Saturday, September 14, 2013

Koopa the Conqueror

Koopa has come a really long way with his fear of unfamiliar toilets. He is far from being completely at ease with them, and is still quite picky about his pubic bathroom choices, but he can handle them now most times. A trip to the bathroom when we're out and about is still never a mundane event for us, but almost always involves at least a slight surge in anxiety, and a lot of negotiations and sometimes tears. But the toilet is not an invincible monster anymore, like it used to be for almost two years for him.

For two years Koopa was terrified of toilets. Or maybe even longer. Or maybe he was always somewhat scared of them, and this fear just developed and evolved as Koopa developed other sensitivities? At some point during the past year I realized just how bad his fear was and that it didn't seem like something that would easily pass on its own.

My first attempt to actively do something about it was in April 2012, when Koopa was 3.5 years old, when I started freaking out about how on earth we were going to survive our upcoming 12 hour long trans-atlantic flight. At the time, I spent a lot of time and energy trying to convince Koopa to use a public bathroom in a "positive" way, telling stories about how the toilet was really his friend and trying to bribe him with stickers. Looking back now, it was the most ridiculous thing I've ever done, and quite insensitive, too. I mean, to a child who is convinced that toilets have teeth this would have been the most confusing and terrifying offer imaginable, especially coming from his mother. After all, from his perspective I was suggesting that he trade his safety and his butt for a sticker, and who in his right mind would agree to that? Thankfully, Koopa has always been a pretty reasonable person, so he did not agree. No, seriously, retrospectively, I am quite happy he chose to trust his instincts and not to do what in his world was INSANE. I'm happy because it is always best to trust one's instincts, even if they seem unreasonable to another person (even if that person is your mom), and I hope he will always do that.

My biggest mistake at that time was that I didn't try to understand him, I tried to "fix" him. I was too busy with my own agenda. I perceived his fear of toilets as MY problem, as in "Oh my god what am I gonna do with this 3.5 year old child if he suddenly needs to go to the bathroom when we're far from home, and what if he poops his pants on the plane!" It took some time to get out of that mindset and realize that this fear was much more of a problem for him than it was for me: that if he would consciously decline a play date offer or another fun event just in order to avoid an encounter with an unfamiliar toilet there, then things were really bad. That's when I finally realized that he was suffering and simply needed my help and understanding. And I had to let go and to consciously tell myself "OK, one day there might be a huge public tantrum and/or a child who pooped his pants and that will be unpleasant and I would have deal with it somehow, but HE shouldn't have to deal with my anxiety in anticipation of that, because he already has a lot on his plate: he has his own anxiety that is much bigger than mine."

So I had to let go of the idea of "fixing" him and "fixing" the whole situation, and we started simply exploring his fear of toilets, just a little bit at a time, as much as he was comfortable with. We played and pretended that toy bins were toilets and we're scared and running away from them. We told toilet stories and drew toilet pictures, composed toilet poems, and played toilet games. We drew pink toilet teeth, and watched toilet videos without sound. And none of it was very deliberate, and almost all of it was initiated by Koopa. On my side, it involved just "letting go", and actively deciding to simply be there with him, wherever he was in his fear, and letting him know that I was there to help and to follow HIS agenda, not mine. 

And then one day I decided that we could try the "gradual exposure" thing that cognitive-behavioural therapy talks about. I proposed him that we approach one of the monsters. I didn't try to convince him that they were friendly or anything. I didn't ask him to change his mind about them. At that time, unlike a year prior to that, it seemed appropriate to offer a reward for his efforts. The difference was that this time it wasn't just my agenda, it was his. By this time he was expressing a new kind of interest in the monsters: whenever we were in a new place he would ask where the bathroom was, not in order to avoid it, like before, but in order to look at the closed bathroom door, with awe and interest, from a safe distance. So he clearly was ready to explore his relationship with toilets a little more, and needed a little incentive.

Since then every time time he approached a bathroom, we drew a toilet on a white board at home, and every five toilets earned him a reward of some kind. He defined what "approach" meant every time. In some cases, it involved approaching the bathroom door, and in others - simply looking at it from several feet away. Ideally, it would have to involve a little discomfort from time to time (approaching the bathroom closer and closer) but we didn't manage it often. So we went on like this for a few weeks, but got stuck pretty quickly, and Koopa seemed to be less and less motivated by the rewards.

And then I had another idea that really seemed to make a difference at the end. I designed a bathroom comfort-ladder. I adopted the idea from that book about selective mutism where they talk about a talking comfort ladder to gradually make the child comfortable talking in various situations. You make a list of people, situations, times and conditions that influence your child's talking anxiety, in the order from least triggering to most triggering, and construct a comfort ladder out of it. Then the idea is to move up the ladder very gradually, moving to more uncomfortable situations one step at a time and becoming more and more comfortable in them. Koopa didn't really need it for his talking anxiety because his SM seem to resolve on its own. But the idea can be adapted anywhere. So I made a list of bathroom situations from the least to most scary (e.g. at school > friend's house > my office > at the mall...) and bathroom-related activities (approach the door > touch the door > open the door >... > pee) and so on), and then combined the two lists to make a bathroom comfort ladder.

In the book they suggest that the child shouldn't be aware of what's going on, which makes sense in the case of SM, because the child would then feel an increased pressure to talk and that wouldn't be good. But in our case, Koopa obviously had to participate and be aware of what was going on. Not just that, I decided to make him really aware of the idea of a ladder. I literally made a ladder out of construction paper, and put it on the fridge. Like this:
And every time he conquers his fear a little more, the little paper boy on the fridge moves one step up the ladder. And on every step we write what the situation was that he conquered. And this tangible representation of his progress seems to be the best reward for his efforts, better than any toys or stickers (I still give him stickers and other rewards sometimes). Some evenings he asks to sit down with me on the floor in front of the fridge and count the steps that the boy has passed. And I can tell you that the expression on his face in such moments is priceless. His eyes sparkle with pride, he widens his eyes and lengthens his face in pretend-amazement and surprise, and every time he asks the paper boy "Hey, boy, you're not scared? You're so high up! You're not scared to fall down?" ("Мальчик, ты даже не боишься? Ты не упадёшь?"). And every time the boy replies that he is confident he won't fall down. And I know that I can trust him in this, because it was his decision and his agenda to go up there in the first place, and I know that he is good at following his instincts.


  1. Replies
    1. Heh. Hopefully I don't sound like I know what I'm doing :) I'm just really good at isolating the best and most successful bits!