Tales of a Bashful Bladder

It is still quite early on in my night out, but the pints of lager I had some hours ago have already made their way through the various tubes and passages that comprise my digestive system and I’m starting to feel a twinge down in my lower regions. I walk through the bar, locate the toilet and enter. I ignore the multiple available urinals and instead focus on the cubicles. One cubicle is free, but it has no door. I walk past. All the others are taken. So I stand and wait. Finally, someone finishes and frees up one of the cubicles. At last I can relieve myself.

This little ritual is one that I undertake whenever I am out in public and nature calls. Sometimes if the toilet is completely empty I take a gamble and try using one of the urinals – hoping I can get the flow going before someone comes in. Why is this problematic for me? Am I a freak? Well, maybe… But not for this reason. In fact, some of you reading this will find that my little tale of toilet trouble rings very true. If so, then you too, suffer from Paruresis (also known as shy or bashful bladder syndrome). But don’t worry, you’re not alone. According to the “International Paruresis Association” about 7% of the public suffer from Paruresis – which equate to roughly 1 in 14. If that’s true across the globe, then a whopping 476 million people out there can’t pee quite so freely.

Paruresis is a social anxiety disorder. It is characterised by a difficulty to urinate whilst other people are present or nearby. It ranges in severity from mild cases like mine (where I can’t pee at urinals but am perfectly fine peeing down dark alleyways or behind isolated trees) to extreme cases (with people who can’t pee anywhere other than their own home). It affects both genders, but due to the presence of urinals is a condition more apparent in men.

Whilst a substantial amount of people suffer from the condition, few will admit it. Which is fair enough I suppose. Urinating habits don’t tend to come up very often in standard dinner conversation (though bringing it up IS an effective way of getting a date to lose any interest in you). There is also the stigma associated with problems urinating, especially among males. An inability to use urinals is often associated with repressed homosexuality or issues with size (and I’m not talking height, here). Whilst it’s true then either of these issues can indeed cause Paruresis, often it’s not the case. These are just two of many potential causes. Take me, for example. Am I insecure about my sexuality? Nope. Am I insecure about the size of my penis? No, not really. (On an entirely unrelated note, I have size 12 feet…)

So why can’t I pee at urinals? In my case, I believe the condition stems from my difficulties relaxing around people. Whilst this article may suggest otherwise, I can be quite self-conscious. In fact, it’s something of a vicious circle. When I attempt to urinate with other people around, I worry that I won’t be able to. Because I’m worrying, I then can’t urinate. Backing up this theory, when I’m completely inebriated I have absolutely no problem whatsoever using urinals.

For me, and the majority of sufferers, Paruresis is only a minor nuisance – merely involving more time spent in the toilet or greater suffering on long journeys. But for those who suffer from severe cases of the disorder it can have a major effect on their lives. Imagine if you could only relieve yourself in one bathroom. Imagine having to organise your entire life around urinating, creating a pee schedule, watching the amount you drink and never being able to stray too far from home.
Urination is something that the majority of us take completely for granted. But that’s the reality for extreme Paruresis sufferers. Help is at hand, however. A group of Paruresis sufferers have formed the UK Paruresis Trust, a registered charity “dedicated to helping men and women for whom urinating in the presence or vicinity of other people is difficult or impossible, and dealing with the problems this brings about”. A guaranteed cure, however, looks unlikely.

So, next time you whip out your wang or squat over the bowl maybe stop for a moment and think about your good fortune. A few aren’t quite so lucky, and don’t find it to be as natural a process. That’s Paruresis for you.

Stephen Lovejoy

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3 Comments on this post.
  • Carol Olmert
    12 March 2010 at 01:26
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    Thank you for writing about how debilitating the condition of shy bladder syndrome can be for the millions who suffer from it. I want to point out that women are equally predisposed to suffer from it — and the long lines that often form in front of womens’ bathrooms don’t help. Please visit the website of the International Paruresis Association (IPA) at http://www.paruresis.org for more information.

    Carol Olmert
    Author, “Bathrooms Make Me Nervous”

  • Andrew Smith
    12 March 2010 at 08:44
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    Hi Stephen

    Excellent article, well put. and well done for disclosing. The UK ParuresisTrust has its website and forum for all to use: both men and women. The website contains a lot of useful advice, case studies, book list etc. The forum is a moderated site which is purposely safe and supportive. The UKPT runs intensive weekend residential workshops that people find very helpful in moving forward with this condition.

    You say a guaranteed cure is unlikely; true to the extent that there is not a button you can press to get rid of it. However the recommended treatment is CBT – Cognitive Behaviour Therapy – and it is this approach we use on the workshops. You can significantly improve, given you treat it like getting in training for a marathon i.e. a long term process that requires regular repetitive practice.

    As for the numbers affected. That 7% probably includes people who only occasionally lock up, so the % that is chronically affected is not known. However Mens’ Health magazine ran a survey and found to its surprise that about 20% of men often lock up , and 35% o occasionally do.

    And who has it? All sorts, all ages and all background; the one thing they have in common is that they are all regular guys.



    Chairman UKPT

  • David
    13 June 2013 at 15:53
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    Is there a CBT or an organisation in South Africa?
    If not, are there any therapists who deal with this sort of thing.
    Does hypnotherapy work and has it been used?

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