The boy in the iron mask: Superego issues in the analysis of a two-year-old encopretic

The paucity of psychoanalytic literature on encopresis is surprising given its frequency as a presenting symptom. Vignettes from the analysis of a two-year-old encopretic boy are presented to demonstrate the prominence of superego determinants, even in a child so young. The implications of this finding for understanding encopresis are subsequently discussed, including the common feature of depression. Technical issues arising from a sensitivity to these superego contributors are demonstrated, and the importance of addressing a child's sadistic superego directly in order to facilitate insight is emphasized.