unexpected regression Reilly's Regression (Ch. 9 posted 11/23/24)

[bj & the bear]

Great chapter, I'm hoping Riley will embrace his diapers and not be so embarrassed all the time.   Jenny is so sweet and caring with him and I think she will be a very important person to Riley.  Keep up the great writing,  your quite talented.  

[wetdiaper55]

I like the sweet story . 

[Alex Bridges]

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Chapter 9: Diagnosis

The room was still, the weight of anticipation hanging in the air like an invisible fog. Miriam sat on the couch, her hands clasped tightly in her lap, while Michael stood by the window, staring out at the backyard, his arms crossed. Julie and Matt were seated on the loveseat, side by side, their expressions tense as they exchanged glances every now and then. Jenny, Reilly’s babysitter, hovered near the doorway, her posture uncertain, but her face carefully composed. It was a scene of quiet tension, the kind that only deepened in the presence of a truth no one wanted to face.

 

Dr. Carrington sat opposite them in an armchair, her clipboard balanced on her knee, pen poised as though she were still collecting her thoughts. She had spent the past couple days observing Reilly, noting his behaviors, his struggles, and the subtle but undeniable changes in his cognitive and physical abilities. Now, it was time to deliver her diagnosis.

 

“Thank you all for being here,” Dr. Carrington began, her tone calm, steady, and gentle. She glanced around the room, making sure to meet the eyes of each family member. “I know this has been a difficult time for all of you, and I appreciate how much love and support you’ve shown Reilly throughout this process.”

 

Miriam nodded faintly, though her grip on her hands tightened. Julie shifted uncomfortably in her seat, biting her lip, while Matt remained still, his expression unreadable. Michael finally turned away from the window to face the group, though his stance remained stiff.

 

“Based on what I’ve seen,” Dr. Carrington continued, “along with the information you’ve shared with me, I believe that Reilly is in the early stages of what we refer to as adult-onset regression.”

The words landed heavily in the room, though no one seemed particularly surprised. It was more the confirmation of a growing suspicion, a fear that had been lingering in the background for some time.

 

“What does that mean, exactly?” Julie asked quietly, her voice barely above a whisper.

Dr. Carrington took a breath and leaned forward slightly, her tone compassionate but direct. “Adult-onset regression is a condition where an individual gradually reverts to earlier developmental stages—emotionally, cognitively, and, in some cases, in their physical capabilities as well. It’s a rare condition – about 1 in every 250,000 adults – and while the causes can vary, it often manifests as a response to overwhelming stress or trauma. In Reilly’s case, we know it was his fear of starting college while still wetting the bed at night. He is currently in what we call ‘Stage 1’ of regression.”

 

Miriam exhaled softly, as if she had been holding her breath. Michael uncrossed his arms but stayed silent. The tension in the room deepened, as if everyone was bracing for what came next.

“Reilly is experiencing emotional regression,” Dr. Carrington explained, her voice measured and clear. “He is more prone to mood swings, increased frustration, and emotional volatility. These are all signs that his brain is struggling to cope with the demands of adulthood, and as a result, he is beginning to revert to a more childlike emotional state. The poor behavioral choices and tantrums are how those manifest most obviously, but less obviously Reilly is struggling to regulate his emotions and think through them with the clarity an adult should have. You’ve all noted that and adjusted rules and discipline for him, which is exactly what he needs right not.”

 

Julie’s face tightened, and she glanced over at her mother, who remained quiet, her gaze fixed on the floor.

 

“But it’s not just emotional,” Dr. Carrington continued, her eyes shifting to Michael, who was watching her intently now. “Adult-onset regression is a cluster of emotional, cognitive, and physical changes, each of which has its own set of stages. Overall, though, Reilly is entering Stage 2 of regression, where we begin to see the loss of independence in basic tasks. He’s starting to have trouble with things that were once routine like toileting hygiene and managing his own time. He’s still capable of doing these tasks with help, but you’ll likely notice he requires more reminders and assistance.”

