When I started this process I had a simple plan. It turns out that executing the plan is more difficult than simply loading up on water and trying to pee in progressively harder situations.
For a start, drinking 100+ oz of water in a work-day means you experience a lot more situations where you need to go to the bathroom with some urgency. This was part of the plan since the urgency helps you know if Shy Bladder is shutting you down or if it's simply the lack of a real need to go.
BUT (and it's a big BUT) that level of urgency is very uncomfortable to maintain. I've sat in important meetings and been unable to truly partake because of the discomfort. In addition, since the plan requires that other people be around when I void I'm often left standing in a stall really burning to go but unable to let myself until someone else enters the bathroom. This is ironic for someone who suffers Shy Bladder but it's also torture.
If you read the book you'll have seen the advice to find yourself a pee-buddy, someone who can help you overcome your problem by walking in and out of the bathroom 100 times if need be.
I am making progress and I'm pleased with what I've achieved so far (though I still need to make the move to the urinal) but I realize that going the do-it-yourself route isn't easy and is much less controlled than having a buddy with whom you can set up progressively difficult scenarios.
So what have I achieved so far? Well, in my test bathroom at least I'm able to go in any stall with only momentary hesitancy with the door left wide open. It's really time I made the move to the urinal but that seems such a leap from the enclosed safety of the stall.
Further reading :
Read how this plan worked out.
Friday, January 27, 2006
Monday, January 23, 2006
Good Summary Article on Shy Bladder
This is an excellent article on Shy Bladder which sums up the condition pretty succinctly.
One of the interesting things the article has to say is :
First, familiarity with other people present in the restroom can trigger BBS, with strangers usually (but certainly not always!) leading to greater inhibition than friends or relatives. Because of the personal nature of elimination, the degree of familiarity and perceived acceptance often determine whether or not the paruretic will successfully urinate.
This might help to explain an unexpected success I had a year or two ago.
The bathroom had been empty and I was standing at the urinal trying to go (unsuccessfully) when a friend walked in and took the urinal next to me. I said "Hi" and we struck up a small conversation. Suddenly I was able to go absolutely normally with no self-consciousness at all.
I thought at the time I'd been spontaneously cured but now I understand that I felt accepted and safe in this person's presence and so was able to go.
Further reading :
Shy Bladder article.
Can Meditation help Shy Bladder sufferers?
One of the symptoms of Shy Bladder is that you often have uncontrolled thoughts in the bathroom. You know that nobody is grading your performance in the bathroom but you simply can't help feeling that way. Your mind seems to race, you feel as if everyone is watching you. This is one of the reasons that a slang term for Shy Bladder is "stage fright".
I wonder if Meditation would be useful for this problem?
At the most basic level, learning to relax is a skill that could be a big help.
But I read an article this weekend and it suggests that at advanced levels meditation can help you "break through" to a higher state of awareness about yourself. I suspect that if you had that ability, fixing your Shy Bladder problems would be a very simple matter. Of course, it might take years to reach that state but being held captive to Shy Bladder for 20 years isn't exactly a good use of time either.
Further reading :
About.com How To Meditate (advice for anxiety sufferers)
How Meditation Works by Shunzen Young.
I wonder if Meditation would be useful for this problem?
At the most basic level, learning to relax is a skill that could be a big help.
But I read an article this weekend and it suggests that at advanced levels meditation can help you "break through" to a higher state of awareness about yourself. I suspect that if you had that ability, fixing your Shy Bladder problems would be a very simple matter. Of course, it might take years to reach that state but being held captive to Shy Bladder for 20 years isn't exactly a good use of time either.
Further reading :
About.com How To Meditate (advice for anxiety sufferers)
How Meditation Works by Shunzen Young.
Friday, January 20, 2006
Beating Shy Bladder : Progress Report #3
In the last week I've been too busy to be systematic about my progress. I didn't have time to stand waiting in the bathroom for someone to come by so I could try to pee.
But I didn't allow myself to regress either. I was lucky enough to find the bathroom occupied on more than one occasion a day and each time I used the stall with the door left open wide. Each time was a success but because it wasn't a progression of success through harder and harder situations I didn't get as much confidence from it as I had hoped. Oh for a pee-buddy!
But I am starting to think that I could move out of the stall into the urinal when there is nobody in the bathroom and wait at the urinal, trying to go when someone enters the room.
This will be a big challenge and I am afraid of slipping backwards but I think I can do it and I'm going to have to try at some point.
Further reading :
Read how this plan worked out.
But I didn't allow myself to regress either. I was lucky enough to find the bathroom occupied on more than one occasion a day and each time I used the stall with the door left open wide. Each time was a success but because it wasn't a progression of success through harder and harder situations I didn't get as much confidence from it as I had hoped. Oh for a pee-buddy!
