The medical term for “shy bladder” is “paruresis.” It describes a condition in which a person finds it impossible or very difficult to urinate in the presence of other people. It is one of the most common social phobias known to men, and is second only to public speaking. Most people first experience the condition in school. The phobia does not discriminate in terms of gender or ethnic origin. Some people only suffer from it occasionally, but others find that the only place they can urinate is alone at home.
Symptoms of Shy Bladder
Shy bladder is a psychological rather than a physical condition. As such, symptoms tend to be psychological. Most sufferers are shy, have low self-esteem and don’t respond well to criticism. Although there are some physical symptoms (the inability to urinate), most symptoms are in relation to fear (people hearing the sound of urinating or smelling it and anxious feelings). Additionally, most people with shy bladder will restrict how much they drink and they will avoid going to social events and long distance travel.
The phobia is very similar to agoraphobia, which is a fear of being in public. People who have severe paruresis may not leave their house at all. As such, they can have a significantly diminished quality of life and less job or education opportunities.
Although many people who have paruresis believe they have a physical condition, it is entirely psychological. Medical tests will reveal that there are no problems with the urinary tract. Rather, anxiety causes the urinary sphincter to seize up and clamp. If the bladder is very full at that point in time, it can increase anxiety, thereby further seizing the sphincter and so on.
In most cases, shy bladder first starts after an embarrassing incident. For instance, someone may have made a remark about the sound they made in a school toilet cubicle, or they may have struggled to fill a cup of urine for a doctor. This single incident can be the catalyst for a full phobia.
Shy Bladder Diagnosis
There are many different physiological conditions that can lead to problems with urination. For instance, men can suffer from prostatitis, which hampers the ability to urinate. Hence, when someone does go to the doctor with this problem, they will usually be subjected to a range of tests to rule out any urinary tract problems. In most cases, if the person admits to being able to urinate at home without any problems, and the medical tests come back negative, they will be diagnosed with shy bladder. Often, doctors will then prescribe antidepressants or anti-anxiety drugs. However, this does not cure the condition and if the person ever stops taking the drugs, the problem will return. In very severe cases, a doctor may suggest that the patient learn how to insert a catheter. This will allow the urine to be drained into a bag.
Shy Bladder Treatment
As the condition is psychological, treatment must address the psyche. This is why most people who suffer from shy bladder fare really well by going to a support group. However, some may also require treatment from a psychologist or a psychiatrist.
A number of techniques have been proven to work. For instance, relaxation techniques are very effective, as is psychotherapy. This is designed to help increase problem solving abilities. CBT (cognitive behavior therapy) can also be very useful, as it retrains the brain to react differently in certain situations. There has also been a lot of success with graduated exposure therapy, whereby someone is encouraged to urinate in increasingly difficult places. It is incredibly successful, but very few people are willing to participate in t.
Graduated Exposure Therapy (GET)
During GET, a psychologist will first ask a patient to create a list of places where urination can take place, and to then order these from easiest to most difficult. In most cases, the easiest location will be alone at home, with the hardest being a crowded public toilet. Patients are then encouraged to work their way through the list, until they reach the hardest location.
Additionally, GET suggests having a “pee partner,” which is someone whom the patient trusts and can confide in. They will help with moving from urinating inside the house to urinating in a public location by standing outside of the door of the home toilet. Once a level of comfort has been achieved here, the patient can start going to more public locations.
The key to GET is to keep going. There will be set backs, but these do not mean the therapy is not working. If one location is too difficult, patients should return to the location before that and start again. Indeed, it can take as much as 12 sessions per location in order for the therapy to be successful.
Finally, with GET, the patient is encouraged to make as much noise as possible while urinating. For many people, the noise that is made is one of the most embarrassing elements and the hardest to overcome. If they can feel more comfortable about the fact that they do make a noise, just like everybody else, it becomes easier to use the toilet in public restrooms as well.
Shy bladder is a very common condition, but one that is often overlooked because people simply do not talk about it. There is still a taboo about certain bodily functions, including urination. As a result, those who do suffer from it often don’t tell others and try to avoid having to use the toilet anywhere. Unfortunately, as with agoraphobia, untreated phobias usually get worse and worse. This is particularly true with shy bladder, as people who age tend to have less bladder control, meaning it becomes increasingly difficult for them to go out in public places for fear of needing to urinate.
If you believe you or someone you know is suffering from shy bladder, seek medical attention. The condition is treatable with some good help. Additionally, the more people who come forward, the more help will be made available as well.