In studying evolution, we find that behaviors are often specifically selected for, generally to increase ones survivability. One might ask, how could paruresis be a behavior that would increase a person’s chance of survival? In my personal opinion, I can see how paruresis could be a behavioral tendency that might benefit the survival of the human species.

If you really think about it, a human, or any species for that matter, is most vulnerable when they are in the process of relieving themselves. At the moment of urination, you are completely susceptible to any number of attacks, not to mention awareness of your surroundings if often little to none. With the combination of vulnerability and lack of awareness of your surroundings, this leaves you wide open to attack. With that in mind, a paruretic would seem to be a person who is less open to such an attack. I once worked with a man who told me that when he was serving time in federal prison, he would always urinate sitting down. The reason for this was that if he were to get attacked while on the toilet (which is quite common in prison), he would be in a better position to defend himself. It is rather clear that urination (or defecation for that matter) is situation in which we are open to our surroundings. As I said, when in the process of urinating, people are often not aware of their surroundings, but not in the case of a paruretic.

No, a paruretic is completely aware of their surroundings before, during, and after their urination. When a person who suffers from a shy bladder walks into a restroom, they immediately begin to make keen observations of their surrounding: How many people are in the restrooms? Do the stalls offer a degree of privacy? How big or small is the restroom? Is there much noise? Is music playing in the background? What is the lighting like? There is quite literately a laundry list of things that a paruretic might observe when they find themselves in an unfamiliar restroom.

Since a paruretic is aware of their surroundings and their vulnerability to others, it doesn’t seem farfetched why paruresis might have been a behavioral trait that was specifically selected. Perhaps shy bladder is a spandrel, an evolutionary by product (spadrels were observed by Stephen Jay Gould and Richard Lewontin in their 1979 paper “The Spandrels of San Marco and the Panglossian Paradigm: A Critique of the Adaptationist Programme”), in which case paruresis was simply and evolutionary accident. As far as anyone can tell, humans are the only species that suffer from paruresis, which could be evidence that shy bladder is nothing more than a spandrel. However, humans are the only species capable of conscious thought (again, as far as we can tell), which opens a completely different can of worms. The fact that humans do possess consciousness opens up the door for evolutionary progress that is not achievable by that of other species.

Early humans were strictly hunter-gatherers, and spent their time moving from place to place in search of a food source. They often found themselves in direct contact with very dangerous wild animals much bigger and faster than them, so they needed to be consciously aware of their environment at all times. This, along with human ingenuity and superior intelligence as compared to other animals is what gave our kind the upper evolutionary hand. With the constant danger that early man lived with, and the fact that something as simple as taking a pee could spell the end for early man, paruresis might very date all the way back to pre-history.

Whether or not paruresis is nothing more than an evolutionary spandrel or that of a selected trait in the race for survival, it is intriguing to think about paruresis from an evolutionary perspective. Understanding how we have evolved and the reasons for said evolutions, we could potentially find answers to some key unanswered questions that we find ourselves asking.

Step 1) Start by taking a deep breath and allow your body relax. It is important to stay at ease while doing the breath hold, otherwise it will take longer for a urine stream to start.

Step 2) Once your body is relaxed and calm, inhale enough to fill your lungs completely, then exhaled about 75% of the air in your lungs, leaving about 25%.

Step 3) Proceed to hold your breath while also keeping your body still and relaxed. By keeping your body at ease, it will facilitate a much smoother process whilst holding your breath for the period of time necessary.

Step 4) Continue holding your breath until you reach the “gasping for breath” feeling. This will be easy to recognize, as your body’s natural reaction to the lack of oxygen will be to take a breath, and it will feel as though you are trying to gasp for air. The time it takes to get to this point can vary, but it will generally be between 20-40 seconds, depending on the individual.

Step 5) Once you come the point where your body is trying to gasp for air, you may feel a bit of discomfort. This is entirely normal, and there is no need to be alarmed. When you have reached the “gasping for breath” threshold, you will only need to continue holding your breath for a few more seconds.

Step 6) You will eventually feel what is known as the pelvic floor drop, or the point in which the internal sphincter allows the urine to begin flowing from the bladder. The stream should start on its own, and you should avoid forcing the urine too much.

Step 7) Once a urine stream has started, keep your breath held until the stream is a full strength before you begin to breath again. If you take a breath too early or breath in too quickly, this can cause the stream to subside. When you do take a breath, try and take smooth even breaths so as not to pant or gasp, which can also cause the stream to halt.

As I stated earlier, once you have mastered the technique, you may apply it to any situation in which you have difficulty urinating. Also, you may try holding your breath while you are walking towards the restroom, which can shave time from how long that you are standing at the urinal/toilet/bush. Remember not to focus too much on how long you hold your breath, as the length of time necessary can vary from person to person. The key to the breath hold is the “gasping for breath” feeling, and being able to hold your breath through it long enough for a stream to start.

Another thing that is important I note is the breath hold will take some practice. You may not get the breath hold on the first try, or even the hundredth try for that matter. It may take a bit of practice before you are able to master the technique. Try practicing it a few times a day until you are able to get the hang of it. You can also practice holding your breath while you are lying in bed or sitting on the couch watching TV, so you can get more comfortable with holding your breath. The breath hold can be a bit uncomfortable and awkward at first, but once learned much to odd feelings will dissipate, and the breath hold will become an invaluable tool for paruretics.

We all get angry at certain juntures. It could be our job, family, spouses, or even an empty toilet roll. There is no telling what the next thing to set us off is going to be. Some of us have shorter fuses than others but ultimately we all deal with it at some point. I believe I can speak with authority when I say that paruresis can be a seemingly never-ending source of anger.

I cannot even begin to count the number of times that I have cursed the universe for bestowing me with such an ailment. For the majority of my life, I have been able to get along fine despite the occasional inturuption of normal life that paruresis would give me. Before recovery, it was possible that I would find myself in a situation so dire that I wondered if I would ever pee again. Perhaps I thought that I would just eventually pass out and die, and I can say that it during those times such an outcome would have been welcomed. During such an occasion, I would feel helpless alone, at least until I was able to void my bladder. In most situations once I was able to free my bladder of urine, the only emotion that I experienced was an overwhelming sense of relief. But anger could present itself and when it did, I found misery to be in company as well.

Ever since I made the decision to rid myself of paruresis (though I have come to find that I will never completely rid myself of it, and it is in fact a part of who I am), I have discovered quite a lot about myself. Perhaps the most substaintial of my discoveries was finding out that my own mother was a fellow sufferer. Not only did this give me a great amount of relief in knowing I had someone, specifically within my family, who could relate to my struggles. Actually, my mom’s struggles are monumental in comparison to my insignificant story.

My mother grew up in a time in which there were no resources available resources for paruresis. On top of that, she was abondoned by her father when she was only nine, leaving her strong yet troubled mother to care after 4 kids, my mother included. For me to say they were poor would be an understatement. During Christmastime when other kids were getting presents, my mothers family recieved boxes of food and clothing from the church. My mother being the oldest, took on a great deal of resposibility at a premature age, and had missed out entirely on a real childhood. She was balancing checkbooks when she was 11 and cooking dinner at 13. Through all of this, she dealt with the same struggles and issues that all of us deal with on a daily basis.

Despite all that she was forced to endure at against all odds, my mother is now a very successful person who commands a great deal of respect in her business (she started her own consulting firm and was on the Board of Directors) all while managing to raise a family. In her 58 years on this Earth, she has suffered from paruresis for 50 of them. She took life head on and never made excuses about anything. I can honestly say that I have an immense amount of respect for both her as a person and what she has managed to accomplish. For every person that I meet or talk with who has dealt with paruresis for a long period of time and managed to live a good life, I also have a great deal of respect for.

It is easy to be angry about suffering from paruresis. After all, its not our fault that this is the hand we have been dealt, but, its what we have to play with. Sometimes it ok to be angry, as it repels us from slipping in to complacency about our condition. I am absoulutely certain that everyone in the world, myself included, has asked the question “Why me?” The fact is, the universe does not care about your futile attempts of demanding justice. You have to take live as it comes, and deal with the situation that you were put in. None of us have any control of the circumstances of our childhoods or our body phisiology, nor can we be held responsible for our paruresis. Nor can we simply will ourselves to be rid of shy bladder syndrome. It takes very deliberate steps that require both time and patience. However, if you follow those steps in a diligent manner, you will eventually find yourself in the driver’s seat. In the end, we are stuck with our situations, and all we can do is make the best of it.

