Shy bladder syndrome or ‘avoidant paruresis’ to give it its correct terminology is classified as a social anxiety disorder. It affects the individual by inhibiting their ability to urinate in front of others, regardless of how desperate they may be to empty their bladder.
The shy bladder hold technique is one of the many tips that paruretics may have in their arsenal as they struggle to overcome or “control” their condition. While other tips include: relaxation, mental images, visualizations, distractions; this breath-holding technique seems to be the one that defies a clear explanation of its mechanism of action.
Does it really work?
Reports of seasoned veterans in the war against shy bladder syndrome bombard online forums every day. Many seemingly jump off the page with cries of ‘success’ after using this mysterious technique. For the first time in years, those who can’t get a drop with the threat of anyone else around them have been able to stand blue-faced until their bladders have given up the fight.
A paruretic on the UKPT (UK paruresis trust) forum reports: “OMG … it just worked for me … I held my breath and when I ran out of air after holding on for a long time, I suddenly felt the urge to piss and I did it !!! THANK YOU VERY MUCH !!! “
Another paruretic on the same forum says: “… it works perfectly. Thanks for this advice.”
How does the technique of holding your breath work?
It might be feasible to argue that this technique works by allowing paruretics to urinate in situations where they could not otherwise do so simply by overriding their inhibitions. Let’s face it, regardless of anxiety levels and how your brain is working and perceiving information, if the first signs of something life-threatening appear (not breathing, for example), then worry about what others might think of you. somehow loses its importance.
Paruretics become anxious and feel that a public toilet environment is ‘threatening’ and ‘fearful’. Fear is based on being negatively judged and scrutinized by others. This simply makes them extremely anxious and tense (the other side of the physiological coin of the pleasant relaxed state one must be in in order to urinate). Although the technique of holding your breath will in no way induce a calming and relaxing effect (not breathing does not tend to do that in a person), it is doing something. We know this through experiential reports. So what else could it be?
From a physiological perspective, if you hold your breath, you stop exhaling CO2 or carbon dioxide. This causes a short-term break in the blood, causing an increase in acidity. The brain and nervous system tightly control the acidity levels of the blood to maintain a strict biochemical level. Any deviation from this critical level of blood acidity can be life-threatening. So when the paruretic disrupts your normal breathing pattern and causes these changes, the brain’s current occupation of ‘worrying about what others might be thinking of me’ is abandoned in favor of ‘OMG, this increased heartburn of blood can become serious. Red alert. Red alert! ‘The sudden lack of concern for anxiety for others causes a full bladder to empty. “Don’t worry” as they say!
How to do it!
Practice holding your breath in increments until you can comfortably reach 45 seconds and still remain calm. Once you can do this, test it “in the field” (in a urinal). After about 45 seconds of holding your breath, you should feel a “dropping” sensation in your pelvic floor muscles and a stream of urine should begin.
For a more detailed description and medical disclaimer, go here.
Whatever the exact mechanism involved, the shy bladder hold technique works for some men and women. It’s one of the many tips paruretics use to help overcome this socially debilitating disorder.