If you’ve never come across this before the notion of having a “shy bladder” and not being able to urinate when in the real or imaginary presence of others may seem like a wind up. However, the issue is real and more serious and widespread than you could imagine. It even has its own scientific name: paruresis. And it’s been officially classified as a form of social anxiety disorder.
The effects can range significantly. From mild cases of occasionally finding it hard to start a flow when urinating in public toilets or around others, to more problematic and avoidant issues that can affect health and well-being. Those who suffer from shy bladder syndrome need to know that they are not alone.
What Is Shy Bladder Syndrome?
There are a few different names for this condition officially called Paruresis. Shy bladder syndrome is perhaps the most well-known as it best describes that the inability to urinate is due to social awkwardness. Pee shyness, bashful bladder, pee phobia, pee fright are amongst a number of others too. Either way, by whatever name you know it, the general issues are the same.
The condition itself is recognised as an inability to either start or sustain urination due to fear of judgement by others. Collins Dictionary defines Paruresis as: “a psychological inability to urinate in the presence of others”. To some extent this is an accurate definition. But, as the condition evolves, it can develop into an inability to urinate in the real, imaginary or possible presence of others. Therefore not just the physical presence of others.
This means that a paruretic (one who suffers from paruresis) can find it difficult at best or impossible at worst to urinate in any public toilet or rest-room. This can be whether other people are there or not. Picture a concert, restaurant, a social gathering, public transport or even at work!
The History Of Paruresis
It was first recognised as a condition in 1954 by psychologists Williams and Degenhart. They produced a paper entitled “Paruresis: a survey of a disorder of micturition”. This publication in the Journal of General Psychology 51:19-29 was as a result of a survey amongst 1,400 university students and was the first official recognition of the condition.
Since then it has been officially recognised as a form of social anxiety disorder because the cause is entirely psychological and not medical.
Is It Really That Common?
Not only is it more common that than you might expect, it also doesn’t just affect men. Sure, by the very nature of the openness of a men’s public toilet or restroom compared with a woman’s, the condition is much more prevalent in men. But some women also struggle to go to the bathroom if there is someone in the stall next to them.
There’s no 100% accurate estimate of numbers affected. The latest research suggests that it’s a condition that affects around 7% of the worlds population. That’s up to 17 million Americans, 3.25 million Canadians, and 51 million Europeans who suffer from Paruresis.
It’s not till you look at those figures that you realise just what an issue this condition is. Yet most of us have never heard of it! Why could that be? It’s simple … the condition is embarrassing and stigmatised to the extent that it’s just not discussed in public!
As with any psychological condition we need to change this. We need more open discussions, more press coverage and more accessible support to encourage those millions of sufferers to talk about it and get the help they need.
Why Are So Many People Affected By Shy Bladder Syndrome?
This social anxiety over urination is most-likely triggered by a negative experience in early years. Potty training pressure, kids that dealt with some form of humiliation in a bathroom at school, toilet related bullying or, in extreme cases, sexual abuse could be amongst the many possible initial causes. Some historical event has caused it but the original incident might not even be memorable any more – it’s left its effect though!
We have to remember that the inability is psychological, not physical. Unless there is some underlying medical problem with your bladder, there should be no physical reason not to urinate when you have the urge to. The problem is that your mind tells your body that it is a bad idea – perhaps through fear of being seen or heard and dealing with further humiliation. There are muscles in the urinary sphincter that can control the flow of urine. The anxiety of shy bladder syndrome causes these muscles to clamp up and not release the flow.
The Triggers Of Paruresis?
There are varying degrees and every case is slightly different. Therefore triggers will obviously vary. Mild sufferers may only find it difficult to start a flow if others are around. To others just the thought of someone else coming in is enough to prevent urination. Some men are OK in the privacy of a cubical but not a urinal, others have trouble even in the privacy and security of their own home if they have guests.
To men it’s often the worry of being judged visually, to women it’s often about being judged audibly. The extended time it can take a paruretic to take a pee break is an additional pressure – as is an increased number of bathroom visits following previous failed attempts to go.
It’s known to be a progressive condition which, left unchecked, will worsen.
How Dangerous Is This Condition?
While “pee shyness” can at first appear a little amusing there are often significant consequences. Sufferers may refuse to use a public bathroom at all and wait until they get home. This habit can be dangerous if they try and hold it throughout the day and cant even use the bathroom at their place of work. Long term behaviour traits like this lead to other damaging behavioural changes and medical issues. Holding or urinating too little can lead to bladder damage, UTIs and the risk of kidney stones. Those that stop drinking to avoid the need to urinate at work risk dehydration.
There is also the potential problem of taking a urine test for drug screening. Those with a shy bladder that can’t comply may fail an interview process or face other repercussions.
Perhaps the biggest issue is avoidance though. As the condition develops the sufferer finds it more and more difficult to go out socially in order to avoid an uncomfortable or embarrassing situation. We’ve even known cases where people have only taken very local jobs so that they can go home to pee. It’s the effects on quality of life and relationships which can really be affected.
Shy Bladder Treatment Options
You are not alone if you deal with shy bladder syndrome and you CAN learn how to make yourself pee again.
First and foremost understand that it’s not a medical condition – it’s psychological. In simple terms this means that your mind has become wrongly programmed for whatever reason. The cure therefore is to re-program the mind back to the way it’s supposed to automatically react and the way it was originally set until whatever the original event was that changed it.
There’s a number of renowned treatment options. We’ll introduce them but if you want to find out more we suggest you visit https://shybladdersyndrome.org.
- Cognitive Behavioural Therapy (CBT)
- Graduated Exposure Therapy (GET)
- Breath Hold Practice
- Self-Help Treatment Programs
We mentioned using hypnosis to treat shy bladder syndrome and can recomend a particular self-hypnosis program that seems to really make a difference whilst proving incredibly cost effective (costing less than $15 … incredible value!). It’s called simply the Overcome Shy Bladder Syndrome program and you can read all about it here >>>.
If this all sounds too familiar, take comfort in the fact that this is a legitimate, recognised condition. You are not alone … far from it in fact! And, most importantly it IS possible to treat your paruresis effectively and discretely.