If you ever find yourself asking that pervasive question, just take it from a man much wiser than myself:

“To the dumb question ‘Why me?’ the cosmos barely bothers to return the reply: Why not?”
-Christopher Hitchens (1949-2011)

It is events like this that paruretics often finding themselves falling back on their “get out of jail free card (breath hold technique, catheterization)”, or more commonly just avoiding altogether. However this weekend, I had an unusual amount of success when it came to using the restrooms at a sports event. Granted I have been having a fairly decent amount of success lately and seem to be making good progress, nevertheless, sports arenas traditionally have been hit or miss in my case.

There were several times both before and during the event that I felt a sufficient urge to urinate, and was able to do so in the prescense of crowded restrooms without the need to use the breath hold technique. Needless to say, I was elated when I was standing in the restroom of a crowded and noisy restaurant lavatory, and had no hesitation in starting a stream. This again happened several times when I actually entered that stadium itself, and found an equal amount of success with a variation on hesitancy. It would seem that I could explain this fantastic success through the resonable progress that I have had in recovery lately, though it seemed unlikely. However it did not take long for me to decipher the culprit of my victory: alcohol.

Preceeding and during the game itself, I was swiling down beer and whiskey like my very ancestors of scottish heratige. It took some time for an urgency to develop, but when it came it did so with a vengence. When I was in the restaurant, I walked into the restroom and relieved myself almost giving it no thought. Immediately after the incident, I found myself realizing that my inhibitions where certainly lower than normal. Despite my awareness and recognition of my reduced inhibitions, it did not seem to stop me from urinating in increasingly difficult situations. Of course this came to no surprise to me as I have had several instances in the past in which my low inhibitions have enhanced my ability to urinate in the company of others. This did, however, force me to give more thought of the effects of reduced inhibitions.

I recently read an interesting study in The American Jounal of Psychiatry which concluded that generalized social phobia may be associated with low dopamine. Since alcohol temporarily increases dopamine levels in the brain as well as reducing inhibition, this in essence allows alcohol to become a temporary cure to that of paruresis. Though I would not recommend using alcohol as a cure to paruresis (which would undoubtedly lead to alcoholism), I do not feel that it is unreasonable to suggest that moderate drinking could have a positive effect on paruresis. Some studies have shown that moderate alcohol consumption can have positive psychological effects such as subjective health, mood enhancement, stress reduction, sociability, social integration, mental health, long-term cognitive functioning, and work income/disability.

As I stated before, alcohol should not be used as a cure, as it would be much like “putting a bandage on cancer” (To quote ex-herion addict and metal vocalist Phillip H. Anselmo). Though, I do believe that moderate alcohol consumption could potentially have postive long-term effects on a paruretics anxiety, in turn allieviating (if only a small amount) their struggles with paruresis.

Live long and Prosper,

Max

For the majority of people, producing a sample for a drug test is an issue that never crosses their mind. Yes those who do consume drugs might have anxiety about their ability to pass said drug test, but the ability to piss into a cup is a completely unconscious thought. For a paruretic however, mandatory drug testing can have in some cases severe professional, mental, and physical consequences. A paruretic who is forced into a drug test can suffer a crushing defeat which can lead to missed job opportunities, physical damage to the bladder, as well as significant mental and emotional impact. Taking the consequences into account, it is my assertion that private companies and government agencies who do not offer alternative measures to urine testing are breaking a fundamental law that was clearly laid out in the United States Constitution: The 8th Amendment.

The 8th Amendment states, as follows: “Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.” The first part of the amendment, though important, is clearly not applicable to the situation. The latter half, however, is what I feel makes denying alternative urine testing to paruretics unconstitutional: “…nor cruel and unusual punishments inflicted.” As I alluded to earlier, urine-based drug testing can leave a paruretic in dire straights. In nearly all cases, if an individual is not able to produce a sample, it is regarded as a failure to test, and said individual is left with the presumptive stigma of being a drug user. This stigma can lead to the loss of a job, which can lead to very serious financial issues for the party involved. It can also be very physically detrimental, as in many cases for drug tests they coerce the patient into drinking large amounts of fluid with unsuccessful results, potentially leading to serious damage to the bladder. For a paruretic, not being able to void into a small plastic cup does not constitute a refusal of test. They are not refusing to give a sample, they simply cannot. I believe that it is fair to say that a paruretic who clean of drugs would be willing to accept a hair follicle or blood test, both of which can be used to detect drugs in the system. By not allowing a paruretic to some form of alternative drug testing, you are subjecting the individual to entirely avoidable cruel and unusual punishment.

Many people who would counter this argument might present paruresis as a non-existent condition and would make great strides in reducing its credibility. In fact, paruresis is a recognized medical condition by the American Urological Association, has been recognized by a credible article on WebMD, and is fits the criteria of a social phobia in section 300.23 of the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders). All of these sources are both credible and held with high esteem in both the national and international medical community. The members of stated sources are experts in their respective fields and they have the knowledge, experience, and resources to speak with authority on such issues.

By understanding that pauresis is a recognized and defined by experts in the fields of both health and mental health combined with the serious implications of disallowing alternative testing for paruretics, it is of my opinion that doing as such is a form of cruel and unusual punishment clearly prohibited by the United States Constitution. Insofar as refusing alternative testing to parurectics is a form of cruel and unusual punishment, measures need to be taken to litigate the matter.

As I am not an attorney, I do not have the authority to speak on the technical matters of litigation that are necessary to this particular situation. I can, however, offer what I feel to be an effective solution with the hopes that a professional can pursue such a measure. An effective way to implement such a solution would require a federal law that would allow individuals the option to alternative testing. There is an issue in this situation, as urine testing is a cheap and relatively quick way of implementing a drug test, and a company might have to pay significantly more as well as devote greater time to testing and individual. This can be circumvented by allowing the company or agency to pass the cost of such an upgrade to the person receiving the test. By doing so, the company or agency would avoid having to pay extra money or devout extra time, and the one receiving the test could avoid being subjected to unnecessary pain and suffering. In taking these measures, we will be able to uphold the principles of the constitution as well as improve one of the more significant issues that paruretics often face.

The breath hold, in theory, is a relatively simple concept. If you hold your breath for a length of time, eventually enough carbon dioxide will build up in your lungs and relax your external sphincter enough to allow a stream of urine to begin. I have also stated that it is vital that you keep your mind and body at ease, or it will take longer to procure a stream of urine. There is, however, one other thing that I feel should be noted that I have yet noticed until just a few days ago.

Last Thursday night, I attended a concert with a few comrades in a small college town just under two hours from my home. It being a town that I have little personal familiarity with, and restrooms of the same fabric, I twice needed to use the breath hold to relieve myself. I didn’t have any particular trouble with the task, and it was the same as any other time that I allowed myself the benefit of the breath hold for urination. In this case though, there were two wildcards that did have a slight effect on my technique: the influence of adult beverages (and perhaps an herb or two), and a lack of time.

My friends and I were in a record shop down the street from the venue, and we decided it was time to enter the concert hall. I needed to use the restroom, and because we were getting ready to leave, I was feeling a bit pinched for time. This did not effect my ability to use the breath hold effectively, but when I began the feel the pelvic floor begin to drop, and instead of allowing the stream to flow unrestricted, I forced it out a bit. A similar occurrence happened later on in the night, when I forced the urine stream as opposed to allowing it to flow naturally.

The next day when I was at work, I seemed to be having a bit of difficulty urinating. I concluded immediately that it was not psychological in nature, due to the fact that we have fairly private restrooms where I work, and I have never had any trouble using the restrooms in my place of business. I derived that the issue that I was having must be physical in nature. This conjuncture was further supported by the strange feeling that I was experiencing with my bladder. When I would empty my bladder, not a minute later I would feel the urge to go again, despite having no urine left in my bladder. It was rather peculiar, and I felt as if my bladder was “sore”. Though it might seem an odd conclusion to draw, I do not believe that it is unfounded.

