Very little research done into therapy for Shy bladder syndrome. However, a study of 101 people with shy bladder who underwent a weekend course of exposure therapy. These people were found to have significant benefits when followed up a year later (Soifer, Himle & Walsh, 2010).Personally I’ve found that most patients respond well to therapy. So what might I do to help?

Therapy approaches for pee shy / Shy bladder syndrome?

There are a few technique which I’d consider for Shy bladder syndrome. I would  take a case history from the patient and based upon this make some decisions as to what techniques to use. Sometimes a patient identifies a starting point to the problem or identifies that their internal voice is pressuring them. In these cases I consider what are called psychodynamic approaches.

Psychodynamic approaches in hypnotherapy for shy bladder syndrome

These are approach to resolve an internal conflict or address an unhelpful early life learning. This type of work could include such techniques as:

• Inner child work.
• Parts therapy.
• Regression to childhood.
• Eye movement desensitisation and reprocessing (EMDR).

Sometimes the original cause of the problem is no longer relevant, but the behaviour has become habit. When this is the case, a therapist can move to techniques which help to retrain the mind and body.

Therapy for direct change to habitual behaviours for pee shy patients

Such techniques may include:

• Systematic desensitisation – this is an approach in which the patient is mentally walked through going to pee in a public place whilst the therapist induces deep physical relaxation. In effect this retrains the body to be relaxed in a previously tense situation. This is similar to the graduated exposure therapy used by Soifer, Himle & Walsh, 2010 in their research, but many consider systematic desensitisation superior as it actively looks to retrain the body to be relaxed.
• Relaxation cues – A hypnotherapist may give suggestions to be relaxed as soon as you get in to position to wee.
• Flow visualisations – there are various visualisations which a hypnotherapist may use or teach. Typical examples may include such things as mentally seeing the urine flowing comfortably. A visualisation may be more abstract such as picturing the flow of a gentle mountain waterfall as its flows downhill.
• Amnesia suggestions – Light amnesia may be given for peeing so that you forget that you are in public or that there are people around you. These will be carefully crafted to fit the specific circumstances which affect you.
• Privacy visualisations – The therapist will come up with imagery specific to you which will allow you to feel more private when in public toilets.

Homework for Pee shy clients

Homework is likely to be a large part of therapy. Typically, homework would be negotiated with the patient. Mostly homework would involve:

• Practicing relaxation and self-hypnosis techniques.
• Using public toilets.

I hope this guide has helped you to understand what sort of things you may encounter if you presented to a therapist for hypnotherapy for shy bladder syndrome. To find out more or book in a free consultation please contact Dr Matt.

The author

Dr Matt is a hypnotherapist based in Birmingham (UK) with a specialism in functional disorders. He is a member of both the NCH and BSCH.

References

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.

The post Hypnotherapy for shy bladder syndrome (paruresis or pee shy)? appeared first on Matthew Krouwel Hypnotherapist.

• 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.

The post Shy bladder syndrome (pee shy or paruresis), what is it? appeared first on Matthew Krouwel Hypnotherapist.