Can’t Pee In Public? This Is Why

When I was in college, I had a good friend who was perfectly normal — except for one thing. Try as she might, she could only, ahem, relieve herself in the comfort of her own home. Peeing in any bathroom other than her own was totally outside the realm of possibility. Needless to say, she could also only go "number two" at home — alone, and in complete silence. She wasn't a germophobe, and she didn't foreswear public restrooms for hygienic reasons. She simply couldn't relax enough anywhere but in her own space, in absolute solitude.

As it turns out, my friend is not alone. As noted in The Atlantic this week, "pee shyness" (also known as shy bladder syndrome or by its clinical term, paruresis) is classified as a social anxiety disorder in the DSM V. Symptoms can range from mild discomfort while urinating in public to a physical inability to pee when other people are present. An estimated 21 million Americans suffer from paruresis, or its poo-related variant, parcopresis — including one Ms. Oprah Winfrey.

Experts connect the disorder to performance anxiety. It makes sense, especially when you consider the way we're all conditioned to think about potty-training (and potty-going in general). In an interview with The Atlantic, Nick Haslam, author of Psychology in the Bathroom, says, “We are socialized from an early age to control excretion and taught that failures of control are embarrassing and humiliating." There's also "an entirely adaptive and evolved aversion to bodily waste," Haslam notes, "which is linked to disease and contamination. To some degree there will always be some anxiety and disgust attached to excretion."

The good news is there are numerous treatment options available for those whose bladders aren't as outgoing as their personalities. According to the International Paruresis Association, a few months of cognitive behavioral therapy can cure four out of five cases of pee shyness. There's also something appropriately called the "breath-holding technique," which hopes that the increased CO2 levels caused by holding one's breath will induce relaxation and allow the stream to begin. Still, there's definite anxiety underlying paruresis — and we think that may be best treated with something more direct than oxygen deprivation.

One anonymous interviewee says she's conquered her pee shyness by covering her ears in particularly stressful lavatory situations. But, as one R29er with a notoriously bashful bladder says, the worst part is the attention she receives (or perceives?) from others regarding her condition. "Once you start having an issue, you just imagine that everyone's judging you, and it gets so much worse from there." Don't worry, girl — if it can happen to Oprah, it can happen to anyone.