Public toilet anxiety is a common experience in which people feel uncomfortable about using public toilets. One study of university students (Knowles 2023) found some interesting facts about public toilet anxiety:
- 14% of participants showed public toilets avoiding behaviours.
- Toilet avoidance was more common amongst women than men.
People who experience public toilet anxiety tend to avoid using public lavatories where possible. They may also adopt specific coping behaviours such as:
- Picking times to visit the toilet to avoid busy periods.
- Holding off bladder or bowel movements to an uncomfortable level.
- Cleaning public toilets with antibacterial wipes.
- Avoiding going to social events or being in public.
- Not travelling.
So why do people develop this phobia?
What causes public toilet phobia?
There are several potential causes and reasons why someone would develop a public toilet anxiety. These include:
- Lack of perceived privacy – Going to the toilet is an instinctually private activity for most people. There’s a reason we call it the privy and sometimes use disguising terms for it like ‘the smallest room’. As we appear to be naturally embarrassed by these intimate bodily functions it is no surprise that sometimes doing them in shared environments become an anxiety problem.
- Abuse experience – A lot of bad things happen to people in public toilets. School toilets are often a place where bullying and other abuse is carried out because there is no adult oversite. This is less common in adulthood and yet people still do have bad experiences in public toilets.
- Traumatic experiences – Loss of bowel, bladder control, excessively pungent movements or any number of upsets which may draw unwanted attention can be traumatising when in a public toilet.
- Contamination phobia – Many people are sensitive to potentially dirty environments and the contaminants and germs they may contain. Few environments are as wildly unpredictable in their cleanliness as public toilets, and sometimes they can be traumatically bad. As a result of this many people with only a mild tendency towards contamination phobia find they develop a toilet phobia. Knowles ( 2023) study found that 21% of avoidance was explained by contamination issues.
- Claustrophobia – public toilets are often poorly lit, poorly ventilated tight little spaces. This can trigger anxiety in people who are prone to claustrophobia and ultimately a wider fear of these spaces.
Can it be treated?
Very little research has been done into treating this condition. However, my experience as a therapist is that generally people who suffer from it make substantial improvements. For more on this topic read my blog – hypnotherapy for public toilet anxiety
The author
Dr Matt Krouwel PhD is a hypnotherapist based in Birmingham (UK) who specialises in treating anxiety and functional disorders. He is a member of both the NCH and BSCH.
r 
References
Knowles, S. R. (2023). Socio-cognitive processes are associated with parcopresis symptoms and public toilet avoidance in university students. Current Psychology, 42(3), 1762-1772.