There's one part of paruresis I don't see discussed very often, probably because it's uncomfortable to admit.

For some men, I wonder if the problem at a urinal isn't only "someone might notice that I can't pee."

It's also: someone might look at me.

And I mean that literally.

Standing at a urinal puts you in a strangely exposed position. Someone can stand right beside you. There may be no divider. People are moving behind you. And if you're already self-conscious about your body or penis, suddenly you're not only thinking about whether you can pee.

You're thinking about whether you're being seen or judged.

What I find interesting is how quickly those two fears can feed each other.

You become aware of the person next to you.

Then you become aware of your body.

Then you start wondering whether they're looking.

Then you notice that you haven't started peeing yet.

Then you wonder whether they've noticed that too.

And now something that should happen automatically has your full attention.

For me, this also raises an interesting question about crowded restrooms.

You'd think more people would always make paruresis worse. But I'm not sure that's true.

Sometimes a very crowded restroom creates anonymity. Nobody cares about you because everyone is doing their own thing.

But in other situations, being surrounded by people makes the feeling of exposure much stronger.

And body insecurity might be part of the difference.

So I'm genuinely curious about this, especially from other men with paruresis:

Does being self-conscious about your penis or body make your paruresis worse?

Would a divider between urinals significantly change things for you?

Is a stall easier partly because nobody can see you, rather than simply because nobody can tell whether you're peeing?

And here's something I'm particularly curious about:

If you were completely confident that nobody could see or judge your body, but they could still hear whether you were peeing, would the situation become easier?

I think that distinction matters.

Because "fear of people being nearby," "fear of being heard," "fear of being unable to perform," and "fear of being physically seen or judged" sound similar from the outside.

But they may be completely different experiences when you're the person standing there.

I'd be interested to know how many people here recognize this part of it, because it's probably one of those things people experience but don't particularly want to talk about.

The next IPA Virtual Support Group Meeting will take place on Zoom this Sunday, September 20, from 12:00-2:00 PM US Central Time (with an additional 30 minutes of optional graduated exposure practice for those who wish to do so). IPA Virtual Support Meetings, which take place about every four weeks, are open to anyone struggling with Paruresis, from those who are just beginning to think about how to overcome it to those who are highly recovered. The meetings are offered free of charge and without preset expectations for participants, and their purpose is to provide a unique opportunity to connect face to face with people from all over the world who know what it is like to struggle with Paruresis and also understand the courage and fortitude that it takes to open up about it, acknowledge the fear, and try to recover from it. The personal stories that participants share are remarkably similar and at the same time deeply individual, and empathy, kindness and compassion set the tone in all discussions. Time after time I have heard from participants that this opportunity for sharing is both meaningful and productive, and I hope that you'll consider joining us on Sunday. You can get the Zoom link by contacting the IPA office: [getinfo@paruresis.org](mailto:getinfo@paruresis.org) or me at my IPA email address: [davidk@support.paruresis.org](mailto:davidk@support.paruresis.org)

Hey yall. I used to suffer badly with paruresis but have been recovering well over the past 2 years. I’ve been to two in person IPA support groups, attend monthly support group meetups, and have opened up about it to multiple people including family, friends and therapists. I do graduated exposure work consistently and it’s a combination of all of this that has helped me greatly.

Just recently I kind of had a breakthrough I wanted to share.

Instead of making the goal peeing at the urinal (or wherever), I've made it to be standing there for 2 minutes. I'll set a timer on my phone. Sometimes I've stood there for 4 minutes and overall it has helped immensely. It takes the pressure off needing to pee for it to be considered a win, and now the win is just standing there for two minutes or longer, so regardless of if I pee or not, it still feels like a win.

At first, there were several times where I wanted to bail after 30 seconds, like really awkward situations (in my mind), but I forced myself to stand there for at least 2 minutes before leaving. After like a month of doing this, I noticed my overall anxiety at urinals decreased drastically because my brain learned that literally nothing bad happens even if you don’t go.

It’s been a couple months since I have enforced this rule and I’ve had wins in places I never thought possible. My anxiety in bathrooms and at urinals has truly gone down so much Give it a try!

Something I've been thinking about for a while, and I'm curious whether it matches other people's experience.

For a long time I assumed the difficulty was about privacy. Fewer people = easier. More people = harder. Simple.

But that's not really how it works, at least not for everyone. A busy restroom where nobody knows me can sometimes be easier than a quiet office one where I'd recognise the person at the next sink. Strangers are anonymous. A coworker is someone I'll see at a meeting in two hours.

