How to deal with encopresis/enuresis in an older child

minecraft asks: I am nearly 10 years old. I don’t know who else to tell this, because it’s really embarrassing. I have a lot of accidents; I some times dirty my pants and I still wet the bed at night. I do not know why I keep having accidents in the day. I get really embarrassed and sad, because my brothers and other kids make fun of me for it. I have six brothers and two sisters; I am the fourth oldest. My mum sometimes gets mad at me and she some times says things like she is going to put a nappy on me like my two-year-old brother (She only gets mad when I have accidents in the day, not about me wetting my bed). My mum took me to the doctor about why I have accidents in the day, and the doctor said I’m fine and there is nothing wrong. My mum said if I have one more accident she is going to put me a nappy on me, because she can’t keep buying me underwear and washing my clothes, and she says it will be a lot better for me because I will be more comfortable and I will sleep better. I don’t want to wear nappies because nappies are for babies. How do I get my mum not to put me in nappies?

Hi minecraft –

It’s very humiliating, I know, to have this problem, and I really respect you for having the courage to reach out and ask about it.

I was lucky in this area.  I was able to get paper-trained and house-trained very quickly.  After that, there were a couple of times when Handsome was so stressed out it made me lose control, but otherwise I’ve been fine.  With one exception!

That exception is that dogs, unlike people, get inspired to pee and poop.  The reason we go to trees, fire hydrants, and such the second we get outside is that we want to pee, but sniffing another dog’s pee smell starts our engines turning.  This is great for leaving trails, marking territory, and all.  But it can also cause a big problem.  What if we’re inside a house, and another dog has peed or pooped (or thrown up) there?  What if there’s a bit of a residue of it on the floor, or in the carpet?  We have no choice! We get one whiff of that, and our system gets going, and we don’t even have time to whine or walk away, we just release right there.  And then the people always yell at us, or at our owners, that it’s our fault, that we’re not trained well enough.  When, if anything, it’s the fault of whoever cleaned it up but didn’t do it well enough (there are products made with enzymes that break the residue down organically; those are the best cleaners for indoor marking).

But here I am talking about myself instead of about you (Am I marking my territory, perhaps?!).  And human bowel control is a very different situation.

It might sound obvious, but there are only two reasons for a child of ten to still be wetting his bed and soiling his underwear:  It’s either physical or emotional.  Some people just have weaker muscles in that area, and they simply can’t hold it in (this is why we hear about old people wearing diapers – they know how to keep it in, but those muscles have gotten weaker in their old age, and so they don’t have the same control they once did).  So your mother was right to take you to a doctor, to check your body out.

But if it’s emotional (which is much more common), then it’s a more interesting dilemma.  Kids lose control over their bladder and bowels for many reasons.  Often it’s that they’re very afraid and anxious.  Sometimes they don’t want to grow up.  Other times it’s a sign of a deep-seated anger, and it’s the only way they can let it out.  And in those cases, it’s necessary to learn better ways of self expression.

Now when it comes to bedwetting, the best solution tends to be what’s called a Bell-and-Pad system.  It’s an electrical device that the person sleeps on, which rings an alarm when it senses moisture.  This trains them to wake up and go to their toilet, instead of peeing their whole bladder into the bed.  Over time, the person learns to wake up when they just feel pressure, the way I do.

But as you say, your mother isn’t even upset about the bedwetting.  It’s the underwear.  So while I understand her thoughts about nappies, I’m going to recommend something probably neither of you will like much, which is to talk to a psychotherapist.

I’m not saying you’re crazy, or mentally ill, or anything like that.  But you humans have gigantic brains that have lots of stuff going on in them that you’re aware of, and even more going on that you’re not aware of.  This is why your dreams are so much more interesting than ours (though mine, which mainly involve fighting and squirrel-chasing, are enormously fun, even if they’re simple!).

And if nothing’s wrong with you physically, then it sounds like there’s something going on emotionally, that you don’t know about yet.  Maybe you’re very anxious about something, maybe you’re upset or angry about something going on in your life.  And if so, putting a nappy on the problem is only going to make it worse (it’s not like walking around with a bunchy diaper is going to make you feel less anxious or angry, right?!).

The first, middle, and last thing I need to say on this issue is IT’S NOT YOUR FAULT.  It’s not anyone’s.  We just want to get to the bottom of the problem (sorry, I had to make that joke, just had to!), and neither you, your mother, nor your pediatrician is going to be able to do that.

If your parents don’t know of a good child therapist, I’d suggest asking your doctor for a recommendation.  If that doesn’t work, and you can’t find anyone who knows of someone, feel free to write me and ask about it; I don’t currently know where you live, but you can let me know and I can have Handsome do some research about therapists there (and I promise I won’t let anyone else know anything identifiable that you tell me).

So please do seek out someone great, and get past this problem. This is truly one area where resolving the issue makes EVERYONE happier.  So I wish you great luck!




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