Overcome Public Restroom Embarrassment

An embarrassment around using the washroom in public, also known as “bashful bladder” syndrome or Avoidant Paruresis, can affect men, women, and children.[1] You may be very uncomfortable using a public washroom and become anxious or agitated once you are in the bathroom stall or at the urinal. Sometimes, this social anxiety disorder can make it difficult to actually go to the bathroom, as the muscles that control your bowel movements and your ability to urinate can freeze or tighten up.[2] When trying to overcome embarrassment around using a public washroom, you should focus on techniques to relax and techniques to distract yourself so you can get over your discomfort. If these are not effective, you may want to use professional techniques for your disorder.

Steps

Using Relaxation Techniques

  1. Go for the stall furthest from the door. To get more of a sense of privacy, head for the stall at the very end of the line. You may feel more comfortable going to the washroom if you are farther away from other people using the washroom.[3]
    • If you are using a washroom with a urinal, you may choose the urinal that is furthest from the door or a urinal where there is no one on either side of you. This small sense of privacy could do a lot to steady your nerves and get you to feel more calm.
  2. Do breathing exercises. Breathing exercises can help you to feel calm and relaxed, which will then help to loosen up your bladder muscles and allow you to go to the bathroom. You may do simple breathing exercises where you breath in and out, inhaling for three counts and exhaling for three counts.[3]
    • You may also try belly breathing, where you inhale through your nose and fill your belly with breathe. You can then hold for three counts at the top of your inhale and then exhale through your nose again, letting your belly pull into your spine. This will allow you to experience deeper breathing and feel more relaxed.
  3. Practice tightening and releasing your pelvic muscles. You can try to activate the muscles that control your ability to go to the bathroom by practicing tightening your pelvic muscles and then releasing them. You can also sync this to your breathing, where you inhale as you tighten your pelvic muscles and then exhale as you release your pelvic muscles.[4]
    • As you tighten your pelvic muscles, you may experience a sensation similar to holding your urine when you have to go to the bathroom very badly. As you release your pelvic muscles, you may experience a sensation similar to releasing your urine, such as when you go to the bathroom.
  4. Listen to soothing music. Get in a relaxing head space by putting in headphones and listening to music on your smartphone or a music player. Choose music that helps you to feel relaxed, from classical music to smooth jazz to trance music. This way, you can focus on the music rather than the environment of the washroom or any embarrassment you may be feeling when you are in the washroom.[3]
  5. Try meditation. Meditation can be great for getting into a relaxed headspace and removing yourself from any discomfort you may be experiencing. You can do deep breathing meditation, where you close your eyes and focus on your breathing as you inhale and exhale. Or, you can try mantra meditation, where you repeat a mantra in your mind as you inhale and exhale. This could be a mantra that you find soothing and relaxing.

Using Distraction Techniques

  1. Try doing a series of math problems in your head. Doing math calculations or problems in your head helps to activate your brain cortex and blocks the inhibiting impulses going from your brain to your bladder.[4]
    • You can choose fairly simple math calculations, such as the times table, starting from 1x1 = 1, 1x2 = 2, or the additions table, starting from 2+2 = 4, 2+3 = 5.
    • You can also try more complex math problems, such as long division math problems or trying to solve complex mathematical equations, if you know any of them by heart. You can also look up equations on your smartphone if you are sitting down in the washroom stall.
  2. Play games on your phone. If you have access to games on your smartphone, you may find it helpful to distract yourself by playing your favorite games while you are in the washroom stall. This will allow you to focus on the game, rather than your discomfort or embarrassment.[5]
    • Keep in mind your phone will likely pick up germs if you take it out and touch it in the bathroom stall. So, always clean your phone after you have used it in the bathroom.
  3. Bring reading material into the stall. This could be an article from the newspaper or from a magazine. Or, you could pull up reading material on your phone. Reading can act as a useful distraction while you use the public washroom.
  4. Use products to hide any unpleasant smells. Bad smells in the bathroom can be an unwelcoming distraction for some. You can try to mask bad smells in the stall or the urinal by bringing in a small bottle of air freshener with you. You can then use it to freshen up the stall before or after you use it.[5]
    • You may also want to bring in other hygiene products like hand sanitizer to make you feel as though you are not picking up any germs while you are using the washroom.
    • There are currently products on the market that can be sprayed in the toilet after you use the washroom to mask the smell. Carry a small bottle of this product in your bag so you can feel less anxious about any bad smells when you are in the washroom.

