Looking for a Paruresis Cure? Try This Instead

There’s No Paruresis Cure—Only Hard Work

Have you ever felt embarrassed to use a public restroom? If so, your social anxiety might be expressing itself in this unique situation. Paruresis (also called shy bladder) is a problem where you feel afraid or avoid using public restrooms. This isn’t because you’re afraid of germs, but rather it’s a type of performance anxiety. While there’s no paruresis cure per se, it’s not a problem that can’t be overcome.

If you have paruresis, you probably can’t use a restroom unless you have complete privacy. You might worry other people will hear you going, so you prefer to use the toilet at home.

You might even go so far as to avoid gatherings or not drink anything while you’re there, so that you don’t have to use the restroom. According to a survey by the International Paruresis Association, in it’s most serious form, paruresis can affect all areas of your life including dating and career.

While I won’t go so far as to say that there is a cure for paruresis (just like there’s no “cure” for social anxiety), you can follow the steps that therapists use in a process called “graduated exposure therapy.”

Research shows that about 80% of people who follow graduated exposure therapy for paruresis show improvement.

Below I will outline for you how you can use this type of therapy as a self-help plan.

Step 1: Rule Out Medical Problems

If you haven’t already, it might be wise to speak to your doctor and make sure there are not any medical problems preventing you from using the restroom. This might be particularly relevant if you find yourself unable to go even in private situations or when you really feel the urge to go badly.

However, for some people, needing to go urgently can make your performance anxiety worse. Still, it’s best to rule out medical causes before you go any further.

Step 2: Find a Partner or Public Location

You can either do these steps using the help of a partner (like a trusted friend or relative) or by choosing a public location where people will naturally be present. Do whatever feels easier for you. If you do enlist the help of someone, let them know that you’ll need their help about one hour twice per week.

Step 3: Make a Hierarchy

This doesn’t have to be as difficult as it sounds. What you need to do is grab a pen and paper and then make a list of the places or situations where you find it really hard to use the restroom. Then, assign a value to each list item from 0 to 10.

For these rankings, 0 means that something is very easy while 10 means that something is very difficult. I’ve written out an example list below.

1. At home alone.

2. At home with someone visiting.

3. In someone else’s home but with a very private restroom.

4. In someone else’s home with a restroom without much privacy.

5. In a public restroom when nobody else is present.

6. In a public restroom when only one other person is present.

7. In a very busy public restroom.

8. In a very busy public restroom when you need to go urgently.

Step 4: Face Your Fear Gradually

Start with an easy item from the list. If you’ve got someone to help you, that could be going at home while someone else is present. Do your best to go while the person is in another room in your home.

If necessary, take a break for a few minutes and go talk to the person in your house. Don’t try to go for more than a few minutes at a time if it isn’t working. Take a break and then go back and try again. If you’re really struggling, try moving back a step in your hierarchy to something easier.

Also – be careful not to use safety strategies like running the water to cover noise. Keep going like this for as long as an hour depending on how well you do.

Once you are able to do that situation, move on to the next easiest item on your list. Plan to practice at least twice a week for anywhere from 6 to 10 weeks while gradually moving up the hierarchy that you created.

Step 5: Join a Paruresis Support Group

While you are working on your paruresis, consider joining a support group for other people with the same problem. This could give you the added push you need to keep facing your fear until you overcome it.