If you think about the anatomy of a bladder, you will find that it is a smooth muscle that operates within the autonomic nervous system. Understanding that I was forcing my bladder to allow a stream, it seems that I may actually have caused some temporary weakening of the bladder muscles. After a bit of research on WebMD, the condition that best described my symptoms is whats known as Interstitial Cystitits. It is described by WebMD as “a chronic, painful inflammatory condition of the bladder wall characterized by pressure and pain above the pelvic area along with increased frequency and urgency of urination.” Though what I experienced was not chronic (it has already gone away), it seems the best description of what I was experiencing. I am not a medical professional, so I have no authority to self-diagnose myself nor am I going to try.

Nevertheless, I felt my experience was worth noting. In all likelihood, what I was feeling was simply a bit of soreness due to attempting to forcibly extract urine from my bladder. Despite the minor issue that I occurred, there is no doubt in my mind that trying to push urine out under any circumstances is not wise and can lead to serious damage of the bladder and sphincter muscles. If you are someone who uses the breath hold or is in the process of mastering the technique, do not attempt to force the urine out. When you begin the feel the pelvic floor, that means that you will have a stream going in a matter of seconds, and it is not necessary to speed the process up. Just keep holding your breath and your sphincter will relax enough to allow you to void.

One last note: If you find yourself in a situation where you are for any reason not able to safely empty your bladder, seek medical attention immediately.

Not only have I changed my behavior and habits when it comes to my old friend the urinal, but even in much more profound ways. I find that I am a much more compassionate, empathetic, understanding person than ever before. I have a great deal of compassion for my paruretics for sure, but I even find myself feeling the effects of people who suffer from other conditions. I can remember in the past, I would curse the condition that shackled me down. But now I realize that paruresis itself was not the chain holding me down, it was in fact my own neuroticism.

I often found myself in complete isolation, and with the irrational thought that I was the only one suffering from the condition. Once I realized that there were others (in numbers that I would have never conceived), I began to feel a glimmer of hope, that at the very least I was not alone. After I read all of the success stories of people who had overcome paruresis and now live happy and fulfilling lives, I realized at that moment that I was done moping. I was no longer going to sit by passively full of self-loathing and just take it. I had been dealt a crappy hand, but I was damn sure going to play it until I was raking in the chips.

Though it might seem odd to some paruretics, I am glad that I have paruresis. Through my recovery process I have experienced a completely different point of view than I was used to, and I am now able to look at the world with open eyes. I see all of the the suffering around the world; the death, disease, murder, starvation, and utter inhumanity. Though my condition decisively falls short of the innumerable amount of such suffering, it has awakened me to a much greater truth.

We are all human beings. We are all related to each other and share the same origins. The species than is homo sapiens can be traced back to a few scattered communities in ancient Africa that was once down to no more than a few thousand. To think of the amount of suffering and despair these people must have endured, it is almost impossible to imagine. In all reality, the odds were not in the favor of the then young species of homo sapiens. Despite the suffering and lack of decent odds, we were able to claw through all of the hardships, and we are now the most advanced and intelligent life currently known.  It is in our very nature to be resilient, and paruresis is simply one of the many conditions that encompass the scope of the human condition.

Paruresis has physical causes, but ultimately root of paruresis is mental. On top of the fact that paruresis is a mental problem, it is exacerbated by negative emotions as well. Paruresis itself tends to be magnified by emotional issues, the very issues that drive some paruretics into such a severe state of the condition, that they often become functional agoraphobics who completely isolate themselves from society and human contact in general. But when a paruretic accepts the condition for what it is: a mental disorder that causes physical issues and is made worse with negative emotion, they can begin to really make progress. It is my firm belief that the most vital step to truly overcoming not just paruresis but secondary paruresis (the emotional impact that paruresis has) is by being able to have a more positive outlook on not just their condition, but life in general.

I have come to accept paruresis as not only a condition from which I suffer, but as part of who I am. Paruresis is a very distinct yet noticable part of who I am. There is not a day that does by in which I don’t think about paruresis and the impact it has on my life. However, I now view this as a very positive and healthy part of living. We all have issues, paruretic or not, that we deal with and often find ourselves wishing that we could trade our condition for something else. But this is a thought that arises in all people, and everyone has some sort of condition or ism that we wish we could trade for something else. In my case, paruresis is a vital part of the very fabric that makes up who I am as a person. I can tell you with absolute certainty that I am a different person after I became a paruretic, and am different still when I became a recovered paruretic. And you know what? I am just fine with that.

I now wake every morning not only knowing that I am a paruretic, but I fully embrace it as a part of who I am. If there is anything that I can leave you with, I hope that it is this catch-22: If you want to truly overcome your paruresis, you must accept it as part of who you are.

To me, paruresis is a very good representation of the snowball effect. With everyone, it begins with a singular, often isolated incident. Maybe you get in line in a crowded restroom, and suddenly lock-up at the thought that there are dozens staring at you, waiting for their turn at the lue. Perhaps you were the victim of an incident of bullying and have a moment of hesitation in a restroom. I have heard dozens upon dozens of different stories about how people first came to have issues with urinating in the presence of others. In all cases however, it almost always begins to become progressively more frequent and more emotionally debilitating. For some, it might even get to the point where they are virtually house bound because of the issues with paruresis. For any paruretic, the first step is almost always graduated exposure therapy, as well as cognitive behavioral therapy, and with good reason. With both graduated exposure and CBT, it has been a proven success for people to begin to breakout of the shackles that have left them prisoners in their own body, trapped but their very mental and emotional limitations. No one can deny the success that both of these therapies have provided to the paruretic community, and I am certainly not claiming otherwise. However, I have come to the conclusion that it is an incomplete picture. For people to have true success and be able to free themselves in a much more profound manner, they must address the emotional side of paruresis, which is known as “secondary paruresis”.

The reason that people struggle with paruresis so much is not inherently the physical side of it, as it is often never a problem to find a “safe” restroom so to speak, but it is the emotional toll that it takes. Just think about it, when you have a misfire and find yourself locking up in a particular situation, it is without a doubt the most deflating experience there is (in a paruretics eyes at least). You will often find yourself overwhelmed with shame, a sense of failure, powerlessness, isolation, doubt, and to coin a term, a rather lugubrious case of “fear and loathing”. Even if you manage to relieve yourself elsewhere, in which case the physical side of the issue has been resolved, the emotional impact still lingers. For myself, it can vary greatly in length. There are times in the past in which I have misfired, and the thought of it has stuck with me for weeks. This is a problem that I feel needs to be addressed. If more paruretics can find a way to address these emotions, I believe that their recovery will have a much more significant and lasting effect.

But how do they do this? I mean, it would be foolish for me to posit that one can directly control their emotions. Emotions are of a mysterious and uncontrollable guild that there is never been any sure fire way to control them. However, I do believe I am not out of line in saying that positive emotions seem to be directly connected with ones self-esteem. When I have higher levels of confidence and self-esteem, my emotions are much more positive which in turn allow me much more freedom when it comes to paruresis. But having self-confidence itself is not always such an easy task either. As a matter of fact, paruresis itself can do a serious number to anyones self-confidence, no matter how high it may be.

Though I have yet to really formulate any algorithm in which one can increase self-confidence or deter negative emotions, there are a few remedies that I have found work for myself. One that I have found to be especially useful is the drown out method. When I am getting ready to walk into a restroom that I know will be difficult, I take a few deep breaths to clear my mind, put in my iPod and blast the sound, then walk right into an unoccupied stall. I have had a great deal of success with this, and have been able to urinate in full restroom without even the slightest bit of anxiety. I know that this may not be a method that works for all, but I now several paruretics who have had success with it.

I believe that the key to this is being able to put yourself at ease before you walk in. You might try listening to music that is soothing for you, or even doing a few simple breathing exercises. All paruretics generally have some anxiety when they walk into a public restroom, but it is all about keeping that anxiety to reasonable levels. If you can do this, then drowning out can be extremely successful in urinating in tough situations. For me, it is become a tool that has helped me manage my paruresis, outdone only by the breath hold technique. Again I will state that it might not work for all, but under the proper circumstances it can be very effective for paruretics.

