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Other Phobias

Paruresis – Fear of Toilets

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Flushing the Fear of Toilets

The fear of going to the bathroom in public spaces due to the risk of germs and infections is something everyone experiences at some point. But have you ever experienced extreme panic at the thought of using a toilet in a public space? What about experiencing a shy bladder that makes it impossible for you to use a public restroom?

If you nodded in agreement to the questions above, you may be dealing with paruresis, or the fear of using the toilet in a public space.

This discomfort or disdain at the thought of using a public restroom can seem like a normal reaction. However, when you go beyond a healthy fear of germs to feeling anxiety and panic about having to use public restrooms, it turns into a phobia.

But don’t worry; you’re not alone in dealing with this fear. In fact, paruresis, commonly known as shy bladder, is so common that it impacts around 20 million people in the United States alone.

So, to help you along your journey to overcome this fear, let’s explore more about paruresis including its causes, symptoms, and the various paruresis treatment options available.

 

What Is Paruresis All About?

Being cautious of dirty public toilets that can spread germs and disease is a good thing. But paruresis goes beyond this rational concern. If you’ve experienced a shy bladder or extreme anxiety where you find it impossible to use a public restroom, you may have wondered what your fear is all about.

Paruresis is a type of social anxiety disorder. It is characterized by the inability to use the bathroom when other people are nearby or go to a public restroom. As a result, people with paruresis find it nearly impossible to use restrooms in public places and may experience intense anxiety at the mere thought of it.

Is Paruresis a Phobia of Fear or Disgust?

Depending on the severity of the phobia, it can severely affect an individual’s overall lifestyle and well-being. Those with a fear of using a public restroom may avoid social situations, have difficulty working in an office, and may also struggle with travel.

Paruresis can make it difficult for individuals to urinate on demand for a random drug test. It may also damage the bladder’s muscles leading to urinary incontinence or cause a urinary tract infection (UTI). In extreme cases, the bladder can also burst if one does not urinate for long periods at a stretch.

Other names for paruresis include:

  • Urophobia
  • Psychogenic urinary retention
  • Pee phobia
  • Bashful bladder syndrome (BBS)
  • Bashful kidneys
  • Avoidant paruresis

 

Paruresis Causes

While there is no specific cause for paruresis, like many different kinds of phobias, there are often various contributing factors that result in this phobia.

Paruresis can develop as a result of post-traumatic stress disorder (PTSD), especially relating to an uncomfortable or traumatic experience involving a public restroom. This can be due to a sexual assault in a public restroom, physical violence, or even teasing or bullying experienced in a school washroom.

Individuals with general anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, or a history of mental illness may also be more prone to developing paruresis.

 

What Are the Symptoms of Paruresis?

Paruresis manifests in different ways in different people. Depending on the severity of the paruresis, you may experience various psychological or physical symptoms.

Psychological Symptoms

  • Severe discomfort or anxiety at the thought of using a public restroom
  • Needing running water or turning the faucet on to start urinating
  • Avoiding drinking fluids just before leaving the house or while outside
  • Reducing travel or avoiding social events
  • Developing agoraphobia in extreme cases
  • Panicking when it is necessary to use a public restroom

Physical Symptoms

  • Cold sweats
  • Hot flashes
  • Dizziness
  • Dry mouth
  • Shivering or trembling
  • Palpitations or a racing pulse
  • Holding pee in for long hours
  • Difficulty breathing or hyperventilating
  • Inability to actually urinate even while on the toilet

 

Self-Help for Coping with Paruresis

Like a lot of anxiety-related phobias, the fear, disdain, or discomfort surrounding public washrooms that accompanies paruresis can be addressed with various self-help techniques.

Meditation and breathing exercises can significantly help to control anxiety and relax the urinary tract enough to facilitate urination even in public washrooms.

If your paruresis stems from trauma, you can try practicing self-affirmations to remind yourself that you are safe in a public washroom and that nobody will bother you.

If it is germs and infections that you are worried about, carrying sanitizer and toilet wipes is also an effective option.

Generally, self-help for paruresis involves doing things that make you feel more in control of the situation and allow you to be more comfortable with public restrooms.

 

Professional Help for Paruresis

Self-help is great for helping with anxiety, but it can only go so far. So, if your paruresis is so severe that it is debilitating and you’re wondering how to get over your fear of toilets, you may want to seek professional help from a doctor or licensed therapist.

