The most common onset of encopresis occurs during toilet training. Going to school is the second most common onset which is covered in the next blog below. Toilet training conflict involves a major initial confrontation between the parent and child. This can trigger a contest of wills. The parent is making a demand for the child to switch out of the convenience of diapers to go to the bathroom to pee and poo. Pee is much less of a problem because the signal urges are so recognizable, followed by quick and easy voiding, immediate relief, and it requires much less in the way of a cleanup. Pee is liquid and flows easily, while poo is more or less a solid. Poo has an immediate foul odor and it is clear that people wrinkle their noises and display disgust. Elimination of poo is literally more difficult and requires more coordination of the muscles to facilitate its expulsion. Also its passage may encounter more or less resistance depending on how dried, hard, and large the stool mass may be. If the child is upset with the interruption of his activity to go to the bathroom, the relevant muscles of the pelvic floor and sphincter are less able to relax and to facilitate passage.
Toilet training typically comes at a time when the child is becoming much more autonomous in his or her mobility. They develop their own opinions and notions about what they want to do or not do. Parental demands to go to bed or to toilet are much more interruptive of their activities and likely to trigger intense resistance and even resentment. Both sides form opinions and theories about the other which can enhance conflict. Judgments of good, bad, or evil quickly become organizing themes. This hardens conflicts which can escalate. A child’s job is to challenge and test; the parent’s job is to maintain calm, love, provide authority, and set limits in the child’s own best long term interests. This is another source of conflict, immediate versus long term interests. The human organism requires the longest period of education and supervision than any other living organism. We possess lower brain systems deep inside the brain and more recently evolved higher brain systems that have to be developed by parents and the culture.