 

Matt finally spoke, his voice gruff but laced with concern. “So what are we supposed to do?”

 

Dr. Carrington met his gaze, her tone firm but compassionate. “Supporting him like you’re doing now. It will need to evolve as Reilly’s regression does, but mostly in the way in which you support him. Reilly will need structure and routine to help maintain as much independence as possible, but he will also need your patience as he adjusts to these changes.”

 

Michael stepped forward, his face tense. “And what about… the other stuff? He’s been having… accidents.”

 

Dr. Carrington nodded, her expression gentle. “The incontinence. Reilly is currently in Stage 5 of incontinence, meaning he is having difficulty making it to the bathroom for bowel movements. That’s not typical of regression in stage 1, but Reilly was already wetting his bed, so his handle on continence was already comparatively weak. Difficulty making it to the bathroom for bowel movements is a particularly distressing stage for both the individual and their caregivers. It’s important to approach this with understanding, not shame. Accidents will happen, and he may try to hide them or deny them out of embarrassment. You’ve already put him back in daytime diapers, which is smart. Most families don’t do that until accidents have become the norm, which only makes incontinence more distressing for everyone. You’ve also figured out, as most don’t, that pull-ups can’t handle an adult’s bowel incontinence. Maintaining a compassionate attitude will help him feel more secure.”

 

Miriam pressed her lips together, the weight of this reality sinking in. “Do we …” she ventured … “Is the incontinence going to improve, or at least stay like this? Do we take him to the toilet as if he were potty training or when he asks for it?”

 

Dr. Carrington knew incontinence was often the most difficult struggle both for the patient – losing something so basic and fundamental to their adulthood – and their caregivers, who must take on an unpleasant task but also recognize it as the clearest sign their loved one is changing. “The incontinence is most likely to worsen and eventually become complete. That’s the bad news. The good news, and I know it isn’t great, is Reilly will reach the point where he’s not aware he’s voiding or even aware after the fact. How is that good news? It means the incontinence will at least become less distressing to him.”

 

Jenny, who had been quiet until now, cleared her throat softly. “He’s already been… embarrassed about it. Humiliated or mortified are better words.” Jenny said, her voice soft but steady. “I’ve tried to make it seem like it’s no big deal, but I can tell it bothers him more than anything.”

 

“You’re doing the right thing,” Dr. Carrington reassured her. “Because it is so distressing, it’s good to still take him to the toilet. That gives him the sense of control and maybe even that he’s improving. But don’t treat it like potty training. Just as you don’t shame him for using his diapers, don’t celebrate it when he makes it to the potty. That will only make his accidents seem like much bigger failures to him. Whether he makes it to the toilet or uses his diapers, for now, the less attention you draw to the accidents, the better. Just focus on helping him clean up and move forward.”

 

“So when do we give up on taking him to the toilet altogether,” Matt asked.

 

“It’s different for every patient. My advice is you’ll know when it’s time. At that point, you actually do want to praise him for using his diapers. We call it diaper training, and the purpose is to make him less ashamed of needing diapers and less distressed about accidents. Over time, he’ll become less self-conscious about it, especially as his emotional awareness shifts.”

 

Julie spoke again, her voice tentative. “What about… physically? He’s been dropping things more, and I’ve noticed his hands shaking a little.”

 

Dr. Carrington nodded, flipping to the next page on her clipboard. “That’s another early sign of regression. Reilly is in Stage 1 of physical changes, where we start to see a decline in fine motor skills. His hands are becoming less precise, which is why he’s struggling with tasks like writing and wiping. This will likely progress over time, but for now, it’s important to offer help when he seems frustrated or unable to complete a task on his own.”

 

Michael let out a long breath, his frustration evident. “And what about his mind? He’s been forgetting things, getting distracted all the time.”

 

“That’s also part of Stage 1,” Dr. Carrington said, her tone gentle but firm. “Reilly is experiencing mild forgetfulness and increased distraction. This is the cognitive side of his regression, where he’s starting to lose focus more easily and forget simple things, like where he put something or what he was just doing. It’s not severe at this point, but it’s something you’ll notice more as time goes on. The biggest change you’ll see cognitively is less and less ability to think ahead.”