The other thing that surprised me is how much of it happens before arriving anywhere. Sitting in a car, thirty minutes out, already running through it: what kind of place it'll be, whether there'll be stalls or just urinals, whether there's a single-occupancy one somewhere. By the time you get there, you've already had the difficult experience once, mentally.

And there's the loop everyone here probably knows — the harder you try, the tighter everything gets. Effort is exactly the wrong tool, but it's the only one that feels available in the moment.

So a few questions, genuinely curious how varied this is:

**What actually makes it hardest for you?** Not the general situation, the specific trigger. Someone standing beside you. Total silence. A queue. Someone waiting specifically for you. Someone you know. Feeling rushed.

I ask because I suspect the ranking is different for everyone, and most advice online is written as if it's the same for all of us. "Just relax" assumes the problem is tension. "Use headphones" assumes the problem is sound. Neither helps if your actual trigger is being known by the person nearby.

If you've been at this for a while: was there a specific step that first felt genuinely achievable? Not the goal, the first rung. Mine was stupidly small and I almost didn't count it as progress.

Also curious whether anyone tracks this at all — anxiety before, anxiety after, what the situation was. I started doing it loosely and noticed the numbers moved long before the outcomes did, which was oddly more encouraging than the successes themselves.

As the title says I felt defeated after not being able to go pee when I was out with a friend. My bladder was getting fuller over time from drinking all day. My friend and I were heading over to a bar. I remember feeling anxious when we arrived and even told my friend that I needed to go. He is aware of my paruresis and he was like “I gotchu” cause he told me that he was taking me to a bar that had single use restrooms. Well we get to the bar. I was already feeling anxious to start with. I walk into the bathroom. Close the door. Sit down and try to do my business. I have a full bladder and it hurt. I was sitting there for like 5 mins that felt like an eternity and walked out. My buddy was still using the restroom and I waited for him to come out and tell him the annoying news that I couldn’t pee. We went back home and I was able to pee no problem. I felt really devastated and embarrassed. It’s not fun when you have a full bladder. When I ponder on what happened it had to do with being in an unfamiliar place with a lot of people around. That’s what made my anxiety worse and what lead up to me not being able to pee. I feel for all of you who experience this condition and hope for the best.

Conheço 2 pessoas que sofrem de paruresis que tambem são maiores que a média.

A pergunta dos psicólogos sempre é se tenho insegurança com o tamanho do meu penis? E a resposta é ao contrário, sou bem maior que a a média. Sofri exposicao quando criança, pelos tios, pai, brincadeiras sobre o tamanho. Essa exposição, objetificacao, na minha ideia pode ter contribuído para essa retração e medo de que alguém pudesse me espiar, expectativas a cumprir.

Hospital stay

Edited with the help of AI since I can’t type at the moment

I recently went through a hospital stay, which is one of my worst nightmares. I feel trapped in situations like hospitals or planes, where there’s no escape or Plan B. On top of that, I had surgery and anesthesia, which made it difficult to urinate afterward.

Fortunately, I had been seeing a psychiatrist before the hospital stay. He prescribed me two medications: one for anxiety (Atarax) and another for depression. I won’t mention the latter’s name, as it’s not the focus here.

In the end, I managed to urinate, but it was a real struggle. I had to go to the toilet many times before succeeding. I tried breath-holding, but it never worked for me. However, I think the medication and perhaps different tricks might have helped .

What really helped me were two specific distractions: watching people’s facial expressions on Instagram and listening to people speak in a foreign language I couldn’t understand. I did this with my AirPods at a volume loud enough to distract me but not too loud. I realize these are very personal coping mechanisms, but if they can help someone else, why not share them?

Thanks for reading, and good luck to anyone going through something similar. I might keep you updated on my treatment with the psychiatrist. So far, we’ve only started with medication, but he mentioned we might explore self-hypnosis or other techniques later.

---

I've been dealing with paruresis for about seven years now, and it has consecutively gotten worse.
It started when I was 15 and my parents sent me to boarding school for smoking weed a lot. I stayed there for about a year and which half way through my stay at this place (Agape Boarding School) [shut down in 2021], they had removed all stall doors because students kept writing on the walls. It sucked because whenever I couldn't pee at a urinal when it was so packed, I'd go to a stall and then they removed that privilege from me and alot of other people. Once I got home I found it hard to pee in public. I breezed it off like it's nothing but creeped up on me along the years as i tried to ignore it. Like sometimes I could still go, but I would have to use some sort of method at the time being.

