The mother of a 3 ½ year old girl with encopresis recently asked me if I thought talk therapy or hypnosis would help her daughter get over her fear of pooping in the toilet.
In my experience, talk therapy (or play therapy for a 3 1/2 year old child) and hypnosis are not effective treatments for children who are afraid to poop in the toilet. Not pooping in the toilet, like stool withholding, is often due to the subconscious anticipation of a painful bowel movement caused by an actual painful bowel movement that occured sometime in the past.
This kind of fear is best treated with "exposure therapy," which I explain in detail in Chapter 11 of my book. The key to effective treatment is to determine which behavioral incentives and which laxative or combination of laxatives is required for a child to have at least one very soft, but not watery, pain free bowel movement every day without accidents for a minimum of six months.
Six months or more may seem long but, as any adult knows from their own life experiences, habits can be very hard to break and pain can be very hard to forget. My book is written to help you and your child understand and then get through this process with as many smiles and as little frustration as possible.
Once the subconscious fear of having a painful bowel movement has been extinguished and withholding has stopped, it’s time to move on to step four of my six-step program for treating encopresis, shrinking the rectum.