Using Professional Techniques

  1. Try psychotherapy. If you are starting to experience other health issues due to your “bashful bladder” or paruresis, such as constipation and abdominal pain, you may want to talk to a professional therapist about your disorder. Look for a therapist who is aware of paruresis and has worked with individuals suffering from paruresis before.[3]
    • Your family doctor may be able to give your a recommendation for a therapist who treats individuals with paruresis. You will likely have to attend weekly one on one therapy sessions or group therapy sessions, where you may talk about your anxiety and fears associated with using public washrooms. You may also learn techniques to cope with your disorder.
  2. Talk to your doctor about graduated exposure therapy. Graduated exposure therapy is a step-by-step program that has participants try to urinate more and more in difficult, public places. Around eight out of 10 people with paruresis are successfully treated with graduated exposure therapy.[2] You can get a referral for a behavioral specialist who does graduated exposure therapy through a psychologist and a therapist.[6]
    • To do graduated exposure therapy, you will make a list ranking urination locations that are the easiest for you to use to the most difficult for you to use. For example, your bathroom at home may be easiest and a public washroom at work may be more difficult. You will then start by trying to use the washroom in the easiest locations and work your way to the more difficult locations.
    • You should do graduated exposure therapy three to four times a week for the best results and drink lots of fluids before each session. Participants usually notice results after 12 weeks.
  3. Work with a close friend or family member during graduated exposure therapy. As part of the process of graduated exposure therapy, you will need to enlist a “pee partner”, who will support you and stand close to you so you feel comfortable urinating or going to the bathroom. This could be a close friend or a family member. Your “pee partner” will stand close to you as you urinate for a few seconds and then stop. He may then move a little closer as you go to the toilet again, urinate for a few seconds and then stop. The idea is to keep practicing urinating with your pee partner as he gets closer and closer to the toilet.
    • You may then gradually start to make noise while urinating to try to get more comfortable using the bathroom, such as splashes. Once you are fine urinating at home, you and your pee partner may move to a quiet public restroom. Your “pee partner” may stand outside the toilet door while you urinate.
    • You will work with your “pee partner” to go down your list of locations until you can successfully go to the bathroom in a loud and crowded washroom.
  4. Join the International Paruresis Association. The IPA is a non-profit organization that helps to educate the public about paruresis and shares information about effective treatments for paruresis.[6]
    • The IPA holds weekend workshops for individuals struggling with paruresis. You can also get a referral to a cognitive-behavioral therapist who can assist you with treating your paruresis.
    • You can access the sign up form for IPA on their website.

Related Articles

Sources and Citations

  1. ↑ https://www.anxietyuk.org.uk/get-help-now/anxiety-information/anxiety-disorders/toilet-phobia/
  2. ↑ 2.0 2.1 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/shy-bladder-syndrome
  3. ↑ 3.0 3.1 3.2 3.3 http://www.health.com/health/article/0,,20448798,00.html
  4. ↑ 4.0 4.1 http://www.embarrassingproblems.com/problem/urination-shyness
  5. ↑ 5.0 5.1 http://www.bustle.com/articles/52194-11-reasons-why-pooping-in-public-shouldnt-be-embarrassing-especially-if-youre-a-woman
  6. ↑ 6.0 6.1 http://paruresis.org/about-avoidant-paruresis/
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