Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
d. Despite needing to urinate very badly, these individual cannot urinate no matter how much will power they apply to the situation. It goes without saying that this can become uncomfortable and painful.
Of course, there are different degrees to which a person can have this disorder. When the disorder is mild, a person may experience some inconvenience and may even be able to urinate in a public bathroom at times. However, when it is severe, as explained above, it can really alter and limit an individual’s ability to live their lives without restrictions.
Basically, Shy Bladder is an anxiety disorder. As long as nothing is wrong organically, it is intense social anxiety and embarassment that causes an individual to tighten the urinary sphincter muscle so that they cannot go. It must be emphasizedd that this tightening of the sphincter is involuntary in nature and not a matter of choice.
What Causes Shy Bladder?
It is not known for sure what the cause is of paruresis is. Men and women equally suffer from the disorder. It is thought that some type of humiliating process may have occurred during childhood or that it is part of a larger General Anxiety Disorder. Whatever the causes, it is very common and nothing to be ashamed of. Here are some treatment options for this problem:
1. Cognitive Behavioral Therapy can be useful in this. In this way an individual is helped to alter their thoughts and feelings about urination and public bathrooms.
2. Systematic Desensitization in which therapy is used to help a patient develop pleasant associations, when totally relaxed, about the need to urnate in bathrooms away from home.
3. Suggestions are given such as: turn on the faucet while you go in order to hide the noise and to promote relaxation allowing the sphnincter release its muscle allowing urination. With repeated success, the problem can abate.
4. The same relaxation techniques applied to all anxiety disorder work here: deep breathing, muscle relaxation, imagining pleasant and relaxing scenarios.
5. Anti anxiety medications are a last resort but carry the danger of addiction.
As I write about this I am aware that some readers might find this amusing, absurd or just plain dumb. I want to assure all of you that paruresis is none of those things.
I invite readers to submit comments and questions.