 

Miriam finally looked up, her eyes full of quiet desperation. “Is he… aware of this? Does he know what’s happening to him?”

Dr. Carrington paused, her expression softening. “At this stage, yes. Reilly is still aware that something is changing. That’s where a lot of his frustration is coming from – he knows that things are becoming harder for him, and that’s deeply upsetting. But as the regression continues, his awareness will likely fade. It’s a blessing in a way. Adults in the latter stages of regression tend to be happy provided they are well cared for. They’re very similar to toddlers emotionally and cognitively. If they are happy, they are all the way happy; if they’re not, they’re all the way not. Provided they get the care they need, they’re happy much more often than not. Right now, though, he’s still trying to fight against it, and that’s a source of sadness and anger for him. But over time, he will become more accepting of his new reality.”

 

There was a long, heavy silence in the room, the weight of Dr. Carrington’s words sinking into the hearts of everyone present. The diagnosis, while expected, felt final in a way that none of them were fully prepared for.

 

Julie broke the silence, her voice soft but steady. “What do we do now?”

 

Dr. Carrington looked around the room, her gaze landing on each family member, her voice calm but resolute. “You do what you’ve been doing. You support him. You create routines, provide structure, and offer help when he needs it. But most importantly, you show him love and patience. Reilly is still Reilly. This process will change him, yes, but your support will be the anchor that keeps him grounded as he navigates these changes.”

 

Miriam nodded, a tear slipping down her cheek. Michael’s expression softened as he moved to stand beside her, placing a hand on her shoulder. Julie and Matt exchanged a glance, both of them quiet but resolved.

 

Jenny, still standing by the doorway, spoke up again. “And if things get worse?”

Dr. Carrington met her gaze. “Then you reach out for more support. I’ll be with you every step of the way, and there are other resources available—support groups, additional caregivers, and therapeutic options. You don’t have to do this alone.”

 

Dr. Carrington observed the family as they digested the diagnosis, the weight of the information settling slowly. Reilly’s regression was real, but he was still early in the process, and now it was time to focus on how to navigate this challenging new reality. Behavior management would be critical to maintaining structure and ensuring that Reilly felt secure as his emotional and cognitive state shifted.

“We’ve gone over where Reilly is in his regression,” Dr. Carrington began, her calm, measured voice cutting through the silence, “but now we need to talk about behavior. Specifically, how to manage misbehavior in the context of his regression.”

Miriam nodded, looking more determined than uncertain. “We’ve already had to discipline him—timeouts, taking away privileges, and even spanking. Like I told, he was the one who actually wanted spanking, but not as discipline. He thought it would help with his bedwetting. Look where we are now. It’s been hard to know if we’re doing the right thing.”

Dr. Carrington offered a reassuring smile. “That’s exactly what I wanted to discuss. What you’ve been doing—timeouts, taking away privileges, and spanking—are all appropriate responses, even more so as Reilly’s regression progresses. As his emotional and cognitive control diminishes, he’ll become more prone to emotional outbursts and misbehavior. Discipline isn’t about punishment or shame—it’s about structure, which helps him feel safe.”

Michael, standing by the window with his arms crossed, looked up thoughtfully. “So how do we know when it’s misbehavior and not just the regression?”

“Excellent question,” Dr. Carrington said, her tone firm but kind. “The key is understanding where Reilly is cognitively. He’s entering Stage 2 of emotional regression, which means that while his emotional maturity is slipping, he’s still capable of understanding rules and consequences. When Reilly breaks rules he know he has, is dishonest, refuses to cooperate with diaper changes, or ignores your instructions, that’s misbehavior—especially if he knows he’s doing something wrong.”

Julie shifted in her seat. “He knows, all right. He’ll push back when it’s something he doesn’t want to do, like when we tell him it’s time for bed.”

