Frequent soiling incidents
Yuval, 7 years
May 30, 2019
I met Yuval’s parents in the clinic on May 30th, 2019. They told me that he’s still wetting the bed. He poops in the toilet but soils his clothes too. The situation has ups and downs, and every so often there are short periods when the problem completely disappears. This has been happening for four years and the soiling occurs in different places. He carries on walking around with soiled clothing and denies anything is wrong when he’s asked if he wants to shower and change. The pediatrician recommended Miralax, but apart from that, they haven’t sought professional help. His mother is going out of her mind and has frequent outbursts of anger. Reinforcements and reminders of various kinds didn’t help at all. Yuval is a goodhearted boy, intelligent, outstanding in math, with a great memory; sometimes he’s impulsive and temperamental.
I instructed his parents about applying the disciplinary treatment.
On June 4th (five days after the clinic meeting), I spoke to Amir, the father. He said that from the day of the preliminary conversation when he and his wife declared they would be applying a very serious therapeutic program, the boy became completely clean. He takes care of himself and makes a point of having his bowel movements in the toilet.
On June 23rd (three weeks after the clinic meeting), Amir reported that since the most recent conversation until today there had been two soiling episodes. Twice his parents took him to the bathroom according to the program’s instructions. Besides that, Yuval is completely clean. He goes to the bathroom at his initiative and keeps himself clean. He also cooperates with handling bedwetting and there too he’s making very good progress. There is a clear improvement in his mood. He’s really proud of his achievements and there are positive effects in other areas of functioning.
February 5, 2019
I met Yuli’s parents at the clinic on February 5th, 2019. They told me that their daughter has complete control of her bladder, day and night, but she poops only in her underpants. It’s not clear in what quantities because she deals with it herself. Almost daily she comes back from school with soiled panties, and also soils in the afternoon and evening. In fact, the soiling happens everywhere. She continues walking around with dirty clothes. Up to six months ago, the problem didn’t exist at all. It started during the summer vacation when she had to attend a summer camp but didn’t want to go there at all. She suffered tremendously, and later developed prolonged episodes of constipation. The pediatrician ruled out organic factors and recommended Miralax. The retention and constipation got worse and worse, and the soiling episodes worsened. For several months she’s been having regular sessions with a psychologist. In the past week, there’s been some improvement in her initiative to go to the bathroom. She’s described as a very well-tended girl; very aware of her appearance and clothes; highly charismatic with a great sense of humor. Her language is well developed. She is very theatrical, and much loved by people around her.
I instructed his parents about applying the disciplinary treatment.
In a conversation with the parents on February 17th, 2019 (two weeks after the clinic meeting), her mother, Mickey, told me that they’d started applying the rules of discipline. The girl’s reaction was very positive. She was completely clean but had to go every day to the bathroom at the designated time, where she immediately emptied her bowels and then remained clean until the following day. Yuli was overjoyed with the change and even asked to meet me personally.
On March 12th, 2019 (a month after our first meeting), there was a really thrilling meeting with the parents—and Yuli herself—at the clinic. She told me she’d been freed from the problem and that it had contributed to other aspects of her life: it had totally changed her life. She described the experience as like a huge knot in headphone cables, which she’d finally managed to unravel. We decided to cancel implementation of all the disciplinary rules for the moment.
On June 23rd (four and a half months since the first clinic meeting), m told me that since our joint conversation with Yuli at the clinic, the situation had improved even more and the topic is now completely off the family’s agenda. Yuli still recalls, now and then, her huge sense of achievement when she overcame her problem.
Ethan, 5.6 years
May 23, 2019
At a meeting with Ethan’s parents on May 23rd, 2019, they told me that Ethan controls his bladder by day and night. He poops in the toilet, but in addition, there are several small bowel movements in his underpants during the day. He goes to the bathroom only when his parents absolutely force him to. Prizes and reinforcements don’t really work. Until two months ago he was absolutely clean. The parents think everything started after his father slapped him. The pediatrician referred Ethan to me. He’s very opinionated and stubborn; extremely independent; unwilling to accept authority. He is a very smart child with a terrific memory, good coordination, and excellent ability to concentrate. He is rather jumpy and agitated.
I gave his parents instructions for implementing disciplinary therapy.
On May 28th, 2019 (five days after our first meeting at the clinic), Ethan’s mother told me that right after the first conversation there was a drastic improvement in the situation. The boy changed his behavior and began to make a point of keeping clean and having full bowel movements in the toilet. And that was even before he heard about the program’s details.
On June 23rd (a month and a half after the first meeting at the clinic), there were two relapses and then his parents launched the program. Ethan experienced punishment three times, and after that resumed full control of his bowel movements. Since two weeks ago, they stopped applying the regulations at all. Even when they were on vacation, away from home, he behaved perfectly. He’s so proud that he managed to overcome the problem. Family members feel that the problem has disappeared. Ethan himself is really happy with his achievements and reports a huge improvement in his self-perception and in other areas. He asked for a prize for his achievement and his mother explained that the real prize is staying clean and controlling his bowel movements. In any event, he has received—and will receive—prizes and gifts in all kinds of areas, without connection to the topic of poop.
Rotem, 8 years
August 8, 2018
At our first meeting on August 14th, 2018, his parents told me that Rotem fully controls his bladder by day and night. He only poops in the toilet when he’s really forced to. He does several bowel movements in his clothes during the day, in different amounts. He does it everywhere and walks around with soiled clothes. That behavior has always been present. The pediatrician ruled out a range of organic problems. He has been diagnosed with ODD (Oppositional Defiant Disorder). This is a recurring pattern of negative, defiant behavior “on purpose—just to be difficult.” He takes medication to alleviate the ODD. The parents have consulted with various psychologists. He’s a very smart, sensitive child; outstanding in math; a football fan. He is highly competitive, with a very low frustration threshold. His parents are at their wits’ end about the question of pooping.
I instructed his parents about how to apply the disciplinary treatment.
On August 29th (two weeks after the clinic meeting), we decided that the first disciplinary measure—a long period in the bathroom—hadn’t significantly changed his behavior. We decided to add to that punishment a ban on screens too. We forbade him to use the tablet, computer, and smartphone.
On September 5th (about a week after the screen ban), his father described a significant change in Rotem’s behavior. He was actively working at emptying his bowels in the toilet, and at keeping himself clean and tidy. Over time, the need to implement disciplinary principles lessened.
On January 21st, 2019 (five months after our first meeting), his parents got in touch to report a deterioration in Rotem’s behavior. He’d gone back to his old habits. They started reapplying the disciplinary principles and the ban on screens. Within ten days he resumed functioning properly—doing full bowel movements in the toilet and staying clean.
On June 20th, 2019 (ten months after the first meeting), Rotem’s parents reported that he was persisting with his perfect cleanliness habits and there was now no need to implement the disciplinary rules.