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S2E20 - Power, Control, and Potty Problems: Effective Strategies for Toileting Challenges · Play Therapy Parenting: Real Parenting Questions Answered by a Child Therapist

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You're listening to the
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Play Therapy Parenting Podcast with Dr. Brenna Hicks.
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Hi, I'm Dr. Brenna Hicks, The Kid Counselor.
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This is the Play Therapy Parenting Podcast where I give
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you insight awareness and enlightenment about your parenting
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and your relationship with your kids.
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In today's episode. I am answering a question from Emma in Ireland.
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So hello to all my Irish friends. So nice to hear from you on the other side of the pond
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and great to
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discuss toileting issues today. So, Emma thank you so much for the email
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and for sharing what's going on with your child.
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She is essentially dealing with her youngest and
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his refusal to sometimes use the toilet
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and therefore there's accidents and
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there's just kind of a lot going on.
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So I'll unpack that and we'll kind of read different parts of the email together
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but a very, very common thing.
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Not only do we see this commonly from the therapy side,
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many of our clients are struggling with
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soiling or wetting accidents in some capacity. So either they are holding
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their bowels or their urine or they're having accidents,
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they are still wetting themselves at night.
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They're refusing to go on the toilet, they're refusing to go at all.
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We officially diagnosed that as
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enuresis or encopresis,
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which is fancy words for everything that I just said.
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But we see this a lot in our therapy center and
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then obviously parents are also dealing with this a lot.
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So Emma thank you so much for the email and
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for reaching out.
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So I'm gonna read parts of her email so that we can kind of see what
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the scenario is and then I'll share some thoughts and we can talk about it together.
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So she says I'm looking for some help with my four year old. He's my youngest.
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I have two other kids that are six and eight. He
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has been toilet trained for over a year,
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but he is still frequently pooping in his pants.
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He'll go through phases of asking to go to the toilet in time or just going by himself.
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But then things will slip and he's soiling his pants every day.
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This especially happens when there's a change like going on vacation.
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And it happens more when other people are taking care of him than when he's with me.
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He's generally fine with peeing.
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I think it's more behavioral and physical because sometimes he will hide to do it
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or I'll ask him and he'll refuse to go on the
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toilet and then he'll poop his pants a few minutes later
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when I did a reward chart or the odd time that I've bribed
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him with a chocolate or whatever when I'm sick of cleaning him up,
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it has gone better.
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But those are not approaches that I would usually use.
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And I'm, they're not providing a long term solution.
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I'm fairly new to the podcast.
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I'm starting to use the techniques and my older kids are responding well,
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but I feel like my youngest is too
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young to really understand the choices limit setting,
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et cetera.
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Or maybe I'm just not implementing it correctly.
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Any help or guidance would be appreciated.
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I can't really think of external situations that would be causing him stress
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other than just generally being the youngest in a busy household.
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He's a happy, cheerful kid who loves preschool.
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Thanks, Emma.
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All right, Emma. Thank you so much and we will certainly dive into this.
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I have quite a few thoughts that I think will be helpful for everybody because
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when we have young kids, this is something that we all deal with
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the path to calm, confident and in control. Parenting starts now.
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All right. So let's start with the basic understanding
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that kids have control over very little in their lives.
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I actually referenced that in the earlier podcast episode.
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We were talking about parenting struggles or power struggles rather,
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I guess parenting struggles are power struggles. But
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I mentioned that kids don't have control over very much. So
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when we think about this kids are told what to do, when to do it, how to do it,
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why to do it.
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That's the nature of their world.
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They have control over very little and really from a therapeutic standpoint,
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they really have control over five things
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and those five things are eating,
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sleeping,
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toileting,
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talking
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and obeying.
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So what we'll often see is that when a child is power struggling,
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they are doing so because they only have really five options of how to do that.
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So I will refuse to eat or I will eat too much.
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I will refuse to go to the bathroom or I will have accidents.
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I will refuse to talk or I will talk a ton.
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I refuse to obey and it's just a willful decision to not ever be told what to do at all.
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Or I will refuse to sleep in my own bed. I will refuse to sleep by myself.
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I will refuse to go to sleep when you tell me to,
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I will not stay asleep in the middle of the night,
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et cetera, et cetera.
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So
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if you're going, oh my gosh, my child does all of those things.
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Now,
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at least you had your aha moment and you
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realize that it's a power and control rooted issue.
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So that gives you the why and therefore then you know how to better handle it, which is
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so important because the why matters.
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So when we recognize that kids don't have control over very much
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and you actually alluded to this.
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But I think I want to make sure that I highlight it because it's important.
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You mentioned I don't think that it's physical. I think that it's behavioral.
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I would agree with you.
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We always want to make sure that we rule
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out any kind of medical or physiological issue.
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So if you know that there's nothing going on physically or physiologically,
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then we categorize it as somatic,
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which is a fancy word for
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the way that our bodies deal with our emotions.
