Interoception issues causing withholding behaviour

[Beatrice81]

Does anyone have experience of addressing witholding behaviour linked to interoception issues (processing of internal sensations), particularly response to the urge for a bowel movement?

My 6yo has struggled with constipation/ withholding since early stages of potty training. We managed to get on top of his functional constipation with Movicol and regular toilet sits but his innate response to withhold whenever he senses the urge to poo remains unchanged. No amount of encouragement, reasoning or explaining seems to have any effect.

If anyone has any experience or advice of successfully addressing withholding due to issues of sensory processing I would be keen to hear.

[Bezzywezzy]

I can’t help I’m afraid, but I’m having the exact same issues with my 5 year old. Interested to see if anyone has any input. Thanks

[ERIC-Charity Partner]

Hi Beatrice81 , Are you familiar with Kelly Mahler's work on Interoception? There are some great videos on Youtube. I've added a link here to a blog post about interoception and toileting: kelly-mahler.com/resources/... Best wishes, ERIC

[Beatrice81 in reply to ERIC-Charity]

Thank you. I have come across her work and wondered if anyone has practical experience or success stories of applying these techniques specifically to stool withholding

[MrsSquirrel in reply to ERIC-Charity]

I remember mentioning this term to 2 consultants (paed urology) a couple of years ago and both of them looking at me like I'd stepped off another planet. For our child (who is 12 and has DCD) this makes perfect sense - that he may need extra time and prompts to identify and give meaning to internal sensory feelings. Especially when engaged with something like his playstation! I will really give some thought about this useful concept and how it could help.

[deliaok]

We have this issue with our 8 yr old. We are working on both managing the situations he is more likely to not pay attention to his body, like during screen time and learning on noticing the sensations. He has to do a 5 min. sit time before any screen time. We have done some activities with our physical therapist, like when he successfully poos, drawing where he feels it. Or rolling on a yoga ball to feel his bladder pressing. I think he is also more likely to have accidents with hightened emotions, so we're working on stages of regulation as well.

[Beatrice81 in reply to deliaok]

How is his response when he notices the sensation of an imminent bowel movement?Is there any anxiety? If so, how do you address it?

We use visual cards to illustrate the toilet routine so he understands what to do when he notices the sensation (these seem to help a little) but he still becomes anxious in the moment and withholds. Constipation is successfully being managed with medication and regular toilet sits, so there is no issue of it being painful.

The bathroom is generally a friendly place with a mat on the floor, a few toys to relax/ play with.

We've talked through concerns about being sucked into the toilet or anything coming out of it.

Not really sure what else to try so any suggestions to manage anxiety as a response to sensation of a bowel movement more than welcome...

[deliaok]

Unfortunately we don't have anxiety issues anymore. He just waits too long and doesn't want to miss anything. So usually it's just "Sean Go!!" lol