Counseling or talk therapy can go a long way in helping address paruresis. Some other therapies that can help include:

  • Cognitive behavioral therapy (CBT) helps change your thought patterns surrounding public toilets and challenges your negative perception of them.
  • Acceptance and commitment therapy (ACT), which includes mindfulness, behavioral strategies, and acceptance, allows you to overcome negative feelings and anxieties associated with public toilets.
  • Exposure therapy gradually increases the intensity and duration of your exposure to public toilets, so you can eventually become comfortable with the situation.

 

How to Avoid Paruresis Altogether?

Dealing with paruresis can get frustrating and exhausting. There is no one way to overcome the phobia, but you can avoid certain triggers.

Here are a few steps you can take:

  • Make yourself familiar with the restroom in a public space, such as your workplace or your favorite restaurant or cafe.
  • Have a particular stall that you always use to increase a sense of safety and familiarity, and make it feel like it’s “yours” so when you do have to use the restroom, it’s less anxiety-inducing.
  • Carry sanitizer wipes in a small pouch that you can take to the restroom whenever you need to go.
  • Ask a trusted friend or co-worker to accompany you on your toilet breaks if required.

 

Conclusion

Being hesitant to use an unfamiliar washroom is completely understandable, but in a severe case where it goes into paruresis territory, it may impact your everyday life. If you find yourself canceling or skipping plans because you don’t want to risk using a public restroom, it may affect your overall quality of life.

However, it doesn’t have to be that way. By understanding your problem, making accommodations for the same, and working to address it, you can overcome it successfully!

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Your Fear Goes Up and Down

Are you someone who would rather climb the stairs than take the elevator? You call it squeezing in a workout after being sedentary the whole morning. Or perhaps you claim it's a faster route. These are both typical, normal, and acceptable reasons. But what if you need to be in the conference room on the eleventh floor in five minutes, and you're wearing your business suit and wingtips? Would you still prefer to take the stairs? If your answer is yes, then maybe it's time to take a closer look at your reasons for avoiding elevators. Elevators stir all sorts of emotions in passengers. From the discomfort of closeness to strangers to the sensations in our gut, elevators can be a source of the heebie-jeebies for many, but for some, they can also be a source of terror. Let's dig a little deeper into the latter, and see what this terror is all about and what can be done to manage it. To begin with, does being inside an elevator give you chills or the sweats? Or does it trigger an unpleasant memory? Perhaps you remember movies you've watched where something terrible happens inside an elevator. From Silence of the Lambs, The Shining, Final Destination 2, or the king of all elevator horror films, 2010’s Devil, the elevator becomes witness to something sinister and horrible. And you want nothing to do with any of it. You know that you're not claustrophobic. You can deal with heights just fine, too. And you know that you're not going to be trapped inside. All of these contribute to a fear of elevators—but they don't apply to you. Yet being inside one does something to you. It's hard to explain.

What is the Fear of Elevators Called?

What you have is a fear of elevators, which is called elevatophobia. It is most commonly triggered by an experience of getting stuck inside either due to a power outage or technical maintenance. Hearing about other people's experiences or watching a movie about similar circumstances can prompt a fear of elevators getting stuck with you inside. Usually, claustrophobics and agoraphobics may also develop elevatophobia because the triggers and objects of these fears are related. Claustrophobia is the fear of closed and cramped spaces, while agoraphobia is the fear of being trapped without any means of escape. Put the two together, and the elevator becomes the perfect combination of both phobias. The space is limited and closed, with only one means of entry and exit. You can add another point of access if you consider climbing the cables like they do in the movies, but that certainly isn't ideal.

Symptoms of Elevatophobia

If for some reason an elevator stops due to an outage or some technical difficulty, passengers with elevatophobia may go into full panic mode. Even if the maintenance team advises that it will just be a matter of minutes, by then, the person's mind has become irrational with the fear of the elevator falling, being stuck for hours, or other unpleasant thoughts. You would expect a person to exhibit the following physical symptoms: Additionally, you would be filled with that overwhelming anxiety where you feel that you have zero control over the situation. You start fearing the unknown and are filled with negative thoughts about death and imminent doom. You become irrational and unresponsive.

