Spectrum of Severity

The spectrum of severity of paruresis

The ability of an individual to urinate when needed can be affected by the environment that the person finds themselves in. A person with paruresis needs to pee, but just can't if there are others in the same area, ­even if they are "bursting" and in pain; they physically cannot do it.

There is a spectrum of severity of this. In its mildest form, a person wouldn't think they had a problem at all until they are expected to give an observed sample for a drugs test, and then find it takes time to do it. At the other end, there are people who cannot urinate at home behind a locked door if someone else is in the same property. Some men
can't go at urinals if someone else is around, but they can use cubicles with no bother. Others can have difficulty with using cubicles if the toilet area is crowded or occupied, including many women who experience difficulties using public toilets when they have to queue and feel as if they will keep other people waiting.

A combination of factors can apply: some men can use urinals if others are there, provided there is a degree of privacy provided by urinal dividers; or can use a cubicle even with the door open, but they would not be able to do so at an open trough or to comply with an observed sample request for drugs testing. In others time pressure can make the difference.

So a significant proportion of people have the symptoms of this to some extent or other. The extent to which it might be a problem depends how it affects you. If you find you have to go in a cubicle from time to time, and that doesn't worry you, then it is not a problem. If you can use a public toilet only if it is otherwise deserted, then that is likely to have a serious impact on what you can and cannot do, and where you can or cannot go. If you can pee anywhere, except in front of someone observing you e.g. for a sample for a drugs test, then that's no problem, ­provided you are never required to give such a sample. But it is a problem if you are required to do so, perhaps for your employment, and can't, and then you lose your job because failure is deemed refusal. And it isn't just stereotypical shy or timid people that get this. One sufferer is 6ft, 13 stone, with a #1crop, and a martial artist. Another is a Marine.

The biggest problem is that most people develop this in their early childhood or teenage years at a time when it is easy to "work around" the problem. You are only out of the house at school for a few hours a day and can hold on until you get home. But as you get older it becomes an embarrassing problem you discuss with no-one. Most people who resort to the internet looking for information about this are surprised to find that they are not the only one with it. And it can become a controlling factor in your life. It is thought that up to 4 million people in the UK could suffer from paruresis to the extent that is affects their lives.

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