Uh-oh. Nature calls and you’re out in public. If you’re like most people, you head for the nearest restroom to get some relief ‘” but not if you suffer from paruresis – the fear of urinating in public. For some people having a paruresis or a “bashful bladder” makes it difficult to even go out. What causes a bashful bladder and what’s the best way to deal with it?
Bashful Bladder Syndrome is Not Uncommon
As many as one out of ten people suffer from the fear of urinating in public – at least to some degree. Some manage to push their fear aside and successfully relieve their urge, but for others entering a public restroom and relaxing their bladder is almost impossible. The urine just won’t flow. The problem can progress to the point that a bladder shy person restricts fluids before they go anywhere – or they may not go out at all. This can be especially problematic if they work outside the home, travel, or if they have to give a urine sample at a doctor’s office.
What Causes a Fear of Urinating in Public?
No one really knows the exact cause of parauresis, but some people point to a traumatic episode as a child such as being teased for wetting their pants. This “event” sets up a psychological barrier to urinating in a public restroom when other people are present. Some people, who suffer from a bashful bladder, fear others will hear the sounds of their urine striking the toilet bowl, while others are afraid inquisitive eyes will witness the act through the crack in the door. On the other hand, bladder shy people are usually able to urinate quite easily when they’re at home in the privacy of their own bathroom.
Are people with parauresis anxiety-ridden individuals? A person with paruresis may be a fearful or anxious person who has other phobias, or they may only have the fear of urinating in public. Regardless, most experience classic anxiety symptoms when they enter a public restroom. Not surprisingly, a person with a bladder shy person will go out of their way to hide their fear from others.
Is There Help for Paruresis?
In extreme cases, a person may need counseling with a therapist who uses cognitive behavior therapy to treat the problem. This involves gradually exposing the bladder shy person to public restrooms, starting with an empty one and progressing up to a crowded one – until they’re no longer sensitized. Hypnotherapy and relaxation techniques may also be beneficial for bladder shy people.
Some people are able to de-sensitize themselves without the help of a therapist using the gradual exposure technique, but it’s better to have a trusted friend or family member come along to ease the anxiety. Sometimes flushing the toilet while urinating makes it easier to relax the first few times, but it’s important to gradually progress to urinating in a quiet bathroom. Learning how to breathe deeply and relax while urinating at home can help a person with paruresis work through a fear of urinating in public.
Finally, it’s important that a person who has problems urinating be checked out by a doctor since there may be medical reasons for the inability to urinate.
International Paruresis Association. “About Avoidant Paruresis”
Merck Manual. Eighteenth edition. 2006.