6 year old is terrified of pooping in the toilet

My 6 year old nephew is beyond terrified of the toilet.

When he pees, he stands nearly half way across the bathroom. We're slowly getting him to move closer but when he poos.. He has to put toilet paper over the hole in the bottom (usually causing it to plug up), someone has to go in and flush it for him (only when he poos, when he pees, he's fine with flushing it himself) and he refuses to sit. When we try to get him to, he shakes horridly and cries.

He gets poo all over the place from the shaking and simply standing to go.. We have no idea what to do. He refuses to say why he's so scared.
Once we managed to get it out of him that he was scared to fall in. We got him one of those children's seats. Still scared. Someone goes in with him to hold his hand. Still scared.

We have absolutely no idea what to do.

[AnnieBrooke]

Put a potty chair in the bathroom, and have him use it and then dump it into the toilet.  He is old enough to manage that himself, including rinsing the little pitcher before he puts it back into the potty seat.  Once the pressure is off for a while, you might re-address the issue, but right now he is too frightened.

[ani_cat_candy]

The weird thing is, though (sorry I forgot to mention it) He was fine with going on the toilet until just a few months ago. He was fully potty trained somewhere between 2.5 - 3 years old.

When he heard me talking to his mom about it, he insisted that "NOooo! Potty chairs are for babies!"

[IChris]

He may have seen or heard something about a toilet accident from peers, in a movie or from tv which may have been frightening. Both accident with falling into it, snakes from a neighbour finding its way to the toilet etc. happens once in a while and if he have heard about something like that it is understandable that he might have been frighten. So the first point is to try figure out if he might have learned about some toilet accidents, and then maybe take contact with a doctor to learn how to handle it.

[AnnieBrooke]

I don't know if this would help or not, but there are double toilet seats at Home Depot that have a smaller seat ring and a larger one.  The small one is kept up in the lid by a magnet, and the person pulls it down to sit on it.  If he is afraid of his bottom actually slipping in, that would solve the problem.

There is also something called a Squatty Potty, a little sort of footstool that goes on either side of the toilet, that (according to its literature) assists people into a more natural position and releases the muscles that compress the anus.  If you're interested, look it up by that name and you can read their literature.  We got one for my son (age 6) and he is VERY enthusiastic, telling me it takes him much less time to poop and is just "easier."  It might be that giving your son something like this to try, would take his mind off his fears (like a magic feather sort of) and it might work just because of that.

[ani_cat_candy]

Didn't think it would ever happen but they FINALLY took him to the doctor and got him a referral to see a specialist.
Dr said it's a type of phobia and he had it when he was little.

Of course no one tells me this until I specifically ask.
(someone mentions him going to the doctor in passing)
"When was this?"
"Oh! Last Monday."

He asked me to hold his hand while he went a couple days ago and I had to pick him up and set him on the toilet right, then hold him in a hug so he wouldn't freak out and wiggle away.

His mom actually took some advice and tried that.. Last night I heard he went on his own with only Pa holding his hand and wasn't even shaking!

YAY PROGRESS!!!!

[ani_cat_candy]

Also, we've asked him so many times. Tried to sneak it into conversations..
He insists he's never seen any movies or heard anything about things coming out of the toilet or anything remotely similar.