Reconnecting with development
The critical factor in time-limited psychotherapy with children with incontinence problems is to help them reconnect with normal development and to assist the parents and child together to move towards the instatement of health and growth. Given the need to find a quick solution to the problem in order not to further impede development, time-limited psychodynamic therapy has a helpful role to play. Placing the focus on the normalising of development, means that we need to make practical suggestions about the management of the problem as it manifests itself on a day-to-day basis. In this sense the practical is the personal, as the actions particularly of the parents, have an impact on perpetuating the problem or on helping to resolve it. Understanding the meaning of the symptom and exploring it as the opportunity, is a powerful element in achieving therapeutic success. Practical suggestions take the form of helping parents to contain their anxiety to help them cease their intrusive control and not to disrupt the functioning of their child’s body. A position that emphasises health and growth and the child’s own physical and psychological capacity takes precedence over a view of the child as ill, helpless and passive.
Helping parents to cease their participation in rituals is an important part of this process. This helps them to open up more appropriate avenues for caring and showing affection. Most importantly, it is vital to ensure that the child takes their place within the school community to enhance their capacity for learning and for developing peer and friendship contacts.