“And that’s exactly when discipline becomes crucial,” Dr. Carrington explained. “The goal isn’t to punish Reilly, but to reinforce boundaries that help him navigate his world. Right now, all of these rules and routines – the nap time, the early bedtime, asking permission for things he didn’t need permission for just a couple months ago, certain choices he can’t make himself – it feels intrusive and unnecessary. But it is necessary, maybe not crucial yet but it will be in the near future. As he regresses emotionally, he’ll need more guidance, and clear, consistent consequences will help him feel secure and will make your job as caregivers much easier.”

Matt, leaning forward with his elbows on his knees, added, “So, how do we make sure we’re handling it the right way? I’m not always sure when we should step in.”

“Discipline, especially for a regressed adult like Reilly, is most effective when it’s used consistently,” Dr. Carrington replied. “You want to be authoritative, not authoritarian. Let him have a say when you can; give him limited options to pick from. Don’t overreact if he’s arguing back. If he won’t make a decision, or keeps arguing after you’ve made the decision and told him it’s final, you can use the same strategies you’ve already been using. Natural consequences are always best when possible. When they’re not, timeouts, which are a good opportunity for everyone to calm down and loss of privileges like taking away toys or screen time are excellent tools. And, as you mentioned, spanking can be used when his behavior escalates. It’s not about punishment, but about creating structure.”

Miriam sighed softly. “He responds to spanking, but I always feel bad about it afterward. He’s already so embarrassed about needing extra care.”

Dr. Carrington’s expression softened. “That’s understandable. But spanking, in this context, serves an important purpose. It stops the misbehavior before it spirals out of control. Regressed adults like Reilly, especially with their adult-sized bodies, can become a danger to themselves or others if misbehavior or tantrums escalate. There’s a difference, by the way: a true tantrum is the result of them having bigger emotions than they can handle in the moment. It’s not something they plan or control, especially as the regression deepens and they lose some of their ability for abstract thinking. You can’t throw a tantrum to get what you want if you’re cognitively unable to understand how your behavior influences others’ behavior or plan ahead. Until that point, however, some outbursts that seem like tantrums aren’t; they’re misbehavior.” She let that sink in for a moment. “If Reilly really were a toddler, I would advise against punishment for true tantrums because they’re not deliberate. Natural consequences are better in those cases. If they tantrum in the toy store, you leave the store. Every parent has been there. With a regressive adult, you can’t count on a tantrum not escalating to the point of throwing, hitting, kicking, or destructive behavior. And you can’t just pick Reilly up and take him out of the toy store. That’s why whether it’s a true tantrum or misbehavior, the goal is always to nip it in the bud. By stepping in early with firm discipline, you’re preventing those dangerous behaviors. Remember, it’s about keeping him and you safe, not about punishment.”

Michael, who had been silent, finally spoke up. “And he’ll need that consistency no matter where he is, right?”

Dr. Carrington nodded. “Exactly. What’s most important is maintaining consistency—whether you’re at home, out in public, or visiting family. Reilly should experience the same care and discipline no matter the setting. That means following through with things like diaper changes, timeouts, or even spanking, wherever you are.”

Matt furrowed his brow. “But what about when we’re out in public? We’ve had situations where he’s refused to cooperate, and it’s… awkward.”

“I understand it can be uncomfortable,” Dr. Carrington said. “But the worst thing you can do is avoid disciplining him because you’re worried about public embarrassment. If Reilly realizes that the rules only apply at home, his behavior will get worse whenever you’re out. You need to be just as firm in public as you are at home.”

Julie glanced at her brother, then back at Dr. Carrington. “It’s hard to imagine spanking him in public… but I get what you’re saying. If we don’t follow through, he’ll think he can get away with it.”

Dr. Carrington gave a small nod. “Exactly. Consistency is key. Whether it’s a timeout in a quiet corner of a store or a spanking in a restroom or the car, the discipline needs to happen when the behavior occurs. Reilly will learn that the rules are the same no matter where he is. This helps prevent more serious misbehavior from developing.”

