Paruresis – Shy Bladder Syndrome
Every day, over 20 million Americans (7% of the U.S. population according to the International Paruresis Association. struggle to relieve themselves. Paruresis, or shy bladder syndrome, occurs when an individual’s process of using the restroom causes great worry or inconvenience.
This inconvenience is compounded by the number of times each day that human bladders need to be drained.
The psychological implications of a shy bladder are far reaching and unavoidable. Men, specifically, are constantly faced with communal restroom experiences that require exposure and visible inspection of whether or not you succeed in going. Go to Wrigley Field men’s rooms and you will see a shy bladder’s worst nightmare.
While collective urinal troughs represent an engineering feat of efficiency for sports stadiums, they grossly ignore the personal nature of urination and block many individuals from being able to enjoy large gatherings, spend time with friends or family, or even travel.
Absent of medical conditions, there are numerous psychological factors that can contribute to a shy bladder, and guide treatment strategies. If you are looking to find relief from a shy bladder, you may consider one of these five treatment strategies as part of your journey on the path to healing.
1. Hypnotherapy
Creating deep states of physical and mental relaxation are the primary objectives of hypnotherapy applied towards bladder shyness. Reconnecting with the unconscious mind, a carrier of so much responsibility in daily bodily functions, allows the natural process of urination to return to its normal state.
Clients who experience hypnotherapy from a certified practitioner will improve their ability to access deep physical and mental relaxation and gain confidence in their ability to change their experience in real time. Accessing relaxation in the bathroom can make the difference between a successful trip, and a frustrating hold. Learn more in this post on the benefits of hypnotherapy for anxiety.
2. Exposure Therapy
Behavior modification through exposure therapy follows a controlled progression of increasingly stressful events, eventually leading to the target desired behavior. For bladder shyness, this may include visualization of using a public restroom, then looking at pictures of a bathroom, to standing in a bathroom, and ultimately using the bathroom with another person present in the room.
Throughout this process, clients are monitored in their expression of “units of distress” to help identify specific triggers for anxiety, as well as to maximize the therapeutic benefit of the process. Exposure therapy should be deliberate, and clients should not be sent into situations that produce unreasonable distress.
Exposure therapy adopts the mentality that some anxiety regarding the experience is acceptable and to be expected. Learning to be more comfortable and to manage that anxiety is the goal.
3. Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) for bladder shyness targets self-beliefs and attitudes towards bathrooms as well as the experience of using the bathroom. Thoughts are important! And the language being provided when preparing for or attempting to use the bathroom can profoundly change our attitude towards the whole experience.
Are you fixating on negative past experiences or are you offering yourself examples of success?
Are your thoughts judgmental and extreme (e.g. “you should be able to go!”, “you’re always going to freeze up!”)? If so, working with a licensed therapist on challenging negative core beliefs, putting our thoughts on trial, and creating adaptive cognitive “performance” cues may be impactful.
4. Trauma-Informed Therapy
Looking below the surface of a shy bladder may reveal emotionally charged events from the past. These events can relate to past experiences of privacy (being barged in on while using the bathroom), sexual trauma, or other events that have triggered the body’s fear response.
Trauma-informed therapy works to acknowledge and reprocess difficult events of the past that may be influencing current experiences.
If a trauma is bathroom-related (whether direct or ambiguous), the daily act of urination, or even having to pee, can re-trigger the traumatic event.
In this case, working with a trauma-informed specialist can help in reprocessing the activating event and developing adaptive coping strategies for use in any bathroom setting.
5. Emotional Freedom Technique
Emotional Freedom Technique (EFT), or tapping, is an excellent strategy for working through mental blocks such as bladder shyness. EFT taps into the body’s natural energy meridians to release cognitive blocks and reduce emotional distress.
Through a series of light tapping in specific areas, coupled with a directive and affirmative mantra, tapping removes the negative emotional charge that may be getting in the way of bathroom relief. Once learned, tapping can be used anywhere, and can offer a way to defuse anxiety about using the bathroom before it can even begin. See this page from EFT International to learn more.
Bladder shyness is anxiety producing and can be debilitating. Modern public restrooms do not appropriately accommodate the needs of individuals who are seeking natural relief.
If you have ever had to change your plans, leave early, or cancel travel due to bladder shyness, consider reaching out for help. The relief you desire is possible!
