Total session: 4 Sessions over 9 weeks

A 12 year old boy was referred to me to help him overcome the anxiety he was suffering with going to the toilet. The young boy had never been able to go to the toilet and empty his bowels when he felt he needed to go, this was a long term issue that had never been resolved since he came out of nappies as a toddler. This problem was becoming ever increasingly embarrassing as a 12 year old boy as it resulted in dirty underwear throughout the day, which his peers were beginning to notice. He had been to see various doctors, dieticians, nutritionists. Many reward or punishment approaches had been tried by his parents over the years but with no success. As he was approaching puberty at times he was showing increased anger and frustration towards his twin brother.

During the first session I ascertained exactly what would happen when he needed to go to the toilet. There was no problem when he actually put himself on the toilet, he then just got in with it and went normally. He was confident with wiping himself and then once finished he didn’t even think about it until the next time he need to go. When he next got the urge to go to the toilet he would hold it. His stomach would hurt for a while and then the urge to go to the toilet would go away for a while and return 10 minutes later. He would then worry about needing to go to the toilet and would keep stopping himself for up to 8 hours a day. He would only finally go to the toilet when he started to feel himself empty his bowels in his pants. He would then go on the toilet and open his bowels without any further issues.

After he had spent time explaining the situation to myself, he began to understand and recognise for himself that he actually spent 8 hours worrying about something that only took 5-10 minutes to complete when he got on with it, he walked out of the clinic saying ” I can’t see why it was a problem in the first place “

One week later he had managed to go to the toilet every day and without having any dirty pants, he was still holding his bowel movements for about 10 minutes each time though.

My client felt that when he went to go to the toilet he would be missing out on something; one of his brothers may cheat on a game or turn the TV channel over or carry on playing a game without him. Handing back the control I asked my client what his family could do to help him. He suggested to help him overcome this last part of holding his bowels for 10 minutes could his family support him by pausing the film, stop playing the game for a few minutes or for his brother not to run off outside without him. The family happily agreed.

The issue had been resolved by the first session, however, I needed to confirm that the changes that had been made were imbedded in and the problem had been completely resolved. Over the next few weeks my client found new ways of dealing with his brother when he had annoyed him, he managed to stop some of the habits he had created himself; fiddling with something whilst sitting or watching TV and swearing in particular, at the same time in the back ground making sure the toilet issue had been fully resolved.

After 4 sessions over a period of 9 weeks, the initial problem of holding his bowel movement had gone for 8 weeks. If he had the need to go to the toilet at any time or in any place he was able to go immediately as soon as he felt the urge. He no longer even thinks about it anymore. He had learnt to deal with situations calmer and had considerably cut down on the swearing. He became a much happier 12 year old boy.

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