A PERSONAL NOTE TO PHYSICIANS:  

Psychologists have adopted the work of a Pediatric Gastroenterologist,
who won the Fourth Nobel Prize for Physiology and Medicine in 1904, much more thoroughly than has the medical
profession. Dr. Ivan Pavlov studied the front end of the GI tract for salivation and I’ve focused on the opposite end.
Earlier, I performed and published the first significant double-blind, active placebo study of the bedwetting alarm.
This eventually led me to focus on the much more culturally and medically distressing condition of fecal
incontinence.

The medical profession came to view the use of suppositories and enemas for Encopresis for “clean out” purposes
only. This bias was introduced out of the Boston Children’s Hospital by D. Levine in publications from 1976 and
1982 in Pediatrics and Pediatric Clinics of North America. These referred to the use of suppositories and enemas
as “anal assault”. Subsequently, two-thirds to three-quarters of general pediatricians have significantly lowered
their use of digital examinations for their patients.

For the most recent abstracts on encopresis, please click here.


A PERSONAL NOTE TO PSYCHOLOGISTS:

The Soiling Solutions® (SS) protocol relies heavily on reconnecting
the stimuli associated with voiding (sitting on the toilet stool, interoceptive voiding cues, etc.) to trigger the voiding
response mechanism. The holding response which is prevalent and, characteristically, first engaged when we
experience voiding urges is what buys us time to get to the toilet. 

This is “natural”, but it can become so dominant that it blocks the voiding response that should take over. The
suppository and enema “primers” (UCSs) in the SS® assure successful voiding. Through a programmed
conditioning process, the enema primer gives way to the relatively inert glycerin suppository, and, finally, to the
child’s own internal triggering cues. This comes under conscious control. The child’s feeling of massive “relief”
with voiding and social reinforcement are usually sufficient operant reinforcements to sustain the voiding habit.

Parents have found the book, “Sneaky Poo” to be very helpful in externalizing the issue toward the Encopresis
monster or “sneaky poo,” rather than one another.

For the most recent abstracts on encopresis, please click here.