Shy Bladder? Try Progressive Muscle Relaxation

If you have experienced a constant, ongoing fear of having to urinate in a public restroom, you’re not alone. Paruresis, more commonly known as shy bladder, affects over 17 million people worldwide. The good news is that even if you feel like you have no way to conquer your shy bladder, there are tips and techniques you can use to help overcome your phobia of using a public restroom. Shy bladder is actually a learned behavior and as with any learned behavior, you can take the positive steps to unlearn it and live free of this phobia forever.

One of the techniques we discuss in this article is progressive muscle relaxation, also known as PMR. But before we learn about how PMR can be used to conquer paruresis, it helps to understand what causes shy bladder and how PMR works on a general level. We will then take a look at how you can implement PMR techniques into your self-help regimen to help overcome your fear of urinating in public.

What Is Shy Bladder?

Shy bladder is usually provoked by one situation: urinating in a public place, although some people may not be able to urinate with other people in the same restroom or may be so phobic that they cannot use the restroom anywhere but in the privacy of their own homes. Shy bladder is usually classified as a type of performance anxiety – as strange as it may sound, you may actually fear the “performance” of using the restroom in a public setting. As a result, you develop an anxious response that activates the sympathetic nervous system. This additional activity in your nervous system can actually make it difficult – if not impossible – for you to use the restroom in a public setting, or any setting in which you fear being judged for your performance.

Shy bladder is actually more than just shyness; it’s a real phobia classified in the Diagnostic Statistical Manual of Mental Disorders (DSM) IV with code 300.23. It’s a bona fide phobia and can be so serious that people will arrange their entire lives around not having to use a public restroom. In fact, according to Dr. Stephan Soifer, executive director of the International Paruresis Association, he receives calls on a daily basis from employees who have been fired or who have been discriminated against in the workplace because of their struggles with shy bladder. If you suffer from paruresis, you can take your life back by embarking on a self-help regimen that will help you to calm your anxious response to urinating in public.

What Is Progressive Muscle Relaxation (PMR)?

When you develop an anxious response to a situation (known commonly as the fight or flight response), your muscles tighten with the anticipation of needing to flee the situation or fight your way out. Progressive muscle relaxation (PMR) was developed by American physician Edmund Jacobson in the 1920s. By alternating between tensing and relaxing the muscle groups in the body, Jacobson found he could calm the anxiety his patients suffered. It has since become a valid form of alternative, non-invasive therapy for anyone who suffers from anxiety, panic attacks, or phobias.

There is no right or wrong way to do PMR. All you do is focus on consciously tightening and then releasing the muscles in your body. You just need a few moments of privacy and a comfortable place to practice it. The quickest form of PMR involves tightening and releasing the muscles in the face, followed by the muscles in the neck, shoulders and arms. Then you move on to the muscles in the abdomen and chest, followed by the muscles in the buttocks, legs, and feet. The entire process takes about five minutes and should, when combined with deep breathing, give the practitioner the feeling of stress relief and will calm the fight or flight response in the body.

Using PMR to Treat Paruresis

Because shy bladder can provoke the same anxious response in the body as any other phobia, PMR is often used as a therapeutic technique. PMR can actually reduce your pulse rate and blood pressure while helping to calm your respiration and even your sweating, all of which can help ease the sympathetic nervous system overload you experience when you have paruresis and which can actually prevent you from being able to urinate at all.

You might try PMR at home, when you have a bit more free time and privacy. While sitting in the bathroom, you can try tensing and releasing the muscles in your body while breathing deeply. You should be able to feel the tension leave your body as your respiration slows and your pulse returns to normal. Many people who suffer from phobias simply use PMR at home while visualizing the very situation that provokes a phobic response. So, if you suffer from shy bladder, you can use PMR while visualizing having to urinate on command for a drug test or having to use the restroom at work.

If you opt for using exposure therapy, you can use PMR to help make your experience with exposure therapy more positive and productive. When you go into a public place to use the restroom, you can practice PMR as you sit in the stall. As your body lets go of tension and your sympathetic nervous system activity slows, you may find it easier than you thought to use the restroom in a public place.

You can also try using PMR to calm the overall stress and tension you feel in your life. Many people use PMR on a regular basis simply to release stress and tension before heading to bed. The better control you have over the stress in your life in general, the more likely you are to be able to handle your phobia – and conquer it. So think of PMR not only as a tool for overcoming your shy bladder, but as a valuable weapon you can use to combat any of the stress you may experience in your lifetime.

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