Good morning, and thanks for writing to JA.
I'm sorry that your son is going through a "rough time" right now. I think it's important for you to know that many children experience anxiety in the school setting. This is both "work" and "play" for them - and it's important for them (especially bright and popular kids) to feel like they feel secure and "in control" over their own environment. Believe it or not, these kiddos grow out of this problem with little difficulty. (Heck - *I* used to be one of these kiddos myself!)
Your GP's recommendation to reduce trips to the bathroom is ideal - and makes sense. Might I also suggest some options that we often employ... (I have done this with students in the role of both a clinician (working from a hospital setting) and as a school psych (working at the school itself)...)
During off-hours, in the company of a supportive school representative (it can be the school counselor, psychologist, nurse, or Principal/Asst. Principal)... take some time with your son to practice in the bathrooms and to feel accustomed to trips there and build up periods of success in the bathroom. Sometimes the frequent trips to the bathroom are really a reflection of concerns about going to the bathroom in a public place. Sometimes bathrooms in schools can be very loud and exacerbate anxiety - and this may be why your son chooses to go during "off hours" - because if he went when all the other boys go - it would be overwhelming for him. It might also be possible to check out some other bathroom options in the school... is there one with fewer stalls? One in a more quiet hallway? etc?
Also, establishing that relationship with an adult in the building will help him have an additional "escape valve" instead of just the bathroom. If he starts to feel overly anxious, a trip (even a 5-10 minute trip) to the nurse or counselor or psychologist can be just the trick!
Finally, there may be a possibility that your son is experiencing real organic digestive distress (not just based upon anxiety). If this is the case, consultation with a nutritionist or perhaps allergist might be in order. If he's in genuine, physiological distress (not just a manifestation of anxiety), that should be thoroughly explored.
I hope this helps - and that you remember your son will get through this little "speed bump" in development with relative ease. In just a short while, mom/dad... he'll be asking to borrow the keys to the family car! :)
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