Social Anxiety
The Role of Social Anxiety in Paruresis: What Do Shy Bladder Sufferers Fear?
Paruresis or shy bladder is a complex issue to discuss. There are documented testimonies that point to multiple fear factors that lead to social anxiety. But there is no known universal explanation about what specifically triggers paruresis. At the very least, this universal explanation has so far been elusive.
What is clear so far is that social anxiety occurs whether or not the presences of other people are real or imagined. There are fears that constitute the underlying psychological causes of shy bladder. We will call them in this article underlying fears. There are also fears that arise from the experience of having shy bladder. We will call these secondary fears.
The underlying fears include child traumas. These may be bullying inside the toilet room in schools or public places. Perhaps one has experienced teasing, physical abuse or deep emotional pain from siblings or classmates or strangers regarding the size of one’s penis, or whether one is circumcised or uncircumcised.
The teasing may otherwise be about the sound of one’s urination, or direction of one’s urine, or the smell of the urine or anything related to toilet training. There are those who have this fear of being regarded as homosexual by the way one urinates. Parents who are overly critical of a child’s urination pattern may also contribute to these underlying fears.
When criticism really hurts, the emotional pain lasts. So does its impact on the person. In reality, the public restroom is also a social venue among people of the same sex. One can get teased there for being different. Unaddressed feelings of inadequacy among children — at home and in school — may spill over to their sense of self-worth in front of a urinal all the way to adulthood.
To compound matters, studies have found a pattern in the personalities of shy bladder sufferers. They tend to be non-assertive and sensitive to what others think. They have this fear of being seen by others as inadequate. These personality traits make them even more vulnerable to underlying fears.
Thus, it is easy to see that, when fear is intense and the person is sensitive, something gives somewhere. That happens to be the involuntary action of the muscles around the bladder to withhold the urine as a response to a perceived threat. Indeed, the subconscious mind is a repository of hidden processes that either help or prevent a person from doing normal things.
Secondary fears are derived from primary paruresis. These are fears that arise from one’s thoughts about his or her shy bladder. It is important to underline the fact that primary paruresis itself does not generate secondary fears. It is what someone interprets about the situation that generates those secondary fears. These fears are significant and must be studied because they contribute to the anxiety and to the disorder:
Fear of Powerlessness. The inability to consciously control urination leaves sufferers of shy bladder with the feeling of powerlessness. Moreover, the presence of others that trigger an inability to urinate gives a feeling that someone or something else is in power. This feeling of powerlessness adds up to the anxiety.
Fear of Appearing Stupid. When a fear is irrational, one gets the feeling of being stupid. It’s like insisting that the apple is green when everyone else sees a red apple on the table. So the tendency is to fake it. The person hides his or her true responses. He or she may even avoid certain situations altogether. The person will also craft canned excuses in case someone suspects something.
Fear of Being Abnormal. Many of those who have paruresis do not know that the disorder has a name. They do not realize that there are others suffering from the same disorder. They don’t see that help is readily available. When they see that others are urinating normally, the feeling of being abnormal wells up and adds up to the pain.
Fear of Being Judged. Many sufferers of shy bladder feel judged negatively by others when they behave differently. Indeed, this can happen when the group gets annoyed by the amount of time one spends in the restroom. This also happens when the car loaded with family or friends has to stop in the middle of the highway to wait on someone who wants to urinate and yet is unable to. This compounds the anxiety when others do not understand what’s going on.
Fear of Being Misjudged. There are heterosexual people who feel misjudged to be homosexual. Sufferers think, most probably due to teasing, that their inability to urinate is a homosexual manifestation. The additional anxiety that this causes can be immeasurable.
Fear of Being an Outcast. Some of those who realize that their shy bladder is a result of social anxiety get empowered by knowledge. But there are a few who go the opposite way. They think they are a mental case. They think they deserve to be at the mental hospital or some psychiatric ward. That adds up to their anxiety.
Fear of Vulnerability. Sadly, many school and law enforcement authorities do not know about paruresis. That makes sufferers of shy bladder vulnerable to harsh judgements in job placements and courts. The additional anxiety this causes is immeasurable among sufferers who are suspected of taking drugs. The fear increases when one is not assertive enough to seek proper legal assistance or to seek support from other people.
Left unattended, paruresis appears to progress in time. Left on their own devices, some shy bladder sufferers force themselves to face the fear, only to find that their anxiety increases in the process. A few have resorted to avoidance of public places or stay home most of the time. That greatly limits their ability to live normally and pursue their dreams in life.
Social anxiety is a serious matter to shy bladder sufferers. Their fears manifest in their inability to do what most people take for granted as something they can do with their eyes closed. The better attitude of the rest is to encourage and support the sufferers.
If you or someone you love is struggling with paruresis or a shy bladder click below to read about what you can to help!