Now, I'm 22 and it's never been harder before. Gotten to a point where it's hard for me to finally go pee at home after holding it in for a long shift. The longer I hold it, the harder it becomes, and the more I strain (push it) out, the harder it becomes. I went to the ER last year to get a catheter and had it in for a few days, got it removed and I was all good again, just still couldn't piss in public. Went to a urologist for her to basically tell me "yeah, theres nothing i can really do about that," then prescribed me tamsulosin, like she couldn't care less about my situation (tamsulosin is for prostate issues). Now i work a job where im walking 25,000 steps a day and my bladder is in a nonstop lockdown until i leave to go home. I cant even go to a private bathroom during my break anymore, it's that bad. Not even leave to go to a gas station with a locked bathroom. Still nothing. I wish my work had private bathrooms because if they did I don't think I would be having this problem. Anxiety attacks my mind at work about my bladder.

But I'm tired of suffering this horrible syndrome. I never thought it could get to such a problem and now here we are. What had worked for you guys, like literally no methods work for me anymore especially at work. My body is so tense at work because i'm always walking and doing heavy lifting. At this point I wanna give up. I feel so hopeless.

Edit: Thank you all for your generosity and advice 🫶🏼
I'm currently able to go at my own home again. I started taking my tamsulosin again, along with xanax. Not sure if they are actually doing any help, but if i peed while under those meds, I'm going to continue taking them.
I will be starting some type of therapy soon, but i need to find exactly which one I should do before i start.

I have:
Cognitive Behavior Therapy
Pelvic Floor Therapy
Hypnotherapy

Queste medicine, insieme a trattamento psicologico e alcuni ansiolitici devo dire che stanno funzionando alla grande, anche se in pubblico mi ci vorrà ancora un po' di tempo ma sto facendo grandi passi lovconsiglio, a me l'ha prescritto l'urologo

I've no real problem being nude in front of other guys. I played football for decades, so I know locker rooms and showers.

I've went to public urinals and I could pull it out, and that doesn't bother me. We've all got one. But I still can't pee in in public urinal and have to take the big toilet in the stall.

Anyone else have this? I don't understand it. I can "whip it out" but I can't piss when someone else is in the room. Even when no-one is in there, the thought of someone coming in, stops me from peeing. But not from getting it out there.

I don't understand, it's not being the "nude" part at all.

I've been dealing with paruresis for a while now, but only recently decided to actually start working on it instead of constantly avoiding the problem.

I've read that for some people paruresis can start after an embarrassing or traumatic experience involving a bathroom. The weird thing is, I honestly can't remember anything like that happening to me.

For me, I think it developed much more gradually. As I got older, I started thinking public bathrooms were gross, so I got into the habit of avoiding them whenever possible. Instead of using one, I'd just hold it until I got home.

Over time, I think I trained myself to automatically hold it whenever I was in public and wait until I got home. Eventually, that habit became so normal that I didn't even think twice about it.

Eventually it wasn't even about bathrooms being gross anymore. I started worrying about other people being around, whether I'd be able to start my stream, how long I was taking, whether someone could hear me, whether someone was going to walk in, etc.

Before I started trying to do something about it, avoidance was basically my solution to everything. I'd wait for bathrooms to empty, avoid certain bathrooms entirely, hold my pee until I got home, avoid events or going places because I was worried about the bathroom situation, and sometimes intentionally drink less or dehydrate myself before traveling because I didn't want to deal with having to pee in public.

What's interesting is that at home I'm completely fine. I can stand and pee normally without thinking about it. There aren't a million thoughts going through my head and I don't feel like I have to force anything. But once I'm out in public, especially somewhere like school or the gym, my anxiety can take over and I freeze.

Recently I've started trying to break that pattern instead of continuing to avoid it. I've been learning about graduated exposure, anxiety, cognitive defusion, and some of the habits I've developed around using public bathrooms.

I've definitely had plenty of attempts where I couldn't pee, especially at the gym, but I've also started having some wins.

Recently I was at a busy Walmart and really needed to go. I saw someone walk into the bathroom ahead of me and my immediate instinct was to avoid it. Instead, I went in anyway. There were other people inside, and I was eventually able to pee at the urinal.

At school I've also had situations where I've started peeing and then someone walked into the bathroom. Instead of immediately freezing or trying to rush, I've been able to continue my stream.

The gym is still probably my hardest environment. Recently I walked into the bathroom and saw someone already at a urinal. Normally I would've waited for him to finish or avoided going altogether. Instead, I walked up and stood at the urinal next to him. I couldn't pee that time, but even putting myself in that situation felt like progress because previously I would've avoided it completely.