But I am starting to think that I could move out of the stall into the urinal when there is nobody in the bathroom and wait at the urinal, trying to go when someone enters the room.
This will be a big challenge and I am afraid of slipping backwards but I think I can do it and I'm going to have to try at some point.
Further reading :
Read how this plan worked out.
What is Social Anxiety?
From Wikipedia :
Social anxiety is an intense feeling of fear, apprehension or worry regarding any or all social situations or public events. It is sometimes known as social phobia and, less commonly, social trauma. In psychiatry, it is diagnosed as social anxiety disorder, a form of anxiety disorder. It is currently the third largest mental health care problem in the world, according to United States epidemiological data.
Read more about Social Anxiety at Wikipedia.
Alternatively, this article from SocialPhobia.org discusses some of the forms of Social Anxiety,
More information :
This article by Dr Winston Bush is an excellent article on the causes of Social Phobia, explaining the structures of the brain responsible. It discusses Cognitive Behavioral Therapy (CBT) in some detail and explains why it is so effective in treating Social Anxiety. From that article :
Read the rest of what Dr Bush says here.
Social anxiety is an intense feeling of fear, apprehension or worry regarding any or all social situations or public events. It is sometimes known as social phobia and, less commonly, social trauma. In psychiatry, it is diagnosed as social anxiety disorder, a form of anxiety disorder. It is currently the third largest mental health care problem in the world, according to United States epidemiological data.
Read more about Social Anxiety at Wikipedia.
Alternatively, this article from SocialPhobia.org discusses some of the forms of Social Anxiety,
More information :
This article by Dr Winston Bush is an excellent article on the causes of Social Phobia, explaining the structures of the brain responsible. It discusses Cognitive Behavioral Therapy (CBT) in some detail and explains why it is so effective in treating Social Anxiety. From that article :
Social phobia (also called social anxiety disorder) is an excessive fear of what other people might think of us. Our opinions of each other should matter — if they didn’t, we’d be living in a corner of hell, not a civilized society. But when someone is suffering from social phobia, he or she is feeling an exaggerated concern for public opinion — one that goes far beyond what we need in order to relate to other people for our mutual benefit.
Read the rest of what Dr Bush says here.
Sunday, January 15, 2006
Shy Bladder : A cure!
First, realize you're not alone
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.
Pee Buddy?
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.
Making progress
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 :
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.
Pee Buddy?
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.
Making progress
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.
Friday, January 13, 2006
Beating Shy Bladder : Progress Report 2
In my first progress report, I had success with peeing in a center stall with the door ajar. The new plan called for using the stall nearest the urinals with the door ajar. A small step to be sure but by reducing my opportunities for failure I hope to avoid an ego-deflating setback.
So how did I do?
Attempt 1 : After drinking water all morning my urgency level was at about a 9. Finding the bathroom empty I took up position in the leftmost stall. I had intended to leave the door ajar per plan but it swung right open. Didn't seem to make me anxious so I left it as it was. Waiting for someone to come into the bathroom was painful, I felt a fool standing there, desperate for a pee waiting for someone to come in. Eventually I heard the bathroom door open and I had a momentary flash of anxiety, more suprise than anything, and was able to pee. Success!
Side Note : I wonder if the standing around waiting for someone else to arrive has a useful behaviour-modifying side-effect. Maybe it is training you so that having someone around is a triggering event for being able to pee. In other words, the presence of other people gives you permission to go. I don't care so long as it works.
Attempt 2 : This time I go to the bathroom with an urgency of about 9/10. I stand ready to act when someone walks in. Nobody does, for 5 minutes. I give up and decide to go to a busy mall for lunch so I can test a different bathroom. Takes 10 minutes to get there, really need to go when I arrive. Someone is just finishing up at the urinal and I think someone is in the far stall so I just take the vacated urinal. Manage to go immediately with no anxiety. After a few seconds realize that nobody is in the stall. I don't know why I didn't stick to the plan. I count this a failure.
Attempt 3 : After 30 ounces of water washed down with Coca-Cola I needed to go with an urgency of about 9.5. The bathroom was empty so I duly waited. Happily I didn't have to wait too long this time. Someone came in, I was able to go just fine. Success!
Attempt 4 : Wanted to make one last try, just to be sure. I hung out in the bathroom a couple of times but there just wasn't enough traffic and I didn't feel I could stand there for 15 minutes just waiting.
Post Mortem
Two successes today but not the three I was hoping for. Today I wished I had a pee-buddy, I probably would have been able to make all my attempts really count. I'm starting to feel that I need a higher-throughput bathroom to be tested.
