RE: encopresis and hx of prolonged traumatic stress

["Stephanie Dallam" <sjdscout@xxxxxxxxxxxxx>]

As a nurse practitioner who worked in pediatrics for many years, I took care
of a lot of kids with encopresis. The doctor who cared for them never looked
for trauma and so it was never an issue. He went out of town and the doc I
worked with covered these kids. We had two new patients come in, both boys
-- one was 6, the other around 10. Anyway, we did the medical workup which
revealed severe fecal retention but didn't show any anatomical problems. 

We also had each child do a session with the play therapist who was trained
to take a trauma hx. Anyway, each boy reluctantly revealed having been
anally raped. One by the husband of his babysitter, who had been insisting
on taking showers with the boy. The other was raped by his father, who we
found out was a known rapist. Anyway, with protection and sensitive medical
treatment both boys made complete recoveries in short order. Then the other
doctor came back. He went back to ignoring trauma histories and having
rather poor success, at least in my estimation, in helping his patients
recover. 

So, although this is only an n of 2, it was remarkable in that these boys
recovered so quickly from what were diagnosed as severe cases and the
intervention that seemed to make the most difference was disclosing, being
protected, and being reassured that they were normal and had not been
physically changed -- that they could heal completely. Their bowel problems
after the rape made them believe that they had been permenantly damaged.

Stephanie Dallam, RN, MS, FNP

> -----Original Message-----
> From: owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu 
> [mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu] On 
> Behalf Of Elise M. Bon-Rudin
> Sent: Thursday, December 16, 2004 7:40 PM
> To: Child Maltreatment Researchers
> Subject: encopresis and hx of prolonged traumatic stress
> 
> I would appreciate references to elimination disorders as a 
> malaptive response to early prolonged traumatic stress, via 
> CNS (catecholamine activity?) or other mechanism.  I have 
> read much of Bruce Perry's work but have yet to find 
> reference to this particular physiological response.  
> Reference to the "no evidence found" of course equally welcomed.
> 
> ___________________________________________________
> Elise Bon-Rudin, Ed.D., LMHC
> Clinical Associate & Instructor in Psychiatry Mental Health 
> Clinician and Program Development Coordinator Child Advocacy 
> and Protection Program Children's Hospital at Dartmouth One 
> Medical Center Drive Lebanon, NH 03756 phone  603 653-3679
> fax       603 653-6050
> email: Elise.M.Bon-Rudin@Hitchcock.org
> 
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