Paruresis

Paruresis (pa? j? '?i: s?s), also known as pee shy, shy kidney, bashful bladder or shy bladder syndrome, is a type of social anxiety disorderin which the sufferer is unable to urinatein the (real or imaginary) presence of others, such as in a public restroom.

It goes beyond simple embarrassmentor desire for privacyin that it is much more severe and may cause unnecessary inconvenience, because the inability to urinate, although psychological in origin, is physical in its effect, and not under the control of the sufferer.

There is growing recognition of the condition by the UK's NHSand government. The condition is catered for in the rules for mandatory urine testing for drugs in UK prisons, and UK incapacity benefit tribunals also recognise it. It is scheduled to be included in the NHS on-line directory of conditions and disorders. It is now reported to have been accepted as a valid reason for jury service excusal. From 1st August 2005, the guidance on the rules relating to the testing of those on probation in the UK, explicitly cites paruresis as a valid reason for inability to produce a sample which is not to be construed as a refusal.

The condition is recognised by the American Urological Association, who include it in their on-line directory of conditions, to which there is a link below.

It has, from time to time been the topic of U.S.advice columns such as Ann Landers', to which sufferers have written in and been counseled on their problem.

Severe cases of this disorder can have highly restricting effects on a person's life. Severe sufferers may not be willing to travel far from their home. Others cannot urinate even in their own home if someone else can be heard to be there.

There can be serious difficulties with workplace drug testing where observed urine samples are insisted upon, if the testing regime does not recognise and cater for the condition. In the UK, employees have a general right not to be unfairly dismissed, and so have an arguable defence if this arises, but this is not the case everywhere.

Various strategies to cope with paruresis include:

• avoidance or use of less-busy public restrooms,
• using a stall instead of a urinal, or
• running the tap or flushing to mask the urination sounds.

Still, the above are merely "work-arounds" that address the symptom and not the problem.

Actual treatments for the condition include:

• cognitive behavior therapy,
• training with biofeedback,
• anti-anxiety medications,
• using a catheter, although this is alleviating the symptoms rather than effecting a cure, and
• reducing the level of privacy at which the condition triggers by indulging in graduated exposure therapy. This last can be achieved by sufferers working together at organised events known as workshops.

External links

• International Paruresis Association
• European Paruresis Association
• United Kingdom Paruresis Trust
• The official IPA (International Paruresis Association)
• American Urological Association - Paruresis

nl:Paruresis

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Paruresis Wikipedia article Paruresis.