I'd call today a qualified success but I'm not sure where to go from here. My successes today were with the stall door fully open which was a step-up from the plan of having the door ajar.
I think I'll stick with the current plan for another 3 clear attempts. If that works then I'll try moving out of the stall.
Further reading :
Read how this new plan worked out.
So how did I do?
Attempt 1 : After drinking water all morning my urgency level was at about a 9. Finding the bathroom empty I took up position in the leftmost stall. I had intended to leave the door ajar per plan but it swung right open. Didn't seem to make me anxious so I left it as it was. Waiting for someone to come into the bathroom was painful, I felt a fool standing there, desperate for a pee waiting for someone to come in. Eventually I heard the bathroom door open and I had a momentary flash of anxiety, more suprise than anything, and was able to pee. Success!
Side Note : I wonder if the standing around waiting for someone else to arrive has a useful behaviour-modifying side-effect. Maybe it is training you so that having someone around is a triggering event for being able to pee. In other words, the presence of other people gives you permission to go. I don't care so long as it works.
Attempt 2 : This time I go to the bathroom with an urgency of about 9/10. I stand ready to act when someone walks in. Nobody does, for 5 minutes. I give up and decide to go to a busy mall for lunch so I can test a different bathroom. Takes 10 minutes to get there, really need to go when I arrive. Someone is just finishing up at the urinal and I think someone is in the far stall so I just take the vacated urinal. Manage to go immediately with no anxiety. After a few seconds realize that nobody is in the stall. I don't know why I didn't stick to the plan. I count this a failure.
Attempt 3 : After 30 ounces of water washed down with Coca-Cola I needed to go with an urgency of about 9.5. The bathroom was empty so I duly waited. Happily I didn't have to wait too long this time. Someone came in, I was able to go just fine. Success!
Attempt 4 : Wanted to make one last try, just to be sure. I hung out in the bathroom a couple of times but there just wasn't enough traffic and I didn't feel I could stand there for 15 minutes just waiting.
Post Mortem
Two successes today but not the three I was hoping for. Today I wished I had a pee-buddy, I probably would have been able to make all my attempts really count. I'm starting to feel that I need a higher-throughput bathroom to be tested.
I'd call today a qualified success but I'm not sure where to go from here. My successes today were with the stall door fully open which was a step-up from the plan of having the door ajar.
I think I'll stick with the current plan for another 3 clear attempts. If that works then I'll try moving out of the stall.
Further reading :
Read how this new plan worked out.
Thursday, January 12, 2006
Advice : Tell your partner about your Shy Bladder
Tell someone about it
That's pretty simple advice that in practice can be very hard to do. But like any other condition, we have to admit that we have it before we can start to do something about it. And once we've made that admission we're going to need some help, even if it's just moral support, to move on.
In general, Shy Bladder sufferers don't talk about it. After all, peeing is the most natural thing in the world and being unable to pee is just, well, weird, so we don't want to admit it to friends or family.
So we stay locked in the secret prisons of our own making.
Telling Her
It took a few years of marriage before I was ready to explain my Shy Bladder to my wife. By then she already knew something was up. She thought I had a bladder of steel since I never seemed to need to go but at the same time she knew that I always closed the door firmly in the bathroom and couldn't take a pee behind a tree in the woods unless I knew she was way off up the path.
Telling her took a great weight off me. I had shared my big secret! I wasn't alone anymore. Suddenly odd behaviour that had previously puzzled her became clear : "Oh! That's why you always seem to go off to the farthest bathroom!".
Some people are not so lucky. When you have Shy Bladder your choices become limited in ways that people who don't have the condition can't understand. You may avoid large public gatherings because you can't use the crowded bathrooms. That means never going to the theater, the movies, sports events. If you have a really bad case of Shy Bladder you may only be able to use one "safe" bathroom (usually at home), in time that can make you virtually house-bound.
How many lives and marriages has that destroyed? When you can't do something but can't admit to the real reasons behind it people make up reasons of their own. He won't take me out because he doesn't love me / he's mean. He hates my family. He doesn't have any drive in business because he won't take the job that requires travel.
So if you suffer Shy Bladder, my best advice is to tell the other people in your life that your Shy Bladder is also affecting. You're not alone, there are millions of people like you and me.
I don't think I could have started to reclaim my life without this first difficult step.
That's pretty simple advice that in practice can be very hard to do. But like any other condition, we have to admit that we have it before we can start to do something about it. And once we've made that admission we're going to need some help, even if it's just moral support, to move on.