Something else that can be done to control ones emotions and boost self-esteem is to simply focus on your acheivements. It does not have to be paruretic acheivements (though they can be very helpful in boosting self-esteem), but even life acheivements. For example, you might pull out your old high school yearbook where you were once a star athlete. You can reminisce about when you received an award at work. It might even be something even more simple, like the time you beat the hell out of your friend at a video game. Being able to look back at things like that, you will often have a burst of self-confidence. You might even find yourself reliving the same emotions that you had when the event occurred. Another suggestion I offer is to write down those positive emotions as you feel them. Keep a journal in which you write daily about the positive emotions that you experienced that day.  If you can manage to do that, you will often found yourself in such a state of joy you will find it difficult to allow negative emotions to creep in.

You don’t want to be narccasistic and allow yourself to always be in awe of the grand successes that you have experienced in your life, but there is certainly nothing wrong about remembering the ecstatic feelings that those situations brought in a private, and humble setting. I have decided that I will being to keep a daily journal of such emotions, and would challenge all with paruresis to do the same. So much of having successful recovery is putting yourself into the correct frame of mind. Although it may seem elementary, I think that recognizing positive emotions and separating them from negative emotions can have a great impact.

I plan on delving a bit deeper into the emotional side of paruresis, but I would very much like feedback before I go any further. Any comment that you may have would be very much appreciated and would contribute a great deal.

To be completely honest, the reason that I have not posted in some time is because I have been so engulfed in other parts of my life. It seems strange even typing that last statement. Why is it so strange? Paruresis has been something that often occupies a great deal of thought for me on a daily basis. Even though I might not be struggling with it on a particular day, I periodically find myself theorizing about the causes as well as effects of paruresis. I might be thinking about the emotional aspects of paruresis one day, whereas I will ponder the mechanical properties of it another. Lately though, this has not been the case.

I have been dealing with this condition since I was about 12 or 13, so it has been some time now. It was late in 2010 when I learned the breath hold technique and was able, for the first time since I had suffered from the condition, to get a grasp on this issue. For the last year and a half, my life has certainly been on the up and up. Things have been going quite for me, and I am more content with my life than ever before. Recently, much of my mind has been occupied with what I want to do with my life (of which I still am not sure on that front), and less about my past issues.

But I have reminded myself that I am, and always will be, a paruretic. I know that I cannot allow myself to become complacent about this condition. Even though I have been very successful with my recovery process, there will always be room for improvement. The few occasions in which I do have some trouble urinating in the presence of others, I am not longer bothered by it. I simply use the breath hold technique, or if I want wait until a more manageable situations presents. With the help of the former, there is no longer any situation in which I just cannot go. As long as I can keep myself relaxed, the breath hold is extremely effective in emptying my bladder. It has been an incredibly effective tool in my recovery process.

Even though I have been lax with my recovery as of late, there are still things that I would like to accomplish. I am still interested in attending a workshop, and am planning on doing one some time this summer. I have been more open about my condition, but I feel that I could speak more candidly about my condition those I care about, as well as others who suffer from this condition as well. Lately I have been more inclined to write in great detail about my experiences with paruresis, and publish on some sort of public forum. I think that 100% openness is the next step for myself, and writing a detailed account of my struggles for the world to see is about as open as I could be. Its just an idea, but I feel it would be good for both myself, and others who also suffer.

I have come a long way since I first began my recovery, but there is no doubt that I can go much further.

This seems to be a rather common trend amongst paruretics, and it is not at all surprising. The “phantom” that the mind of a paruretic often creates for itself encompasses the entire scope of the condition itself. On one side, you have the influence of sound (whether real or imagined) that can greatly hinder a paruretics ability to use a restroom, particularly in a public setting. On the other side, therein lies the issue of the mere presence of another human being. Again, whether real or imagined, just the idea of someone else sharing the proximity of the restroom while you are implementing its use can lead to a crushing defeat. Those of us who suffer from shy bladder seem to have an innate proclivity to give ourselves problems before they actually arise. In this case, we have conceptualized a non-existent entity that has entered the restroom, thus hindering our ability to fill the porcelain throne. It is the very issue that creates the condition in which we so despise.

When someone is bladder shy, they do not become anxious when they step up to a urinal or even when they walk into a restroom. No, the feelings of uncertainty come much before even that. The uneasiness of having to approach a public restroom, or urinate in the proximity comes the very moment that even minute urgency is felt. With recent discoveries made in neuroscience that show that brain scans can reveal decisions seconds before one actually “decides” (1), it is not surprising that these issues come up with paruretics. It might very well be that even before signals coming from the bladder that tell the brain that you have urgency to urinate, your mind has already conjured up feelings of dismal uncertainty. Just as being the victim of a violent crime can associate those feelings with negative emotions, via classical conditioning (2), the idea of having to enter the dreaded public restroom can become associated with negative thoughts, which in turn can stunt  the recovery process. It is vital that paruretics learn to control these emotions if they ever want to have success being comfortable within the domain of a public restroom.

The solution that I propose is rather simple. The next time that you have an urge to urinate, and are uncertain about you ability to use a particular restroom, walk into the nearest (or safest) restroom. Whether or not there is anyone present or not, take the time to look around a minute. What do you see? What is the color of the restroom? What are the stalls like? The urinals? How many toilets are there total? Make sure that you really take the time to get a feel of the restroom itself. Why? Its allows you mind to familiarize itself with its current surroundings. As I have iterated before, paruetics are strongly influenced by their surrounding, and tend to have greater success rates in familiar places.

Once you feel like you have a good idea of the restroom, then walk out, without reliving yourself. Allow a few minutes before you re-enter the restroom. You can go back to what you were doing previous to your urge to urinate. If you’d like, you may also want to take the time to do a relaxation technique. One that I like to do when I’m on the fly is a simple breathing technique. Take a deep breath in, focusing on how the air feels entering your lungs and hold it for a few seconds. Then, slowly exhale while softly saying the word “calm”. Repeat this about four or five times, and by that time you should be rather loose and feeling at ease. When you feel that you have reached the point of calm, allow yourself to walk into the previous restroom. During the time it takes you to walk there, allow yourself remain at ease. Remind yourself that you have seen this restroom before and know exactly what to expect.

Upon entering the restroom, step up to a urinal or into a stall, depending on what your personal level of comfort is. your variability of success will depend on the current situation (i.e. restroom traffic), as well as your own threshold of urinating in a public setting. If you are in fact alone, the “phantom” should not be an issue at all. Your mind will be calm and rational, and any negative thoughts or paranoid imaginations will be long gone. If there are others present, your mind will be centered and your chances of success will be significantly increased. If you are in fact unable to void, don’t sweat it. Simply exit the restroom and try again a few minutes later. Remind yourself that having some hesitancy can happen to anyone, paruretic or not, and that you will simply try again. You may repeat the breathing exercise if you like, or even use another relaxation that you like.

If you allow yourself to become familiar with a particular restroom, you will obtain the comfort that comes along with knowing exactly what to expect. Not only will you have a higher chance of voiding, you will rid yourself of the “phantom”, which represent  the negative and perpetually pessimistic views that the paruretic mind often creates itself. Remember that not only altering your behavioral tendencies is import in the recovery process, but modifying your though process is a vital ingredient for any success.

References:

(1) http://exploringthemind.com/the-mind/brain-scans-can-reveal-your-decisions-7-seconds-before-you-decide

(2) http://faculty.ncwc.edu/mstevens/300/300lecturenote04.htm

And thats how it goes for many paruretics. It has become an irrefutable fact that many paruretics have to plan their entire lives around the increasingly debilitating condition of paruresis. Aspiring college students find themselves determining which university to attend based on the conditions of the campus restrooms. High qualified and indispensably talented men and women find themselves working jobs far beneath their capabilities, all due to the fear of a drug test.

I myself have recently been considering the prospect of serving in the United States Military. As many of you who know me, it is recognizable that I am a mild to moderate paruretic, though I have come long distances in recovery. Pissing is no longer an issue in my life anymore, as the combination of a positivist outlook and practice (with some help coming from the breath hold technique). In the last year or so of my life, there has not been a single situation in which I could not relieve myself even in the face of extreme duress (crowded concert halls, ball games, bars, etc…). Yet despite even all of the success that I have, there is a very small part of my brain in which paruresis still seems to attach itself to, I have reservations about stressful bathroom situations.

