Why Do I Struggle to Pee in Front of Other People?

Paruresis—AKA, shy bladder syndrome—is the second most common type of phobia.


It’s just a fact of life for many of us that it’s more difficult to pee when you’re flanked by two tall men at the urinal. Paruresis, or shy bladder syndrome, is a very common type of social phobia, ranking second only to the fear of public speaking. But why does the presence of others put a kink in your hose, so to speak? According to psychologist Aida Vazin, the social stigma that comes along with using the restroom is what shuts down our ability to pee.

“Using the restroom is something we typically do in a private setting, and we’re strongly conditioned by that social norm.” Vazin explains. “As a result, when we go to use the restroom in front of other people, that internal social cue [the one telling us that we should only pee in a private setting] triggers our body to push back.” As a result, this anxiety we feel about urinating in front of others overstimulates our nervous system and clamps the urethral sphincters (two muscles that control the exit of urine through the urethra) shut, making it more difficult to pee.

For some, paruresis stems from an embarrassing incident—say, they wet their pants in front of their classmates as a child. For most, however, paruresis simply stems from the fact that we’re being asked to do something in public that we typically do in private. In severe cases, a person with paruresis might only be able to urinate when alone at home.

Now, how do you overcome serious cases of paruresis? The medical community recommends joining a paruresis support group, where they teach relaxation techniques that help you pee in public settings. Holding your breath while using the restroom, for instance, increases the amount of carbon dioxide in your bloodstream, resulting in reduced anxiety. Support groups also encourage what they call gradual exposurethat is, taking small steps that slowly desensitize you to the act of peeing in public. Here are a few of those steps:

  1. Load up on water, so your urge to pee is greater than your anxiety.
  2. First, try peeing with a close friend whom you’re comfortable with, or even another person experiencing paruresis.
  3. Start by having the person stand across the bathroom from you, then gradually allow them to move closer and closer.

Using these tips, you’ll eventually become comfortable enough to use the restroom with complete strangers. Or, you can just plan your pee schedule so you only have to go when a private restroom is available. Hey, whatever works for you.