Watch this important segment this Monday, October 27th@ 8:20 on San Diego 6 News In The Morning.
Background: Withholding is a condition that some children develop during the childhood years and refers to inhibiting defication. At times the condition is pervasive enough to warrant medical intervention and can be very painful for the child. Typically beginning during the second and third year of life when parents begin the toilet training process, this select group of children develop anxiety around going to the bathroom and an emotional attachment to their *** becomes a focal point in their lives. Given their young age, they do not consciously understand “why” they will not “go number two” and most parents do not understand either. Together, both the child and parent alike are frustrated.
As with any symptom, their is never a single explanation for why this condition develops, but often times the themes of “fear” and “control” become underlying issues which cause problem Most children, when go through the toilet training process, have an easier time urinating in the toilet than pooping. This is because of the various fantasies that children have in their minds referring to what goes in and out of their bodies. For example, many young children, in their young magical minds, believe that when they poop, they are actually losing a part of their bodies “down the drain”. This can create intense fear and worry that they, or parts of them, are getting lost or disappearing which can then lead to an inhibition to go readily to the bathroom. Here, the toilet becomes a phobic object and is seen as dangerous.
Another common cause is that of control. During the second and third year of life, normally children are trying to individuate and become more separate from their parents. Such desires for being a “bigger” boy or girl manifest in the child desiring to “do things by themselves”, often including toilet training. Here, a battle of wills may develop whereby the parent is trying to “force” the child to go to the bathroom and the child is resisting due to a desire to “want to do it by themselves”. Because such young children do not have the insight and verbal capacity to express themselves in words, the withholding of *** becomes an outlet for frustration, despite having horrible compromises for the child, including constipation and pain. The child is also feeling afraid of letting their parents down, so anxiety also clouds the picture for fear of being rejected by their parent for not complying.
The longer the withholding continues, the more solidified the underlying issues become and the habit becomes harder to break. This is why the initial process of toilet training needs to follow certain criteria to help avoid this and other conditions. Below are the optimal ways of approaching toilet training with children.
1. Do not introduce the process until at least 18 to 20 months of age.
2. Introduce the concept of using the toilet in non-stressful ways.
3. Clarify that the process is normal and that they are fine when they present fear.
4. Do not punish mistakes and reward success.
5. Eliminate diapers and pull-ups when the child is capable of physically ready to train.
6. Avoid power battles by being loving but encouraging.
Once the condition is in place however, the child will need the parent helping them clarify their issues of frustration. Here, the first step is the parent trying to “put into words” what the child is not able to understand, namely anger at the parent for “wanting them to go to the bathroom”. If the parent can help their child understand that the process is for the child, and not the parent, some anxiety may lessen and the child will then “own the process” themselves. Refraining for getting angry at them is also essential as well as collectively trying to find ways to ease their discomfort also becomes frequently essential, such as a high fiber diet, and plenty of water. The most important issue however, is the balance between the parent leading their child towards healthy development, but at the same time respecting their independence. When the savvy parent practices this type of parenting, power struggles tend to lessen and both the child and parent alike feel successful. If this condition becomes habitual and painful however, a consultation with both a Pediatrician and child psychologist is recommended.

Dr. Keith Kanner l Morning Show Host
Your Family Matters
XETV l Bay City Television
8253 Ronson Road, San Diego, CA 92111
San Diego Living Show
(: (619) 261.2346 8: Dr.Kanner@sandiego6.com
