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Psychogenic constipation is a very frequent symptom in neuroses of childhood, and often a transient symptom during the normal process of toilet training. But it is seldom possible even in child analysis to penetrate to the first appearance of psychogenic constipation and to see the influence of toilet training in the genesis of the symptom. This is because the symptom often appears at a time when the child is not yet able to verbalize his feelings adequately and he therefore cannot subsequently produce memories of those experiences which might explain the details of the symptom formation.
The analytic study of little George's symptom presented an opportunity to observe psychogenic constipation almost in statu nascendi at such an early age that all contributing factors could be traced and the complex etiology of the symptom unravelled. George was 26½ months old when he was brought to me because of constipation which had lasted for several months, and which was clearly psychogenic.
He was an only child. Both parents were young, and were employed in business concerns; they were in modest but comfortable circumstances, and were greatly attached to their little boy, whom they tried to educate without prejudice. They made constant efforts to shield him from any unpleasant or frightening experience, gave him all possible freedom, and were never particularly severe, harsh, or unfriendly with him. They took pains to answer all his questions truthfully, kept nothing secret from him, and always tried to handle him as reasonably as possible.
George himself was a normally developed, perhaps somewhat delicate child. He was attractive, and had a particular charm which no adult could resist, so that wherever he went he immediately became the center of interest, and was spoiled by everyone. He was neither timid nor shy, nor on the other hand, was he bold or obtrusive. He was fully conscious of the effect he had upon others, and took the attention that came his way as a matter