Michael’s expression softened slightly. “So, you’re saying it’s not about embarrassment—it’s about what’s best for him.”

“That’s right,” Dr. Carrington said. “Compare it to a diaper change. If Reilly has a messy diaper away from home, you change it, right? If he sits in a messy diaper for an extra hour, though, there’s no harm done. If he has a messy tantrum, however, real harm is a possibility. That’s why you deal with it right away, know matter where you are. You’re not just correcting behavior—you’re helping him understand the boundaries that will keep him safe and secure. Yes, there will be awkward moments, and both Reilly and you all will feel embarrassed at times. But avoiding discipline because of embarrassment will only lead to more problems. Inconsistent care could lead to Reilly becoming house-bound, and house-bound regressed adults are often miserable.”

Miriam winced slightly. “I don’t want that for him.”

“And it won’t happen,” Dr. Carrington reassured her. “As long as you keep taking him out, involving him in family activities, and caring for him consistently, Reilly can continue to be part of the world around him. The embarrassment will fade, and you’ll find that people often become more understanding over time.”

Matt crossed his arms thoughtfully. “I can’t imagine what people will say or do if they see Reilly getting scolded in public, let alone spanked in the car.”

“I know,” Dr. Carrington replied. “It’s so far outside the norm. That’s why you keep the medical alert bracelet on Reilly and also those cards I gave you explaining Reilly’s condition and care. If you have any issues, show the card. You’d be surprise, though, how much people will mind their own business. It also gets easier over time as Reilly’s regression becomes visibly apparent.” She considered for a moment and added, “It’s not on families to be the champions of adult-onset regression or solve all the problems we have socially in caring for victims, but by caring for Reilly consistently and lovingly in public, you’re also raising awareness about this rare condition. The more people see a family caring for a regressed adult with compassion, the more people will know adult-onset regression exists and we combat the stigma surrounding disabilities like this more broadly. You’ll be surprised at how understanding people can be once they realize what’s happening.”

Michael let out a deep breath. “So we just keep going. Keep involving him, keep taking him places.”

Dr. Carrington smiled. “Yes. Reilly is still part of your family, and he deserves to participate in life just like anyone else. By giving him the structure and care he needs—whether at home or away from it—you’re ensuring that he doesn’t become isolated. And that’s what will make all the difference for his well-being. Home-bound regressive adults tend to be very unhappy, and their decline is much more rapid. Many families end up institutionalizing their loved one, and that can be avoided if you keep Reilly active and involved and care for him lovingly and consistently. I know this sounds like the worst thing that can happy to Reilly and to your family, and you will hate me for saying this, but it’s not. Well-cared for regressive adults and their families lead happy lives. It’s not easy, but it’s possible.”

Miriam looked at her family, her resolve clear. “We can do that. We’ll keep taking him out, keep caring for him—no matter how hard it gets.”

“Good,” Dr. Carrington said, her voice warm with approval. “Consistency, structure, and love—that’s what will help Reilly navigate his regression. And you’re already doing such an incredible job. Remember, it’s about giving Reilly the stability he needs to thrive, both at home and out in the world, whether he’s with you or another caregiver or authority figure.”

 

____

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[Pierry Louys]

That was a interesting Chapter showing how the family and Jenny gonna treat Reilly , I think Reilly is gonna be treated like a 3-4 toddler diaper dependent, curious to see next chapters

[Shotgun Diplomat]

Well that got kind of serious kind of fast. Not too sure how I feel about the whole "Regression as a science" aspect but time will tell I suppose. Thanks for the update. Take care and have a gooder! 

[wetdiaper55]

Good chapter...Reilly needs a bracelet that says needs diapers. Maybe a note diaper pined on his shirt that will say......big baby...or something with a pasifer next to it . 

I really love the story .

[wetdiaper55]

I really love reading this one . 

[D503]

Really hope we can get an update for this one!

[wetdiaper55]

Can you give a next chapter........please