U.K. PARURESIS TRUST: How Living In China Became A Daily Nightmare

Hi everyone,

I have suffered from this condition since I was a young boy, I think it started because my Dad has OCD and an obsession with cleanliness, so he often made us avoid public toilets, and put me under a lot of pressure to urinate on demand before we left the house or beside the road. I never actually learnt to urinate in front of others and took the belief that it was a "private function" to be done with nobody else around. In fact, I don't ever remember using a urinal in my life. My body/mind seemed to strongly support that early belief, in only allowing me to go in the right circumstances. And I was told that on occasion I was unable to go under the pressure - creating the mental blueprint that has stayed with me ever since. From the age of 8 til about 30 I never actually attempted to go at a urinal, even if the toilet was quiet or empty, which seems pretty naive now. My earliest memory is of standing in the school toilets with my best friend and being unable to urinate with him in the room, so I moved to a cubicle to relieve myself. From that day on I'd take a locked cubicle and normally always be able to go, except in very extreme situations e.g. when lots of people were waiting outside at a football stadium or in a busy bar/club, or places with only one cubicle or cubicle doors missing. It was also difficult at a friend's house with only one toilet and with everyone knowing I was in there. At that stage, the issue was simply a minor irritation, normally a safety behaviour (using a cubicle) and slight hesitation, followed by a successful outcome.

At the age of 30 I took a job teaching English in Vietnam and spent 8 months there, followed by a year in China. People that suffer from this problem should avoid China and Asia at ALL costs until they are more confident urinating without privacy! Unfortunately for me, my time in Asia transformed a "slight issue" into a potentially "life-changing problem."
I know that it's not the public toilet or situation that causes the problem, rather my perception and reaction to the situation that creates the problem. And I want to make it clear that I still take 100% responsibility for my current condition and the thinking/behaviour that has got me where I am. But let me know tell you about my experience: China was full of undesirable toilets in many ways: 1) Lots and lots of people in every public toilet 2) A live-in cleaner that would keep trying to open the cubicle doors 3) Very few places with full doors that locked 4) Very noisy. 5) Very small and claustrophobic. 6) Lots of time pressure on long distance trips.

As soon as I was travelling around outside the main cities I was horrified to be presented with a series of public toilets without cubicles. Imagine a long trough that runs along the whole wall, with knee-high partitions to separate people who are urinating or defecating. With my past experience and level of the problem, I was unprepared and unable to urinate in such conditions, like a non-swimmer thrown into the depths of the Pacific Ocean. I was left with a constant headache of holding on to a full bladder for awful lengths of time, attempting to locate "safe" toilets or quiet alleyways in a country that simply had people everywhere and no privacy, and having to limit my liquid intake for fear of not being able to find a suitable toilet anywhere. My situation declined mainly because I worked in a school where we had to share the toilets with all our students (aged 5-15) and there were only two toilets in the whole school, one on each floor (and horribly small), with one locked cubicle and two urinals. Once inside a locked cubicle I was often interrupted by the stream of noisy kids running in and out, leaving the outside door open so that others could see in, plus an oblivious cleaner that would choose break time as the moment to keep coming in and out of the toilet, continually opening the outside door and ruining my peace or privacy. The problem with teaching is there are only 15 minutes out of every hour when you CAN use the toilet. Add to my privacy/noise/personal space intrusion problems the issue of time pressure and I was soon dealing with failed attempt after failed attempt. Indeed, entering that toilet and locking myself in that cubicle resembled to me the equivalent of being put in a cage with a lion. So I got to the point where I was having to go back into class and teach another hour, absolutely desperate for the toilet. I was suddenly at a point where I'd have to control my fluid intake and carefully time my toilet stops. It dominated my working day - the place where I spent most of my life had a toilet I could hardly use, and there was no escape. Paruretics are experts at finding ways around toilet troubles and once my usual ones had failed, e.g. unable to find a safe toilet nearby, not living within 15 minutes of work, I was forced to take such actions as keeping my students late during the first hour, so I could restart the class 5-10 minutes after every other teacher/class, thus giving myself some valuable toilet time which was largely uninterrupted. This plan was still not the answer.

The problem got so bad in my last month of work there, that even if my contract hadn't been up, I would've had to leave anyway. The unfortunate hangover was that I began to have problems in many other situations, out in bars with friends, on a long-haul flight etc. I had one weekend trip with all my work colleges that proved disastrous. We were on a bus most of the time, meaning each toilet stop was planned but also timed and with lots of people I knew in the vicinity of the toilet. My worst cocktail and lots more failure. Somehow I struggled through despite huge mental pain and physical discomfort. Anyway, to cut a long story short; I've now returned to the UK and I'm trying to face up to this problem head on. I've spoken to a CBT, who had suggested I get as much exposure as possible. At the moment, the prospect of urinating at a urinal seems about as likely to me as being able to take a dip in river and relax with a crocodile swimming in it. But I know my cognitive thinking/behaviour and mental software needs to change to help me move forward. At present, I can usually urinate in toilets with more than one cubicle as long as I'm under NO real or perceived time pressure. But whenever I'm out with a group of people, on a day trip for example, I struggle to go because everyone sees me go into the toilet and the perceived time pressure of people waiting locks me up. So it's back to the drawing board, practising going at home with people around, getting out to public toilets every day and trying to relax and feel comfortable in that environment again. Very slow, gradual steps forward are the order of the day. If anybody can give me some advice I would be hugely grateful. Do you think self-catheterisation would help, as a back-up? Any other things I could do every day to get me back on track? I know I can beat this, and it's the biggest challenge I've faced in my life, so here's to urinating in public as a future life dream!

Thanks for your time,

Mark