Hello. Just wanted to introduce myself, I'm James, 49 years old. For many years I have struggled with having a pee in public toilets or even at home / friends houses. The main reason being I always feel under pressure if I feel someone is waiting for me or someone is waiting to use the bathroom / cubicle. And, under these circumstances I just cannot go. My worse situation is on an aeroplane. Many years ago I had some urology investigations and again more recently have been referred again but discharged as nothing physical was found. I went to my GP and suggested something I have thought for a while, that it is psychological. I am due to go back to see my GP but I have been doing my own research and suddenly everything makes sense. And, there is a name for it which is a relief. I also have a medical condition called Kallmann's Syndrome, from my teenage years I always avoided urinals because of my medical condition and fear of what someone might think about my size. Life hasn't been easy but I try and stay positive. Are there any guys who want to chat, offer advice etc, it would be much appreciated. Thanks, James

Hi James

What you describe about feeling under pressure to go is exactly what most men and women who come to us feel. And as you say it is psychological. So I hope you would consider attending one of our workshops, where, among other things, we address that issue.

As for the Kallman's Syndrome I understand what you are saying. Here it is necessary to learn that guys do not look at each other's tackle in a public toilet. Its not until you use toilets a lot that you can see the extent to which people do not look from side to side; most are totally absorbed in their own little world of peeing. Secondly it is easy to "hold" oneself in such a way that it is hidden from sight; something you could try. You could also use urinals where there is an adequate divider, and cubicles when there is not; men who do not have shy bladder have no compunction about using a cubicle to pee.

Finally about the pressure to pee; there is no law about how long you are allowed to take; men stand there as long as it takes. Read up on our website under "Living with Paruresis"/ "CBT & paruresis" about Latency. One participant decided to test how long he could stand at a urinal without peeing; he gave up after twenty minutes out of sheer boredom; no-one called him out.

Hope this helps; what do you think?

All the best

Andrew

Hi James, welcome to the forum. I am glad you have found out that you suffer from paruresis as it should put your mind at ease a little to know exactly what problem it is that you have. I am sorry to hear you have Kallman’s syndrome & want you to know I am sympathetic to what must be a difficult thing to live with. I remember there was a programme on BBC1 about 20 years ago following a man in his 30’s who went through treatment for it and it was very interesting. If you google Kallmann’s syndrome BBC1 you will find links to various web pages. I think Andrew has given you great advice with regards to using urinals with big dividers, & cubicles when there is not.

Two ways of improving paruresis are to practice fluid loading by drinking loads of water to create a high level of urgency, letting a small amount of urine out at the urinal (or cubicle if preferred), go to other public toilets & repeat process until your bladder is empty. You could try this at home first so you can learn to control the stop/start again technique. The other way is to change your way of thinking & the workshop will teach you this & give you paperwork to take home to learn from. If you could attend a workshop as Andrew suggests you won’t have to disclose that you have Kallmann’s unless you want to.
I really wish you the very best of luck indeed!

Hi Karl. Thanks for your reply and advice. I'm just waiting for a referral back to urology, hopefully they will be able to help further, I am looking into the option of self catheterisation to use in certain circumstances. I guess the main issues are I have are getting started, this is an issue even if my bladder is full. Especially in places were there is only maybe one toilet and someone else is waiting. I think the next workshops are later this year, so I will have a look. Thanks again.

Good luck with urology, James. I have never tried the catheter route and thankfully because I attended the ukpt workshop, follow-up workshop and read the the paperwork at home many times that I was given at the workshop, I haven’t needed catheterisation.
I had exactly the same problem as you with regards to starting, even when my bladder was full but from the workshop i learnt to mark that full bladder on a level of urgency from 1-10 & wait until it’s an 8-10 before attempting to urinate & it’s worked lots of times for me. Sometimes it’s latent (a bit slower to start), but I do pass urine. If you know which toilets only have one toilet in then just avoid them & only attempt to use one’s that have more than one.
I hope you get to attend a workshop and that it helps. The team are wonderful & the other paruresis sufferers are all sympathetic to each other because they’ve been through the same experiences.

Hi Karl.
Hope you're well?
Thanks for this advice, I am going to try the full bladder technique you explained. I do tend to wait as long as possible (especially in certain situations - when I know toilet facilities are limited or I when I know I will probably struggle to go). I'm not someone who will avoid going out or to places even if I know I'll struggle or I don't know what the facilities will be like. I like to think I try and not let it control my life and stop me from dong things. Some situations are difficult to avoid or wait till I know where there might be more than one toilet, as I seem to have most issues when I know someone is waiting for me or I have to be somewhere at a certain time - planes and football tournaments been two examples, situations where been able to self catheterise might help me or even relax me to the point where I can go naturally, knowing I had a back up.
Thanks again Karl.