One particularly common issue is that anxiety about going to the toilet can mean that it actually becomes physically impossible to go due to muscle tension. It’s a condition which has many names and applies to both urination and defecation. Being unable to urinate due to anxiety usually comes under the names of Paruresis, Shy Bladder Syndrome, Bashful Bladder, Urophobia and several other names, while being unable to defecate due to anxiety comes under the names of Parcopresis, Psychogenic Fecal Retention and Shy Bowel

As far as I know, being unable to urinate is a far more common problem than Shy Bowel and can be particularly problematic given that often we need to urinate several times a day. The problem can end up causing a restrictive lifestyle for a person meaning they do not travel far from their home or meaning that they do not go out for too long in case they need to urinate. People may also develop unhealthy habits such as restricting their fluid intake to manage how often they need to go. In more severe cases people may be so unable to urinate that they still cannot go even when they are in pain and in some cases this can cause damage meaning complications for them in the future.

Research seems to indicate that this problem is equally split between men and women, although it seems men are more likely to seek help with it. Although essentially the problem is the same for men and women – anxiety causing tensing making it physically impossible to go – there are some distinct differences. This is mainly due to the differences in male and female public toilets. Due to the exposed urinals that are commonly found in men’s toilets, men are more likely to be concerned with issues such as performance, other people seeing their private parts, etiquette and technique, while women can be more concerned with issues such as being overheard and taking too long when there is a queue. There is an amusing game that I am sure many men can relate to on the UK Paruresis Trust website. Just click on this link to play it. For my friends in the US there is the International Paruresis Association, although unfortunately they do not have any games to play.

Some people may not have so much or an issue about being unable to go, but may just get anxious about using public toilets in general. This was an issue for me and was something I developed at school, although it also extended to using toilets anywhere, including my own home sometimes. I seem to remember it started when some of the boys at my school realised that it was quite amusing to push someone on the back while they were using the men’s urinal trough meaning they had to put their hands on the splash-back to prevent them falling into it. After experiencing this one or two times and seeing it happen to several others I started getting anxious about using the toilets. As a consequence I stopped using them and would only go when I was really desperate. I remember I would often try and go the whole day without going which was quite uncomfortable at times. I have also suffered with Paruresis at times meaning I could only go when a cubicle was available, when I was really desperate or when no one else was in the toilet room. That is probably more about me than you wanted to know, but hopefully it is helpful for those who have experienced similar issues.

Both Shy Bladder and Shy Bowel are both considered a form of social anxiety, although Toilet Phobia can be related as well as unrelated to social situations. If you are struggling with Paruresis then there is a book called Shy Bladder Syndrome: Your Step-by-step Guide to Overcoming Paruresis which you may find useful. You may also like to try contacting the UK and US organisations linked above who offer workshops and may be able to put you in contact with a support group. Typically the recommended treatment is Cognitive Behavioural Therapy, as it is with many issues relating to anxiety, although in the case of Paruresis there is an option to use a Catheter which is basically a tube that can be inserted into the urethra past the muscle that keeps the bladder closed meaning it can empty through the tube. Although this is not a very attractive option for many people, if you are desperate (literally) then it might be a serious consideration.