For some men, a little known anxiety disorder called paruresis makes peeing in front of others difficult
Recently, a friend of mine named Andrew and I worked out together at the gym. When we finished, he told me that he needed to leave quickly so that he could run back home and take a piss.
When I pointed to the men’s locker room that was just off the weight room floor, he shook his head and said he preferred doing it at home.
This seemed odd to me. It was obvious that Andrew really had to relieve himself. You can always tell that type of thing because people get all jittery.
Related: Half of gay men dislike their bodies
In any event, we quickly left the gym and parted ways. But the incident stuck with me. Curious, I decided to ask him more about this over coffee the next day.
“Whenever I try to pee in a public bathroom, my plumbing freezes up. It’s like I want to go – badly – but for the life of me I can’t relax enough to let it flow.”
Andrew, an outwardly confident 35-year old man whose attractive looks turns the heads of others, suddenly appeared vulnerable. As he kept talking, I began to better understand his situation.
“It’s been going on for as long as I can remember. I don’t want people hearing me take a leak … the sound of my stream hitting the porcelain. And I really freak out if someone is next to me taking a whiz because I don’t want them to see my business.”
He paused and then added:
“Why do you think I never hang out with you and some of our friends at the bars on weekends?”
The more we talked, the more I learned. On some level, I could relate to his problem.
I’ve always hated going number two in a public toilette and will avoid it like the plague if possible. But that’s only because I fear germs. This was the first time I had heard of a urinal phobia.
Apparently, a condition exists called paruresis whereby a person experiences extreme anxiety when confronted with using a public restroom.
After we met, I decided to do some research. Chalk it up to a weird fascination with the unusual. What I found out was interesting and humbling, all at the same time.
Apparently, back in the 1970’s, a group of researchers investigated the issue of men peeing in public urinals to assess their level of comfort.
The findings from this research study, published in the Journal of Behavior Therapy and Experimental Psychology, were fascinating.
Camouflaged in a nearby stall, with a periscope nestled in a stack of books (ethical standards were much different them), the scientists observed men taking a pee with 1) a stranger close by, 2) a stranger somewhat farther away, or 3) nobody around (the control).
What they found is when a stranger was standing directly next to them, it delayed peeing on average by 8.4 seconds, compared with 6.2 seconds with the man and stranger separated by one urinal, and 4.9 seconds if nobody else was around.
Related: How to wipe your butt for men guide
“Space invasion”, as it was coined, also impacted the duration of pee time, which lasted for something like 17.4 seconds with a stranger close by, 23.4 seconds if separated by multiple urinals, and 24.8 seconds when peeing all alone.
I remembered from my conversation with Andrew that not only did he fear being seen taking a leak, he also didn’t want others to hear him.
I decided to talk to an expert in men’s issues and mental health and discussed the matter with Dr. John Moore, a licensed psychotherapist and associate professor of Psychology at New York Institute of Technology.
“I really freak out if someone is next to me”
Apparently, the condition is called Shy Bladder Syndrome (SBS) and is more common that people might think.
“No matter how much a guy might want to go, he simply can’t because he’s filled with anxiety,” says Moore. “I’ve worked with clients who’ve had to hold it for upwards of 8 hours.”
He goes on to explain:
“Men with SBS experience a high degree of anxiety because they fear others may be listening or seeing. Making matters worse are busy public restrooms where people are waiting in line, like an airport.”
I wanted to know more about the psychology involved here. This is what I was told:
“Much of this has to do with the flight or fight response. If a man perceives he is in danger, his body will respond accordingly. In the case of paruresis, the plumbing shuts off making urination difficult, if not impossible,” explained Moore.
He pointed me to the International Paruresis Association, an organization I was stunned to find out even existed.
I learned that some guys apparently develop a problem with peeing in public for a variety of reasons. Current theories suggest it may be related to:
- Anxiety ridden childhood toilette training
- Emotional, physical or sexual abuse
- An early childhood trauma involving schoolmates
The research suggests that 9 out of 10 people who seek out treatment for this issue are men.
“The typical story is of being teased, harassed, or hurried by classmates at a sensitive age, usually around puberty, while trying to use the restroom,” says an expert on Web MD.
“To keep from feeling that anxiety again, the person avoids public bathrooms, a behavior which ultimately becomes ingrained. Eventually, it’s no longer a choice. The person is physically unable to urinate in public.”
What I discovered in my learning about this issue was that the condition is treatable. Using a form of counseling called graduated exposure therapy, paruritics [yep, that’s what they’re called] can eventually teach themselves to lower their anxiety and use the restroom.
But getting these men to seek out therapy is another story. That’s because paruritics carry with them a high degree of shame about their condition. But once they do open up, they seem to experience a tremendous psychological and emotional relief.
Because I care about my friend, I decided to share some of what I had learned. Additionally, I sent him the link to the Paruresis Association and a book recommendation for more insight.
He thanked me – genuinely – and seemed to appreciate the info. “I didn’t know any of this,” texted Andrew in a message.
I’m not sure if he’ll seek out therapy for his condition but at least the ball is rolling. Hopefully, he’ll be able to work through this issue and allow himself to go to the bathroom when the urge comes on.
By: Conrad Braxton