The paruresis it is a psychological disorder that prevents or hinders urination in public or private bathrooms, especially if there are other people nearby. If you have this condition, you will avoid going to the bathroom in restaurants, discos, airports or other public places, where it is highly likely that there are other people urinating next to you, even if there is a screen in between.
Even if your case is severe, you will avoid going to the bathroom in the house of a relative, or in your own house if you have visitors. Alterations when urinating can vary depending on the degree of paruresis.
Some people have a more or less long wait for the start of urination (mild paruresis) and others cannot urinate at all (severe paruresis).
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What happens is the following: people affected by this disorder feel a lot of stress and anxiety when they have to urinate in public or private bathrooms, when they have other people around.
This anxiety prevents or makes it difficult for the voluntary sphincter of the urethra to relax, and therefore, it is also difficult or impeded the exit of urine. Some researchers believe that paruresis could be a special manifestation of social phobia.
Problems urinating around other people usually begin at puberty, as a result of a traumatic experience, high stress, or an extremely shy and introverted personality, with low self-esteem and an inferiority complex..
It is also possible that their parents or others have made them feel very embarrassed, that they have been bullied in the bathroom, or that they have suffered sexual abuse..
Many people who have gone through these types of situations have not developed paruresis, which indicates that there are also other influencing factors, such as a physical or psychological predisposition.
Whatever the case, after the traumatic situation that generates the disorder or the first bad experience when wanting to urinate in a public service, the subconscious relates these negative emotions to the fact of urinating in the presence of other people.
Thus, those who suffer from paruresis begin to avoid public toilets and the problem persists or worsens, if proper treatment is not followed. In a large number of cases, those affected by this disorder think that other people present near them in the bathroom are watching them or will make fun of them.
On the other hand, many people are embarrassed to talk about this problem, because they feel that they will not be understood..
But remember, it is a very common problem (it is believed to affect 10% of the population), therefore there are millions of cases around the world and most of them have a cure. Surely yours too, and you have nothing to be ashamed of.
These are some of the common behaviors in people with paruresis:
If you have problems urinating, of course you should consult your doctor and rule out underlying organic problems, such as a urinary infection, kidney stones or prostate problems in the case of men..
But basically, if you can safely urinate in the privacy of your home but have difficulty doing so in a crowded public toilet, then you probably have paruresis..
If you have this problem, surely you have already started to avoid certain situations, such as long trips for example.
If you are not able to urinate anywhere other than your home, you may begin to avoid social gatherings and outings to a restaurant or a movie theater for example. Or maybe you urinate before leaving the house, then when you have to go out you drink almost no liquids and you resist the urge to urinate until you return home..
But this is not good for your health: surely these situations cause you a lot of stress and anxiety. So if you have paruresis (a condition also known as "shy bladder" or "urinary psychogenesis"), it is best to start looking for a solution today..
Fortunately, paruresis can be cured in most cases. These are the two most effective treatments.
Some studies indicate that 8 or 12 sessions of this type of therapy, or a week-long workshop helps 4 out of 5 people with paruresis. Cognitive behavioral therapy is a treatment that combines two aspects.
The first is the cognitive aspect of the problem. The person with paruresis often thinks that other people will watch or make fun of them while they urinate.
Don't forget that this condition is considered a form of social phobia. Social phobics are very sensitive to the noises and smells that they produce and when they have to urinate near other people, they fear being criticized for this.
During the sessions of the cognitive psychological treatment, the therapist tries to banish these irrational fears and replace negative thoughts with more rational positive ideas..
The second aspect is the behavioral one. It is about modifying the behavior of the person through gradual exposure, so that he can overcome anxiety and urinate in a public bathroom, as explained below.
Some people don't need cognitive therapy, especially if their paruresis is mild..
Simply by gradually exposing yourself to the object of your fear and seeing that you are successful in urinating around other people and that nothing bad happens, the symptoms begin to disappear..
Ideally, this exposure should be guided by a psychotherapist, especially in cases of severe paruresis..
But if your symptoms are not too intense, then perhaps you can overcome the anxiety yourself, without the help of other additional therapy, and so that you can do it, we will give you some tips:
You should practice this treatment frequently, if you can, several times a week and for as long as necessary..
Ideally, each “session” should last about an hour and include 15-20 attempts to urinate with people nearby. That's why at the beginning we advised you to drink plenty of fluids before starting.
You can also drink fluids during each session, to always have the feeling of wanting to urinate urgently. If one day you are successful and the next day you are not able or it is difficult for you to urinate, do not worry, the fluctuations in the results are normal.
One more tip before finishing this section: don't go too fast, slowly expose yourself to close proximity to people and to more crowded public restrooms.
And remember: if you also have problems urinating at home, you need to see a doctor urgently, it could be a urinary tract infection or obstruction.
The results of these studies were published in the Journal of American College Health Association.
If you have difficulty urinating under certain conditions but this does not affect your life the most, then paruresis may not be a problem for you..
Did you know that paruresis can improve if you increase your self-esteem? Some experts believe that people with fears and phobias often grant a certain "power" to the object of their phobia, a power that they believe they cannot overcome..
So, when the person improves self-confidence, the object of their fear loses strength, loses its power, and the symptoms improve or disappear..
This condition has been referred to in many famous TV series. On NCIS Los Angeles, Eric confesses that he has difficulty urinating in public when notified that he will have to wear a microphone on an undercover mission.
The Mitchell character from Modern family recognizes a strand that has a “shy bladder” and therefore cannot urinate in any
site.
And the funniest of all: in Two and a Half Men, Charlie is unable to urinate in front of his girlfriend, even though she was waiting by the
door, outside the bathroom. "I can't do it under so much pressure," Charlie said. But then his girlfriend sings "the pee song" that his mother taught him and this is very helpful. "Is working!" shouted Charile.
In short, don't let paruresis dominate your life and fill you with fear and trauma. There are millions of people in the world who have the same problem and are working to overcome it.
Use the gradual exposure exercises we have described or seek professional help, until paruresis is no longer a problem and you can urinate freely when and where you feel like it..
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