I believe that it would be fair to say that the military would have to be the most extreme situation there is for a paruretic. Let’s first start with the drug testing policy of the US military. Before you can even enlist, you must first report to a qualified military MEPS (Military Entrance Processing Station). There, you will be given a battery of physical examinations, which is culminated in an observed drug test, with other enlistees standing next to you on either side. It that itself is not enough, you will also be given an observed urine test when you arrive at basic training, which occurs during in-processing. Then, if you decide to go active duty, you will be tested when you arrive at your base and subsequently when you are transferred to a new base. Myself personally, am leaning towards joining either the reserves or national guard, though drug testing is a right the military claims for any service while on duty. An observed drug test is no longer an issue with me (again, with help from the breath hold), but the pessimistic sect of my brain still nags at me thoughts of the military come up.

It just shows you how much paruresis consumes us. Even someone such as myself, who is by all accounts (ok, maybe just my own account) someone who has experienced great success in recovery. This notion just strengthens my theory that all paruretics are lifers. Even if you do recover and get to a point where urination is a non-issue, you will always be plagued by negative thoughts. No matter how small or infrequent those thoughts might be, it is simply impossible to completely and fully exert them from your mind, whether conscious or unconscious.

In my opinion, the earlier that paruretics come to terms with the seeming fact that they will never be fully recovered, the more successful they will be in their own recovery. We have to stop fooling ourselves into thinking that there is a “magic cure” or a full-proof (or more appropriately “fool-proof”). There is no cure. There is no magic pill. We are and always will be paruretics. Just as the saying goes: “once and alcoholic, always an alcoholic”, to use the saying to fit my point: “once a paruretic, always a paruretic.” And just as alcoholics have to take everything one step at a time, one day at a time, paruretics must do the same.

Those with paruresis must be goal oriented. We mustn’t look too far into the future. Of course it is important to have long term goals (for example, being able to pee at a concert), but ultimately how the war is one is through battles. Short-term goals are the catalyst that lead to more lasting and impacting long-term goals. If paruretics do not learn how to take everything one step at a time just as the alcoholic, they will suffer the same fate, that being the relapse.

The last thing that I will note is that to overcome the obstacles of paruresis, positive mentality must be maintained. If it is not, failure is the only outcome. Paruresis is a condition that feeds of pessimism, and negative thoughts is the potent gasoline that fuels the fire. You have to recognize that there are going to be setbacks, and failures will be incurred. In many ways, I feel that failures can be just as valuable, if not more so than successes. Failures shows us what does not work. It acts as a process of elimination in finding the proper formula for recovery. When it comes to a condition like paruresis, it affects everyone differently, and therefore should be addressed differently for everyone. Each person have things that work well for them, as well as what does not work.

To put it simply, you have to find what works for you.

Standing firmly before my foe,

With a range of mixed emotion,

I wonder if I’ll be able to go.

I stand, and I stand,

A whole world passing me by,

Each minute a new neighbor,

I curse silently: “Just let me die”.

It seems today is not my day,

As I step away with a bladder still full,

I zip up with a feeling of defeat,

All that effort, to forever be null.

My mind is racing now,

Of the many perils I have had,

A seemingly simple task to many,

The feelings of isolation leaves me rather bad.

Pacing about now, I wonder,

“What in the world shall I do?”

It is then that I realize,

What I have to do to get through.

I stroll defiantly up to the urinal,

This time though, a head full of steam,

“I will not fail” I proclaim,

For now is the time I shall redeem.

Before I have even a chance to think,

A stream begins to make its way,

Rather slow at first,

I procure a feeling for which I am willing to pay.

The stream now at full strength,

I am overwhelmed at my actions,

With all that I have been through,

My successes seem only a mere fraction.

I finish up with beaming delight,

Satisfied with the pleasant outcome,

The tense energy now done,

I ponder at where the ability came from.

But I realize now,

It had come from my own accord,

My optimistic thought and inner strength,

My own will an unbreakable board.

From that day forward,

My mind was always set right,

And when I stepped up to that urinal,

It was no longer a losing fight.

Toilet, John, Loo, Crapper, Water Closet, Potty, Lavatory, Oval Office, Privy, Latrine. Whatever you preferred vernacular is, many of us use the good ole’ toilet on a daily basis (assuming regularity… or indoor plumbing).

Popularized by British plumber Thomas Crapper (now a rather infamous name) in England during the latter part of the 19th century, it has become a popular and useful invention, though an also under appreciated one. Most of visit the toilet on a daily basis (assuming regularity), and often visit it multiple times throughout the day. Some use the same toilet day in and day out, while others may use several different toilets in the course of their daily lives (just think, a trucker might use hundreds of different toilets in a year). If your keeping count of how often people use the toilet in the world, you can check out the flush meter on worldometers. Some stand, some sit, some even do both. Hell, some even squat. Some pull a lever, and some yank a chain. No matter the way you use your toilet, take this day to give your toilet some appreciation (with a 21 flush salute… not really). Most of us go through the day without giving any though to the toilet, and how vital it is to the lives we live. Toilets have helped prevent the spread of diseases, and have allowed people to live more sanitary, hygienic, and overall healthy lives. Without the toilet, the zombie apocalypse may have already happened.

On a more serious note, we should all take the time to recognize the immense poverty that we are encountering in the world.  According to the World Toilet Organization (WTO), around 2.6 billion people around the world do not have accesses to a flushing toilet. Even here in America, there are many people in the fringes of society who consider indoor plumbing a luxury. A luxury? For the majority of our society, the toilet is not seen in such a glamorous light. In industrialized first world countries, toilets are considered a basic necessity rather than that of a luxury. We all have to remember how fortunate we are to have all of the benefits that come along living in a prosperous nation, and that even the most basic commodities such as a toilet are used by even some of the poorest of Americans. It can seem a bit silly to speak so magnificently  in talking about the subject of the toilet,bue the real foolishness is being so flippant about something so important. People do not realize how important the toilet is to modern society, and we should not take it for granted. It is just another one of those little things that people just brush off on a daily basis. In this modern technological age, we are afforded the luxuries and comforts that modern day inventions have brought us, without thinking about how lucky we are. Around 40% of the worlds population does not have access to a toilet on a daily basis, and are stuck dealing with the unsanitary and unhealthy conditions that a lack of plumbing brings along.

It can be easy to look past the modern commodities that we are fortunate to use everyday, but sometimes we just have to sit back and be thankful. Well today is that day. I would strongly encourage anyone to visit the WTO website and make a donation. Even a small donation can make a difference. It may sound cliche, but if we all can give just a little bit, the numbers will add up quickly. I would also strongly encourage everyone to raise awareness about the World Toilet Organization by posting on the Internet (social media, blogs, forums, etc…), and also telling friends and family about it. You might get a few odd looks and tilted heads, but it can make a difference. You might not sway many people into donating money, but raising awareness alone can make a big difference.

So today when you use the loo, just remember how lucky you are.

For example, a five foot putt might seem like a very easy thing to make. Alone, you might make that putt every single time that you attempt it. But put a dozen cameras on you with thousands in the stands and millions watching at home, and even the best of the best will miss it sometimes.

This can be aligned with situations involving paruresis. At home alone, pissing may be absolutely no problem at all. But in the restroom at a sporting event or concert with dozens of people waiting in line intently watching your every move, and it might seem like a dire task to empty your bladder. This is intensified when you begin to ponder what others are thinking, or what judgements they might be making (when they almost certainly could not give a rats ass). Such a common trend among paruretics.

Your overall mental health is also an important factor in both games. If you are in good spirits, have a positive outlook, and are feeling confident about yourself, you will most likely play better when you hit the links; same goes with paruresis. Your overall mood and health mentally can make or break you when it comes to golf, as well as in paruresis.

A great illustration of how the mental affects you, is that of golfer Tiger Woods. He was once the greatest golfer in the world (arguably ever), and seemed to make incomprehensible and breath-taking shots at will. Then came scandal (wife bashing his car, his transgressions with women revealed, divorce, etc.), and seemingly overnight he fell of the wagon and lost his grasp for the game. For the last year, he has been unimpressive at best, and has displayed an apparent issue when it comes to the metal side of the game. He is no longer confident with himself, and thus lost his ability to play the game well. We all now he has the ability to perform well, but as famous golfer Bobby Jones once would have said, he is losing the battle taking place on the 6 inches between his ears.

