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THE RESOLUTION of Laura's phobia, reported below, demonstrates the usefulness of considering phase-linked ego apparatuses in evaluating regressive symptoms. It dramatically brought home to the author the need to clarify and to interpret the specific fantasies of a child in therapeutic effort. It may amplify our understanding of that common constellation of fears, the threat from below. For these reasons, it is reported here.
Laura, a bright, personable, outgoing, and to all appearances well-adjusted girl of three years and three months, suddenly refused to go to bed one night. She insisted she was "afraid I'll make a doody in my bed" and straightaway went to sit on her potty chair whenever told to go to sleep. She exhausted the usual sleep rituals of storytelling, trip to urinate, a drink of water, a good-night kiss and tuck-in. She would not stay in bed whether her parents remained in the room or not.
The parents (father, a psychologically-minded physician, mother, a former teacher) were unable to understand this precipitous regression. Despite long talk and eager listening to Laura, they got no clue they could use. She stuck to her story that she was afraid only of making a "BM" in her pants; that she really had to make now; that she had to go on the potty chair. Once on the potty, she did not defecate, nor would she consent to get off. She insisted she had to go and thus couldn't go to bed. Reassurance that she had already made that day and thus really didn't have to make again was ineffective. Review of the day's incidents was not productive. Support that she hadn't defecated