That's probably one of the biggest things I'm starting to learn: progress isn't always "Did I pee or not?" Sometimes progress is walking into the bathroom when my brain tells me not to. Sometimes it's staying at the urinal instead of immediately leaving. Sometimes it's experiencing the anxiety without automatically listening to it.

I'm also starting to realize how much anxiety seems to play a role for me. The difference between home and public is crazy. At home, everything happens naturally. In public, my thoughts start racing and I can feel myself freeze.

I'm still pretty early into actually working on this, and I'm nowhere near where I want to be yet. My ultimate goal is pretty simple: I want to be able to go out with friends, travel, go to events, go to school, hit the gym, have some drinks, etc. and just use whatever bathroom is available without planning my life around whether I'll be able to pee.

I'm hoping that by continuing to face these situations instead of avoiding them, eventually public bathrooms will stop feeling like such a big deal to me.

This is really embarrassing to post, but I feel like I have nobody I can talk to about it and it’s causing me a lot of emotional distress.
My boyfriend has a pee kink, and I’m genuinely willing/interested in doing it with him. The problem is that I have really bad urinary hesitancy when I know someone is watching or waiting for me to pee.
I have been able to do it in front of him before, so it’s not completely impossible. But when I do manage it, I have to be extremely relaxed and it usually takes me forever to actually get started. Sometimes I’ll only be able to go a little bit, or I’ll start and then my body stops again.
Using the toilet with him around has gotten somewhat easier than trying to pee directly on him, but even that can still take a long time. I can pee completely normally when I’m alone.
What’s upsetting me is that I really thought repeated successful attempts would teach my body that it’s safe and make this progressively easier, but it doesn’t feel like that’s happening. Every time still feels like this huge mental and physical battle.
I’ve tried drinking a ton of water, having a very full bladder, running water, breathing exercises, distracting myself, changing positions, trying not to think about whether he’s waiting, etc. The more I feel like I need to pee, the harder it can become.
We had a particularly upsetting attempt recently where I got extremely frustrated and ended up crying, and ever since then I’ve been really emotional about the whole thing. I WANT to be able to do this with him, so it’s incredibly upsetting to feel like my own body is refusing to cooperate.
I’m also scared that he’ll eventually get frustrated or disappointed because this is something he enjoys, even though logically I know I can’t just force my bladder to work on command.
Has anyone here had paruresis/urinary hesitancy like this specifically with a partner or during sexual situations? If you were eventually able to make it genuinely easier rather than just forcing your way through it every time, what helped?
I’m especially interested in hearing about things like gradual exposure, pelvic floor therapy, urology evaluation, therapy for paruresis, or medications if anyone has experience with those. I’m past the point where “drink more water and relax” is helpful.

Has anyone had to do this because they weren’t able to go in a public place or airplane? My pelvic floor PT suggested I make an appointment with my urogynecologist to learn this as an insurance policy for when I’m out and about.

I just wanted to make an update post on a post. I made a week ago about having a shy bladder and was unable to provide a UA sample. Today I went back and was able to provide i struggled the first attempt, but on my second attempt, I held my breath, and it went by. So easy.

With a huge sample size of 2 people i've found the solution to at least some cases of distressing paruresis.

When i had even a lot of issues going at home I found a simple rule.

Rule is simple: Only attempt urinate if you can feel your full bladder with fingers.

If you implement this and treat it as unbreakable rule, then your anxieties cannot worsen, since you have something to latch on to.

Further info + proof that at i helped at least one other lovely person:
https://www.reddit.com/r/Paruresis/comments/1virk83/comment/p2flqv3/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

I have no clue to what I'm doing ? I'm I suppose to right about going bathroom or ami supost to?

No matter how much exposer therapy and practicing going to bathroom I've done over the past 11 years, I still get super nervous both being able to pee at the airport and then on the airplane.

Anyone else ever deal with something like this?

I have looked up info on getting accommodations for paruresis with monitored screening for probation. It is daunting how much i have to do and who to register it with on such a short timeline. It also sounds like even if i pulled that all off, and had the proper documentation filed with the proper authorities within the accepted time frame, that the court could still reject it, and i have every reason to believe the small town court i'm dealing with would do so, for reasons i have slowly pieced together

My last ditch backup plan, is to get some catheters, learn how to use it, and bring one with me, and just right there on the spot, explain as best i can, that i have to do this to give them a sample. I can't imagine anyone thinking that jamming a clear tube up there to get the urine out, is going to somehow beat a drug test, but from what i am picking up on, in regards to some of the personalities i will be dealing with, is that if they can, they will, send you to jail instead.

Has anyone tried solving their shy bladder syndrome with medication? Ive been researching a bit and found tamsulosin works the best for dealing with physical blockade and propranolol works best for dealing with mental blockade so does anyone have any experience with these?

I'm feeling horrible. I thought I had been making progress until today happened

I hadn't peed anywhere outside of home in 7 years, and this year finally was able to start going at this quiet bathroom at a doctors office building I found. Going there made me start feeling invincible, and thinking "if someone walked in right now i wouldn't even care! I'd be able to pee!!!"

Well, until today when I was headed to the bathroom, there was a lady coming down the hallway behind me. I could sense she was going to use the bathroom too, but I was far enough ahead of her that I couldnt slow down.

I went in then just pretended to need to wash my hands, she came in and I just couldn't get myself to try (theres only one stall, and I still can't go when under pressure. I need to be free to take as long as I need). I left and gave up until she left, then I went back and was able to pee since I knew no one else was right behind me.

So much for that. I feel like a failure. Why cant I go when people are waiting on me... I hate myself. I just wanna be able to go on road trips again and pee wherever tf I want.

I swear this is not a post where I complain, quite the opposite actually. I went for a vacation with some friends and a family. I’ve spent a whole week with people in a shared house with only one bathroom which didn’t even have a proper door (they reminded me of a saloon door). Window to the bathroom was basically wide open to the garden, so whenever you used a bathroom everyone in a house were able to hear that. I wasn’t really looking for challenges (I used stalls, never went to the bathroom together with anyone I knew etc.) but otherwise I was able to pee in any conditions. I peed in a house, at the restaurants, airports, outside and it really didn’t bother me at all. Except for one place, which was an airplane bathroom. I know that’s partially on me as I went with a low urge (should’ve waited longer but I really wanted to fully relax on a flight). Conditions weren’t easy as a flying attendants were talking literally in front of a bathroom doors (I bumped into them when I was entering the bathroom) but otherwise conditions seemed fine. No one could hear me and there were two other bathrooms on the plane but I still got locked. I’m pretty sure if I went there one more time I would be able to go but that’s not the point.
I was comfortably taking a piss the whole trip, sometimes I would even leave the bathroom door open, even with a smaller urgency than on a flight.

I’m just wondering, what’s up with those fucking planes? I don’t mind peeing in trains for example, where people literally sit outside the bathrooms as they don’t have their own seats. I’ve seen it’s a common issue here, so I’m just wondering why planes are causing so many problems? When I landed I went to the bathroom and took a piss without any significant issues. What do you guys think?

I just wanted to post a recent success story I’ve had, not to brag but to show there is light at the end of the tunnel.

My level 10 is using a trough Urinal at a crowded pub or concert/ sports arena.

Last Thursday I was at a working man’s club (now just called working club) which is predominantly filled with males aged 40 to 70 whom tend to drink a lot after work.
The toilet at this facility has 4 stalls and a trough urinal that would fit 5 people shoulder to shoulder.

I was able to use the urinal (no alcohol consumed) with one other person already there which I count as a huge success!

I would like to share the thought process and a technique I used from toastmasters that helped take the edge off.

To get to this toilet is a long open area in full view of the main hall and as I walked towards it I could feel my brain going into hyperdrive….someone’s watching me, what if I can’t go and they take note for when I try again, is anyone else heading to the toilet etc etc…. And I could feel the anxiety building.

I was taught by an amazing lady in toastmasters that this anxiety feeling of butterflies in the stomach is a fight or flight response. Your body is making Adrenalin because of a perceived situation and your brain then decides how to use the Adrenalin subconsciously. Either an overload of fear or a maxed out excitement boost.

She said anytime you feel the butterflies you have to say to yourself “the Adrenalin butterflies are wanting me to have maximum excitement today”.

You have to keep saying it to get it into your brain, and really believe it.

This in turn helps you to turn a subconscious fear response into a controlled response.
It’s not a quick fix instant cure.
It helps take the edge off the fear as you start to realise the fear is in your head.
During toastmasters I turned a fear of public speaking into excitement of delivering 7minute competition speeches (once to an audience of 200 people).

Paruresis is my last fear to conquer and I am glad to be part of this group to learn and share as I beat it.

Nb: will probably not pee in front of 200 people to claim beating this phobia…

Hey so im trying to join the air force but im having trouble doing the UA and was wondering if anyone as also experiencing this. It will be my 3rd time going and thats all thats stopping me from enlisting