
Wednesday, February 28, 2007
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by Joe Kerr
Imagine that you're at a baseball game. You've had one too many Cokes with your hot dogs and nachos, but when you head for the restroom, you freeze up. Your full bladder demands immediate attention, but when you try to empty it, nothing happens.

"Pee Shy"
Paruresis, the medical term for "shy bladder syndrome," is a social anxiety disorder in which a person is unable to urinate in a public restroom. For those who suffer from this condition, daily life can be a struggle. Imagine being away from home for hours or even days and not being able to relieve yourself. Besides the tremendous discomfort of "holding it in" for hours at a time, ignoring the signals from a full bladder can also lead to possible bladder inelasticity (loss of tone over time) and, in women, urinary tract infections.
According to a 1997 Harvard University study, approximately 17 million Americans suffer from this phobia. It affects about one to two million Americans so significantly that it impairs their lives and forces them to seek treatment, says Steve Soifer, M.S.W., Ph.D., associate professor of social work at the University of Maryland at Baltimore.


What's the Cause?
The exact cause of paruresis varies, but approximately fifty percent of paruretics can cite an incident, usually one that took place when they were much younger, in which someone made a negative remark or hurried them in the restroom. For example, a parent may have said, "Hurry up and go now, or you'll have to hold it in until we get to Grandma's house." For someone with a predisposition to paruresis, this type of offhand remark can trigger the condition. The other half of paruretics can't remember a specific incident, but nevertheless developed the phobia.


Dealing With It
Whether you're an employee of a large company, a college student living in a dorm, or simply a concert-goer who needs to take a leak at intermission, public restrooms are a fact of modern life. The best way to deal with paruresis is to gradually become desensitized to public restrooms. As Soifer points out, "Each person has an idiosyncratic hierarchy from what's easy to what's difficult."


Once, you've made your list, the goal is to gradually desensitize yourself to each setting. Start with the easiest place. Go there when there's low traffic (in the "off peak" hours). Next, try the same setting a high traffic time. Improve your tolerance by gradually working your way up to the point that you can go even when a restroom is crowded. You may want to get a friend to tag along to help make the place feel safer for you and to provide a friendly face. Eventually, you will build up a comfort level and be able to pee under any circumstances.

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