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Encopresis: Understanding and Remediation of an Unconscious Disorder in Children

  • Post category:Disorders
  • Reading time:6 mins read

Understanding Encopresis: A Neurotic Disorder in Children

There are children who every day, or at intervals of a few days, inadvertently let a stool under themselves; the phenomenon is also called encopresis. It is not an organic bowel disease. The stool in such a case is usually normally formed and the child does not suffer from diarrhea. Encopresis usually occurs in younger children, but sometimes occurs until prepubertal age. It is normal for a child to learn to control bowel movements at the second year, to keep it when necessary, and to defecate consciously. However, he should not be offended if, even at preschool age, his stool “escapes” at longer intervals, for example, when he is very excited or playful about something, so he did not pay attention to the emergency. In such cases, one should react quite calmly, the child should be comforted.

The Link Between Encopresis and Enuresis: Congenital Sphincter Disposition and Dysfunction

Encopresis is a neurotic disorder when a child is physically healthy, has no diarrhea, is in his fourth year, and yet often lets his stool down. Sometimes it is a symptom of dementia, but then the child shows other major signs of mental retardation, so encopresis is only an accompanying symptom. Encopresis usually occurs because the child has been clean for a long time or even many years. Unlike psychogenic bedwetting (enuresis), which occurs regularly at night, less frequently during the day, encopresis usually occurs in the waking state. Once the child is let go of the floor only part of the stool, the second time the whole stool. He often doesn’t even complain about it, or hides dirty laundry somewhere.

Among our patients, we observed 10 cases of encopresis during two years – 5 boys and 5 girls. They were children from 4 to 11 years old. All but one also suffered from bedwetting. This frequent association of encopresis with enuresis indicates that there is probably some congenital sphincter disposition for dysfunction in these children, if they develop in a neurotic sense. Yet the bladder closure muscle is much more prone to neurotic dysfunction than the posterior bowel closure muscle. Interestingly, we found marked defiance and aggression in all 5 boys with encopresis; the girls were also defiant in 2 cases, and the others behaved in a timid, withdrawn manner.

The Psychology Behind Encopresis: Unconscious Desire to Harm Parents

It seems that encopresis is indeed most often an expression of childish defiance that is sometimes openly manifested and other times disguised. The indifference with which the child usually receives his encopresis, or even a certain enjoyment of the fact that the parents are dealing with his dirty laundry, indicates that the child thereby unknowingly wants to harm his parents. This is truly unconscious, because a child suffering from encopresis cannot consciously remove this inconvenience. That encopresis is most often an expression of children’s resistance to educators is also proven by the fact that in 8 out of 10 of our cases we found that parents treat a child in an extremely rude way, regularly punishing him with beatings. Strict upbringing was carried out even before the encopresis, and it became even stiffer when the child became unclean.

Effects of Strict Upbringing on Encopresis: A Case Study

The likelihood of encopresis occurring increases if the educator’s rigor is most concentrated on the child’s habituation to physical cleanliness. So the 9-year-old boy often let the stool under him. Encopresis began when he was 4 years old. At that time, he was already properly monitoring his sphincters, but one day it still happened to him that his stool had “escaped”. Then his mother, who was very strict with him anyway, beat him severely. After a few days, the boy let the stool fall to the floor again. He was beaten again. Now he was repeating encopresis, and more and more severe corporal punishment was repeated. This fixed the boy’s encopresis turning it into a veritable neurosis. The release of the stool was associated in the boy’s psyche with a strong fear of beatings and defiance of the mother. This created a neurotic conflict in him that manifested itself in encopresis. His mother supported his interference with her actions.

Other Motives for Encopresis: Jealousy, Going to School, and Separation from Parents

Encopresis can have other motives, such as jealousy, going to school, separation from parents. Of our two patients who were not raised in an authoritative manner, one reacted with encopresis when his younger brother was born and the other when he went to school. Both children had been extremely spoiled by that time.

Anal Masturbation and Encopresis in Girls: An Observational Study

Interestingly, in 3 girls who suffered from encopresis, we found that it was associated with masturbation. The children were aged 4-5 years and were raised in an authoritative manner. It has been observed that they occasionally squeeze their legs, shrink, blush, sweat, and eventually drop a little stool into their pants. Only then do they declare that they must defecate. It is anal masturbation. When a child has a hard stool, he sometimes tends to play with it at the opening of the back intestine, because he experiences a certain feeling of comfort.

Remediation of Encopresis: Ignoring the Symptom and Removing the Cause

In remediation of encopresis, the symptom itself should be completely ignored. Educators should not scold or beat a child when he lets a stool fall to the floor. He should be calmly warned to watch his stool better the second time, to go to the toilet as soon as he feels the slightest need. In addition, you should try to wash your dirty laundry if possible. And it should be done in a calm, friendly way. The child must not experience this as a punishment by the educator, but as a logical consequence of his behavior. At the same time, it is necessary to consider where the cause of encopresis is, so it should be removed.