In general, Shy Bladder sufferers don't talk about it. After all, peeing is the most natural thing in the world and being unable to pee is just, well, weird, so we don't want to admit it to friends or family.
So we stay locked in the secret prisons of our own making.
Telling Her
It took a few years of marriage before I was ready to explain my Shy Bladder to my wife. By then she already knew something was up. She thought I had a bladder of steel since I never seemed to need to go but at the same time she knew that I always closed the door firmly in the bathroom and couldn't take a pee behind a tree in the woods unless I knew she was way off up the path.
Telling her took a great weight off me. I had shared my big secret! I wasn't alone anymore. Suddenly odd behaviour that had previously puzzled her became clear : "Oh! That's why you always seem to go off to the farthest bathroom!".
Some people are not so lucky. When you have Shy Bladder your choices become limited in ways that people who don't have the condition can't understand. You may avoid large public gatherings because you can't use the crowded bathrooms. That means never going to the theater, the movies, sports events. If you have a really bad case of Shy Bladder you may only be able to use one "safe" bathroom (usually at home), in time that can make you virtually house-bound.
How many lives and marriages has that destroyed? When you can't do something but can't admit to the real reasons behind it people make up reasons of their own. He won't take me out because he doesn't love me / he's mean. He hates my family. He doesn't have any drive in business because he won't take the job that requires travel.
So if you suffer Shy Bladder, my best advice is to tell the other people in your life that your Shy Bladder is also affecting. You're not alone, there are millions of people like you and me.
I don't think I could have started to reclaim my life without this first difficult step.
The Shy Bladder Arena
More than 90% of the population doesn't even spare a second thought for their use of the bathroom. It's a place they go to empty their bladder. End of story.
For those of us with Shy Bladder, it's the Arena. It's where we go to struggle with our demons.
Does that look like hell to you? It does to me and to many other men with Shy Bladder.
See the one in the middle? I hope to be able to step up to one like that someday in a crowded public restroom, with people using the urinals either side and with people waiting their turn behind me.
I'll simply walk up, urinate and walk away. Nobody will notice because people don't look you in the eye in the mensroom, but I'll have a big victorious smile on my face and 20 years of self-doubt and avoidance will be over. I'll be normal again.
I have a simple plan for how I'm going to do it.
For those of us with Shy Bladder, it's the Arena. It's where we go to struggle with our demons.
Does that look like hell to you? It does to me and to many other men with Shy Bladder.
See the one in the middle? I hope to be able to step up to one like that someday in a crowded public restroom, with people using the urinals either side and with people waiting their turn behind me.
I'll simply walk up, urinate and walk away. Nobody will notice because people don't look you in the eye in the mensroom, but I'll have a big victorious smile on my face and 20 years of self-doubt and avoidance will be over. I'll be normal again.
I have a simple plan for how I'm going to do it.
Shy Bladder and Peeing Rituals
People with Shy Bladder have a distorted view of the dynamics of the bathroom. We can't help thinking that everyone is watching or listening to us and judging us. Are we making too much noise? Does our urine smell offensive to others? Have others noticed that we haven't started to go yet?
Skewed as my perception of the bathroom is, I think it's true to say that people in public bathrooms act differently than in any other social situation. My experience is solely with the mensroom so I can't speak for what happens in the ladies room.
First, you're in the bathroom to urinate. That is the first order of business. What conversation goes on in the bathroom is generally confined to small-talk. People do not generally conduct business meetings in the bathroom, even if the participants are all present.
Second, eye-contact within the bathroom should be kept to a minimum. I think this is a defence mechanism. We're all standing around with out peices in our hands, we want to draw minimum attention to ourselves.
Third, the peeing ritual. There are people who seem to habitually make grunting noises when they start their flow and people who spit into the urinal first.
I wonder if adopting one of these rituals helps or hurts someone with Shy Bladder? Lately I've found myself spitting before urinating. While spitting is a disgusting habit when performed in the street I've decided to stick with this for a few reasons :
1. It has a sort of symbolic "I spit on my enemy" feeling about it.
2. I think that having a ritual will help train my brain to make what should happen next easier.
3. It seems to be perfectly acceptable behaviour in a bathroom setting.
4. It goes directly against the "People are judging me" Shy Bladder mindset, so I spit, go ahead and judge me.
Skewed as my perception of the bathroom is, I think it's true to say that people in public bathrooms act differently than in any other social situation. My experience is solely with the mensroom so I can't speak for what happens in the ladies room.
First, you're in the bathroom to urinate. That is the first order of business. What conversation goes on in the bathroom is generally confined to small-talk. People do not generally conduct business meetings in the bathroom, even if the participants are all present.
