How Family Members Can Help Someone Struggling with Paruresis

If someone in your family is struggling with paruresis, you may not know what you can do to help ease the burden that he or she is living with day to day. Let’s face it; many individuals struggle from time to time with urinating in public, and we sometimes even laugh at ourselves when it happens. For most, this is an isolated event and nothing to be concerned about. For the long-time sufferer of paruresis, however, the inability to urinate in public is a daily source of struggle, shame, and pain.

There are three primary ways that family members can help someone struggling with paruresis. First, it’s imperative to understand the condition. Next, compassion is essential for helping your loved one to cope with the effects of paruresis. Finally, by offering to help your family member find a physician, therapist, and/or support group, you can provide hope for a paruresis-free life in the near future.

Understanding Paruresis: What it is and Isn’t

Paruresis, in simplest terms, is the physical inability to “pee in public.” Paruresis is not a one-time incident; rather, it is a mind/body connection that makes it difficult to urinate in restrooms away from home (e.g. public restrooms, public transportation, school restrooms, restrooms at work, etc.). The anxiety that prevents the person from urinating is so strong that it affects the sympathetic nervous system and prevents the individual from the physical ability to urinate. In other words, the pressure not to pee is stronger than the need to pee.

The paruretic – the individual living with paruresis – usually develops the condition during adolescence. It is most often a result of a teasing or bullying incident that takes place in a public restroom. It can also stem from sexual abuse or from a traumatic toilet training incident. For most individuals, however, the inception of paruresis can be traced back to his or her teenage years.

Paruresis is social anxiety – a phobia that is directly related to the fear of judgment from others during the process of urination.  It’s not something that the individual can just wish away. It’s a strong, inhibiting anxiety that prevents the paruretic from relieving him or herself when someone is nearby. This can be confusing to family members because some paruretics are able to urinate when a family member is near but not in other situations.

Paruresis can range from mildly annoying to completely disabling. For instance, some paruretics can urinate in public when no one else is in the restroom while others cannot pee in public because the implied “threat” of another person entering the restroom prevents them from relieving themselves. This implied threat increases the individual’s anxiety level, which, in turn, causes the sphincter muscle to freeze, so to speak, preventing successful urination. As anxiety is induced, the individual “chokes under pressure” and cannot urinate.

Family Members Should Approach the Paruretic with Empathy and Compassion

The truth is that you may have a family member who suffers from paruresis and not even be aware of it. Individuals with paruresis often feel so much shame and embarrassment that they do not discuss their condition with family members or physicians. In fact, most paruretics never reveal their conditions and never seek treatment, for that matter.

Compassion from family members is paramount to the individual paruretic. However, some individuals are teased about their condition within their families. Paruresis is no laughing matter, and it is not something that can be wished away. It’s important to recognize that paruresis is a psychological condition that affects different people in different ways. A compassionate and empathetic approach is always best.

If there are other children in the family, have an open and honest conversation about paruresis. Stress to them the importance of not teasing the paruretic about his condition. Because paruresis often stems from adolescent teasing, it’s critical that children know their roles in helping a family member who suffers from this condition.

If your family member has been diagnosed with paruresis, you can assist by helping to ease his or her anxiety in public situations. They may ask you to stand outside the door so that no one enters in order to feel “safe.” It’s best to do what makes your family member most comfortable without questioning the motivation. You don’t want to imply that you are passing judgment on the situation.

By providing empathy and compassion, your family member will be more likely to be open about his or her condition and, hopefully, seek treatment.

Offer to Locate a Physician, Therapist, and/or Support Group

Paruresis can be embarrassing, but it is also a condition that causes physical pain when paruretics cannot relieve themselves right away. Unfortunately, individuals with paruresis suffer from broken relationships and lost jobs as a direct result of the effects of this condition.

On the job, paruretics are often unable to take company-required drug tests. They may not be able to go to long meetings or even urinate during the course of a work day. Relationships are often difficult to maintain because paruretics sometimes avoid going to social functions or leaving their homes for long trips, which causes discord between the paruretic and his or her loved one.

Since paruresis encompasses all areas of an individual’s life, finding a therapist, urologist, and/or support group to help your family member is a positive step toward healing. The good news is that for paruretics who seek help, the prognosis for recovery is favorable. There are a variety of effective treatment methods available for paruresis, ranging from cognitive therapy to breath holding to hypnosis. Individuals who find effective treatment may experience complete relief in a few weeks to a few months’ time. Physicians and therapists may also prove helpful in finding a local support group. Online, there are numerous forums for paruretics who seek the support of others, as well.

Living with paruresis is embarrassing, painful, and often a secret that goes unrevealed. If your family member has paruresis, be supportive, understanding, and help them to locate the treatment they need to recover. Also, suspend judgment toward the paruretic because the fear of judgment is what perpetuates the condition. With support from family members, healthcare providers, and an active paruretic support group, your family member can rest assured that relief is most likely in the future.

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