Hello Dr Deb,
I have been trying to toilet train my almost 3 year old daughter for 4.5 months. We gave it a break after no progress with doing a poo on the toilet. She seems anxious and can’t let go even if she is desperate and has already started going. We are on our second go at toilet training and a week into the process she still hasn’t done a poo on the toilet. Her poo has become harder than I would like despite using laxatives for the last few days. She is totally dry during the day and night and really doesn’t want to be in nappies. Do you have any ideas that could help? My husband has anxiety too especially when needing to perform.
Hi there ,
I’m so sorry your daughter seems anxious.This is an all too common problem – so you are not alone. There are many children who for various reasons may have developed anxiety surrounding pooping in the potty. They have what I refer to as almost a “vicious triangle” between three major components – anxiety, constipation, and avoidance. These three things are so closely interrelated and intertwined, that one affects the other. Anxiety creates more constipation, which can create more pain/discomfort, hence avoidance, which creates more anxiety, etc … and so it goes on.
First of all, let’s get clear on the goal for your daughter At this point given that she is not quite 3 years old, she is still within the norm of potty training progress. Although you said she wants to be in undies (which is a very noble goal for such a young toddler!), at this point she is still well within the normal range of potty training progress. Only 50% of 36 month olds have mastered daytime toileting successfully, with the vast majority (90 – 95%) completing daytime dryness by 4.
Therefore, at this point, our goal should not be to help her ‘perform’ (or poop in the toilet), but rather on helping reduce her anxiety around the potty. Naturally, when we reduce her anxiety, and make her feel more comfortable, this ultimately WILL have the side effect you want – pooping on the potty. BUT this should not be our goal at this stage of the game. She is far too anxious right now and the more we push it, the greater her anxiety will become (and the worse the constipation!!).
SO- Here are my suggestions:
1. Minimize your child’s anxiety using “The Magic Number 3”…Try to think of your child’s anxiety as on a scale of 1 – 5 (this is much like a thermometer with ‘1’ at the bottom and ‘5’ at the top).. “1” is her safe zone, whatever is comfortable for her to do. At this point, she may be most comfortable pooping in her nappies in the corner of the living room, for example; this would be her ‘comfort zone’. “5” is at the top of the scale and is her ‘panic zone’. Perhaps pooping on the potty is a “5” for her right now. A “3” is something that your child can do that is perhaps less than comfortable, but is something she can manage if you provide ample reinforcement and praise! To find her Magic Number 3, you could start at her comfort zone is in terms of where she wants to poop, and then add a little bit of challenge or novelty to make it slightly more challenging, but manageable. For example, can she poop in her nappy in the bathroom sitting on the floor? Hip hip hooray! Good for her. If that is too easy (maybe only a “2” on her 1-5 scale), can she poop in her nappy while sitting on the closed potty? Fantastic! What about pooping in her nappy sitting on the potty when it is open? Even better! There are a million ways to modify this so that you are ‘approximating’ her using the potty, without it provoking too much anxiety. That’s the magic number ‘3’ zone and that’s what we want her to practice. After frequent repetition what you will find is what used to be a ‘3’ becomes easy (like a ‘1’), and then you can offer more challenging alternatives.
2. Resist the urge to focus on success vs failure, and ENJOY the process. Overall, the goal at this point is to help her feel calm, good, and happy, enjoying the process of toilet training without a focus on the product or ‘performance’ Encourage, but don’t force. Let her direct things if need be, offering gentle encouragements and praise for slight improvements, and matter of fact acknowledgements for accidents or blatant refusals. If she wants to sit in her nappy and poop on the toilet for a week, then changes her mind and decides she wants nothing to do with it, that is ok! As Elsa says, ‘Let it go…’
3. Consider taking a break. If your goals are too ambitious, she will have too much anxiety, and you may need to take a step back. There is no harm in reverting to more ‘pre’potty training strategies (i.e. having her accompany you when you use the potty, reading potty books, or watching older siblings, etc.) before considering the above.
4. Consider switching the potty coach. In some cases finding a novel or neutral party to encourage potty behaviors like pooping on the toilet can be just what the doctor ordered. For example, a preschool teacher, a grandmother or aunt, or even the non-primary parent can be a refreshing change for a child, and may introduce new dynamics into the mix that may make your daughter feel less pressure.
5. Try to reduce your anxiety.You mentioned your husband may have some anxiety, and naturally at this moment, you may have some too!! Try to remain as calm as possible with your daughter, to communicate to her that you are not worried about her! You may have already noticed how your daughter picks up on your moods and feelings. This is especially the case when potty training!!. Reassure her that all is well, that fears are natural, and that she will get there when she is ready! This will go a long way in helping her feel some sense of self-confidence.
Overall, remember, potty training is less as an either/or thing (“ e.g. we are training her or we are not”), and more as a gradual stepwise progression incorporating numerous milestones and stages. Don’t feel there is a definitive beginning and end or that it is working or not, or you may fall into your own performance anxiety as a parent!
I hope this helps – keep me posted.
– Dr. Deb