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Interoception and Toileting: Improving Body Awareness for Successful Bathroom Routines

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How Can Interoception Improve Toileting?

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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.

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:

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The child may be fearful of the toilet flushing or not like the feeling of toilet paper on their hands.

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Sitting on the toilet might feel unsafe.

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The person could struggle to relax the pelvic floor muscles in order to pee or poop.

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The child might need nurturing and/or comfort strategies to feel safe in the bathroom.

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The person could have an underlying medical need, like chronic constipation.

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They may have a food sensitivity or limited nutrient intake.

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The person might not yet notice and understand internal pee and poop signals.

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:

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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.

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.

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the interoception curriculum