The Weekend Pee Workshop: Overcoming Paruresis
Editor's note: though this is not about poop, I found it fascinating nonetheless.
A little while ago I wrote in to Dave about paruresis, or shy bladder syndrome -- a form of social phobia marked by the physical symptom of being unable to urinate in the presence of other people. According to the Wikipedia entry, one of the best known methods of therapy is called "graduated exposure", which can be achieved by sufferers working together at organized events known as workshops. As a paruresis sufferer, the idea of a workshop intrigued me. So, figuring I had nothing to lose, I went ahead and signed up for one. The following is a report, for all who are curious, on what one of these workshops is like.
The first meeting of the workshop was scheduled for Friday evening in a hotel conference room. We were advised not to drink a large amount of fluid since we would not be practicing on Friday -- the first session was to be informational only. I must admit I was a little bit nervous, but knowing we wouldn't be practicing that night took a lot of the edge off. When I arrived there was a room full of about twenty men, and they were each taking turns telling their stories. I realized by sharing my own story and listening to others' that my case is not all that bad -- in fact, it could have been far worse. A person's social life can literally be brought to a screeching halt by this disorder. It can dictate what job a person takes, which restaurants they eat at, where they go to college, and, in the most severe cases, even keep a person confined to their own home.
After we had gotten through our stories, the two leaders of the conference gave us some information and explained some of the causes of shy bladder syndrome. They gave a physical explanation for why the bladder "freezes up" during times of stress. As it turns out, there are not one but two sphincters that have to be open in order to urinate. One of them is voluntary and the other involuntary. (Poonurse goes into more detail on this in her article, "Why do we pee when pooping?") If the limbic system of the body senses fear, then the internal urethral sphincter, which is involuntary, can close shut, making it physically impossible to urinate.
This explains why, for a person with paruresis, it is possible to have a bladder so full it feels like it is about to burst and yet, when you try to pee, nothing comes out, no matter how hard you push. Even drinking a ridiculous amount of water in hopes of forcing yourself to pee doesn't necessarily work -- and can land you in the hospital.
(I also found out that there actually is such a thing as Shy Bowel Syndrome, or parcopresis, as well. Though I don't have a shy bowel myself, it makes sense to me that such a thing could exist, since defecating also requires an involuntary sphincter to be open before you can poop.)
The meeting closed with one of the co-leaders, Carl Robbins, explaining that paruresis is not the fear of urinating -- but rather the fear of not urinating. It took a moment to get what he was saying; but when I understood it, it made a lot of sense. If I were able to pee in a public restroom, I would have absolutely no problem with peeing. Nothing about peeing scares me. On the other hand, the thought of standing there struggling to pee with nothing coming out and my hands shaking and my face turning bright red and people noticing that I'm obviously not peeing and me wondering if they're thinking I must be some kind of abnormal freak for standing there five minutes and not peeing -- that is what scares me to death!
Saturday morning was when it got really interesting: it was time to put our money where our mouth is and actually practice! When I arrived at the conference room, there was a table full of every kind of drink you could imagine -- what looked like hundreds of bottles of water, Gatorade, fruit juice, and so on, plus a plentiful supply of soda and coffee. Our first practice session was scheduled for one hour later, and we were all encouraged to drink up.
They then divided us into groups based on our estimation of our ability level, and off we went to the bathroom. It was quite a sight to see -- a group of men all going into the restroom together, just like women do. When we got there, some of the guys took the urinals and others took the stalls. I didn't expect I'd be able to pee at a urinal, so I went to a stall and sat down, since normally I can almost always pee in a stall so long as there isn't someone in the stall right next to me.
But this time was different. They all knew exactly why I was in that stall! I couldn't pretend like I was taking a crap. Worse yet, I felt like they were all counting on me to go. I knew they would understand if I couldn't -- they have paruresis too, after all! If anyone would understand, it would be them. But the thought of them all standing there waiting for me, knowing I was in there trying to pee, was just too much for me. Try as I might, I just couldn't pee. I actually managed to take a crap without peeing one single drop, which has never happened before.
As we were leaving to go back to reconvene, the guy two stalls down from me (I believe Mark was his name) asked, "Nate, is that you in there?" to which I replied that it was. Then Mark said, "Do you want to go practice in a hotel room next session?"
I told him that that would be a good idea. I sat through our next meeting and didn't drink any more fluid since I really, really had to go, and all I could think about was, "Come on, let's hurry up and get to the next practice session!" Had I not had paruresis, I think I probably would have wet myself. I was beginning to get afraid I might never pee.
I got to Mark's room and immediately I said, "I'm going first!" I told Mark to walk all the way over to the end of the hall with the book he was reading while I commandeered the bathroom and locked myself in. Nobody was going to come between me and that toilet!
Oh, what a relief it was to finally piss! When I was about halfway done, I remembered, "Better save some for later!" so I stopped -- which was awfully hard to do, since I really wanted to be completely empty.
After that, practicing got a lot easier. I had some misfires (couldn't pee) and some fires (could pee), but it no longer mattered, since I knew if necessary I could always lock myself in the bathroom and be able to go.
We were instructed to all try to be completely empty for the next meeting. In that next round, we all watched while Carl showed us a different kind of practice. First, he walked right up to the hotel clerk and unashamedly said to her, "I have this problem where I can't pee around other people, and so I was wondering if you could tell me where I can find the most private, secluded bathroom you know of." He made no attempt to speak softly, and everyone within earshot could easily hear what he had said. We then followed him to a mall, where he told us he was going to go stand at the urinal, dick in hand, for fifteen full minutes -- with no intention of peeing.
Of course we didn't dare all go in there at once, since that would draw attention to ourselves; but we trickled in and out to make it look more normal. I went in and stood at the urinal two places over from Carl for about five minutes. Several times I heard Carl complain to everyone within earshot that he couldn't pee, and also say out loud that he could pee just fine at home, but he felt nervous in front of other people. All I could think was, "Wow, this guy has guts!"
This second kind of practice is hugely important, since most paruretics feel extremely embarrassed by their problem and do everything they can to hide it from other people. I know, because up until a couple months ago I hadn't dared tell anyone, including my best friend. For more than a decade I suffered with a holding a full bladder for several hours at a time, deliberately letting myself get dehydrated to try to avoid needing to pee, and going out of my way to find "safe" bathrooms rather than suffer the embarrassment of telling anyone I had this problem.
We finished up the conference with one last session on Sunday. We had been told on Saturday morning that if ever during a meeting before a practice session we really had to go bad, we should excuse ourselves to the bathroom and pee a little bit (but not completely), so that our level of urgency was about a 7 or 8 on a scale of 1-to-10. This was referred to as "topping off." I never felt comfortable doing this on Saturday, since I had always been the good little student who never excused myself from class, and I felt like it would be rude to get up and leave in the middle of a meeting; but lots of the other attendees were doing it frequently during the meeting, so I decided "F*** it! If I gotta go, I'm gonna go!"
Sunday for me was truly amazing. I was walking up to urinals with other people there and actually peeing -- which I have literally not been able to do in years! It did happen a few times that I was unable to pee, and perhaps some other people noticed -- but I no longer cared. Practicing no longer felt awkward or weird for me, but instead rather routine, and even boring. I even took a crap a couple of times and made sure to let everyone know about it. It sure feels great to have just emptied your colon, doesn't it?
This was truly a weekend I will never forget!