Treating Your Paruresis: Psychologist or Psychiatrist – What’s the Difference?

People who have never suffered from paruresis don’t understand what a serious impact it can have on a person’s life, and may not believe that the condition is as socially and emotionally debilitating as it is.  However, those that do suffer know precisely how damaging “shy bladder syndrome” can be to one’s social life and employment.

Understanding that the problem exists and seeking treatment are the first steps down the road to recovery, but some confusion exists for many people about what kind of treatment they should seek, and from whom. Whether to seek treatment from a psychologist or a psychiatrist depends largely on your goals, as we’ll examine below.

Psychology vs. Psychiatry: Understanding the Differences

The names are similar, the length of university education is similar, the research underscoring each profession is similar, and members of either profession may practice psychotherapy on patients with a wide range of mental health complaints.  Beneath the similarities, however, psychology and psychiatry are quite different.

At the most basic level, the difference between the two is simple – psychiatrists are medical doctors with a specialty in mental health, whereas psychologists are scientists who focus on the workings of the mind.  We can see the difference in the names: the suffix “-logy” means “theory” or “science,” whereas “-iatry” refers to medical treatment.

A would-be psychiatrist must first complete medical school, followed by a four-year hospital residency program; this mental health training is provided by the psychiatric department, and may include subspecialties like geriatric psychiatry (mental health issues specific to the elderly).  The doctor can then apply for a license to practice psychiatry once the residency has been successfully completed.

By contrast, a would-be psychologist must complete between five and seven years of graduate education, emerging with either a PhD or a PsyD.  Students pursuing the latter typically go on to pursue clinical treatment of patients, while those pursuing a PhD may focus primarily on research.  Once the program has been completed, the graduate takes an internship and may apply for a license to practice psychology once the state’s internship requirements have been met.

This covers the essential differences between the two professions, but what about the differences in their treatment of paruresis?  Below we’ll examine how each profession treats patients suffering from a bashful bladder.

The Psychological Approach to Treating Paruresis

Paruresis is a debilitating condition on par with agoraphobia and social anxiety disorder, and there are several types of psychotherapy which have been shown to help patients overcome the symptoms.

• Cognitive Behavioral Therapy (CBT):  This model of therapy, which includes several different therapeutic techniques, encourages patients to recognize that it is his or her own thoughts that cause emotional distress, rather than external forces.  It takes relatively little time compared with other forms of psychotherapy, but it may not be ideal for those who are averse to doing homework – some level of home study and practice are often required.
• Eye Movement Desensitization and Reprogramming (EMDR):  EMDR is a therapeutic process designed to reprogram the patient’s responses to emotional stimuli that cause distress, and has been shown to be effective in treating paruresis.  Though effective, the therapy itself can prove distressing to some people because it brings the root cause – traumatic memories – to the surface for thorough and repeated examination.
• Biofeedback: This treatment works by conditioning the patient to take control over seemingly involuntary responses. Measurements of the patient’s heart rate, muscle tension, and brainwave activity are used to determine the physiological response to a particular stressor.  The therapist gives patients psychological tools, such as visualization, to teach them how to take control over unwanted responses.

The Psychiatric Approach to Treating Paruresis

Psychiatrists are known to use the same psychotherapy methods as psychologists, but as medical doctors they also have the ability to prescribe medications (two states, Louisiana and New Mexico, allow psychologists to prescribe medications after consulting with a licensed psychiatrist).  Anxiety medications certainly can’t be considered a cure-all treatment for paruresis, but there are several prescription drugs that can help patients manage anxiety symptoms while undergoing further treatment, such as those listed above.

Which Road to Recovery Should You Choose?

The quality of care that you receive can be excellent either way, but one thing to consider when making the choice is whether your insurer will be footing the bill.  Psychotherapy tends to be more expensive through psychiatrists than psychologists, and many insurers encourage psychiatrists to prescribe drugs rather than engage in lengthy sessions that take money out of their pocket.  Unfortunately, the insurance companies’ bottom lines may have more influence on your treatment than you’d care to think.

The path that you take to recovery from paruresis depends largely upon your ultimate goals: whether you’re willing to take prescribed medication, whether your insurance will cover treatments, and how much you’re willing to pay for treatments if insurance won’t cover it.

There are also self-help routes to consider if for some reason professional treatment isn’t an option for you.  No matter which route you choose to take, know that there is help for bashful bladder syndrome, and that you’re far from alone.  Many people have successfully put paruresis behind them and gone on to lives unburdened by the question of who could be standing near the bathroom door.

Click below now to learn more about overcoming your paruresis or to get your free email seminar “The Shy Bladder Solution”: