Fourteen hundred students at Rutgers University in New Jersey (USA) must have been quite confused when they participated in the study by psychologists Griffith W. Williams and Elizabeth T. Degenhardt that, in 1954, first led to the identification of paruresis or shy bladder syndrome
“The problem”, as Williams and Degenhardt call the inability to urinate in the presence of others, had been documented since the Middle Ages, when it was believed that there was a spell “by which an enemy was rendered impotent or unable to expel his urine”. In modern times, it had also been mentioned in the psychiatric literature, not as a syndrome, but as a a symptom of some other pathology, either psychological or of the urinary system.
In this study, published in the Journal of General Psychology, when urinating in the presence of others, although this number varies greatly from study to study. In later years, other works released ratios between 2.8% and 25%.
Of course, and excuse the indiscretion, it has also happened to you on occasion. If you are a man, in the men’s room when you perceive that another person is occupying the toilet next to you just as you are trying to urinate. If she is a woman, when she hears how the door to the booth next door closes and another bladder sits parallel to her.
Make no mistake, science already knows this since, in 1975, Bill Rees and Debbie Leach described, in a study published in the Journal of the American College Health Association, : visual, auditory or olfactory. Women were more affected by what they heard, men by what they saw.
And in each type, a gradient that goes from mild, in which the paruresis causes a delay in the flow of urine, to severe, where urinating outside the home is impossible.
A taboo problem for psychology
But in the late 1970s, not all academics were ready to bring it up. Two years after the study was published, psychologist Gerald Koocher (who became president of the American Psychological Association) questioned, to put it mildly, the work ethics of Rees and Leach in an article titled , published in the Journal of Personality and Social Psychology.
This type of speech caused that, for years, the study of this peculiar syndrome has not been a priority. “My first exposure to paruresis was quite random,” Dr. Antonio Prunas, a researcher at the Università degli Studi di Milano-Bicocca, told Sinc. “I was reading an article on social phobias when I came across this disorder. I must admit that I had never heard of paruresis despite the fact that I have been teaching psychopathology at the university for more than ten years.
Thus, Prunas, author of several studies on the syndrome, searched the internet and found a forum for people with the syndrome. “I was extremely struck by the discomfort of these patients, as well as the fact that they felt abandoned and misunderstood by mental health professionals.”
As is often the case with most psychiatric disorders, even causes are not well understood that cause shyness of the bladder. “Reasonably -explains Prunas- there are different biological, psychological and social risk factors interacting in the etiology of the disorder. Therefore, we can assume that people who develop paruresis are probably characterized by some biological vulnerability that interacts with other factors, both of the psychology of the individual and of the social environment.
However, for a minority there is another explanation. “One in three people suffering from paruresis identified a specific traumatic event in your childhood related to the use of the toilets that they consider the beginning of their disorder”.
On the best treatment or therapy for shy bladder, Prunas concedes that there is not yet “solid scientific evidence. However, some studies show that cognitive-behavioral therapy can be effective.”
trauma in youth
Though graceful in not naming names, hints of the Italian point in the direction of Dr. Steven Soifer, a professor at the University of Memphis, CEO of the International Paruresis Association, and a guru in cognitive-behavioral treatment (CBT, for its acronym in English) of the syndrome.
There is quite a bit of literature on the subject that dates back to the 30s, as a document in my book Shy Bladder Syndrome: Your Step-by-Step Guide to Overcome Paruresis, from 2001″, says Soifer to Sinc. This psychologist and doctor in Social Work acknowledges that it affects him: “I got involved because I have had the problem since adolescence, and there was no treatment that I could find. I developed the treatment method we use in our workshops, based on CBT techniques, with a colleague.”
These techniques, he says, “are well known here in the U.S, not so much in Europe yet. But it is evidence based on practice, that is, it works in 80-90% of the cases.”
Since 2000, he has published five books and as many journal articles on paruresis and is quite clear that a traumatic experience of youth is often the noose that strangles the urethra. “Absolutely,” says Soifer, “my workshop experience indicates that some form of bullying is the most common cause of this social anxiety disorder. The median age of onset is puberty, around twelve or thirteen.”
In Japana large number of public restrooms have a small battery operated device that sticks to the wall and, when pressed, plays the sound of a waterfall for several seconds, camouflaging the bodily noises emitted by its users.
But for Western paruresics, the present does not look as rosy as it does for the Japanese. And yet it could always be worse. could be another most disabling syndrome, rarer and even less studied than paruresis. It could be parcopresis. Yeah, just what they’re thinking