Going in Front of Strangers or Friends

Many sufferers of paruresis tell us they often find it harder to go to the toilet when they are out or with people they know than with strangers. The issue suggests we worry a great deal about what our friends, family and acquaintances think of us; perhaps more so than strangers.

Paruresis or "shy bladder syndrome" affects sufferers by making it difficult for them to urinate when other people are around. This can apply to using public toilets but also ones in offices, other people's homes, restaurants, pubs and other public places.

What can happen is that people will take extraordinary measures to avoid having to use a toilet, such as drinking less fluid, going out of their way to find empty public restrooms or even cutting back on their social lives so they do not have use bathrooms away from home.

What is common too is for people to go out of their way to hide the condition from their family and friends. For example, if you are with strangers or people you do not see or meet up with that often, it can be easier to explain aspects of your behaviour. If you can't go to a bathroom with other people, then you might pass this off as an aversion to a particular toilet. It's unhygienic or it smells awful.

But if you have been out with your family and friends before, then you might feel your avoidance of going to the toilets with others is too noticeable. That in turn can be stressful and increase the sensation of not being able to pee. Another noticeable trait might be refusing to drink in company. Drinking, whether that is teas and coffees or alcohol, is a sociable activity and again if you suffer from paruresis you might worry your repeated refusals are noticeable.

Why do we go to such lengths to hide the condition from the people we know? Part of the reason can be not realising how common the condition is. Most of the population have heard of shy bladder syndrome. If you asked most men, it would be interesting to note how many of them prefer toilets that have cubicles rather than urinals. And because paruresis relates to the toilet and bodily functions, there is a stigma attached.

Friends and families often surprise us by empathising far more than we think they will. It can be a relief to find out that a friend turns down invites a lot of the time not because he or she doesn't want to spend time with them but because toilet use is troublesome.

Explaining the issue can make life much easier in the long-run. Worthwhile friends and family want to help. If that means they choose to meet up with you in places where there are public restrooms that are more 'private' or agree that you go to the toilets by yourself, it isn't a lot to ask.

If you feel your condition is affecting your relationships with family and friends, there are steps you can take to tackle paruresis. From cognitive behavioural therapy to seeing a psychologist or taking part in workshops, we have help and advice about the way forward here.