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So almost always when we have children
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that are having accidents or bathroom issues,
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it's somatic in nature, meaning there's an emotional root.
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And in your son's case, Emma, it could just be,
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he emotionally gets worked up
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and it becomes a power and control thing
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so they can work together. So it's not to the exclusion of the other.
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There's very much a sense of
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I want control. I get really emotional about not having control.
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So this is the way that I'm going to make sure that I get it.
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All right.
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So when we recognize that there's a somatic component
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and it's likely rooted in power and control.
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The next scenario to consider then
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is that you want to identify what's going on
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to motivate your child.
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We call it a currency. I've used that word quite a few times
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and what that means is what matters to your child and is significant enough
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that it becomes a currency
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that
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is going to have
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a measure of
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sway.
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In other words,
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your four year old
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might love hot wheels, cars, your four year
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old, might love riding his bike. Your four year
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old might love
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Legos or bubbles. Whatever is something that is really meaningful to him
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that becomes the currency
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so that
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there's motivation.
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In other words,
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you mentioned that when you did a reward chart or gave him a chocolate,
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it went better.
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Here's what I think is going on there
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when he earned a sticker or earned chocolate.
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He was happy,
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he was proud,
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he was excited,
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he was pleased.
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There's probably all kinds of other emotions. But guess what?
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You can't feel those things and be fighting for power at the same time,
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you can't feel those things and have anxiety at the same time.
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So you just
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by happenstance,
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kind of gave him a positive emotion
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that was connected to him using the toilet
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and it took away the somatic nature of what's going on for him.
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So whether it's anxiety, whether it's shame, whether it's guilt,
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whether it's frustration, whether it's something else,
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if he's stuck in a negative emotion
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surrounding this, he's likely going to try to have control over it,
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which means it becomes a power struggle.
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If he feels positive emotions about it,
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it's very difficult to be anxious or have a negative emotion about it.
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And therefore he will not need to power struggle so much.
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So we can see how that makes sense. And you mentioned that it happens more.
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If there's a change
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that is stressful,
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change is stressful you mentioned that it
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happens more when there are different caregivers
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that's also stressful.
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So you can see that in those scenarios, it's worse because the emotions are negative
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when there's stability and predictability and you're home and you're
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in your routine and you're taking care of him.
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He does better. Why? Because he has happier emotions.
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Therefore, he's not needing so much control.
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So we can see what's driving all of this.
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If we unpack this layer by layer, it's easy to see what's going on.
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So you're going to want to use his currency, what really matters to him.
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And you mentioned, I'm using the techniques with my older kids.
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They're responding well, by the way, I'm so happy to hear that.
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But then you said,
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I feel like my youngest is too young to really understand the choices limits.
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No, he's not.
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So
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parents have used
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the four pillars of the child-centered model with infants
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to practice.
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And then by the time their infants were 2, 2.5,
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choices and limit setting were such a standard part
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of their parenting approach that kids responded to it.
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And it's very effective. We,
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we
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see children as young as 2.5 at the center
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and we use all of these pillars with all of our clients.
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So
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we are using these approaches with children as young as 2.5.
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So the fact that your child is four, he absolutely can
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respond appropriately to choices and limits.
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So here's the way that I would approach this.
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Emma, here's the way I think that we can all kind of envision what this looks like.
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So you find his currency,
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I'm going to say that it's LEGOS just because that's easy and
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it, it's something that could work in this scenario.
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So you
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would want to make it very clear,
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not in a moment where there's been an accident
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or not in the moment where there's a power struggle over a toilet issue.
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So it's going to be at a time when everyone is calm and neutral
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and well fed and rested and everything is as happy as it can be.
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You're going to set the expectation of the behavior.
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So I'm going to say that his name is Emmett for
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the sake of using the first name because that's important.
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So
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Emmett,
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I know sometimes that you go to the toilet when you need
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to go to the bathroom and then I know sometimes you don't,
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but you're four
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and you are capable of going to the bathroom on the toilet.
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Ok. So there's the neutral expectation.
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You're acknowledging that,
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you know that sometimes he does and sometimes he doesn't,
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but you are four and you're old enough to do it.
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It's not a force, it's not a guilt, it's not a manipulation,
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it's just a fact you're old enough to go to the bathroom on the toilet.
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So we're setting a neutral expectation.
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So there's the, the preface
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and then you're going to give choices
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as part of the limit.
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So
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starting tomorrow
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or starting on Monday or starting this weekend or whatever
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date is when you can feasibly begin this new process.
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So starting on such and such time and day.
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If you choose to go to the bathroom on the toilet,
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you choose
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to
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build Legos
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for
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20 minutes
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at night.
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If you choose
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to not use the bathroom and go in your pants,
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you choose not to build Legos that night.
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Ok? Legos have to be the currency. I'm only using that as an example.
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What matters to your child? Emma? That's important.
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So if it's friends, if it's biking, if it's dessert,
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whatever books, I don't know. But what matters to him is the way that this works.
