Whenever I try to use a public restroom, everything freezes up!
...No matter how badly I need to go, nothing happens if i'm not at home. I can urinate when i'm alone at home, no problem. But if Im away at a ball game, someone elses home, or wherever even if Im at home and somebodys over visiting, I can't pee. This crazy problem has done nothing but interfere with my life!...
These are but a few representative comments of people who experience bashful bladder syndrome (BBS), also referred to as bashful kidneys, pee-phobia, urophobia, psychogenic urinary retention and paruresis (the official clinical term). People with BBS are sometimes referred to as paruretics.
In contrast to physiological conditions like prostatitis (inflammation of the prostate) that block the flow of urine, BBS is a psychological disorder that involves the urinary system. More precisely, BBS is a type of social phobia, meaning the paruretic is usually shy and fears being scrutinized or criticized by others when performing in public in this case, urinating in a public restroom. The psychological conflict that generates this particular form of social phobia is expressed through the physical symptom of being unable to urinate whenever the person desires.
The experience of BBS varies somewhat from person to person; however, certain general patterns are evident. First, BBS occurs mostly in public restrooms, but it can also occur in the homes of friends and relatives, or even at home if visitors are nearby or a family member is waiting for the paruretic. Typically, though, she or he finds the home bathroom to be the only truly safe toilet the only place where the paruretic is consistently able to void.
Second, BBS ranges in intensity from mild, in which the person can urinate in public facilities under certain circumstances, to severe, in which the person can only urinate when alone at home. Thus the degree of BBS hesitancy ranges from a momentary delay in initiating the process to chronic and acute retention. Most people occasionally experience at least some hesitancy in public restrooms, but this differs from BBS in the matter of degree and context. A person who every now and then must wait an extra second or two before being able to urinate is not a paruretic. Rather, BBS is often a life-long condition characterized by excessive hesitancy or a total inability to urinate. The problem also causes distress over everyday activities like travel, social engagements, long business meetings, and interferes in a significant way with the paruretics ability to carry on with these normal activities.
Third, most paruretics describe a personal comfort threshold required for urinating, whether in public facilities or at home. When this comfort threshold is eclipsed by too many negatives in a particular situation such as noise, odors, lack of visual privacy, and other people in the restroom talking. BBS kicks in and prevents the person from urinating at that time.