Very stubborn 12 year old with encopresis?
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Denise101
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So I posted this yesterday in older kids and teens but a few people suggested I post it here.
My 12 year old daughter has been dealing with retentive encopresis since age 6. She avoids going to the toilet at all. This results in soiling and the production of an amazing huge toilet-clogging log-like object every week. We have been trying for years to get her to talk about this, but when we do talk about this, the response is ALWAYS "I don't know" despite what her pedi, GI doc and psychologist tried to do or suggested we do to get her to talk about it. We switched psychologists last year after a year of not talking about this, no luck. We have tried so many treatment plans for years, specifically tailored to her, such as enemas, scheduled toilet sittings, rewards, consequences, psychologist, etc. she just keeps holding it in. Right before summer, her pedi and the GI doc laid out a clear treatment plan of laxatives, regular bathroom visits, and a rewards program. She did take the Miralax (2 table spoons) but she just kept holding it in and soiling her pants. She avoided going to the toilet. I made her stay at the toilet and told her "if you poop, I will buy you XYZ" (something she REALLY wants)" you can do XYZ only after you poop" and not letting her do things "you can't do XYZ until you poop" and XYZ would be something she LOVES to do. I wouldn't let her leave the toilet until she pooped, so she sat there for hours, no luck. When school started, she refuses to take the Miralax. Now we laid out a new treatment plan. We TRIED to involve her, the response is again "I don't know." She is supposed to take an enema every morning and sit on the toilet, but she fights daily about taking it. When she does take it, she holds it in and won't sit on the toilet. There is also a diet plan she refuses to follow. She is not supposed to drink dairy, but drinks milk at school. Now the past 2 weeks she refused all treatment which we fight daily about. She refuses to sit on the toilet, no matter what we try. 2 years ago we tried ucanpooptoo, didn't help. We asked her why she holds it in. Does pooping hurt? Does it scare you to poop? Does it feel good to hold it in? The answer is always "I don't know" and you can question her for hours and hear "I don't know". We explained to her digestion and she knows why she needs to poop. We ruled out any physiological reasons for retention, and all the professionals working with her believe this is entirely behavioral. Luckily her friends don't notice, but one day her friends might smell her soiling, and I talked to her about this, how it would affect, boys, high school, etc. Her response was "I don't know" and she would not talk about this. Has anyone gone through this? Does anybody have suggestions for me? Any advice appreciated. |
Anonymous
| I noticed in the other thread that a poster mentioned how similar this sounds to an eating disorder. Would you agree, op? |
Anonymous
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I have a friend who goes once a week. She drinks some herbal cleanse the night before she needs to go and goes the next morning.
Could you try something like that with her? That way you hardly talk about it. Just the night before, set out the drink. She drinks when she's ready and then goes in the morning at her convenience. |
Anonymous
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She may not know anymore, OP. Behavior is like that. Continuing to question her is futile. Why does someone smoke when it's unpleasant, socially unacceptable, life limiting and unhealthy? Expecting her to give you an expose into why she engages in inappropriate behavior is not helpful and it's not really going to solve the problem. If she knew...if anyone knew...they wouldn't do it.
I appreciate that you've tried treatment plans, rewards, punishments, etc. But she's getting to an age -- adolescence -- where she knows what she has to do and I assume she's no dummy. She's going to have to click with this and take the reins. Continue to have her be in therapy, talk therapy, and with someone she trusts. One day she's going to decide she wants this to stop. There's a strong element of control with this that you need to let go of. Going to the bathroom is her decision. And she's the one who needs to work on this, not you. |
Anonymous
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OP,
I mentioned the Kazdin Method on the other thread. You need to follow a behavioral approach. There are child psychologists trained in this approach. Stop quizzing her about why. Withholding poop is about control and she's probably not aware exactly why she does it. She probably feels helpless and unable to exert control in her life. |
Anonymous
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There's a lot about your post I don't like. Changing therapists, forcing her to talk, forcing her to go to the bathroom, not letting her leave the bathroom, a diet plan she has to follow, the mandatory use of Miralax, laxatives, enemas, "trying to involve her" in her own treatment, daily fights about her treatment. This all sounds very very strange to me with a twelve year old. She's not two years old. It's her bowel, OP. It's her bowel movements.
What in the world are you thinking? |
Anonymous
| BTW, a child who says "I don't know" to repeated questions does not want to talk to you anymore. |
Anonymous
You really can't imagine why OP did the things she did - not just at age 12 but starting at age 6? What is your experience with encopresis, pray tell? |
Anonymous
I think the PP is alluding to the amount of control trying to be exerted by the OP. That's probably the biggest obstacle in getting this kid back on track. |
Anonymous
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I have a lot of sympathy, OP. My now 8 year old has been with holding since he was 4. He does go a few times a week, and rarely now has accidents, but they still happen sometimes. He takes Miralax daily, but really it is about the behavior of pooping, not the consistency of the poop, that is the problem. He can't say why he won't/can't/doesnt like to poop, either. It is now a habit, not a behavior he consciously controls...and until he does decide to consciously change it, he'll have sore tummy and poop problems. It is tough. With my son it really isn't an issue of wanting control in a family where he gets little - he is an only child, and we follow the Alfie Kohn "unconditional parenting" method that gives kids lots of control. So this isn't caused by controlling parents...though I can see where a kid who was a perfectionist or needing to control a situation out of their control engaged in the behavior.
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Anonymous
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Here is a fairly recent discussion on this:
http://www.dcurbanmom.com/jforum/posts/list/392740.page#5318708 Might be worth using the search function to review older posts as well. |
Anonymous
I don't think the PPs were saying her parenting was causing this problem, more that the way she described her efforts seemed very aggressive and controlling -- which may be counterproductive. |
Anonymous
You obviously dont have a kid with this problem. I do (not the OP). What OP is doing is actually what specialists suggest in this cases. The issue also doesnt start at 12, in my house it started at 4, so the more controlling things work well for younger kids and the more involved once said to work better for older kids. And some of OP is describing is coming out of pure frustration with the kids and the issue, we are all human... |
Anonymous
This. Also, PP with the 8 year old, I think you should re-think your parenting model. Go with the Kazdin Method; it's evidence based, Kohn is not: http://www.britannica.com/blogs/2009/02/alfie-kohn-is-bad-for-you-and-dangerous-for-your-children/ |
Anonymous
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OP, I posted in the other forum too. Who is your gastro-enterologist? Have you tried Kerzner? He's really great with kids. I feel for you. It is horrible - especially cleaning out the undies.
It turned out our child was very unhappy at school. I think this was one way he reasserted control. New school, no issues. |