What is Paruresis?

Paruresis orfear-of-public-urination-paruresis-causes-treatmentspee-shy” is a type of social phobia involving a fear of urinating in public restrooms or other situations where other people are present causing inability to perform and avoidant behavior, anticipatory anxiety and distress.

What are the symptoms of Paruresis?

  1. Paruresis is characterized by fear of scrutiny by others leading to fear of embarrassment or humiliation. This causes anxiety, tension, ‘freezing up” and the inability to perform.

  2. The Paruresis situation almost always provokes fear or anxiety.

  3. The Paruresis situation is actively avoided, or endured with intense fear or anxiety, and inability to perform.

  4. The fear or anxiety is out of proportion to the situation.

  5. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.

  6. The fear, anxiety, or avoidance causes significant distress or impairment in normal social, occupation, or other important areas of functioning.

What are the causes of Paruresis?

There is no one single cause of Paruresis. Negative, anxiety provoking, or traumatic experiences involving urinating sometimes, but not always, precede the development of paruresis. As with other types of social anxiety, risk factors include childhood adversity and maltreatment as a child.  Underlying traits include fear of judgement or negative evaluation, self-criticism, self worth issues. Social Anxiety is heritable and children with high behavioral inhibition as more susceptible to environmental influences such as socially anxious parents.

How can you treat Paruresis?

Dr. Dufford and Anxiety Treatment Services provide integrative and comprehensive therapy for Paruresis including individual therapy, group support and behavioral fieldwork.  Modalities include Cognitive-Behavioral Therapy including guided imagery practice and real life desensitization/graduated exposure therapy, Psychotherapy, Hypnotherapy, EMDR, Energy Psychology, and Meditation/Mindfulness.

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