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This article was co-authored by Klare Heston, LCSW. Klare Heston is a Licensed Independent Clinical Social Worker based in Cleveland, Ohio. With experience in academic counseling and clinical supervision, Klare received her Master of Social Work from the Virginia Commonwealth University in 1983. She also holds a 2-Year Post-Graduate Certificate from the Gestalt Institute of Cleveland, as well as certification in Family Therapy, Supervision, Mediation, and Trauma Recovery and Treatment (EMDR).
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Whether at school, in the work office, or just away from the house, nearly everyone has the need to use a public restroom on a regular basis. An embarrassment around using the washroom in public, also known as “bashful bladder” syndrome or Avoidant Paruresis, can affect men, women, and children. You may be very uncomfortable using a public washroom and become anxious or agitated once you are in the bathroom stall or at the urinal. Sometimes, this social anxiety disorder can make it difficult to actually go to the bathroom, as the muscles that control your bowel movements and your ability to pee can freeze or tighten up.[1] When trying to overcome embarrassment around using a public washroom, you should focus on techniques to relax and techniques to distract yourself so you can get over your discomfort. If these are not effective, you may want to use professional techniques for your disorder.
Steps
Method 1
Method 1 of 3:
Using Relaxation Techniques
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1Go for the stall farthest from the door. To get more of a sense of privacy, head for the stall at the very end of the line. You may feel more comfortable going to the washroom if you are farther away from other people using the washroom.
- For men and boys who just need to pee, you may pee at the urinal that is farthest from the door or at a urinal where there is no one on either side of you. This small sense of privacy could do a lot to steady your nerves and get you to feel more calm.
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2Do breathing exercises. Breathing exercises can help you to feel calm and relaxed, which will then help to loosen up your bladder muscles and allow you to go to the bathroom. You may do simple breathing exercises where you breath in and out, inhaling for three counts and exhaling for three counts.
- You may also try belly breathing, where you inhale through your nose and fill your belly with breathe. You can then hold for three counts at the top of your inhale and then exhale through your nose again, letting your belly pull into your spine. This will allow you to experience deeper breathing and feel more relaxed.
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3Practice tightening and releasing your pelvic muscles. You can try to activate the muscles that control your ability to go to the bathroom by practicing tightening your pelvic muscles and then releasing them. You can also sync this to your breathing, where you inhale as you tighten your pelvic muscles and then exhale as you release your pelvic muscles.[2]
- As you tighten your pelvic muscles, you may experience a sensation similar to holding your urine when you have to go to the bathroom very badly. As you release your pelvic muscles, you may experience a sensation similar to releasing your urine, such as when you go to the bathroom.
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4Listen to soothing music. Get in a relaxing head space by putting in headphones and listening to music on your smartphone or a music player. Choose music that helps you to feel relaxed, from classical music to smooth jazz to trance music. This way, you can focus on the music rather than the environment of the washroom or any embarrassment you may be feeling when you are in the washroom.
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5Try meditation. Meditation can be great for getting into a relaxed headspace and removing yourself from any discomfort you may be experiencing. You can do deep breathing meditation, where you close your eyes and focus on your breathing as you inhale and exhale. Or, you can try mantra meditation, where you repeat a mantra in your mind as you inhale and exhale. This could be a mantra that you find soothing and relaxing.
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Method 2
Method 2 of 3:
Using Distraction Techniques
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1Try doing a series of math problems in your head. Doing math calculations or problems in your head helps to activate your brain cortex and blocks the inhibiting impulses going from your brain to your bladder.[3]
- You can choose fairly simple math calculations, such as the times table, starting from 1x1 = 1, 1x2 = 2, or the additions table, starting from 2+2 = 4, 2+3 = 5.
- You can also try more complex math problems, such as long division math problems or trying to solve complex mathematical equations, if you know any of them by heart. You can also look up equations on your smartphone if you are sitting down in the washroom stall.
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2Play games on your phone. If you have access to games on your smartphone, you may find it helpful to distract yourself by playing your favorite games while you are in the washroom stall. Alternatively, for men and boys, you can use earbuds to listen to music from your phone while you are at the urinal and sink area. This will allow you to focus on something other than your own discomfort or embarrassment.[4]
- Keep in mind your phone will likely pick up germs if you take it out and touch it in the bathroom stall. So, always clean your phone after you have used it inside a stall. Please be aware of any school or workplace policies that may only allow for the use of phones during hours such as lunchtime or may prohibit phones in the restrooms altogether.
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3Bring reading material into the stall. This could be an article from the newspaper or from a magazine. Or, you could pull up reading material on your phone. Reading can act as a useful distraction while you use the public washroom.
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4Use products to hide any unpleasant smells. Bad smells in the bathroom can be an unwelcoming distraction for some. You can try to mask bad smells in the stall or the urinal by bringing in a small bottle of air freshener with you. You can then use it to freshen up the stall before or after you use it.[5]
- You may also want to bring in other hygiene products like hand sanitizer to make you feel as though you are not picking up any germs while you are using the washroom or antibacterial wipes in case there are no toilet seat covers.
- There are currently products on the market that can be sprayed in the toilet after you use the washroom to mask the smell. Carry a small bottle of this product in your bag so you can feel less anxious about any bad smells when you are in the washroom.
