THE PSYCHOLOGIC ASPECTS OF PEDIATRIC PRACTICE

[摘要] What have we seen in the aforementioned cases? In both cases the parents were apprehensive about dirt, and extremely anxious about the period of time that elapsed between movements. Each child had gone through the usual routine of cathartics, enemas, etc. In requesting that the mother finger paint together with the child, we were doing two things. We were helping this mother to overcome her own feeling about being messy, and at the same time getting her to convey to the child that dirt need not be feared, nor must it be removed immediately. Interestingly enough, if we look at the finger painting when it is done by these mothers and children, although they have a choice of all the primary colors, in a majority of the cases the ultimate painting turns out to be brown, or greenish brown, a color so closely allied with feces.It was equally interesting to hear some of the mothers say, "You know, it really can be fun to finger paint. At first I thought it would be so messy." Although in the cases described above, it was a little late to educate the parents against undue aggression toward the infant at the time of toilet training, however, with an understanding of the problem, came some sympathy toward the child, and a lessening of the parental aggression. This is very quickly sensed by children, and may, to some degree, be responsible for the improvement in the total situation of the parent-child relationship. Furthermore, one should not overlook the fact that the help of the pediatrician is of great importance to the parent. His is the voice of authority which enables the helpless and frustrated mother to overcome earlier emotional attitudes and assume a more tolerant parental role.We do not presume to convey that every case of constipation is cured by resorting to finger painting. However, we have observed 22 cases which were treated by the method of reeducation of parental concepts plus finger painting, with positive results.From the foregoing material, it is evident that there is a dire need for the pediatrician to fully understand the psychologic implications of fecal movements from the first day of birth on. It is the pediatrician who guides the mother, who relieves her anxiety when the child has no movements for several days, and who can explain to her the harmless composition of feces. It is he too, who can make her aware of the problems of toilet training and the more positive attitudes she can maintain to negotiate successfully this step without undue aggression.Inasmuch as the period of life up to the age of approximately three or three and a half years is so fraught with incidents which could have been avoided with adequate understanding, it would be a pity to overlook the measures by means of which we could avoid as distressing an illness as what we term chronic constipation.

[学科分类] 儿科学