For some sufferers of paruresis, the solution is simply a bit more privacy in a public toilet facility, such as using a stall instead of a urinal where possible. — Jens Wolf/dpa
Shy bladder syndrome.
Cute though the condition may sound, it can really cramp your style.
People who have it are unable to urinate around others, such as in a public toilet facility.
So they organise their life around the problem, always being mindful of where the nearest “safe haven” is.
They carefully plan trips to the toilet or avoid certain places altogether.
The medical name of the condition is paruresis, a type of social anxiety disorder.
Paruresis isn’t widely known and is little researched, but it’s not uncommon.
About 3% of the population are thought to have it, men more often than women, according to Dr Nadine Striepens, chief physician at the Christoph Dornier Clinic for Psychotherapy in Münster, Germany.
The number of unreported cases is probably higher than this estimate, she says, and the number of people who only occasionally experience paruresis higher still.
Nearly a third of all men at least sometimes enter a public toilet only to leave without emptying their bladder.
They can’t go – there’s just no flow.
The good news is that paruresis can generally be effectively treated.
But “many people are afraid to address the problem (with a doctor),” says Dr Striepens.
They’re too embarrassed.It’s important to seek help though, she says.
Otherwise you could get caught in a vicious circle: “It often starts with a triggering event, for example a stupid comment made in a lavatory.”
Those who have paruresis have a type of social anxiety disorder and sometimes organise their life around the problem. — Franziska Gabbert/dpa
The next time you visit a public toilet, you might be afraid of having a similar experience.
The resulting stress, particularly in men standing at a urinal, can make it impossible for them to urinate because the muscles in their bladder and urinary tract won’t relax enough.
So they start avoiding certain toilets.
”In severe cases, sufferers are loath to drink any fluids outside their home,” Dr Striepens says.
Before they go anywhere, many calculate when and how much they can safely drink, or when they need to be back by so that they can go to the toilet in private.
Consequently, shopping can pose a major challenge, she says, leisure activities are problematic, and blockages can occur at the workplace, too.
“Many sufferers largely seclude themselves and hardly leave their home,” remarks Dr Striepens.
”Paruresis not uncommonly arises together with depressive states or alcohol dependence,” says Benjamin Dickmann, a behavioural therapist at the University of Düsseldorf’s Psychotherapeutic Institute Outpatient Clinic, where the condition was researched in the early 2000s and sufferers are now treated.
What can you do to get a bashful bladder to open up?
The first thing, Dickmann says, is to see a urologist to rule out any medical conditions that may be causing the problem.
For some sufferers, the solution is simply a bit more privacy in a public toilet facility, such as using a stall instead of a urinal where possible.
”Although more research needs to be done, cognitive behavioural therapy has proven effective,” says Dickmann.
The course of the therapy depends on the patient.
Typically, the patient, assisted by the therapist, works out the anxiety underlying their paruresis.
To overcome their avoidance behaviour, patients are gradually exposed to situations that trigger the anxiety.
If their bladder’s streaming service stops, say, when someone’s waiting for them to void and they try to force it, in therapy they practice “blocking” a toilet for themselves, explains Dickmann.
This can help them to allay their anxiety, stop avoiding public toilets and boost their sense of self-efficacy, i.e the belief in their ability to cope with the situations.
Dickmann recommends that anyone with paruresis undergo psychotherapeutic evaluation to determine whether therapy is advisable.
There are also various internet fora where sufferers can share their experiences and useful information. – dpa
