we first took Kelly Mahler’s Toileting, Interoception & Nutrition on-demand course, our son was only 3, and potty training just wasn’t clicking yet. Over the next two years, we tried everything: rewards, charts, you name it. But when our son turned 5, and we were still facing the same struggles, we knew we needed a new approach. That’s when my husband and I decided to revisit Kelly’s course together.
The results were nothing short of incredible. Within just two weeks, we saw more progress than we had in years of trying. Kelly and Kerri’s insights on helping our son recognize and understand the signals his body was giving him were game-changing. In just one month, he went from not communicating his bathroom needs to confidently recognizing when he had to go.
He even started telling his preschool teachers when he needed to use the potty! We are beyond proud of his growth, and most importantly, he is so proud of himself. Thank you, Kelly and Kerri, for giving us the tools to support our son’s success in potty training!”
– Danielle Black
Why Doesn’t External Reinforcement Work?
Rewards, sticker charts, and alarms often don’t work for successful toileting because they fail to acknowledge the “deep whys” of many toileting challenges. For example, does the external reinforcement consider:
Sensory Processing
The child may be fearful of the toilet flushing or not like the feeling of toilet paper on their hands.
Core/Postural Stability
Sitting on the toilet might feel unsafe.
Pelvic Floor Muscles
The person could struggle to relax the pelvic floor muscles in order to pee or poop.
Anxiety
The child might need nurturing and/or comfort strategies to feel safe in the bathroom.
Nutrition
They may have a food sensitivity or limited nutrient intake.
Interoception
The person might not yet notice and understand internal pee and poop signals.
Interoception and Toileting Regulation
So, how can interoception better help with toileting? For effective toileting regulation, people need to develop a keen sense of their internal signals. One way to help people learn this sense is to read The Interoception Curriculum, which provides a framework for building independent self-regulation. This way, they can:
Interoception is the inner sense of self that connects all of these steps. This sense tells us when we have a fever, when we’re feeling happy, and yes, when we need to pee or poop. This sense can be difficult for some of us to really connect with, which can make toileting difficult or lead to accidents.
The core of self-regulation, including toileting regulation, is recognizing these inner feelings that are connected with the need to use the restroom. These sensations will vary from person to person. This is why connecting to our body and developing an understanding of what our body is uniquely telling us is so important.
💩How Do You Know When You Need To Poop? 💩
Our social media is full of great interoception discussions, including this post that really highlighted how different each of our bodies can feel when we need to poop! Gone are the days of teaching the way an emotion or experience “should feel.” Here are the days of exploring and celebrating unique interoceptive experiences. Do you resonate with any of these interoception experiences?
- I think of it as “pressure” personally
- Need to poop is a heaviness and pressure near my butthole
- I feel the jiggle
- A slight tingle
- My stomach hurts
- A pushy feeling around my bum
- Tickly in the lower abdomen
- Muscles are tighter from holding it in
- Because I can taste it
- Honestly, the poop feeling is not there. It is often a surprise
- I get a headache and feel hot
- My tummy feels hard
- I have a pucker sensation down below
- I get pain in the stomach—it is left-sided and crampy (like if someone is squeezing the area with their hand, hard and fast)
Interoception Activities for Toileting
In collaboration with various colleagues and graduate students, I’ve spent the past few years conducting the first pediatric studies to investigate the outcomes of interoception-based interventions in areas like toileting and emotional regulation.
From these studies, we’ve learned that, for some learners, as they develop their interoceptive awareness, they may be dry during the day but still experience nighttime bedwetting—which is very common. However, as the child continues to practice tuning into their internal signals, they often gain enough interoceptive awareness for those nighttime accidents to disappear eventually.
I don’t mean to oversimplify toileting, as we know many underlying factors contribute to success. Still, our studies have highlighted the importance of incorporating interoception practices into the toilet training process.
If you’re interested in exploring interoception and toileting further, we invite you to join us for our On-Demand course. In this class, we share practical, evidence-based strategies that are easy to implement and suitable for learners of all ages, backgrounds, diagnoses, and learning styles.
If you think interoception is ideal for toileting difficulties, you should further explore all its uses! Check out The Interoception Curriculum and the rest of our interoception resources to learn how to notice body signals, connect body signals to emotions, and then determine which action to take to promote comfort within the body.