NEW YORK TIMES COLUMN: FAMILIES TODAY:
IN TOILET TRAINING, A PREMIUM ON PATIENCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.
Problems in toilet training nearly always arise because of an imbalance in the parent-child relationship. Children usually show signs of readiness between age 2 and 3. When parents can’t wait until then, and impose toilet training as their idea, the child will feel the pressure as an invasion.
All parents, of course, want their child to grow up and cross this threshold. Preschools often insist that a child be “trained” before he comes to school.
Other parents may offer advice and condescending comfort when their children are already trained. Grandparents may imply that toilet training is a measure of effective parenting and of a child’s overall competence. Some families may see the child’s entire second year as preparation for success in this area.
A toddler for whom independence is a passionate issue anyway will have his own struggles. He may stand in front of a potty, screaming with indecision. Or, he may crawl into a corner to hide as he performs a bowel movement, watching his parents out of the corner of his eye.
It’s a rare parent who won’t feel that such a child needs help to get his priorities straight.
When a parent steps in to sort out the guilt and confusion, the child’s yearning for autonomy becomes a power struggle between them. Then the scene is set for failure.
In bedwetting, as in many of the problems encountered with toilet training, a child’s need to become independent at his own speed is at stake. When a child’s need for control is neglected, he may see himself as a failure: immature, guilty and hopeless. The effect of this damaged self-image on his future will be greater than the symptoms themselves.
Given that toilet training is a developmental process that the child will ultimately master at his own speed, why do parents feel they must control it? My experience has led me to the conclusion that it’s very hard for parents to be objective about toilet training.
The child becomes a pawn – to be “trained.” It may take us another generation before we can see toilet training as the child’s own learning process – to be achieved by him in accord with the maturation of his own bladder and central nervous system.
When Problems Exist:
A.) Discuss the problem openly with your child. Apologize and admit you’ve been too involved.
B.) Remember your own struggles, and your eventual successes, so that you can let the child see that there is hope ahead.
C.) State clearly that toilet training is up to the child. “We’ll stay out of it. You’re just great, and you’ll do it when you’re ready.”
D.) Let the child know that many children are late in gaining control, for good reasons. Then, let him alone. Don’t mention it again.
E.) Keep the child in diapers or protective clothing, not as a punishment, but to take away the fuss and anxiety.
F.) Don’t have a child under age 5 tested unless the pediatrician sees signs of a physical problem. A urinalysis can be done harmlessly, but invasive tests and procedures – enemas, catheters, X-rays and so on – should be reserved for children who clearly need them.
G.) Make clear to the child that when he achieves control, it will be his own success and not yours.
(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)
Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.
Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.
Reprinted with permission from the authors.