Thanks for sharing this. As a person who also experiences incontinence I have some understanding of how you feel. And I appreciate how difficult it was for you to share it. I think your therapist was wise in suggesting you reach out. There are probably millions of people worldwide who experience incontinence for various reasons. You are very far from being alone. And coming to realize this, I think, is comforting in-&-of itself. There are even individuals who wish to be incontinent and / or choose to be voluntarily incontinent, again, for various reasons.

I don't know anything about you or your situation other than what you wrote here. So it's possible anything I write may be completely off the mark. If so, please forgive me. With that thought in mind, though, the first thing I would say is that taking as much control of your incontinence as possible is the first step in lessening the guilt & shame you feel. Believe me everyone, or at least almost everyone, who experiences incontinence goes through a period of guilt & shame over it. But many are able to find their way past this over time. You can too.

The first most basic way of taking control of your incontinence is to find & use an incontinence product(s) appropriate to your needs. We are fortunate, nowadays, to have available a wide range of very effective incontinence products. Some can be purchased at your local pharmacy or even supermarket although the best ones are mostly sold on-line. (There are even alarm systems for use overnight.) Yes, your caregivers may still have to change and clean you to some extent. But the more you can do to take charge of your issues yourself, and minimize the amount of cleaning & changing your caregivers have to do, the better you will feel about the situation. At least that's my perspective.

Beyond that my personal opinion is that guilt & shame, whatever it's cause, is best addressed with acceptance. I believe in DBT they refer to it as "radical acceptance", if I'm not mistaken. However there's a Buddhist practice I'm personally fond of: "compassionate abiding". Here's a link to a mental-health-oriented description of the practice:

Relieve Distress By Allowing It: Compassionate Abiding 101 | Mindset: Perspective Is Everything

So these are my recommendations (for what they're worth) for overcoming the guilt & shame you feel over your incontinence:

1. Develop an understanding of the fact you are far from alone. Many people experience incontinence in various forms.

2. Find ways to take as much control as you can. Your caregivers should be able to help you with this. This will also help to minimize the amount of work your caregivers have to do.

3. Cultivate radical acceptance of your condition. (If you haven't already done so, & you feel you can, it may be helpful to express to your caregivers how you feel.)

My best wishes to you.