Paruresis

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Classification according to ICD-10
F40.1 Social phobias
ICD-10 online (WHO version 2019)
Classification according to ICD-10
F40.2 Specific (isolated) phobias
ICD-10 online (WHO version 2019)

Under a Paruresis (colloquially shy bladder ) refers to a bladder dysfunction , primarily under the person on public toilet facilities suffer or outside the private living area. The degree of severity varies from person to person and ranges from a more or less long wait to the beginning of micturition , to incomplete emptying of the bladder and the inability to urinate at all.

It is a mental disorder that usually develops during puberty . It is one of the anxiety disorders and, depending on its cause, is classified either as an accompanying symptom of the social phobia or as a specific (isolated) phobia , provided that the fear relates to micturition itself (see emetophobia ). The name itself was introduced in 1954 by G. W. Williams and E. T. Degenhardt.

Despite the widespread use and the sometimes great suffering, the term is mostly not even known to those affected. There have also been hardly any publications on the subject in the relevant scientific literature to date. Thus, even doctors and psychotherapists usually have little information. The therapy is based on the principles of treating social phobias.

causes

Physical component

Paruresis is based on mental tension of the sphincter that makes urination difficult or impossible. This tension can be traced back to psychological factors such as fear and stress. Relaxation exercises such as autogenic training or deep relaxation can help those affected to regain control of the bladder muscles. But the psychological cause weighs more heavily than the physical component.

Mental component

Urinals with bulkheads

Through a reference experience, the person affected experiences a paretic reaction for the first time (often during puberty), which leaves such a formative impression that from the moment of the experience, he can no longer go to the toilet uninhibited. The cause of the reference experience can be manifold: from the inferiority complex to stress at school or quarrels with the family. On the basis of the reference experience, the subconscious links the circumstances of the first paretic reaction with the tension of the urethral sphincter muscles, which usually leads to the micturition disorder being attributed to the presence of other people, although the cause may lie entirely elsewhere. This mechanism is called conditioning (see Ivan Petrovich Pavlov ).

The immediate impression of a Paruresis patient is based on the felt certainty that other people are watching and evaluating him in the toilet and - in the event of failure - making fun of him. In male patients it can be observed that they often attach their masculinity to the ability to urinate at a urinal or in a urinal next to other boys or men.

Sufferers rarely talk about their illness because the shame threshold is too high. Fears of being ridiculed or not taken seriously lead to increasing social isolation among patients.

Patients want to hide their paruresis from other people (friends, family, acquaintances, etc.), which leads to paruresis leading to a shadowy existence.

literature

  • Philipp Hammelstein: Let it go! A Guide to Overcoming Paruresis. Pabst Science Publishers, Lengerich 2005, ISBN 3-89967-221-6 .
  • Philipp Hammelstein, Britta Jäntsch, Winfried Barnett: Paruresis. A previously neglected psychotherapeutic problem. In: Psychotherapeut , 2003, Edition 4, pp. 260–263.
  • Steven Soifer et al. a .: Shy Bladder Syndrome. New Harbinger Publ., Oakland CA 2001, ISBN 1-57224-227-2 (English).
  • Carol Olmert: Bathrooms Make Me Nervous: A Guidebook for Women with Urination Anxiety. CJOB Publications, 2008, ISBN 978-0-615-24024-4 (English).
  • Walter Schmidt: Why men don't want to pee next to each other and other puzzles in spatial psychology . Rowohlt, Reinbek near Hamburg 2013, ISBN 978-3-499-62996-9 .

Web links