The Diagnostic Profile: VIII. A Terminal Profile on a Latency Boy (George)

The boy was seen five times a week for three years; the mother was seen weekly and the father occasionally.

Parents' Manifest Reasons: George's refusal to use the lavatory for defaecation. He had never become clean, though he had begun to use the pot or lavatory for urination at the appropriate time. He had, however, achieved bowel control, being able to choose the time and place for defaecation. Mrs A. had not worried about his continued soiling before, thinking that he was just ‘slow’, and would begin to use the lavatory when he was ready. She referred George on the advice of a psychiatrist whom she had met socially, but probably would not have bothered had not George begun to seem unhappy at that time. Though George was said not to be constipated at the time of referral, constipation was found to occur at times, and this worried the mother more than the soiling. Treatment showed retention to be an important aspect of the symptom, with keeping faeces in his trousers equivalent to keeping them inside himself.

Parent' Latent Reasons: Their fears for George's mental and physical normality, arising from their anxiety and guilt over George's older brother, Toby, a mentally defective child.

The parents disagreed over the handling of George; part of their disagreement was due to George having become the focus of marital discord. Mr A. disapproved of his wife's encouragement of George's infantile and feminine tendencies, but was powerless to oppose her.

Neither parent was able to control George's tantrums and outbursts of rage by which he ruled the family. (No mention of this was made at the diagnostic stage.)

Child's Manifest Reasons: George was beginning to worry about his symptom, and wished to get rid of it. Treatment showed this to be a highly conflictive wish since Geor