In many ways, Tiger Woods is the perfect metaphor for paruresis. For everyone, at first, peeing comes as natural as breathing. You stroll up to the urinal or toilet, confident, reliant on your second-natured task of urination, and do your business. No questions ask. Then something happens. It might be a singular event or a series of events, but eventually things begin to fall apart. You lose the ability to pee on command (as Tiger was once able to make shots on command). The consistent failure just adds to your feelings of defeat, and walking into a public restroom feels like a high pressure ordeal, and the whole world is watching whether or not you can urinate. This is of course untrue, but it is exactly how our brain rationalizes the situation. You know that you can do it, and have done it hundreds of time before, yet that 6 inch course is barring you from accomplishing a once insignificant goal, urination.

As in golf, paruresis is a combination of both physical and mental issues. In golf, you practice the physical: swing mechanics, putting practice, film study, and even physical fitness. In paruresis, you practice as well through desensitization and graduated exposure therapy. But ultimately with both, much of the problem lies in the mental game. It does not matter how many balls you hit on the range, or how many times you practice your swing, if you have a negative attitude you will undoubtedly fail. The exact same goes for paruresis: no matter how much graduated exposure therapy or desensitization techniques you practice, failure is a certain if you have a negative attitude. This is why it is important to maintain a positive attitude. At times, optimism can be a rather elusive creature, but it is a key element to paruretic recovery.

There are many paths to maintaining an optimistic outlook: some use therapy; some seek the help of a life coach; some confide in those close to them. Whatever way you use to achieve a better attitude is simply up to your individual needs. To many, therapy can be just the thing to change their outlook whereas for others, it might have no effect at all. Life coaching might even help, as plenty have had very good experience with it, and have changed their outlook for the better with it. For me personally, confiding in others led me to a path of self-discovery and was able to obtain a strong sense of self-awareness through my experience.

Whatever be your way, just remember the importance in maintaining the optimistic outlook that I alluded to earlier. If you can keep your thoughts positive, that will translate into positive actions.

The formula is simple: positive thoughts = positive actions.

-Friedrich Nietzsche

No person could have put it more eloquently and as beautifully concise than that of Nietzsche.

Self-awareness is a topic that often comes up, but what does it really mean? If you were to have asked Nietzsche, he would have said that self-awareness comes from within. Ask Jean-Paul Sartre, and he would have told you that it comes from the relationships that you form with others. To Soren Kierkegaard, it came from a sense of deep individualistic faith in god, and an unwavering commitment to faith. In my personal and humble opinion (somewhat futile in the company of such great thinkers), self-awareness is a constantly evolving understanding that we obtain as out life plays out its scenes and moments. Whatever be the opinion of my reader, I would presume that most would agree that self-awareness (or self-consciousness if you will) is a deeply complex and important topic. Despite most people having an understanding that self-awareness exists, many have not the slightest inclination nor ability to draw conclusions of their own self-awareness.

As a recovering paruretic, I would not have been able to make any of the progress I have currently made if it had not been for a deeper and more observant view of my own self. When I first made the decision that I would rid myself of the darkness and unrelenting power and shackles that made up paruresis, I knew that I would have to seek help from others. I did some research, and much to my surprise I found a rather copious amount of information on the topic. It was around that time that I stumbled upon (literately, no relation to the web crawler) the IPA and their forum. At first I was reluctant to sign up for the forum. As I speculate now on the reasons, I suppose I was still stuck in the ever present stage of denial. Though I did recognize that I had a problem, it seemed that there was something keeping myself from really stepping out and taking the great plunge of the unknown. After a couple of bad incidents with my condition (the last straw so to speak), I signed up.

Once I signed up, I immediatly regretted not taking the dive much longer ago. I found so many people with my condition. I read stories of may fellow sufferers, and began to assimilate connections with their stories with mine. It was then I realized something that was key in my early recovery, I was not alone. There were literately dozens of others who had, and were experienced that same things that I was. It was truly liberating. It was a feeling of exuberance that I simply cannot describe with words. Anyone who found the website knows exactly the unmatched feeling that comes along with knowing that feelings of worthlessness and solitude were shared by many others. It was a game changer.

After reading a sufficient amount and coming to the conclusion that it was my time, I officially began my recovery. Well, not really. At that point I was still blindly ignorant to my self-awareness. I was searching for an answer when I didn’t know what the question was. I was trying to solve when I had yet to formulate a problem. It was at this time that I sunk into a deep depression, indubitably the worst bought that I had ever suffering in my entire life. I secluded myself for a very long period of time, and began to lose control of my stability. All I could do was think about the worst. What if I can’t recover? What if  I’m not strong enough to get through it? What if its just not meant to be? These of course, were all questions with no answer. They are what I call negative speculation. Negative speculation is the irrational and unfounded speculation that comes along when you doubt yourself without a constructive manner to your own self-criticism. It is the negative energy that you bestow on yourself when there is no logical or productive reason to do so. It is the type of thinking that has driven many people mad with uncertainty and despair. The damage that can be caused when enough negative speculation occurs can be irreversible, and lead to drastic consequence with no solution. I can say that this point in my life was absolute rock bottom for me. It was ground zero.

Through all of the self-hate and regret, I realized something. I am alive. I am here. I have been to hell and stared the devil square in the eyes. I had gazed deeply into the abyss, and it also had gazed into me. The revelation gave me a sense of self-awareness that I had never experienced in my life. I came to realize that all of the negative experiences that I had been through, that all of the failures I had experienced, only made me a better and much stronger person. I found strength in myself that I never knew resided within the realm of my body. The condolence of others, the pity of peers, and venting of irrational and slightly insane emotions laced with apathy were not what gave me that realization. It was me. I was the one who procured my own strength from within myself. The experience of such self epiphany was so overwhelming that the wave of emotive experiences that I felt rendered me a seemingly different person. But I was the same. The same Max that I had always been. I had just shed the long worn exoskeleton of a pessimistic, apathetic, self-loathing, fearful, distraught, unstable, reliant, and underwhelming nature of my previous self. I had unsheathed the armor that I had so long used to protect myself from reality. I was exposed, and glad to be. I was vulnerable to the emotional and metal hazards that the world had to offer. With that however, I was beginning to realize true happiness.

With my newfound world view and positive attitude and forward thinking mentality on life, I realized that my path to recovery led through me. Certainly I could use previous experiences of others and advice as an aid to devise my own recovery, but ultimately my recovery would be unique to myself. I came to the realization that there was no one size fits all for recovery. There was no twelve steps or full proof method to recovery. What had worked for other paruretics might not be as beneficial to me, as my experiences and my condition was in itself an entity of its own. I would have to find for myself what worked and what did not work, and that is how I would formulate an answer to my question. A solution to my problem. Eventually, through trial and error, failure and success, I have come to understand my own path to recovery.

As I sit here know, It has been well over a year since my initial attempt at recovery. I reflect on the past with great satisfaction, and find myself with a feeling of great delight in such and auspicious moment. I have come such a long way in my recovery process, and no longer feel the tremendous burden that paruresis was gave me. I am free to live my life without fear or worry of what is to come. I do not look to the future with any bit of hesitation, rather with great excitement and anticipation. Our country and our world are going through some tough times, and equally going through a rather drastic paradigm shift. I, as everyone else, have had to change my lifestyle to conform to the rather austere and persistent economic situation. I have less money know that I have ever had in my life. Yet, I am more content know than I thought I would ever be. As Bob Dylan once wrote “the times they are a’changin”. Without yield, I am ready to move forward and greet with full force any challenges I might face in the near future. My self-awareness has given me a sense of transcendence and ability to overcome. I am ready for whatever curveball is ready to throw.

“If you don’t know where you are going, any road will get you there.”

-Lewis Carrol

Your path lies through the looking glass.

