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How To Cure Pee-Phobia (Paruresis)

man with pee-phobia

The first thing that a pee-phobia sufferer should learn is that he isn’t alone. As the fear of urinating in public places develops for a patient, he tends to consider that he’s the only one having this problem. The result is that paruresis becomes permanent and the quality of life is severely affected. If you suffer from the ‘shy bladder’ or ‘bashful bladder’ syndrome, avoidant paruresis, psychogenic urinary retention or popularly called ‘pee-phobia’, please read on for some great tips for curing it.

What is Paruresis?
Although pee-phobia is know under a wide array of names, it signifies one and the same thing and that’s the inability of urinating in public places, or when other people are around. The sufferer can only wee in the safe harbor represented by his home bathroom and in severe cases not even there if his having guests around and feels ‘threatened’ – without having any real reason, of course.
Paruresis can manifest itself at any age and is predominant in boys and men, although girls and women can also be affected.

Pee-Phobia Causes
Paruresis causes are always psychological. Sufferers don’t have any physical problem with their urinary tract, as urine is able to pass normally. The problem is triggered nervously and anxiety contributes to the involuntary closing of the urinary sphincter. Thus paruretics are unable to urinate although their bladder is full.
Anxiety is triggered by a series of factors and can be different from individual to individual which include:
embarrassing social incidents like: being approached by a bullie at the school’s restroom while peeing; or being unable to wee in a cup in front of a doctor (getting embarrassed and developing anxiety towards urinating in the presence of others).
genetic factors: it seems that children that have a parent with pee-phobia are more likely to develop the bashful bladder syndrome themselves.

Shy Bladder Symptoms
The most common symptoms experience by people suffering from psychogenic urinary retention include:
– the urge of total privacy while using the restroom
– not being able to urinate while in public toilets (including workplace, restaurants, pubs, trains, airplanes, boats and so on.)
– impossible to urinate while visiting their friends’ homes
– feeling anxiety even in their home bathroom if other guests are in the house

All these symptoms are caused by the self induced fear of getting in an embarrassing situation if other people are around and get the chance of hearing how their urine hits the toilet water or are to close and are able to smell the urine.

As a result paruretics end-up feeling anxious about having to visit the bathroom. In more cases they start restricting the intake of fluids in order to reduce the times they need to visit the restroom and even go as far as avoiding travel and refusing to attend to important events. This will slowly but surly ruin their social life.

Pee-Phobia Cures
If you experience some of the symptoms described above you should first visit an urologist for the diagnose. The doctor will check that there is nothing wrong physically with your ability to pee. If your urinary tract is fine paruresis is to blame for the inability to wee.
From this point there are two treatment options. You can ask for the help of the doctor to overcome your problem or you can try to do it yourself with the help of your family. However, it’s imperious to underline that there is no general treatment and cures vary depending on individual circumstances. What works for someone couldn’t do the trick for you and so on.
Let’s take a look at both options:

Conventional Treatment
Your doctor can recommend you to visit a psychologist that can apply a series of therapies including relaxation techniques, psychotherapy, cognitive behavior therapy and graduated exposure therapy (which is the most efficient and detailed in the unconventional cures section).
Medication can be also prescribed in cases of severe anxiety and depression.
A third an final treatment option, if all other options fail, is self-catheterisation. The patient is taught by the urologist how to drain the urine from his bladder by introducing a catheter in his urinary tract.