Second, eye-contact within the bathroom should be kept to a minimum. I think this is a defence mechanism. We're all standing around with out peices in our hands, we want to draw minimum attention to ourselves.
Third, the peeing ritual. There are people who seem to habitually make grunting noises when they start their flow and people who spit into the urinal first.
I wonder if adopting one of these rituals helps or hurts someone with Shy Bladder? Lately I've found myself spitting before urinating. While spitting is a disgusting habit when performed in the street I've decided to stick with this for a few reasons :
1. It has a sort of symbolic "I spit on my enemy" feeling about it.
2. I think that having a ritual will help train my brain to make what should happen next easier.
3. It seems to be perfectly acceptable behaviour in a bathroom setting.
4. It goes directly against the "People are judging me" Shy Bladder mindset, so I spit, go ahead and judge me.
Beating Shy Bladder : Progress Report 1
In my post My Plan to Beat Shy Bladder I discussed my plan, it started with peeing in a stall with the door ajar while others are in the room.
How did it go?
Attempt 1 : Had an urinary urgency of about a 7, uncomfortable but not yet painful. Met a co-worker going into the bathroom, said hi, walked to the middle of the 3 stalls. He took a urinal. I peed with no hesitancy. Success!
Attempt 2 : Had a urinary urgency of about a 6, just uncomfortable. Two co-workers were already in the bathroom. Took the center stall again. Managed to initiate flow and finish before they left. Success!
Attempt 3 : Urgency of about an 8. Went into the bathroom, disappointed to find it was empty. Took the center stall. Waited for someone to come in. Waited 5 minutes. Gave up. Was wishing the whole time that someone would come in so I could allow myself to go. In the past I've stood in bathrooms unable to go because I was worried that someone might come in so I consider this good practice. Marginal success.
Attempt 3 (repeat) : Urgency of about 8 still. Someone was in the center stall so I took the one beside it (nearest the urinals). Slight hesitancy but nothing serious. No anxiety about it. Urinated noisily per plan. My Shy Bladder brain did briefly think that the guy in the stall was probably wondering why I decided to pee in the toilet instead of the 3 free urinals but did not get anxious about it. Success!
Post-Mortem
I may have set the bar too low on myself but I feel great about my success today. I was able to execute the plan (peeing in the center stall with the door ajar) quite easily. The bathroom was never crowded but I've had problems in similar conditions before. This has been a great day for my ego, a small win but a win nonetheless.
Time to raise the bar. New plan :
Left-most stall (adjacent to the urinals) with the door ajar.
It's another micro-step and the big-leap for me will be to come out of the stall completely but I hope that by making small adjustments I'll get my brain re-trained without having a setback.
Futher reading :
Read about how this plan worked out.
How did it go?
Attempt 1 : Had an urinary urgency of about a 7, uncomfortable but not yet painful. Met a co-worker going into the bathroom, said hi, walked to the middle of the 3 stalls. He took a urinal. I peed with no hesitancy. Success!
Attempt 2 : Had a urinary urgency of about a 6, just uncomfortable. Two co-workers were already in the bathroom. Took the center stall again. Managed to initiate flow and finish before they left. Success!
Attempt 3 : Urgency of about an 8. Went into the bathroom, disappointed to find it was empty. Took the center stall. Waited for someone to come in. Waited 5 minutes. Gave up. Was wishing the whole time that someone would come in so I could allow myself to go. In the past I've stood in bathrooms unable to go because I was worried that someone might come in so I consider this good practice. Marginal success.
Attempt 3 (repeat) : Urgency of about 8 still. Someone was in the center stall so I took the one beside it (nearest the urinals). Slight hesitancy but nothing serious. No anxiety about it. Urinated noisily per plan. My Shy Bladder brain did briefly think that the guy in the stall was probably wondering why I decided to pee in the toilet instead of the 3 free urinals but did not get anxious about it. Success!
Post-Mortem
I may have set the bar too low on myself but I feel great about my success today. I was able to execute the plan (peeing in the center stall with the door ajar) quite easily. The bathroom was never crowded but I've had problems in similar conditions before. This has been a great day for my ego, a small win but a win nonetheless.
Time to raise the bar. New plan :
Left-most stall (adjacent to the urinals) with the door ajar.
It's another micro-step and the big-leap for me will be to come out of the stall completely but I hope that by making small adjustments I'll get my brain re-trained without having a setback.
Futher reading :
Read about how this plan worked out.
My Plan to beat Shy Bladder
Before I start, a disclaimer:
This is my plan, it's something I made up for myself after reading the book. You will need to make your own plan.
