If you are squeamish about scatological concerns you can stop reading now. If however you can take on the tough topics of pee and poop, tushies and penises, read on:

At Soho Parenting our approach to toilet training is gradual, developmentally informed, and child-centered. We encourage parents to start this process somewhere between eighteen and twenty-four months. We suggest they buy a potty, let their toddler be naked and show them by example and clear instructions how this natural process works. Toddlers slowly learn to master this basic body function and have the opportunity to take ownership and pride in this new skill. We teach parents that only a small portion of toilet training is physiological. The lion share of toilet training is the emotional work of growing up and tolerating imperfection. Parents need to introduce the concept, provide the materials, give the support, but accept the inevitable ambivalence that young toddlers have about “letting go” in this way.

For many families, toilet training moves along in fits and starts but without too much difficulty.  Often though we meet parents whose children have come to an impasse in the whole process. Three, four and even five year olds can become embroiled in a long and grueling battle with their parents over using the potty. These children are often using the potty regularly to “pee” but are only “pooping” into a diaper. Having learned to hold their poop for days on end, these children seem to have decided that they just are not going to do it. Whether there has been too much pressure or not enough structure- a “window of readiness” seems to have passed. The child has dug their heels in and the parents have all but given up. They have tried bribes and threats and manipulation and even shame and nothing is working. Parents know that their child “can” do it and just “won’t “ and they often come to us with a mixture of worry and fury.

Catherine Lloyd Burns’ book “It Hit Me Like A Ton of Bricks” a memoir of a mother and daughter poignantly and hilariously  depicts this very struggle and  Burns attributes much of 3 year old Olive’s ultimate success to their work with  what we call SPPBC (Soho Parenting Potty Boot Camp).

“Olive and I are going to a gastroenterologist referred by her pediatrician. She has been taking five tablespoons of mineral oil a day for three months and she’s still constipated.  She can’t make a poopy for days at a time and then when she finally does, it is so enormous, it is no wonder she screams in pain.
The doctor appears and says, “You must be Olive.”
“I are having trouble making a poopy,” she tells him.
His examination room is nice. There is a Snoopy poster circa 1972. He makes Olive count how many Woodstocks there are.
“Free,” she tells him. He ignores her and interrogates me: her diet, allergies, her delivery, when did the problem start, when was her last bowel movement. Olive wants to talk too.
“Well, I drink mineroil,” she interjects, but he is not interested.
“Is she toilet trained? He asks me instead.
“She uses the potty and she uses diapers.”
“She’s not toilet trained then?”
“She uses the potty and she uses diapers, I repeat. She is a little bit toilet trained.  She is working on it. She has an interest in the toilet but she is not exclusive about it and I am not the type to remove her diaper until she is ready.”………..
“There is nothing wrong with her. She is just constipated, which is fairly common and her colon is stretched. I want you to give her Senacot for two weeks, and she needs to be toilet trained. I want her to sit on the potty with her feet firmly touching the ground three times a day after meals for ten minutes. Make a chart and reward her with stickers and rewards for each bowel movement that goes in the potty. And you will come back in two weeks and show me the chart.”
“She’s not toilet trained…” I start to say.
“She needs to be,” he interrupts me again. “That is part of the problem.”
“You know she’s a smart girl and my philosophy is that when she is ready—“
Can she do it in a diaper but sitting on the potty?”
He interrupts me again, “No, if you follow these instructions—Senacot, potty three times a day for ten minutes, and a system of rewards and stickers—the problem will be fixed. Do you want the problem fixed? I assumed that is why you came to see me.”
I hate him. He obviously does not have children and if he does, he doesn’t spend any time with them.
….I will never tell Dr Spillman  any of this but Olive gets Swedish fish for pooping, period—in her diaper, in her bed, on the potty, anywhere- and she gets a present if she does it on the potty without her diaper. The candy is bad for her teeth and it isn’t really working anyway. She hasn’t pooped for six days..It is time to pull out the big gun. Lisa Lillienfled   She costs two hundred dollars but she is always’s right. ( Those of you who know and love our own Lisa will know how happy this last line made her.) She thinks Spillman is a genius and she wants his number. I give it to her but I tell her that he’s an asshole. She says an asshole is better than a nice guy who prescribes enemas. She tells me I have to potty train Olive.
“The longer kids go, the harder it is for them to do it. I think Olive needs you to help her get to the next level. Take away her diapers and make a weekend project out of it, stop with the presents, and just do it. Tell her you have complete confidence in her. I really think the whole thing will be resolved when she gets out of diapers.”
“Really?”
“I really do. I think she’s having trouble going there on her own so you have to help her.”
That night, after her bath, I tell her that tomorrow we’re going to do a project. No diapers all day and we’re going to work on using the potty. She seems excited about the plan and even reports it to Adam like it is wonderful news. We cancel all of our plans for the weekend so we can stay inside and potty train.
In the morning I take off her wet diaper and when I don’t put on another one she freaks out. She starts kicking and screaming and climbs down and gets a diaper from the shelf and tries to put it on herself. She begs for a diaper.
“Honey remember what we talked about last night? We’re not using a diaper today. You are going to use the potty whenever you need to make a pee or a poopy.”
“Nooooooo! I want my diaper. I want my diaper.”
“Lovey just for today, okay? We’ll see how it goes. We really think you are ready and can I tell you something?  I would never ever ask you to do something if I didn’t think you were ready.”
“No. I want a diaper. I want a diaper! I want a diaper! She is working herself up into a major lather.
“What are you afraid of, honey? You already use the potty sometimes, we’re just trying to get you to use it even more.”
Through her tears she says’ “ I’m not ready. I’m not ready!”
“Olive honey everyone thinks this is going to help with your poopy trouble and we’re going to try it and see how it works. I know you can do it. I promise you can do it.”
“No I can’t!” she cries. Finally she lets go of the diaper and she cries in my arms. After breakfast she announces she needs to pee and she does. She keeps telling us what happened, “I peed in the potty.” She is very proud. Then she needs to poop. So she does. And she poops five more times, in the potty, before the day is done. It’s done and she is cured. All they need is a little help. All I need is to act like I know how to help her. It’s a confidence game, a charade.”

Burns’ hysterical depiction of Olive and her mommy’s toilet training travails reminds us all of how hard and ultimately important it is to help our children when they get stuck by firmly, confidently but lovingly and patiently leading the way to the next level. Children respond with relief and pride to having mastered something they had convinced themselves they couldn’t do.  Parents do too.