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Method 3
Method 3 of 3:
Using Professional Techniques
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1Try psychotherapy. If you are starting to experience other health issues due to your “bashful bladder” or paruresis, such as constipation and abdominal pain, you may want to talk to a professional therapist about your disorder. Look for a therapist who is aware of paruresis and has worked with individuals suffering from paruresis before.
- Your family doctor may be able to give your a recommendation for a therapist who treats individuals with paruresis. You will likely have to attend weekly one on one therapy sessions or group therapy sessions, where you may talk about your anxiety and fears associated with using public washrooms. You may also learn techniques to cope with your disorder.
- Remember that holding in your urine for too long can cause medical problems like urinary tract infections. It is a good idea to get help before serious problems arise.
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2Talk to your doctor about graduated exposure therapy. Graduated exposure therapy is a step-by-step program that has participants try to pee more and more in difficult, public places. Around eight out of 10 people with paruresis are successfully treated with graduated exposure therapy.[6] You can get a referral for a behavioral specialist who does graduated exposure therapy through a psychologist and a therapist.[7]
- To do graduated exposure therapy, you will make a list ranking peeing locations that are the easiest for you to use to the most difficult for you to use. For example, your bathroom at home may be easiest and a public washroom at work may be more difficult. You will then start by trying to use the washroom in the easiest locations and work your way to the more difficult locations.
- You should do graduated exposure therapy three to four times a week for the best results and drink lots of fluids before each session. Participants usually notice results after 12 weeks.
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3Work with a close friend or family member during graduated exposure therapy. As part of the process of graduated exposure therapy, you will need to enlist a “pee partner”, who will support you and stand close to you so you feel comfortable peeing or going to the bathroom. This could be a close friend or a family member. Your “pee partner” will stand close to you as you pee for a few seconds and then stop. He may then move a little closer as you go to the toilet again, pee for a few seconds and then stop. The idea is to keep practicing peeing with your pee partner as he gets closer and closer to the toilet.
- You may then gradually start to make noise while peeing to try to get more comfortable using the bathroom, such as splashes. Once you are fine peeing at home, you and your pee partner may move to a quiet public restroom. Your “pee partner” may stand outside the toilet door or behind you at the urinal while you pee.
- You will work with your “pee partner” to go down your list of locations until you can successfully go to the bathroom in a loud and crowded washroom.
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4Join the International Paruresis Association. The IPA is a non-profit organization that helps to educate the public about paruresis and shares information about effective treatments for paruresis.[8]
- The IPA holds weekend workshops for individuals struggling with paruresis. You can also get a referral to a cognitive-behavioral therapist who can assist you with treating your paruresis.
- You can access the sign up form for IPA on their website.
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Expert Q&A
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QuestionHow can I make my pee come out faster?
Klare Heston, LCSWKlare Heston is a Licensed Independent Clinical Social Worker based in Cleveland, Ohio. With experience in academic counseling and clinical supervision, Klare received her Master of Social Work from the Virginia Commonwealth University in 1983. She also holds a 2-Year Post-Graduate Certificate from the Gestalt Institute of Cleveland, as well as certification in Family Therapy, Supervision, Mediation, and Trauma Recovery and Treatment (EMDR).
Licensed Social WorkerUsually, the speed you have cannot be varied too much. You can force a stream sometimes. -
QuestionIs it illegal to pee on someone's property?Klare Heston, LCSWKlare Heston is a Licensed Independent Clinical Social Worker based in Cleveland, Ohio. With experience in academic counseling and clinical supervision, Klare received her Master of Social Work from the Virginia Commonwealth University in 1983. She also holds a 2-Year Post-Graduate Certificate from the Gestalt Institute of Cleveland, as well as certification in Family Therapy, Supervision, Mediation, and Trauma Recovery and Treatment (EMDR).
Licensed Social WorkerIt is less a matter of someone else's property than exposing your genitals in public. Check your local laws or ordinances. -
QuestionHow do you cure Paruresis?Klare Heston, LCSWKlare Heston is a Licensed Independent Clinical Social Worker based in Cleveland, Ohio. With experience in academic counseling and clinical supervision, Klare received her Master of Social Work from the Virginia Commonwealth University in 1983. She also holds a 2-Year Post-Graduate Certificate from the Gestalt Institute of Cleveland, as well as certification in Family Therapy, Supervision, Mediation, and Trauma Recovery and Treatment (EMDR).
Licensed Social WorkerIt is more a matter of de-sensitization so that you gradually get used to the idea of using public bathrooms one step at a time, sometimes using self-distraction behaviors.
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Warnings
- Holding in urine or feces for too long can cause serious medical issues, such as urinary tract infections or urinary retention.⧼thumbs_response⧽
- Paruresis can cause you to retreat and isolate yourself from social and public occasions. Getting professional treatment from a therapist can help.⧼thumbs_response⧽
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References
- ↑ https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/shy-bladder-syndrome
- ↑ http://www.embarrassingproblems.com/problem/urination-shyness
- ↑ http://www.embarrassingproblems.com/problem/urination-shyness
- ↑ http://www.bustle.com/articles/52194-11-reasons-why-pooping-in-public-shouldnt-be-embarrassing-especially-if-youre-a-woman
- ↑ http://www.bustle.com/articles/52194-11-reasons-why-pooping-in-public-shouldnt-be-embarrassing-especially-if-youre-a-woman
- ↑ https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/shy-bladder-syndrome
- ↑ http://paruresis.org/about-avoidant-paruresis/
- ↑ http://paruresis.org/about-avoidant-paruresis/
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Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
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