One treatment that seems to have consistent results for all types of social anxiety is gradual exposure therapy, slowly expanding the situations in which you can perform "normally".
The plan is pretty simple, I'll need two things :
1. A bathroom.
2. Water. Lots of water.
Obviously you can't practice peeing unless you need to go so the plan calls for drinking water near-continuously during the day. In order to increase my chances of success I'll only go into the bathroom when I feel truly desperate to do so. Hopefully I should be able to generate at least 5 or 6 urgent bathroom-trips this way.
My plan diverges from what is recommended in the book in that I don't have a pee-buddy (someone who is going to stand around and make me nervous) so I'm going to have to enlist the services of strangers and co-workers who happen to wander into the bathroom.
No, the idea isn't to approach people and say "Do you mind standing next to me while I try to pee." That might be an interesting experiment but it's not what I had in mind. Instead, I plan to wait in the bathroom until someone comes in and then, and only then, attempt to urinate.
I'm going to start by trying to go in a stall with the door closed but unlocked. If when I reach the bathroom people are already in the stalls or at the urinals I will attempt to go immediately, otherwise I'm going to have to wait until someone comes into the bathroom.
If I fail to go before the others in the room leave, I stop trying and wait until the next person comes in.
When (and if) I do manage to pee I'm going to aim straight for the water to make as much noise as possible. I'm tempted to add a few loud "Ahhs" of relief but maybe that would be too much for this plan.
Making noise is important because part of the Shy Bladder mindset is unreasonable thinking that others are noticing your performance and judging you for it.
If I can do this 3 times, I'll try to graduate to a greater challenge.
Further Reading :
Read about how this plan worked out.
Read more about graduated exposure therapy.
Read about my progress after the first month.
This is my plan, it's something I made up for myself after reading the book. You will need to make your own plan.
One treatment that seems to have consistent results for all types of social anxiety is gradual exposure therapy, slowly expanding the situations in which you can perform "normally".
The plan is pretty simple, I'll need two things :
1. A bathroom.
2. Water. Lots of water.
Obviously you can't practice peeing unless you need to go so the plan calls for drinking water near-continuously during the day. In order to increase my chances of success I'll only go into the bathroom when I feel truly desperate to do so. Hopefully I should be able to generate at least 5 or 6 urgent bathroom-trips this way.
My plan diverges from what is recommended in the book in that I don't have a pee-buddy (someone who is going to stand around and make me nervous) so I'm going to have to enlist the services of strangers and co-workers who happen to wander into the bathroom.
No, the idea isn't to approach people and say "Do you mind standing next to me while I try to pee." That might be an interesting experiment but it's not what I had in mind. Instead, I plan to wait in the bathroom until someone comes in and then, and only then, attempt to urinate.
I'm going to start by trying to go in a stall with the door closed but unlocked. If when I reach the bathroom people are already in the stalls or at the urinals I will attempt to go immediately, otherwise I'm going to have to wait until someone comes into the bathroom.
If I fail to go before the others in the room leave, I stop trying and wait until the next person comes in.
When (and if) I do manage to pee I'm going to aim straight for the water to make as much noise as possible. I'm tempted to add a few loud "Ahhs" of relief but maybe that would be too much for this plan.
Making noise is important because part of the Shy Bladder mindset is unreasonable thinking that others are noticing your performance and judging you for it.
If I can do this 3 times, I'll try to graduate to a greater challenge.
Further Reading :
Read about how this plan worked out.
Read more about graduated exposure therapy.
Read about my progress after the first month.
Wednesday, January 11, 2006
How does shy-bladder make you feel?
First, I should say that I don't have a truly crippling case of paruresis, it's been worse and it's been better but generally I'm at least able to pee in a closed stall, even in a busy bathroom.
Others have it a lot worse.
But I still resent my condition. Bathrooms are supposed to be places you go to relieve yourself, they are not supposed to be a source of anxiety.
Shy bladder makes you weird..
* I'm the guy you see hanging around anxiously outside the bathroom waiting for it to be empty because I can't go if anyone else is in there.
* I'm the guy who walks up to the urinal next to you and does...nothing.
* I'm the guy who walks into the stall when you show me to the bathrooms even if there's plenty of space at the urinals.
* I'm the guy who, unable to go in the busy public place has to leave to find a bathroom he can safely use and then gives you some odd story about why I had to leave.
* I'm the guy who can't pee while you're in the bathroom because my overactive brain thinks that you're listening to every sound I make and judging me for it.
You get the picture.
Finally, I resent the lost illusion of control. We all get some comfort from the idea that, if nothing else, we are at least in control of ourselves. If you suffer from shy bladder you know what a joke that is. We can't even pee. It would be laughable if it wasn't so frustrating.
