How can I support a friend or relative living with paruresis?

Do you have a family member or a friend who has confided in you that they have a social anxiety around using public toilets, often known as shy bladder syndrome or paruresis? If you have, your friend or family member probably really values your friendship as it's not an easy thing to admit to, and they may have agonised long and hard before deciding to tell you. They are likely to be embarrassed but trust that you will not ridicule them or minimise their problem. They have confidence that you will try to understand their problem even though it may seem illogical to you, and that you'll be able to support them in a way that will help them to get to grips with their problem and work towards beating it.

So what is the best way to help them? First of all it's key to listen to them while they tell you how distressing it has been for them and what a huge impact it's having on their life. You may have wondered why they often seemed reluctant to go out to pubs, restaurants, the theatre etc, so their admission may provide answers to things you'd wondered about in the past. Many people tell us that the relief of being able to talk about their toilet issue openly to someone else is immense. That may be enough for them. But why not ask them what, if anything, you can do to help. They might welcome your company on a shopping trip, but ask you to discreetly absent yourself when they need to visit the toilet, with no time pressures implied and no questions asked. Don't wait for them by the hand basins and mirrors in the toilet – go outside, gaze into shop windows, browse in a bookshop – anything that will occupy you until they finish, without them feeling that you're waiting for them. Don't ask them how they got on. They might ask you not to comment if they have to make several lengthy toilet visits quickly in succession. Just knowing that you're on their side and not judging them may be all that's required to help them begin to take toilets in their stride.