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But notice that it's if then
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choices
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and you say choose every single time. So
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if you choose to go to the bathroom on the toilet,
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you choose to have 20 minutes of Legos
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each night.
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If you choose to go to the bathroom in your pants,
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you choose not to have Legos that night, which do you choose?
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He's obviously going to say he chooses to have Legos and therefore go on the toilet,
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but he may not execute that flawlessly
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the first time or maybe a couple of times.
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So the the point of all of this is he has made a choice. He knows the expectation.
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It's been clearly communicated. He
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has a choice
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when he chooses to go in the toilet.
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You don't make a big deal. You don't cheer. You don't show him how excited you are.
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You don't tell him how proud you are of him.
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That's agenda driven
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and then it becomes a power struggle.
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Oh, well, she wants me to go in the toilet. So now I'm not going to
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you very neutrally say
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you chose to go to the bathroom on the toilet. So you chose to have Legos tonight.
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You acknowledge the choice that was made and the outcome that went with it.
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If he goes in his pants,
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you equally very calmly.
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So you're not gonna go.
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Well, I see you've chosen not to have Legos tonight because that's agenda
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driven.
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I wanted you to go in the toilet and you didn't. So now I'm mad
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if that is the tone, it creates a power struggle.
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So it's completely neutral.
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I see you've chosen to go to the bathroom in your pants.
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So I see you've chosen not to have Legos tonight, but you can try again tomorrow.
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This doesn't work. If you are not neutral,
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you have to remain neutral and there can be no shame,
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no guilt,
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no frustration,
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no embarrassment.
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This has to be completely neutral because any of those other
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things I just threw out there warrant a power struggle.
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So the more neutral and calm you are, no matter what choice is made,
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this will be effective because he will choose
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to play with LEGOS.
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If that matters to him, he will choose to have books if that matters to him.
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So this is about setting the expectations, letting choice,
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giving and limit setting work for you
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and making sure that your response is neutral enough
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to not trigger another power and control grab.
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Since we understand that this is rooted in control, right?
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So Emma thank you so much for the email. I hope that that's helpful.
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I hope that's helpful for all of you. We all have dealt with kids struggling with
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bathroom accidents.
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I will never forget there's a restaurant in the States.
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I know many of you are international listeners,
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but there's a restaurant in the States called Steak and Shake.
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And it's like this little old timey diner
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that serves like burgers and fries and stuff.
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And our son was probably three
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and we're sitting in the booth eating
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and he crawled under the table which wasn't abnormal.
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Like sometimes he would switch to come to the other booth or whatever.
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So he crawls under the table and we go, what are you doing?
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And he like was under there too long.
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And so my husband and I are both like crouching down trying to see
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and we just see like a pool on the tile floor under the booth
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and he went under the booth to pee
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and, and
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he was like hiding under there. And I mean, the it's a tile floor in there. So
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it slopes to the drain, right.
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So there's like this sea of urine, like traveling down the restaurant.
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And so I like, run up and I tell the person and I'm like, I'm so sorry,
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my son just had an accident and
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I mean, he was arguably potty trained at the time too
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and I just remember like, oh my word. And so I was like, I'll mop it.
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I'm so sorry and they were mad and
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whatever.
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But I mean, I'm laughing because what else can you do? You laugh or you cry, right.
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But the point is,
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you know,
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every child goes through moments where they are
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potty trained and they can manage it.
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And then there's times when they don't
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and the only thing that I can chalk it up to is,
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you know, anything new,
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takes a lot of work and a lot of
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effort and sometimes when you're in a compromised state,
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so you're tired, you're stressed, you're hungry, you're bored, you're something,
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right?
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Like you're feeling something,
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you just don't have the bandwidth to work on the new skill.
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And so you know what, it's just easy to go under the table and like pee my pants.
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I mean, that, that's so much easier than
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telling you and walking to the bathroom, whatever. Right. So
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I think that it's helpful to just be mindful
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that there are always ups and downs with toilet
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and, you know, I've been telling this to parents for almost 20 years.
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Like your kid's not gonna start high school still like having accidents.
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So this is a temporary problem.
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It will resolve itself,
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but you at least now have some skills and some tools that will ideally help.
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So
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I hope that that gives you some encouragement.
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And thank you so much again, Emma for the email. I really appreciate it.
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If you all would like to email me, please reach out brenna@thekidcounselor.com
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and if you haven't already,
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you can sign up for my newsletter and then I'm able
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to send you updates and podcast episodes and things like that.
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So if you're interested,
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I can also send you one of my talks that I gave as a thank you for signing up.
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So
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if you go to playtherapyparenting.com
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you will find all the information there and get signed up for the newsletter.
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I'm grateful for each to every one of you. Hope you have a great week.
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We'll talk again soon. Bye.
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Thank you for listening
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to the Play Therapy Parenting Podcast with Dr. Brenna Hicks
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for more episodes and just subscribe to our newsletter.
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Please go to www.playtherapyparenting.com.