Others have it a lot worse.
But I still resent my condition. Bathrooms are supposed to be places you go to relieve yourself, they are not supposed to be a source of anxiety.
Shy bladder makes you weird..
* I'm the guy you see hanging around anxiously outside the bathroom waiting for it to be empty because I can't go if anyone else is in there.
* I'm the guy who walks up to the urinal next to you and does...nothing.
* I'm the guy who walks into the stall when you show me to the bathrooms even if there's plenty of space at the urinals.
* I'm the guy who, unable to go in the busy public place has to leave to find a bathroom he can safely use and then gives you some odd story about why I had to leave.
* I'm the guy who can't pee while you're in the bathroom because my overactive brain thinks that you're listening to every sound I make and judging me for it.
You get the picture.
Finally, I resent the lost illusion of control. We all get some comfort from the idea that, if nothing else, we are at least in control of ourselves. If you suffer from shy bladder you know what a joke that is. We can't even pee. It would be laughable if it wasn't so frustrating.
How Shy Bladder started for me
One of the suggestions in the book is to write down your history of shy bladder and how you feel about it. Doing so can help you discover some things about your condition that perhaps you didn't know or hadn't thought about before.
Do you remember the first time you experienced shy bladder?
At 16 I was taken to hospital with severe abdominal pains. The docs thought it was acute appendicitis but they wanted me to give a urine sample to test.
I couldn't do it. I was left in an emergency room with only shower-curtain type screens to shield me from the rest of the E.R. They were kind enough to run the faucet but I just wasn't able to go. Eventually they catheterized me.
They say that catheterization is painful but I don't remember it hurting at all, compared with the abdominal pain at least.
Some years later I was drinking in a pub with a group of friends. We went to the bathroom as a group and I experienced TBF (Total Bathroom Failure). My friends teased me about it a little but I don't feel it was a big trauma. Certainly not enough to put me off peeing in public for life.
Since then I haven't been able to use a urinal in a public restroom unless I was alone in the bathroom and the chances of someone else entering the room were very low.
This was a curse through my college years since trying to find a quiet bathroom in a crowded club or bar is near impossible.
Slowly but surely my condition worsened to the point that I could only go in a stall while sitting down.
One day, on a whim, I decided to do a web search on Shy Bladder and discovered that I wasn't alone. This changed my world. I'd thought I was the only one who suffered with this problem (something most Shy Bladder sufferers think). I learned that Shy Bladder was a known medical condition with the name "Paruresis". I knew my enemy and I felt empowered to do something about it.
I bought the book and decided to follow the steps outlined for Graduated Exposure Therapy. That led to my first plan and from there, I hope, an eventual cure.
Update : A month or so after writing this I review my progress. I've progressed to being able to use the Urinal in a widening set of circumstances through the application of Graduated Exposure Therapy. I am winning!
Do you remember the first time you experienced shy bladder?
At 16 I was taken to hospital with severe abdominal pains. The docs thought it was acute appendicitis but they wanted me to give a urine sample to test.
I couldn't do it. I was left in an emergency room with only shower-curtain type screens to shield me from the rest of the E.R. They were kind enough to run the faucet but I just wasn't able to go. Eventually they catheterized me.
They say that catheterization is painful but I don't remember it hurting at all, compared with the abdominal pain at least.
Some years later I was drinking in a pub with a group of friends. We went to the bathroom as a group and I experienced TBF (Total Bathroom Failure). My friends teased me about it a little but I don't feel it was a big trauma. Certainly not enough to put me off peeing in public for life.
Since then I haven't been able to use a urinal in a public restroom unless I was alone in the bathroom and the chances of someone else entering the room were very low.
This was a curse through my college years since trying to find a quiet bathroom in a crowded club or bar is near impossible.
Slowly but surely my condition worsened to the point that I could only go in a stall while sitting down.
One day, on a whim, I decided to do a web search on Shy Bladder and discovered that I wasn't alone. This changed my world. I'd thought I was the only one who suffered with this problem (something most Shy Bladder sufferers think). I learned that Shy Bladder was a known medical condition with the name "Paruresis". I knew my enemy and I felt empowered to do something about it.
I bought the book and decided to follow the steps outlined for Graduated Exposure Therapy. That led to my first plan and from there, I hope, an eventual cure.
Update : A month or so after writing this I review my progress. I've progressed to being able to use the Urinal in a widening set of circumstances through the application of Graduated Exposure Therapy. I am winning!
Shy Bladder Syndrome : The Book
This is it, THE Book on Shy Bladder by Dr. Steven Soifer PhD. 150 pages packed with information about paruresis including what causes it and approaches to it's treatment. At the very least this book can give you hope, I'm using the techniques described in this book to get my life back. If you suffer from shy bladder you can too.