Its been awhile since I last blogged, as I have had quite a bit on my plate as of late (excuse the unintended rhyme). Work as been very busy lately as we have moved into a new location (same good ole single user locking restrooms), so it has been quite hectic around there. My school workload has also hit full stride, as I am nearing the final month of the semester. I am excited for this winter break, and am ready to commit time to some non-work related projects that I have been wanting to do. I recently went on the annual family camping trip (males only) and had an terrific time. Only a couple hesitations in terms of urinating, but did not get in the way at all. Overall it was an incredible trip with a family I love dearly.

The subject that I wanted to address in this blog was paruretic awareness. When I say paruretic awareness, I am speaking of the general recognition of paruresis as a condition in society. I think that many paruretics would be surprised at just how many people have flat out never heard of anything related to shy bladder. Despite the fact that 7% of our population suffers from this problem, paruretics are infamously talented and hiding and suppressing their condition from others, including those who are close to them. This behavior has got to stop. If there is anyone that a paruretic should open up to about their condition, it is their loved one(s). I cannot even begin to quantify the impact that telling my mother about my condition had, especially due to the fact that I learned she was a sufferer as well. My mother was also not shy about her condition, and had no problem opening up to others about her problem. This has inspired me, and I have since been more willing to tell others that I have trouble relieving myself in the presence of others.

In many cases, just allowing themselves to open up about their condition often improves a paruretics condition tremendously because they no longer have the feelings of loneliness. By keeping your condition a secret, you are encasing yourself in a treacherous and incomprehensible abyss of both mental and physical suffering. By telling those close to you, the abyss that has held you in so long, and most likely worsened your condition, vanishes into thin air as if it never existed. Once I told my mother about my suffering, I released myself from a significant amount of internal suffering, and my condition instantly and significantly improved. There is no doubt in my mind that opening up paved the way for my recovery. I encourage all paruretics to open up about their problem with the someone they love. Even if it just one person, the impact can be beyond the imagination. The ultimate goal is to be completely open about it, but telling the person who you feel closest to and are most trusting of is a great place to start.

Though opening up to others is a vital and virtually necessary step in both recovery and awareness, we need to take it even further. Paruretics need to start educating others about the condition, and make paruresis known to society.

It is rather shocking to me (I am rather biased however) the number of people who have never even heard of paruresis. With the fact that 7% of the population suffers from paruresis, It is statistically improbable that people who so not suffer from paruresis have never met or know someone who does suffer from it. According to the Autism Society, between 1 and 1.5 million people suffer from Autism in the US. That means that far less than 1% of our population suffers from autism, yet everyone knows about autism and a majority of people have encountered or will encounter a person with autism in their lifetime. Many might call me out on autism and would claim that more people know about it because it is easy to recognize those with autism. They would be wrong. As a matter of fact, autism is often not easily detected, and only the most severe cases are visibly noticeable.

Now, why is it that autism, a disease that has been recognized by the entire world, and been researched and funded as well as recognized by every major medical association in the world? Simple: awareness. There are thousands upon thousands of activists around the world who have made it their mission to raising awareness about autism. This is exactly what paruretics need to start doing.

I recently read a post on the IPA forum (link to post here: http://www.paruresis.org/phpBB3/viewtopic.php?f=2&t=8329&p=34855#p34855) in which a man (I am assuming, forgive me if I am wrong) called a theme park and explained his paruresis to them, and asked if there were any alternatives to the public restrooms. Much to his surprise there was, as there was a single user locking restroom facility generally reserved for the medics, though was rarely used. Apparently, he was not the first to call and ask the very question he asked, and the woman he talked to was aware of paruresis as a medical condition. So there you go, awareness can make a huge difference.

If we as paruretics can manage to raise awareness about our condition, there is no doubt in my mind that we will have the ability to affect great change. Imagine being able to go to a them park in which there will single user restrooms available to those uncomfortable with using public restrooms. Imagine being able attend a concert venue without worrying about having to relieve yourself, because there is a set of single user restrooms off to the side built for those who need them. Imagine Congressman who propose legislation that would give tax incentives to paruretic-friendly employers. I know, I know. I am sounding a bit like a paruretic John Lennon. But in all seriousness, these are all legitimate possibilities. However, they are only legitimate possibilities if we can raise awareness about paruresis.

My challenge to all paruretics is simple: write at least one letter a week to either a public official or a business, and raise their awareness about paruresis. It might seem like a small task, and it is, but it could have a great impact of paruretic awareness. If we can start making both public officials, and businesses more aware about paruresis, we might start seeing some real change in terms of both restroom design and availability, as well as alternatives for people who suffer from paruresis. Increased awareness about paruresis might also promote research of paruresis, both medical and psychological. Who knows where that type of research might lead. Overall, increased awareness about paruresis would have a strongly positive impact on the paruretic community, and might lead to some very drastic and progressive change in the way people view paruresis.

Thank you for taking the time to read this, and I hope that everyone will subscribe to my challenge.

Max

I saw shows on Friday and Saturday (Down and Bad Brains respectively), and had an absolute awesome time. Live shows are like therapy for me, and gives me a great escape from the boiling pressures of the world. Not only that, but I always come out of great shows with a positive attitude, and apply it to my life. As of this point in time, life is good my brothers and sisters.

Naturally at the concerts, I found myself in rather difficult restroom situations. This was intensified by the long lines (longer than usual), and abhorrent sanitary conditions of the restroom. Despite all of the successes that I have had with my recovery, I felt myself getting tense as I approached the restrooms. I instantly recognized my anxiety and just stuck with my system. I held my breath, and calmly approached the urinal, and after about 20 seconds of breath-holding, a solid stream of urine made its way into the urinal. No problem. I dealt with this for two days in a row, and never felt more than a mild level of anxiety. This just adds to my recovery, and hopefully shows all of the paruretics out there that just because you have anxiety, does not mean that you are going to fail. Anxiety is often to root of the problem, and once the anxiety is dealt with, urination should be no problem at all.

It had been sometime since I had experienced any level of anxiety at all while using the restroom, and naturally I began to ponder the reasons. The reason that I came up with is rather simple: a paruretics success or failure in a particular situation often depends on said persons comfort in the environment. Allow me to elaborate further. The venue that I went to is the same venue that I had been going to for quite a few years, even back when I was still a very mild paruretic. Despite the fact that I have been able to urinate there many times without hesitation, I have had a few times in which I could not, and therefore I experienced a bit of an flashback if you will. My mind still associates the venue as a place where I have had trouble using the restroom, which gave me my anxiety. To me, this shows that the mind puts an emphasis on bad experiences, and they can even overshadow good experiences. This is why working on your secondary paruresis, or the emotional impact paruresis has, is vital to the recovery process, and can make or break a paruretic.

I have also noticed this with places that I am unfamiliar with. When you travel, your mind has to adjust to the new environment, thus putting your mind in a bit of a fragile state. When I first went to visit my sister at college in Columbus, Ohio, I found that I had a bit of anxiety when I approached restrooms there not because I was worried I would not be able to go, but the fact that I was unsure of the restrooms. However, once I adjusted and became more comfortable, I found absolutely no problems whatsoever. I can be certain that I am not the only paruretic who has experienced this, due to the fact that paruretics are infamous for avoiding potentially difficult situations. As long as you remember to maintain your poise and remember to fall back on your recovery work, these situations should pose no challenge at all.

To conclude, it is vital to remember that it is OK to have anxiety. No matter how far you are along in your recovery process, you will always feel some anxiety when you approach a situation or environment that you are unfamiliar. Remember that everything is one step at a time, and reference your previous experiences, and you will be able to tackle any paruretic curveball that life might throw at you.

Keep it positive, and don’t forget to walk with one foot in front of the other.

If you ponder in depth of paruresis as a mental condition, it truly is a comedy of errors. To me, the definition of paruresis can be accounted for in a single statement. Paruresis is a “Behavioral disorder in which an individual has a fear of not being able to urinate in the presence of others.” By that statement, we can assert that paruretics fear while urinating in the presence of others, but rather more glaringly to me that a paruretic has a fear of not being able to urinate before the problem actually arises. I can remember several instances in the past in which I chose against attending particular events, due to the fear of not being able to relieve myself. As I look back on these instances, I cannot help but fill myself with laughter. I decided not to attend the events not because I was not able to go, but because I feared I would not be able to go. I am certain other paruretics can attest to the same behavior, as I certainly have seen it.

