For men and boys who just need to pee, you may pee at the urinal that is farthest from the door or at a urinal where there is no one on either side of you. This small sense of privacy could do a lot to steady your nerves and get you to feel more calm.
You may also try belly breathing, where you inhale through your nose and fill your belly with breathe. You can then hold for three counts at the top of your inhale and then exhale through your nose again, letting your belly pull into your spine. This will allow you to experience deeper breathing and feel more relaxed.
As you tighten your pelvic muscles, you may experience a sensation similar to holding your urine when you have to go to the bathroom very badly. As you release your pelvic muscles, you may experience a sensation similar to releasing your urine, such as when you go to the bathroom.
You can choose fairly simple math calculations, such as the times table, starting from 1x1 = 1, 1x2 = 2, or the additions table, starting from 2+2 = 4, 2+3 = 5. You can also try more complex math problems, such as long division math problems or trying to solve complex mathematical equations, if you know any of them by heart. You can also look up equations on your smartphone if you are sitting down in the washroom stall.
Keep in mind your phone will likely pick up germs if you take it out and touch it in the bathroom stall. So, always clean your phone after you have used it inside a stall. Please be aware of any school or workplace policies that may only allow for the use of phones during hours such as lunchtime or may prohibit phones in the restrooms altogether.
You may also want to bring in other hygiene products like hand sanitizer to make you feel as though you are not picking up any germs while you are using the washroom or antibacterial wipes in case there are no toilet seat covers. There are currently products on the market that can be sprayed in the toilet after you use the washroom to mask the smell. Carry a small bottle of this product in your bag so you can feel less anxious about any bad smells when you are in the washroom.
Your family doctor may be able to give your a recommendation for a therapist who treats individuals with paruresis. You will likely have to attend weekly one on one therapy sessions or group therapy sessions, where you may talk about your anxiety and fears associated with using public washrooms. You may also learn techniques to cope with your disorder. Remember that holding in your urine for too long can cause medical problems like urinary tract infections. It is a good idea to get help before serious problems arise.
To do graduated exposure therapy, you will make a list ranking peeing locations that are the easiest for you to use to the most difficult for you to use. For example, your bathroom at home may be easiest and a public washroom at work may be more difficult. You will then start by trying to use the washroom in the easiest locations and work your way to the more difficult locations. You should do graduated exposure therapy three to four times a week for the best results and drink lots of fluids before each session. Participants usually notice results after 12 weeks.
You may then gradually start to make noise while peeing to try to get more comfortable using the bathroom, such as splashes. Once you are fine peeing at home, you and your pee partner may move to a quiet public restroom. Your “pee partner” may stand outside the toilet door or behind you at the urinal while you pee. You will work with your “pee partner” to go down your list of locations until you can successfully go to the bathroom in a loud and crowded washroom.
The IPA holds weekend workshops for individuals struggling with paruresis. You can also get a referral to a cognitive-behavioral therapist who can assist you with treating your paruresis. You can access the sign up form for IPA on their website.
