Urinals along a wall in a men's restroom.

Unable to Pee in Public; aka Bashful Bladder, Being Pee Shy, or Paruresis

You wouldn’t believe the number of men who have trouble using public rest rooms, and not because they don’t like the smell or have hygiene issues.

Being unable to relieve yourself in a public rest room is called paruresis or bashful bladder syndrome. It’s a very real problem that can limit how far away from home a person can venture and for how long. Being pee-shy can get in the way of taking a urinalysis at work or for a job interview–forget being able to take a leak at a concert, sporting event, or when at a bar or restaurant. People with this problem can even find it a challenge to urinate in a private bathroom while at a friend’s home or when at a party.

You might have the idea that this is a wimp’s disorder, e.g. “A real man could just whip it out and pee.” But plenty of guys who have this problem are strong and tough. They have no shortcomings with women or sex, and can be in high demand on both scores. Not only is it impossible for them to go in a public bathroom, but some need to sit when they urinate at home for fear the stream will make noise and someone will know they are peeing. This is in stark contrast to the independent and able men who they are in other parts of their lives. Most people wouldn’t believe that something so simple is such a huge challenge for them.

A college student recently wrote in who was worried because he had enlisted in the Marine Corps and was soon going to ship out for basic training. He would sometimes walk up three flights of stairs in his college dorm to find an empty bathroom where he could pee. He had no idea how he was going to manage in basic training, where there would be next to no privacy at all.

For millions of people this happens each and every time they try to urinate when they are not in their own home. The only safe place they can go for vacation is to the beach. Or maybe someone’s swimming pool. No matter how much they need to relieve themselves, their bladder can freeze up whenever someone walks into the rest room or whenever they so much as think someone will be walking into the rest room.

Paruresis exists in different degrees: some people who have it can go in a public rest room as long as they are in a closed stall. Others are unable to go in a rest room if anyone else is there, and some can’t urinate at all if they are anywhere but home. They won’t even try to enter a crowded rest room after a movie, between classes, or during an intermission at a large event.

Far more men suffer from this than women. Perhaps one reason is because few women are asked to urinate next to each other without being in an enclosed stall, while guys are expected to go where other guys can watch, casually discussing the weather or League of Legends while whipping it out and doing their business. 

The problem often starts before adolescence. Some people with shy-bladder problems can remember back to a specific event that triggered the anxiety. For instance, a kid having to use a group urinal at a baseball stadium with dozens of grown men who are standing around him with peeing out six innings’ worth of beer. For others, the causes can be more unconscious.

Paruresis can be severe enough that some people need to carry a catheter in order to relieve themselves. But the best way to deal with the problem is with desensitization techniques. For most people, these exercises can provide a decrease in the severity of their bashful-bladder problem These exercises are described in an excellent book and in the resources that are available at www.paruresis.org.

Here’s a TEDx talk by one of the world’s top experts: Do Public Restrooms Make You Nervous? You Are Not Alone!

Also visit his very helpful website at: www.paruresis.org. This website provides a great list of articles, resources, workshops, support groups and forums.

HIGHLY RECOMMENDED BOOK: The Secret Social Phobia: Shy Bladder Syndrome (Paruresis): Second Edition, by Steven Soifer, George Zgouridges, Joe Himle and Nan O’Brien.