For me, this behavior is beginning to fade away quite swiftly. Within the last week, I had a particular instance in which I noticed similar behavior occuring. The first was while I was visiting a good friend of mine at his new apartment. It was quite small but cozy, consisting of a single bedroom and restroom. The restroom was maybe 10 feet from the living room, and ones presence in the restroom was quite noticeable. I was there with a group of five, in this matchbox of an apartment. After a few beers, I had worked up enough urine to constitute a trip to lue. I walked in an immediately reached for the door to close it. I caught myself in the act, and smirked at the realization of the habit I had acquired. My brain is trained to automatically close the door, no matter the situation. I might have had trouble with this particular situation in the past, but to no avail these days. As I left the door open and in the clear few of everyone at the apartment, I relieved myself without hesitation. Yet another habit that I have broken on my road to total paruretic recovery.

Paruresis is very much a cognitive-behavioral disorder, and should be treated as such. In order to have a successful recovery, there are habits that you are going to have to break. There are a couple common habits of a paruresis that I can think of, that breaking the chain of them will increase chances of a successful recovery.

1) Don’t empty your bladder before you leave the house. This is arguably the most common habit of paruretics, and I would recommend breaking it. By emptying your bladder before you leave the house, you are already basing it on the premise that you will fail. I you assume you are going to fail, then you are invariably going to fail. You might not be able to break this habit overnight, but if you work at it in increments, you can eventually break the habit.

2) Don’t avoid social settings because of your paruresis. For me personally, actively attending more social events helped me quite a bit in recovery. I used to be in the habit of declining particular events due to there social setting, but I no longer do. An important part of getting rid of paruresis is breaking the chains that paruresis has bestowed upon you. Having to miss out on social settings is one of the more emotionally taxing side-effects on paruresis, as it can put strain on close relationships. It imprisons you to your own solidarity, and should be a spell to be broken.

3) Tell those close to you about your condition. Quit hiding, especially to your loved ones. Probably the greatest burden of the disease that is paruresis is having to hide it, which consequently makes it worse. Hiding places a heavy weight on the already heavy shoulders of paruretics, and should be rid of as quickly as humanly possible. Start by telling your spouse or immediate family, and then move to close friends. The eventual goal is to not be ashamed of your condition, but rather embrace it with open arms.

4) Don’t avoid difficult restrooms. Keeping away from difficult restroooms should not be included in your recovery. Even if you are not able to go in a particular restroom, the the process of gradual desensitization is taking place, and you are gaining valuable experience by approaching these restrooms. Even if you have to use a different toilet in the end, just attempting seemingly impossible feats can be quite liberating, and themselves can help you in recovery.

If you can break these habits, you should be on your way to a successful recovery. Just remember to stay positive and keep working hard. Also keep in mind that your failures can be just as valuable as your successes. Even if you are not able to go and you require the use of the breath-hold technique or the catheter, its all a part of the process. Even when you fail in a particular situation, the experience of desensitization it gives you ultimately turns failure into success. Stay positive always, and treat negative experiences as important as positive success.

So this week has been a rather good week so far. On sunday, I went to the PGA Championship (golf) with my father (my fathers day gift to him), and had a great time. The bathrooms at the event consisted of port-o-potties, all in a collective area. As any paruretic would (even a recovered one like me), the first thing I did when I got there was inspect the bathrooms. I noticed that all of the port-o-potties were all lined up side by side, with no room in between. I also noticed that there were both male and female potties. I was intrigued by this, as I had never seen port-o-potties that made the distinction between the sexes. At first I thought that there might be trouble with them due to the fact that they were so close, but this thought was instantly dismantled when I was able to use it with no hesitation whatsoever. Even in the more crowded restroom areas, I was able to go without thinking twice. Even though I am long past suffering from the condition, I am now able to go in any situation, even if I have to use the breath-hold technique. For those of you who do not know, the breath-hold technique is a technique in which I hold my breath (go figure) long enough and am able to keep my body relaxed enough to build up enough CO2 in my lungs, which in turn allows me to relive myself in the most difficult of situations. My buddy Dominic and I share a YouTube channel, , in which we both have several videos demonstrating how to do the technique. I would highly suggest giving it a try, as it has been an invaluable tool in my recovery process. I plan in the near future to do an in depth post related to the breath hold.

Other than the golf tournament, the only other public restrooms I have come into contact this week have been the restrooms at my work (restaurant). The restrooms where I work are single-user locking, which is quite friendly to that of a paruretic. Despite the fact that is is a single-user restroom, it has been quite helpful for my recovery process (inadvertently coincidentally). For example, in my younger days one thing that irritated my paruresis was a time limit. When I had time pressure on myself, then I would often lock up. The other day while I was in the middle of a shift (dinner rush), I stepped out to use the restroom. I found myself under intense time pressure due to the fact that the restaurant where I work was quite busy. On top of that, I stood in a line and had other behind, which added to the pressure. Despite the fact that I had quite a bit of pressure on me, I was able to urinate with not even a bit of hesitation. At the time it was no big deal to me, as it had become a normal thing for me. As I reflect on it though, I begin to realize how far I have come in the last year or so. This time last year, there was no way in hell that I would be able to have done what I did. It is truly a liberating feeling to know that I have let myself go from the shackles of paruresis. I do not want to sound to idealistic to those looking for recovery, and will tell all that it was a very intense process to get where I have. I suffered through a tough experience of desensitization, self-reflection and criticism, and life-changing mentality.

I want those reading to know that the path to recovery is a difficult one, but it will change you as a human being. You will gain a greater appreciation for life and the things in life, and will have obtained a level of self-enlightenment that few have ever known. I do not exaggerate when I say that you truly do become a more complete person. Just remember to take everything one step at a time and to fully embrace the challenges that lie before you with a head full of steam, and to not get ahead of yourself.

Note self-enlightenment cannot be achieved by changing certain aspects of your daily life, but by changing yourself as a whole entirely.

My story is rather textbook of that of the average paruretic. In my case it started in middle school, when the antics of young middle school aged boys forced me into the stalls at school. I found myself having trouble going in certain situations, though ultimately I had a rather mild case of the condition, and was able to live a normal life. I had the occasional episode, of varying scales of discomfort, in which I voided and could not relive myself. These situations were quite rare, though had the potential to be very downing. It was not until my late teens that my problem got worse and I made the commitment to ridding myself of this debaucherous disease that I possessed. I began searching the Internet for any imformation I could find on the subject, which led me to the fourms of the . I was pleasantly astonished when I realized all of the different people who suffered from this condition. Male or female, young or old, the condition did not seem to have any prejudice of who it might encounter. With all of the information that I found on graduated exposure, desensitization, the breath hold technique (of which I have now mastered), I was able to take control of my paruresis.

I am now no longer hamstringed by paruresis, and now consider myself a recovered paruretic. I still to this day learn new things about myself in regards to the condition, and am improving to even greater heights everyday. I have also greatly improved my own outlook on things, and have learned to embrace life head on and to try new things on a daily basis. I have realized strengths within myself that I never new existed, and thats why I have decided to start this blog.

In this blog, I will be writing about my day-to-day experiences with paruresis. I have yet to decide on the frequency in which I will write to this blog (daily, weekly, monthly, what have you), but I will make my best effort to write on it as much as possible. I will also write on topics such as self-help (self-empowerment rather), philosophy, and life topics in general. I encourage anyone who reads any of the future blogs that I post to leave comments with feedback and constructive criticism. Don’t feel the need to hold back any thoughts, as I have a rather thick skin (besides, I don’t bite…. too hard).

This is my first step into the world of writing, and hope that my writing can help those out there looking to better themselves. I might quote an old proverb in saying “Every journey begins with one step.” Though this may be true, I have to criticize the last part for the purpose of this blog. Your journey to recovery should not being with one step, but rather the largest leap that you can manage to muster. Learn to embrace not only individual things such as recovery, but life in general with excessive joy and ambition. Become an addict of knowledge, learning, and life experience. Most people are far too afraid to live life with that degree of excessiveness and experience, but as you will come to find out, I encourage it on an astronomical scale. I will leave you with one last quote, one that I hope resonates with you: “The road of excess leads to the palace of wisdom.”

Live dangerous and curse moderation