Possible Complications of Elevatophobia

When the panic sets in, the possibility of emergencies related to pre-existing conditions may make themselves known. This might include serious health crises like heart attacks or asthma attacks. When this happens, fear becomes a medical emergency. Elevator rides do not last long; it's just a matter of minutes or even less. But the fact that a person can escalate from panic to a near fatal medical situation classifies the fear of elevators as a 'hard phobia.'

Trying Some Self-Help Methods

Your fear of elevators can likely interfere with your social and work life and relationships. Not everyone understands that elevatophobia, like most phobias, can be crippling. But don't be disheartened. Depending on the level of your fear and level of control, you can gradually face and manage your phobia. Here are some recommendations you can try:
  1. Make a List of Everything that Entails Riding in an Elevator This is a systematic approach to getting over your anxiety. By following a step-by-step process, you can identify where the fear kicks in at its strongest. You can write a list of steps like pressing the topmost button and waiting to arrive on that floor, watching as the door closes and opens, being alone inside the elevator, or having delays with the doors opening. Now try doing the opposite. For example, face away from the door or occupy yourself with your phone so that you are distracted.
  2. Create Your Fear Ladder Although the name says fear of elevators, it is not the whole process that scares you. There are just phases and parts of the elevator riding experience that cause you to panic. So go back to the list you initially created and label the fear level you feel. You can do it numerically, too, like ten being 'really scary,' six, 'manageable scary,' and one, 'not scary at all.' You can put the corresponding fear levels so you can focus more time and effort into activities that are more scary to you.
  3. Face Your Fear By now, you have identified what scares you the most. You can try repetitive action to minimize your fear and increase your sense of ‘normalcy’. Remember that the longer you expose yourself to your fear, the better you get at handling your emotions. If you are feeling overwhelmed, stop. Pushing yourself too fast and too soon can backfire. Modify your pace and go slower instead.
  4. Talk About Your Fear People by nature, unfortunately, are not quick to offer understanding and support. You need to tell them what's wrong before they can empathize. Talk to someone who you trust and ask for their support, especially in the initial phase of overcoming your fear. If you are too afraid to ride the elevator alone, you can ask them to go with you, and before you realize it, you are on your floor, and there was no indication of panic.
  5. Learn To Be Patient Be patient with yourself and your predicament. This is, after all, your fight against fear. It might take hundreds of elevator ride practices before the fear gets under control. Even then, there might be some hesitations and episodes of nervousness. These are acceptable and expected, so cut yourself some slack and congratulate yourself for every progress.

Seeking Professional Help

Along with self-help, you can always enlist a medical professional's aid to support you with your elevatophobia. Talking to someone who has experience with similar cases can be comforting, because you know that you are not alone, and this situation can get better. Talk to your doctor about the severity of your fears and the symptoms that you experience. Explain how you deal with it in an attempt to control it. An exam and a health history are made to ensure that there are no unrelated or underlying problems that your symptoms might mask. Usually, phobias like this are approached with a combination of psychotherapy and medication. Your doctor will talk about these options with you, and it's entirely up to you, with your doctor's recommendation, what you want to pursue. For psychotherapy, the most common type is cognitive behavioral therapy (CBT), which aims to help you find different ways of behaving, thinking, and reacting when about to step inside an elevator or when already inside it. With medications, there are beta blockers and benzodiazepines, but note that these can have side effects. Whatever these side effects are, you should promptly share it with your doctor.

Simple Tips to Overcome Elevatophobia

Elevators are not perfect, but their likelihood to malfunction, fall, or get stuck is very low. If you are not fully confident with this information, you can help overcome your elevatophobia by learning common elevator safety tips and basic elevator operations. These should help curb your mild fear until you become more self-assured. In addition to that, here are some of the things that you can do to gradually overcome your fear of elevators—both in getting on and riding one.

Conclusion

Yes, elevatophobia can be a challenge in today's world, but don't allow the elevator to win. Don't let it stop you from taking a job on the top floor or attending a social gathering on the rooftop. Sure, you can take the stairs if you insist and arrive winded and sweaty, with the party about to wrap up. But is this the quality of life you seek? Elevators are designed to make life easier. There are guaranteed ways to help you overcome elevatophobia. Take the first step and seek help. Soon, you’ll see yourself breezing through the floors with those arduous stair climbs little more than a memory.
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