Shy bladder sufferers work to overcome their anxiety
It's precisely because it's so easy for the rest of us, it can be paralyzing for millions of others.
Snicker if you will, but the
Think about it: You can avoid spiders or heights or flying and many other sources of common fears. But hydrating the body and releasing toxins is essential to life.
"Well, it doesn't work like that."
Paruresis is so debilitating for some, it has destroyed careers and lives and made them virtually homebound.
Dating is a nightmare. Jobs with shared bathrooms or close working quarters add to the pressure. Long trips by car or, particularly, plane are nearly impossible.
Some sign up for quiet night shifts.
Leaving home for long periods of time simply wasn't an option, he says.
The condition is a constant preoccupation, dominating meetings, recreational outings, conversations, says
FEAR OF BEING JUDGED
It's unclear what triggers the disorder, and doctors are still trying to understand the brain-bladder connection.
Our sphincter muscles are what keep us dry. Almost always tense, they allow the bladder to work like a reservoir, keeping the urine in while we're typing on our computers at work, playing with our children, chatting on the phone or reading the newspaper.
Six or eight times a day, we ask it to relax on command — a command so natural for most of us that there's no hesitation, no second-guessing in it, says Dr.
But for some, a momentary hesitation can lead to panic and finally to a frightened paralysis as muscles of the pelvic floor refuse to relax.
The fear is not in peeing, it's not being able to — and having others notice, says
Much like the performance anxiety associated with stuttering, insomnia or sexual performance, "the anxiety or fear of the event makes it more likely to occur," he says.
He talked about it with colleagues, as though it was a client of his who was struggling with it: "But everyone you tell, they just kind of scratch their heads — psychologists included, neurologists included and family practitioners included."
Even friendships can be tough when it's hard to enjoy a few hours at a ball game or a shopping trip to the mall.
"I've had people hide it ... from their spouses for 20, 30 years," Soifer says. "When they finally are truthful about it, it's such a relief (for the spouse). It's 'What? That's it? I thought you were a gangster or something.'"
As a young man, O'Rourke knew that a wife and family would threaten his privacy.
"I had doubts. 'Do I even want to get married?' When you're alone, you control your own destiny, your day. You do what you want to do on your schedule," he says.
"It's both a psychological and physiological reaction. It's the fear that someone will hear or see you and evaluate you negatively. It's the fear of being judged," says Olmert, who remembers being at a summer camp the first time she grew anxious in a restroom.
WORKING THROUGH SHAME
His anxiety began after he was sexually assaulted as a teenager. The more he tried to cope with the anxiety, the more panicked he became.
On a high school trip across the country, he went for more than 24 hours without a restroom stop — an excruciating experience.
"The shame was instilled in me as a kid," he says. The debilitating panic reinforced it — a cruel cycle. Like so many others, Melchert kept his condition secret for years. His father died a few years ago without knowing about Melchert's condition.
He and others say they've been able to regain control through workshops with Soifer and other speakers at the IPA.
The three-day workshop works on a "pee buddy system" and begins with lots and lots of liquid — water, juice, tea.
It sends fearful voiders first to hotel restrooms and then to a Detroit Tigers game to ease participants back into the public restrooms. Sometimes, participants are challenged to simply walk into a restroom, comb their hair, wash their hands and leave — that, in itself, can be panic enough.
Over time, though, they work through the process together.
"One individual challenged me to tap him on the shoulder and say, 'Hurry up, buddy.'" Melchert says, adding with a laugh, "I don't think I'll ever be that good."
But patience is plentiful and essential, says Soifer, who's also an associate professor at the
"If you don't continue to work at it, you ... lose the gains you made," he says. "The question then is how to respond. Do you freak out? Or do you say 'OK, it's fine. This is how I'm going to handle it next time.'"