On Healing 8/7/2006: Shy bladder caused decades of shame

Dear Dr. Dan:
Thanks for the opportunity to contact you in this anonymous medium, because it would be intolerable for me to face anyone with my curse.

I have suffered from a misery with the technical name of parauresis, or shy bladder syndrome, since I was a child.

I was traumatized as a little boy by my mother who insisted on giving me enemas at the slightest provocation and would examine the contents of the toilet when she knew I was in the bathroom.

The bathroom had no lock and I would wait for a bathroom session until nobody was around to see me do my business.

This anxiety has carried over for my entire life, and I have never been able to use a public bathroom. I am now 74 years old and believe I am beyond help. I live alone now, so the problem is of no concern at this point in my life. But I pray that you would devote a little time and space so that others may be saved from my kind of misery in their formative years.
–Suffering in Silence
Dear Suffering
It may help you to know that you are not alone. It is estimated that 7 percent of people have shy bladder syndrome, a psychological condition that often prevents people from urinating in public. That’s seven times the number of people diagnosed with schizophrenia or bipolar disorder.

Parauresis ultimately is an anxiety disorder. Specifically, it is a form of social anxiety. And like many people, you have coped by withdrawing from what triggers the anxiety and hiding the problem.

Anxiety disorders are quite treatable with cognitive behavioral therapy and have a pretty good prognosis. Often, group support helps deal with the isolation – and the shame. After living with this for so many years, you would agree that the shame has affected your life more profoundly than even the anxiety.

Shame feeds on itself. When we feel ashamed of something, we tend to hide and withdraw so we won’t be exposed to what’s shameful. Everyone does that with the parts of their personalities they were ashamed of. But the act of withdrawing worsens the shame. And shame is one of the most painful emotions because it is so isolating.

The cure for shame is exposure. Group support helps by sharing the secret, and cognitive behavioral therapy helps diminish the anxiety by moving toward what we fear in slow, safe steps.

As for your history, your theory may be correct. Your mother may have caused your shy bladder syndrome by her inappropriate behavior.

But as you know, understanding the cause doesn’t necessarily effect a cure. And even if you are right, there is probably much more to the story.

My guess is that your mother also had an anxiety disorder, and hers may have taken the form of an obsession – specifically with your toileting behavior. Her inappropriate behavior was her misguided and ineffective way of controlling her own anxiety.

Much of your anxiety disorder could be caused as much by your mother’s genetics as your mother’s behavior. So if you can see your mother as a woman who caused you great pain because of her own illness, you might be able to feel less resentment for her. And if you are able to see her in that light, maybe one day you will feel compassion for this woman.

I would imagine quite a burden would be lifted if you went from resentment to compassion. That will go a long way to diminishing your sense of powerlessness and victimization. And who knows? After that, you might just find more compassion for yourself.

You see, even though you don’t have to use public bathrooms, you still live with shame. Please get help; it is really not too late. These therapies can be quite effective regardless of your age. And if you are ambivalent, just try to imagine going through life free of this shame.