Treatments for Paruresis

Paruresis, also called shy bladder syndrome, is a social phobia or anxiety in which a person cannot urinate if other people are nearby or if they think other people are nearby. As can be expected, paruresis sufferers are unable to urinate in public restrooms. The phobia is shared by males and females of varying ages. The condition is psychological but affects the physical ability of the sufferer to control the disorder. Treatments for paruresis are available.

Cognitive-Behavioral Therapy (CBT)

• With Cognitive-Behavioral Therapy (CBT), the paruresis patient works with a psychotherapist in graduated-exposure therapy, which introduces the person with paruresis to his feared environment gradually over time until he becomes desensitized to the fear and more comfortable with the situation. CBT also seeks to examine the thought process involved in the paruresis so that the person can learn to counter illogical thinking with healthier patterns of thought.

  The benefits of CBT are that it is a short-term process, generally lasting from six to 10 sessions, followed by a period where the patient works independently and then a follow-up visit or two. CBT can often produce permanent change in the person's behavior without the necessity of long-term medication use. The treatment can be successful with a skilled therapist and a motivated patient.

  The drawbacks to CBT are that treatment is costly, running about $125 per visit. The success of the method depends on establishing a good therapist-patient relationship. Participating in mental health therapy can affect a person's insurability, although paying cash might solve the problem of the treatment showing up on insurance medical records. CBT does not provide relief for all paruresis sufferers, so the patient may have to seek other treatment methods.

Support Groups

• Support groups allow the paruresis sufferer to regularly participate in a group of people who also suffer from paruresis. Participants encourage each other, practice graduated exposure therapy and share their thoughts and experiences about recovery.

  The benefits to support groups are that they are generally free. Support groups can produce permanent change in the person's behavior without the necessity of long-term medication use. Groups usually include some people who have experience in recovering from the disorder.

  The drawbacks to support groups are that the size of the group and the people who frequent it may change from one session to the next. Since there is no professional therapist involved, the group may not address the psychological issues that are a big part of paruresis.

Medication

• Paruresis, if medicated, is usually treated with a selective serotonin reuptake inhibitor, which is used to treat social anxiety. Sometimes it is treated with momoamine oxidase, which also treats social anxiety but has strict restrictions on diet.

  The benefits to medications are that they have proved successful in treating paruresis in some patients, and others are able to discontinue use after about a year. They have been effective in eliminating the disorder.

  The drawbacks to medicating paruresis are that some patients require multiple medications, increased dosages or changes in medicines that may decrease quality of life.