Problems peeing with others present

Originally Published: April 19, 1996 - Last Updated / Reviewed On: August 27, 2010
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Dear Alice,

I'm currently a Freshman at a large University in on-campus housing. Being a dorm, everyone shares a bathroom which has several urinals along one wall. My problem is that I can't urinate when other people are in the room. I have found this to be true in other restrooms as well. It seems that my pipes just seal themselves up. Unfortunately, I even have difficulties "taking a dump." It's bad enough that I have trouble even going down to the bathroom when I have to go. I purposely take a long drink at the drinking fountain outside of the bathroom to try to give time to clear out. Unfortunately, it’s happened more than once that I stand there just beginning and someone comes in. I just stand there like a moron and then flush pretending that I actually did something. Any ideas? Thanks in advance!

Dear Reader,

Instead of the soothing sounds of the wind and rivers, bathrooms echoing of footsteps and piping sounds constitute the modern place of pee and poo. Feeling anxious about urinating and defecating in the presence of others is known as "bashful bladder" syndrome or "shy" bladder syndrome (a.k.a., paruresis). Your "pipes just seal[ing] themselves up" when you're feeling uncomfortable in certain social situations, like a public bathroom, happens to many people — you're far from alone. Fortunately, a number of treatment options are available (alone, or under the guidance of a health care provider/counselor) to decrease and eventually eliminate the anxiety you feel when nature calls.

Paruresis, a social anxiety disorder, may cause the sphincter muscles in the urethra (or anus) to tighten when you're feeling anxious about urinating or defecating in public, making it difficult to pee or "take a dump" while others are present. Keep in mind that difficulty peeing may sometimes be indicative of a serious health problem. However, since anxiety is to blame in most cases, addressing this anxiety with a counseling professional may be helpful.

Cognitive Behavioral Therapy (CBT), conducted by trained counseling professionals, has been shown to be effective in turning bashful bladders into the life of the party (so to speak…). It involves gradually exposing yourself to a situation that you fear and gradually becoming "desensitized" to that feared situation. Although CBT may take some time, it may be an effective treatment option for some people.

In addition, you may want to try your own relaxation techniques. While standing or sitting in the bathroom, close your eyes, take a few deep breaths, and think to yourself, "I am warm" when you inhale, and "I am calm" when you exhale. You may also want to put mind over matter and pretend you hear a faucet running, a river flowing, or maybe even visualize Niagara Falls. Flushing the toilet may help get the stream going. Another method to keep your mind calm or distracted while in the bathroom is listening to music with headphones. Pick your favorite song or sounds of nature and close your eyes for a quick escape from other distracting bathroom patrons. You may also want to check out Stress, anxiety, and learning to cope and Meditation for general relaxation tips.

Joining a support group and taking prescription medication (in conjunction with CBT and/or support group) may also be other options. Depending on individual circumstances, a health care provider (urologist) may suggest self-catheterization, a process in which a tube is placed in the urethra to remove urine. If treatment seems too long-term, however, you may want to consider some "quick fixes" in the meantime:

  • If possible, seek the comfort and privacy of a stall instead of a urinal
  • Find a private bathroom somewhere on campus that you may use
  • Stifle any sounds that embarrass you by putting toilet paper inside the toilet bowl before urinating or "taking a dump" or flush the toilet while urinating

List adapted from Can You Pee In Public? from About.com

If this issue is affecting your life and/or ability to pee or "take a dump," you may want to consider talking to a health care provider or counselor to discuss possible treatment options. If you're a student at Columbia you can make an appointment with a health care provider from Primary Care Services by calling x4-2284 or by logging in to Open Communicator. You can also make an appointment with a counseling professional from Counseling and Psychological Services. If you are not at Columbia, you may want to seek the services that are available at your school, or visit the International Paruresis Association website for more information.

Next time nature calls, you can calmly stand (or sit) and deliver!

Alice

January 3, 2013

521074
I used to have that problem, big time. What I discovered accidentally was if I was not able to listen while urinating, I normally did fine. So I normally go into a stall, and plug my ears. That...
I used to have that problem, big time. What I discovered accidentally was if I was not able to listen while urinating, I normally did fine. So I normally go into a stall, and plug my ears. That took care of the problem almost immediatelly. Another way was to have my ipod on while at the urinal. Bingo. Hope that helps someone.

May 16, 2004

20727
Alice, Some suggestions re: peeing in public toilets or where others can hear you: Flush the toilet first; pee may come more easily during the noise of the cistern refilling; try sitting a bit...
Alice, Some suggestions re: peeing in public toilets or where others can hear you: Flush the toilet first; pee may come more easily during the noise of the cistern refilling; try sitting a bit skewed or further forward so that the pee hits the porcelain rather than the water; you might be able to pull skin around your lower parts to help direct pee towards the porcelain (try at home, maybe in the bath?) Or, maybe distract yourself by reading something.

March 29, 2002

20412
Alice, A comment on bashful bladder. I had something like this problem for years and it could be really painful (I'm female, so it wasn't a question of using urinals, but e.g...
Alice, A comment on bashful bladder. I had something like this problem for years and it could be really painful (I'm female, so it wasn't a question of using urinals, but e.g. of knowing that other people would notice how long I took to go to the bathroom; having that hang-up would REALLY make me take a long time, and then people thought regularly that I must be ill, and I found it so embarrassing that sometimes I just pretended I was ill, but then I felt guilty about receiving sympathy when I wasn't...). Lately I'm much, much better, having realized that I can go if I concentrate on remembering a list of things that is hard-ish to remember, like the list of all the people who took my classes three years ago (yes, faculty members find Alice helpful, too). I really recommend trying this sort of thing as it's helped me so much. Also wanted to add a warm thank you, both to Alice and to all the people asking questions; it's wonderful to know that I'm not the only one who's wondering about so many issues!

January 18, 2002

20397
Alice, I used to have this problem. I found that thinking about something that requires some concentration makes me forget all about not being able to pee. We had to learn everyone's name in a...
Alice, I used to have this problem. I found that thinking about something that requires some concentration makes me forget all about not being able to pee. We had to learn everyone's name in a history class I was taking. I found that trying to remember everyone's name made me take my mind off not being able to pee and Voila! Doing multiplication in my head works, too, you know, not like 2*2, but like 18*23 or something that you have to think about. Anyway, this technique really worked like a charm for me! Ahhhh