Shy Bladder Syndrome (Paruresis)

[Daniel E.]

Do You Have a Shy Bladder?
Allan N. Schwartz, LCSW, Ph.D.
April 9th, 2008

It's called paruresis and its no joking matter to anyone who has it. Why am I writing about it now? Actually, a few days ago some friends and family were at my house and got to talking. I don't remember how we drifted onto this topic, of all things, but we did. One of our friends, a woman, mentioned the fact that when she urinates she hates to make any noise and cannot go if she thinks anyone is listening. I was surprised to hear how many people in the group then admitted to the same problem. For those who experience what is commonly referred to as "Shy or Bashful Bladder," the experience can cause painful and embarrassing dilemmas.

For example:

1. There are people who are so self conscious about public bathrooms that they must wait to urinate until they are home.

2. Feeling the necessity to wait until one can urinate until they are home can cause life to become very restricted:

• These individuals must find work near home where they can walk home so that they can go.
• Many will not travel because of an inability to go in airline bathrooms or other places.
• They feel so embarassed about this problem that they make up excuses to other people for what appears to be odd behavior about wanting to get home.
• Despite needing to urinate very badly, these individual cannot urinate no matter how much will power they apply to the situation. It goes without saying that this can become uncomfortable and painful.

Of course, there are different degrees to which a person can have this disorder. When the disorder is mild, a person may experience some inconvenience and may even be able to urinate in a public bathroom at times. However, when it is severe, as explained above, it can really alter and limit an individual's ability to live their lives without restrictions.

Basically, Shy Bladder is an anxiety disorder. As long as nothing is wrong organically, it is intense social anxiety and embarassment that causes an individual to tighten the urinary sphincter muscle so that they cannot go. It must be emphasizedd that this tightening of the sphincter is involuntary in nature and not a matter of choice.

What Causes Shy Bladder?
It is not known for sure what the cause is of paruresis is. Men and women equally suffer from the disorder. It is thought that some type of humiliating process may have occurred during childhood or that it is part of a larger General Anxiety Disorder. Whatever the causes, it is very common and nothing to be ashamed of. Here are some treatment options for this problem:

Treatment:

1. Cognitive Behavioral Therapy can be useful in this. In this way an individual is helped to alter their thoughts and feelings about urination and public bathrooms.
2. Systematic Desensitization in which therapy is used to help a patient develop pleasant associations, when totally relaxed, about the need to urnate in bathrooms away from home.
3. Suggestions are given such as: turn on the faucet while you go in order to hide the noise and to promote relaxation allowing the sphincter release its muscle allowing urination. With repeated success, the problem can abate.
4. The same relaxation techniques applied to all anxiety disorder work here: deep breathing, muscle relaxation, imagining pleasant and relaxing scenarios.
5. Anti-anxiety medications are a last resort but [some] carry the danger of addiction [for a minority of people].

As I write about this I am aware that some readers might find this amusing, absurd or just plain dumb. I want to assure all of you that paruresis is none of those things.

I invite readers to submit comments and questions.

Followup post by the same author:
Shy Bladder Syndrome (Paruresis): Getting Help

Related article:
Paruresis - Wikipedia, the free encyclopedia

 

[busybee]

Actually Daniel, that was rather enlightening. From being a woman who used to avoid public toilets for exactly that reason, I did not know that there was a name for it. Some of those strategies I put in place but as I had more children it was a matter of going or having an accident. My husband did not even know when I went to the ladies room, in the first year of our marriage.

Now when I do to the public toilets, there are a lot of women out there who are pretty much the same. Maybe not the anxiety disorder, but trying to be quiet not make a sound. Many public toilets now have piped music in there to provide some semblance of privacy.

Busybee