The first step to curing Shy Bladder is the realization that you are not alone. There may be as many as 17 million sufferers in the US yet every sufferer thinks they are the only one.
Nobody is talking about it. I'm trying to change that.
Things that don't work
Over the years I tried many things to shake the problem. Drinking a lot in the hope that I would need to go so badly that my body would "let me", trying to Will myself to go - standing at the urinal until I could go. Alchohol to reduce my anxiety. None of it worked. I never sought medical help because I was always 100% normal outside of a public bathroom. This may be just as well since it seems that Shy Bladder or "Avoidant Paruresis" as it is medically known, is not well-understood in the medical community.
Like most sufferers I didn't understand where this problem had come from and I hoped it would one day go away. It didn't and it was slowly getting worse before I decided to look for some help.
Shy Bladder is a Social Anxiety
Shy Bladder is a form of Social Anxiety sometimes brought on by negative bathroom experiences and sometimes just developing out of the blue, for no apparent reason.
Once you experience one failure you can become anxious about your performance resulting in further failure and a self-reinforcing downward spiral.
These experiences train your subconscious to think that the bathroom is a dangerous place and it protects us by amping up our fight-or-flight reflex which in turn shuts down our ability to go at all.
That's the bad news.
A therapy that does work
The good news is that since it's a trained response it can be successfully treated with Graduated Exposure Therapy. By slowly and deliberately pushing the boundaries of what your subconscious considers safe you can start to regain your confidence and your life.
In my case, my Shy Bladder had reached the point that I could only go successfully in a closed stall while sitting down - because I felt that people were judging me for using the stall to pee.
The book (and the Paruresis association) recommend finding a so-called pee-buddy, someone who can help you to progress by deliberately making it easier or harder for you to perform : for instance, standing 10 feet from the bathroom door or standing behind you, muttering.
As a rule we Shy Bladder sufferers are bound into silence by embarrassment and shame at our condition so we don't always have someone we can trust with this role. The Paruresis Association runs workshops where Shy Bladder sufferers can get together to help each other in this role.
While my experience suggests that you can progress without a pee-buddy it definitely would be easier with one.
Read more about how a pee-buddy can help you with Graduated Exposure Therapy.
Other therapies : Drugs? Hypnosis? Cognitive Behavioural Therapy?
The International Paruresis Association maintains a section on drugs and their affect on Shy Bladder (Paruresis). Some people have reported that certain medications did improve their condition.
You can also opt for Cognitive Behavior Therapy (CBT) which is a method of psychotherapy known to be effective in the treatment of Shy Bladder and other Social Anxity Disorders. It is likely a course of CBT will involve some Graduated Exposure Therapy.
At least one person has tried hypnosis as a therapy and reported some success.
Disclaimer : I am not a doctor and I am not giving medical advice. You should seek the advice of your physician before undertaking any course of therapy.
There is hope for those of us suffering Shy Bladder and though graduated exposure therapy is challenging and time consuming at least it's something you can start doing immediately with no side-effects.
See how I started my recovery, on my own, with no drugs or therapy using the information I found in the book.
Futher reading :
What is Social Anxiety?
What is Graduated Exposure Therapy?
The Internation Paruresis Association maintains a great page on overcoming Shy Bladder
Article on Shy Bladder at WebMD
My plan to beat shy bladder.
Read about my progress one month into my plan.