Here's a breakdown of the chapters :
Chapter One
What is Bashful Bladder Syndrome and how do you know you have it?
Chapter 2
The Brain, Bladder and Urination : Working in harmony but Not Always.
Chapter 3
Causes of Bashful Bladder Syndrome : Unraveling the Mystery
Chapter 4
You Can treat Bashful Bladder Syndrome Yourself
Chapter 5
Adjunct Therapies, Support Groups and Workshops
Chapter 6
The Medical Community and Paruresis
Chapter 7
How family members, Intimate Partners and friends can support your recovery
Chapter 8
Evolving Legal Ramifications: The Americans with Disabilities Act and Mandatory Drug Testing.
Chapter 9
Future Directions
Appendix A
Literature Review
Appendix B
Evolution of the Bathroom and it's Impact on Paruresis
Appendix C
For further help.
And here's a quote from the back cover :
The inability to comfortably use a public restroom has halted travel plans, promotions, and job changes. It has caused endless daily suffering for millions worldwide who have hidden a shaming, debilitating disorder from even their closest friends. Recovery is not easy, but it is simple. The instructions within these pages can guide you to that long sought freedom.
- R.Reid Wilson, Ph.D., author, Don't Panic : Taking control of Anxiety Attacks
Get it from Amazon.
Getting Help for Paruresis
Paruresis is the medical name for Shy Bladder.
www.paruresis.org
The site for shy-bladder sufferers. Information on support groups, support forums, success stories.
A support site for sufferers in the United Kingdom.
A support site for sufferers in Australia
There are many other support sites listed at the paruresis support site links page.
Further reading :
www.paruresis.org
The site for shy-bladder sufferers. Information on support groups, support forums, success stories.
A support site for sufferers in the United Kingdom.
A support site for sufferers in Australia
There are many other support sites listed at the paruresis support site links page.
Further reading :
A cure for Shy Bladder?
Read about my plan to beat my Shy Bladder using Graduated Exposure Therapy.
What is Graduated Exposure Therapy?
What is Shy Bladder?
Shy Bladder, Bashful Bladder, Stage-Fright : These are all terms used to describe a medical condition known as paruresis.
Whatever you call it the result is the same, an inability to urinate in public restrooms.
Nobody knows why people develop this, most of us arn't born this way. It's been suggested that the condition develops as a result of an incident (usually in a bathroom) that somehow trains the brain to see public bathrooms as a dangerous place. That could be some kind of trauma : sexual assualt, physical assault or mortifyingly embarrassing experience but it could also be simply the feedback loop of the brain.
Everybody experiences occasional "stage fright" and it may be that you experience it once, the next time you try to go you worry that the same will happen again - a self-fulfilling prophecy. A few more abortive attempts and you've trained your subconscious to believe that public restrooms are a source of danger and it amps up your adrenaline and clamps shut your sphincters.
It is estimated that Paruresis affects as many as one-in-seven adults, disproportionately men. In the USA that means that there are approximately 14 million men aged between 15-64 years of age who routinely have difficulty peeing; about the same number of people as the population of New York and London combined.
I started this blog to get two simple messages out : You are not alone and There is a cure.
It's early in 2006, I've been struggling with paruresis for years and I want this to be the year that I beat it. I plan to document my efforts, I hope it's useful to you too.
Useful links :
Getting Help
Whatever you call it the result is the same, an inability to urinate in public restrooms.
Nobody knows why people develop this, most of us arn't born this way. It's been suggested that the condition develops as a result of an incident (usually in a bathroom) that somehow trains the brain to see public bathrooms as a dangerous place. That could be some kind of trauma : sexual assualt, physical assault or mortifyingly embarrassing experience but it could also be simply the feedback loop of the brain.
Everybody experiences occasional "stage fright" and it may be that you experience it once, the next time you try to go you worry that the same will happen again - a self-fulfilling prophecy. A few more abortive attempts and you've trained your subconscious to believe that public restrooms are a source of danger and it amps up your adrenaline and clamps shut your sphincters.
It is estimated that Paruresis affects as many as one-in-seven adults, disproportionately men. In the USA that means that there are approximately 14 million men aged between 15-64 years of age who routinely have difficulty peeing; about the same number of people as the population of New York and London combined.
I started this blog to get two simple messages out : You are not alone and There is a cure.
It's early in 2006, I've been struggling with paruresis for years and I want this to be the year that I beat it. I plan to document my efforts, I hope it's useful to you too.
Useful links :
Getting Help
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