It's not that I don't believe it is TMS, it's that it can be TMS amplifying the sensations but there are also times when I do actually need a toilet so it's hard to differentiate.
What programs are you referring to? I use the Curable app, and also trying to live my life normally while giving less thought to it. But it is still difficult so just looking for advice.
And I'm also asking about how a coach can benefit me, because I think I might need some more help, but since I have never gotten coaching before, I don't know what they can tell me that the current videos online don't already say. For example, how are they different from Dan Buglio's daily videos?
So I think with this it's a case of calling your bladder's bluff (or more accurately your brain's bluff, your bladder isn't doing anything different). This isn't pumping up my own tyres (I feel this about other coaches) but the below is why coaching can be valuable. People who create videos can't really be this specific (unless their channel only focuses on specific symptoms - so if you had a channel that is dedicated to urgency and frequency you could be privy to this), as if they were and they were addressing individual circumstances they'd have a billion videos (and there wouldn't be universal application so there'd be no point in sending it to a mass audience). That's in response to your query about how a coach could provide more than Dan's videos as an example (I love Dan by the way and he helped me a lot, so that's not a knock on him).
Say we have an imaginary line in our bladder, at 3/4 full (like a petrol tank). Every time we hit that line, our brain reacts and we need to go - this is completely healthy and necessary to protect the relevant organs.
What's happening here (assuming TMS) is the alarm is going off say at 1/2 tank and 1/3 tank unnecessarily. So we need to retrain our brain to only react to the 3/4 full (as is normal - I am not a urologist I'm just making these fractions up to illustrate the point). What's happening, and this isn't blame because I did the same thing, is every time you react to the 1/2 or 1/3 imaginary line you are confirming to the brain that it was correct to send the message at that level, which strengthens the conditioning.
You're right though in terms of how do I know the difference? It isn't as if you can measure it yourself. You need to use logic, rely on the knowledge of your normal habits and also react appropriately to what happens when you do go to the toilet.
I'll discuss the last one first. So obviously you should note and it should land in your mind when you go and nothing happens (if that happens in your case), that's obviously powerful and good evidence that you didn't need to go. But you need to avoid getting sucked into confirming your behaviour in another way here. What I mean is when you do rush to the toilet and you end up going, that doesn't necessarily mean that you actually needed to go (which from what you've written it seems like you are under that impression). How does that make sense? Well if we are operating normally, then you should only feel the urge at 3/4 full. Just because you haven't felt that urge under normal conditions, doesn't mean you couldn't go if you tried. It's like when you were a kid, and your parents told you to try to go before a road trip even if you felt like you didn't. Then you did and you were able to (often to the child's surprise - because they don't understand that you can go without the urge, because it doesn't trigger until 3/4 full). You might have been 1/2 full so you were able to go, even if the urge wasn't there. What I mean is because your sensor is off, just because you were able to go didn't mean you had to, as the sensor wouldn't have gone off under normal conditions. If, however, when you go under these circumstances you tell yourself "see, I really did need to go" that's not necessarily correct and it may be telling your brain that it was right tell you you that you needed to go, which is only confirming the mistake (i.e. confirming that it was right to tell you that you needed to go at 1/2 full when that's not what we want and that isn't normal function).
The first two (logic and your normal habits) overlap. So say you go to the toilet and then you need to go 20 minutes later, despite not drinking during that time. For most people, that's not normal (unless there's another issue) so that clearly points to TMS in those situations. Another sign is how badly you need to go. For most, there won't be a massive urge to go (you won't be busting immediately) unless either you've drank a lot of water quickly or you've held it in for quite some time. It usually starts more gradually and builds up. If you're getting massive urges to go multiple times a day, then that's even more evidence that it's likely TMS. If the logic isn't adding up, then you need to resist the urge to run to the toilet and you need to sit with the urge - reacting differently to it is the only way you're going to convince the brain that it's a false alarm. Knowing how often you go is also important, as assuming you keep the same levels of hydration (now is not the time to play with hydration levels in my opinion as that will only add another variable to confuse you), that will be another indicator.
The underlying emotional work is separate to this (I split it into two parts, this first part around symptoms and how you act around them, which revolves around your belief in the TMS diagnosis, and the second part is working on overall safety which looks at your emotions, personality traits etc and what likely led to this in the first place - this is crucial because we don't want to turn this into a case of mastering every type of symptom, as new symptoms can arise if the underlying emotional work isn't done).
The reason I asked you about the tests (and I'll ask again) is because if you still think something is wrong with you, it's very hard to implement the above. What I suggested will seem risky to you, and you won't be able to avoid going to the toilet if you think there's something wrong that you could cause more damage to (which is fair enough, I would be the same and I wouldn't want someone to engage in the above without that assurance - you shouldn't take risks with a potential structural problem). If you haven't gotten the relevant tests and you still have doubt around whether there's a structural cause, that's definitely the first thing to do before anything above.
Hope that helps