Unconventional Cures
As with the case of conventional treatments the sufferer first has to acknowledge his problem and understand that there is nothing physically wrong with him. He needs to mentally overcome his fear. A few unconventional tips for curing pee-phobia are:
1. Go for a few drinks: attempting to urinate in public restrooms like pubs or nightclubs after drinking a few glasses. Alcohol helps overcoming most inhibitions. Why wouldn’t it cure your fear of peeing in the presence of others? Once you manage this, you can deeply reflect on the subject when sober and motivate yourself to overcome your fear even when alcohol is not around.
2. Sea Stealth: one more great place for trying to urinate in public and lose the shy bladder syndrome is during summer holidays. Detach yourself a little from the group while swimming in the sea or the ocean. Make sure that water is chest-level deep. The sea is a perfect insulator for your anxiety. Nobody else will be able to see, smell or hear your urine, while you can stand relaxed and look all others on the beach. Such an experience will scatter all your fears about peeing.
3. Get Inventive: You can use a few tricks for disguising your peeing session. For example, avoid urinals and wee at a normal lavatory. This way you will be able to flush while peeing and thus conceal the sound of your urine hitting the toilet. You shouldn’t have to worry about smell either. So, no reason at all to feel anxious! Good luck!

{ 3 comments… add one }
  • Sophia August 12, 2015, 9:55 pm

    Girls have this WAY worse. Unlike boys, us girls have no fall-back options, very little to no support, and very little to no representation for this issue. Our only option is to self-catheterize. It would be great if people would stop ignoring the fact that this is not a gender issue, and acknowledge the fact that us girls suffer from it just as much as (if not more than) boys. And I am BEYOND sick of people telling me that, because I’m a girl, my feelings are invalid and I have “nothing to complain about” because I’m “in a private stall” and no one can see me.
    -1. People CAN see through the cracks in the stall doors if they try hard enough (someone did that to me once when I was 12).
    -2. Even though people can’t see in the stall most of the time, they can still hear everything that is going on inside the stall, which is super embarrassing to me. (And don’t try to tell me that it’s a stupid thing to be embarrassed about because “everyone pees”. I know everyone pees, Captain Obvious! It’s still embarrassing to me and it has been ever since I was about 5 or 6 years old. I’m not sure why.)
    -3. Just because it’s not embarrassing to you doesn’t mean that my feelings are invalid. I’m not embarrassed to eat in public, but I don’t judge people who are. If it bothers them, their feelings are valid, whether I agree with them or not. Case closed.
    -4. Just because I don’t remember having a traumatic public bathroom experience that caused this issue for me doesn’t mean that my feelings are invalid.
    -5. Time pressure is a BIG issue in women’s bathrooms, and it just makes female paruretics’ anxiety worse.

    Sorry. Rant over. I just feel so alone and I’m sick of it! I just want some female-only advice for this issue for a change, not some jerks telling me that I have no right to feel the way I do about public bathrooms just because I’m a girl.

    • Nick December 26, 2016, 12:47 am

      Hey, I get what you’re saying, but don’t assume people will say ‘oh you’re just a girl…’. Guys have this problem too. It seems you want this to be a gender specific issue, but it affects both sexes so you know.

  • hormidas July 18, 2016, 7:45 pm

    As A 50+ year old male, I can attest to the fact this is a real anxious disorder. I have worked very hard to try and progress away from this condition, into a situation where I am comfortable using public lavatories. It is a challenge, and it is never the same situation. I have accommodated many situations by sitting rather than standing, and that has worked well. Focusing on an unrelated issue also is a strategy, and i’ve trained myself to put my mind on that though, even when at home, so that I can associate that thought with urinating.. For example, I think about something arcane like socks, when I am urinating in a safe location, so when I have to go out into the world, I sit on the toilet, and think about socks, the association of the two things, makes it easier to urinate outside the safe environment. Noisy places like restaurants, bars, are still a challenge, as are airplanes, which can be very problematic. My plan for my next short haul airplane trip is to train by playing airplane cabin sounds in safe bathrooms, to accommodate myself to the sound, and associating the success of urinating with those airplane sounds. (youtube has thousands of hours of airplane cabin noise BTW). Prior to the short haul flight, I’ll drink several coffees or beers, to force the issue. (I don’t really drink, but I’ve heard alcohol can reduce the anxiety). I know we all do it, we all must urinate, it is a normal human activity, but I have to work to overcome my imagination of people thinking I’m doing something weird in there while, in reality, I am just taking a leak.

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