ENCOPRESIS (Enchopresis)

Involuntary defecation not caused by organic defect or illness.In our culture inability to control bowel function after the age of two is an indication of faulty training, or, in some cases, retarded development or psychiatric disorder. In a review of seventy cases among children, Shirley (1938) found that thirty-seven had an I.Q. of less than 80, and in many instances there was evidence of an exceptionally poor home environment or parental oversolicitude. Persistent soiling is generally considered a much more severe symptom of emotional disorder than enuresis. It may also lead to disturbances of the colon, and for this reason a thorough physical examination is necessary. As English and Finch (1964) point out, “The child of grade- school age who continues to soil usually represents a more seriously disturbed child than one who has chosen a less primitive way of showing his problems.” These authors state that more often than not the child has shown great resistance to toilet training and is reacting to parental inconsistency or overdiscipline: “For a variety of reasons the child has retained unconsciously the magical concept that defecation has both sexual and aggressive connotations, and may involuntarily soil himself when sexually excited or angry.” Similarly, Redlich and Freedman (1966) state, “In the case of encopresis, a mixture of infantile sexual pleasure and rebellion and revenge against the parents coexist.” The disorder usually requires intensive psychotherapy.