Welcome to my first blog as a dramatherapist and child and adolescent psychotherapist. I really love what I do so that’s what I am going to write about, interesting then that my first blog is addressing Encopresis and Dramatherapy!

 This is because I had a recent enquiry from a parent who was dismayed to find small rounded stools in her child’s bedroom, she felt that they looked as if they had been ‘played with’, and as she explored her child’s room found other evidence of smearing. Another parent has recently expressed horror at finding containers in her child’s room which had been used to hold wee and poo.

‘Why are they doing this?’ both parents exclaimed,

 ‘Is it just defiance?’

Encopresis is the soiling of underwear with stool by children who are past the age of toilet training. Because each child achieves bowel control at his or her own rate, medical professionals do not consider stool soiling to be a medical condition unless the child is at least 4 years old. Both these children were older, they knew how and when to use the toilet but they weren’t.

My response was to think about how to help the parents tackle this issue and to look at it in the child’s therapy session  

We do have to think about the practical issue how to help our children manage their relationships with their bodies; do they need the loo?, is it hard to go to the loo?,  are they constipated, going to the toilet too late? etc.

Secondly is to think about it as an expression of worry or anxiety rather than defiance or a layer of ‘horrible’ behaviour. I remember when I was small that just outside the bathroom we had a poster of a tiger in long grass, the kind of poster where the eyes follow you. I was terrified. I had a very active imagination and was convinced that the tiger knew all my misdemeanours and one evening would get me! I used to wake my sister in the middle of the night to go to the toilet with me; if she refused I would crawl on my belly under the picture trying to avoid the tiger’s gaze! This went on for weeks until my mum realised that there was a problem and I plucked up courage to tell her and the poster was moved. That night I went to the toilet without any problems.

Be curious, what might your child be worried about?

Your child may also like the texture so what could you substitute poo with.  Can they play with clay, use finger paints at home, find other ways to get the same texture and feel?

Although it may look and feel revolting to you I am sure you know that it is important not to show this to your child but to think with them about what might help and to reassure them.

In dramatherapy one of these children was playing with dinosaurs and had created a world in which the smallest dinosaur was king, everyone was very gracious to this King and he was gracious back. This is nice, I thought, lots of positive reflections between the dinosaur characters, and then the little King was placed on the head of a much taller dinosaur by the boy in therapy. The little boy started to make thumping and whooshing noises. I wondered what was happening.

‘He is pooing and weeing all over the dinosaur’s head,’ he said.

We made the noises of pooing and weeing together and laughed at the skill of each other’s trumpy sounds. Then I asked what had caused the little dinosaur to poo and wee on the big dinosaur’s head.

‘Oh’, the little boy said, ‘he’s really scared and when he’s scared he can’t hold it in anymore. Commenting on the world the dinosaur lived in I asked if there was anyone who could help the little dinosaur with this dilemma.

The little boy nodded and manipulated a long necked Dinosaur to bring the little dinosaur back down to the ground. Then he used other dinosaurs to come up to the little King, one by one each said

‘I do that too sometimes when I am scared.’

In recognising, naming and normalising both fear and response the little dinosaur was able to reunited with his community without shame..

 

The little boy left the session laughing and was greeted with a big hug from his mum.

Next week his mum told me that there had been no more problems ‘in that area’.

Next time: Dramatherapy and Release – Enuresis within a trauma frame of reference.

 

Comments really welcome.