Successful treatment by Cognitive Behaviour Therapy

Posted by Fiona Barrington (a pen name) on 27/4/2007, 1:32 pm

I first suffered from this condition in 1963, when I was six years old. That winter was so cold that the snow lay for three months and the pipes of the school's outside toilets froze. Some men were sent to fix them and that lunchtime to my horror I found these men opening the doors of the toilets to see if they were empty. The fear of one of these men bursting in meant that I was totally unable to go and spent the afternoon in dreadful discomfort. Later that year my brother, who had a violent temper, reached his teens and his violence towards me intensified. This, together with pressures at school, led to a breakdown. As a result, I found I needed to go to the toilet very frequently. My brother teased me unmercifully, calling the toilet my home and asking me if he should pay me rent each time he went there. I will never forget the anger and disgust in his voice when he caught me committing the unspeakable crime of visiting the toilet twice in under an hour. After a few months, my nerves improved and my visits to the toilet became less frequent, although the anxiety whenever I was far from a toilet remained, making any outings stressful. My brother's teasing went on for years, until he went off to university. The stresses of puberty, combined with bullying at school, meant that once again I needed to visit the toilet frequently, but by now I was convinced that this was a deeply shameful problem which must at all costs be concealed. The scolding another girl received for asking the maths teacher if she could be excused, only reinforced this belief. As you can imagine, it was no easy task trying to use the toilet in secret in a busy school. At first I only had difficulty in going when the bullies were nearby, but by the time I reached the sixth form it was physically impossible for me to go if anyone was around, whether at school or anywhere else, including my own home. During these years I was forced to rely on ever stronger tranquillisers to survive the school day. The return of my brother from university only added to the stress and immediately after my A Levels I had a complete breakdown. Within a month I was found a place at a psychiatric clinic and started cognitive behaviour therapy(CBT). The treatment involved eight stages and lasted for three weeks. At first I had to use the toilet with a nurse standing halfway down the corridor, then during the next stage she stood just outside the door. I also had to use a bedpan with a nurse in the room. The final stage involved using the toilet with two men shouting outside and banging on the door. It was horrendous at first but by the end I was not only coping but could even see the funny side. It is now thirty two years since I had my therapy and the occasions that I have been unable to use the toilet during that time can be counted on the fingers of one hand. I still dislike going to the toilet with other women and hate it if they start talking to me when I am in there, but I can cope. I just tell myself that the feeling of panic will pass and start to count. I usually manage to go by the time I reach ten and virtually always before reaching thirty. Since leaving the clinic I have been able to lead a full life, completing a maths degree, having a successful career and adopting two boys with Down's Syndrome. Recently I was diagnosed with Asperger Syndrome (a mild form of autism), which helps to explain my high anxiety levels. I understand that Toilet Phobias are particularly common in those on the autistic spectrum. My own father, who probably had Asperger's, once told me that he could not use urinals in front of other men. The enduring success of my treatment can be shown by the way I have managed to cope with a number of situations. In one job the only toilet was at the top of the stairs, with rooms at either side let to another company. The people in these rooms always had their doors open, so anyone entering the toilet did so in full view of several people. Before my treatment I could not possibly have taken that job, but thanks to the CBT it was no more than a minor embarrassment. Returning home from holiday one year on a ferry, my sons and I were all together in the disabled toilet. My older son was having a tantrum and people were knocking at the door, wondering why we were taking so long. Again, thanks to the CBT, I was able to cope. A few weeks ago I faced another challenge. On the way to the toilet at my gym, I met one of the trainers. Not only did she choose the cubicle next to mine, but she started talking to me. I felt the panic rising, but gave her a brief reply and started counting under my breath. Before I had reached ten the panic had subsided and another victory had been won. It is a life long battle, but ever since the CBT I have been on the winning side.