The term ‘pee shy’ or having a ‘shy bladder’ means a person who finds it difficult or to urinate when another person is around. Shy bladder syndrome is:
- A specific form of public toilet anxiety.
- More common in men than women.
- Frequently accompanied by another anxiety issue.
How many people have shy bladder syndrome remains unclear. However, some studies have found that severe pee shy effected as many as one-in-seven of the people they asked. What is known is that it can impact people’s quality of life and even their physical health.
Negative effects of pee shy / Shy bladder syndrome
There are many ways in which people’s lives are affected by living with pee shy / Shy bladder syndrome.
Adopting coping strategies
The most common coping strategies include:
- Finding quiet or secluded toilets where the chances of being alone are higher.
- Using public toilets at quiet times.
- Men will often avoid urinals and use cubicles to gain a sense of privacy.
- Reducing intake of liquids so that don’t need to go so frequently.
- Avoiding unfamiliar environments where other coping strategies may not work due to lack of familiarity of the expectation to drink (pubs and cafes).
- Holding off on urination until they are very full to minimise the number of toilet visits and have the benefit of biological pressure to overcome shyness.
The major drawback for most people living with pee shy / Shy bladder syndrome is that they find themselves thinking about it all the time. This prevents them from relaxing into situations and enjoying themselves. Many people will experience emotional consequences, such as:
- Shame / embarrassment.
- anxiety / panic.
Further, Pee shy / Shy bladder may limit access to social situations due to concerns about being unable to use toilets facilities in unfamiliar locations. This can lead to a reduction in:
- Socializing and dating.
- Work opportunities.
Leading to social isolation, which can cause or worsen issues with anxiety and depression. Although relatively uncommon, over the long-term biological consequences can occur, such as:
- Urinary tract infections (UTI) – These can result from urine sitting for too long in the bladder thus allowing bacteria to grow, or persisitent dehydration due to drinking too little.
- Bladder damage – This can result from excessive holding of urine in the bladder over a prolonger period.
- Kidney problems – Resulting from prolonged dehydration.
What can be done about it?
Pee shy / Shy bladder syndrome are under researched areas of therapy. However, early research is with CBT by Soifer Himle and Walsh looks positive, and my own experience as a therapist has been very positive.
For more on this topic see hypnotherapy and pee shy / shy bladder syndrome.
The author
Dr Matt Krouwel PhD is a hypnotherapist from Birmingham (UK) who specialises in functional and anxiety disorders. he is a member of both the BSCH and the NCH.
Key sources
Hutchings, H. A., & Kehinde, A. (2024). Exploring paruresis (‘shy bladder syndrome’) and factors that may contribute to it: a cross-sectional UK survey study. BMJ open, 14(11), e086097.
Soifer, S., Himle, J., & Walsh, K. (2010). Paruresis (shy bladder syndrome): a cognitive-behavioral treatment approach. Social Work in Health Care, 49(5), 494-507.