Overcoming Paruresis

Paruresis is a psychological condition or phobia in which you're unable to urinate in public. This can become a serious problem, as you may be unable to use public bathrooms or to urinate at all when you aren't assured of complete privacy. The condition, also referred to as "shy bladder", may interfere with your daily life, since people often need to use public bathrooms while at work, school, or on trips. There are several different treatments that are used to overcome paruresis, which are used by phobics with varying degrees of success.

Self-Catheterization

• Catheters are small tubes that are usually made of rubber or plastic. They can be inserted into the bladder though the urethra or stomach in order to empty or drain the bladder. Men and women suffering from paruresis can visit a urologist and learn how to insert a catheter themselves in order to drain urine.

  Clean-intermittent catheterization is used in treating Paruersis, which means a clean (but not necessarily sterilized) catheter is inserted on an as-needed basis to allow you to drain urine form the body in situations where you are unable to use the bathroom.

  For some patients, the use of these catheters is an important step in overcoming paruresis because having the catheter can allow you to cope with situations you might otherwise be afraid of due to your fear of being unable to use the bathroom.

Cognitive Behavioral Therapy

• According to UrologyHealth.org, behavioral exposure therapy may be useful in overcoming paruresis. Although Urology Health states that no clear scientific studies have been published to prove the effectiveness of the treatment, they also state that this form of therapy seems to be between 80 and 90% effective for many patients.

  Behavioral therapy usually involves getting used to urinating in public. You may make a list of places where it is easy to use the bathroom, and then list places where it becomes gradually more difficult. You will then start working your way up to using the bathroom in ever-more difficult locations. This form of behavior therapy, called graduated exposure therapy, gets you used to going in more and more difficult spots. Many patients have an easier time succeeding at graduated exposure therapy if they drink a lot of fluids before the attempts to urinate, and if they attempt to go several times in each session.

Drug Treatment

• Both Urology Health and Paruresis.org suggest that drug therapy may be helpful in overcoming paruresis. Selective serotonin reuptake inhibitors, called SSRIs, are used to help minimize the anxiety associated with urinating in public. Often, these SSRIs can reduce the anxiety enough that it becomes possible to use public restrooms, especially if the SSRI medication is combined with behavioral therapy.