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Having trouble with mindset and gradual exposure

Posted by David on 19/11/2017, 6:49 pm

I've been doing gradual exposure for about 9 months now and I still struggle with having misfires because all I can do is fixate on the fact that I couldn't go and that I'm not as far into recovery as I thought I was, I also don't know what mindset I should have when doing gradual exposure because I feel if I haven't gone to a public toilet that day to pee then I'll regress and I live in this state of anxiety of feeling I HAVE to go somewhere to pee every day or I'll regress by the next day or if I've had a misfire that day I'll think about it all day and have to leave my house at 8 or 9 at night to go somewhere to desense just to stop the anxiety because I'm so paranoid about regressing as this is the third time of trying to recover and don't want to do back to what I was like before when my paruresis severe. I use the breath hold technique but only when I feel I can pee but just can't because something is locking me up enough to not let the flow start, is this bad for recovery as I'm kind of cheating? What mindset should I have when I'm doing desensing? Thanks, David

Re: Having trouble with mindset and gradual exposure

Posted by Dylan on 20/11/2017, 7:32 am, in reply to "Having trouble with mindset and gradual exposure"

I have trouble with thinking about paruresis too. I was quite severe to the point of not being able to use cubicles, spent 4 years doing gradual exposure I can urinate at most cubicles the only fear I get is having to urinate in a cubicle whilst a friend Or Co worker uses a troff and they ask why or failing in front of them. I also think if my life would be better without paruresis but alot of it is in our heads. I have improved significantly and I should be happy with what I have achieved.

Re: Having trouble with mindset and gradual exposure

Posted by Andrew on 20/11/2017, 12:02 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

Hi Dylan

About your fear. The trick here is to have a non-committal answer ready in your mind in case he asks that question; which he is unlikely to ask anyway.

If he asks, why you are in a cubicle reply in an off hand way either "Don't like troughs" or "I prefer cubicles". If he comes back with why, just repeat the answer "Don't know, just don't like troughs" "Don't know just prefer cubicles". It is not massively interesting to them. Don't elaborate!

As to not peeing in from of them. If he notices and comments like "what happened?" again just say "Don't know, sometimes it doesn't happen". There's a chance he will say " happens to me sometimes".

We make the mistake of thinking our peeing or not peeing is very interesting to others. It isn't. Peeing is off the bottom of the scale of interesting. Its equivalent to not being able to blow your nose; difficult to show much interest in that isn't it?

Hope that helps

Andrew

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 21/11/2017, 10:26 am, in reply to "Re: Having trouble with mindset and gradual exposure"

I used to work in a factory and one end of the building had urinals and the other end had a trough which wasn't very long.
I worked at the end of the factory that had the urinals but the canteen was at the end of the building that had the trough so when i had break time i had to use that one.
I absolutely hated it but used to try. If i couldn't go i either went back to work and asked my line manager a bit later on if i could go to the toilet or i used to wait until the trough was free and i would use a cubicle before anyone would notice i had switched from one toilet to another.
The sinks used to be in line with the trough (although you would have your back to the men urinating) but i remember a man who used to work on the next line down from me would always talk to me when we passed each other and he would make conversation with me whilst he was urinating at the trough and i was washing my hands. It didn't bother him that i would be facing him sideways on.
It seems different men have different toilet etiquette to other men.

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 22/11/2017, 10:10 am, in reply to "Re: Having trouble with mindset and gradual exposure"

I did some desensing in town yesterday Dylan.
I used four public conveniences and successfully went to the urinals in each one.
Twice the proximity was close and twice the proximity was next.
I went into one toilet with a man following me in. That particular toilet has two urinals that are very close together with no dividers and the hand wash is right by them.
The man went into a cubicle and there was a man washing his hands at the hand wash whose arms would of been almost against my back. I could hear the other man was just using the cubicle as a urinal and then another man came in and used the one next to me. All challenges but i successfully urinated.
I then went on to the last gents and once again a man came in just after i did. This time there was nobody else in the gents and there was four urinals. I was at the one by the wall and the man had the choice of privacy by using the third or fourth one but instead he went into the cubicle and once again i heard this man use it as a urinal only too.
Another man then came in and used urinal three and another man came in and used the one between us. At the time i was draining off before i walked home and took a good while to empty but i did so with absolutely no problem at all.
The point is Dylan is that this is evidence other men use the cubicles as urinals too and they don't worry what other men are thinking as they seem to go in their quite confidently.
Maybe other colleagues of yours use the cubicles too but you aren't in the gents at the same time to notice this?
If a colleague notices a misfire and comments you could say "i know, i've seen my dr about it and he says it's just one of those things... apparently other men have the same trouble too and is very common but it is nothing to worry about", your colleague will think less about it then.
If any of your colleagues make fun of your size in front of others at work then just say "how would he know what i look like?", it would shift the attention off you onto him and they may even make fun of him every time he goes to the the toilet then with comments like "don't go into the toilet with him, he looks at your dick lol".
That would make him feel embarrassed then.

Re: Having trouble with mindset and gradual exposure

Posted by Andrew on 20/11/2017, 11:53 am, in reply to "Having trouble with mindset and gradual exposure"

HI David

First off I think you are putting yourself under pressure to feel that you have to desense every day! Can you tone it down a bit to two or three times a week to give yourself a rest?

Secondly progress in anything is not steadily upward; instead it is up and down in the short term, with a long-term improvement? So can you remind yourself of that?

Thirdly is your hierarchy in place? That is, are you desensing at the right level, or are you jumping up and down the hierarchy? It does take some organising but not doing so would be like training for a marathon by running 100 yards one day, two miles the next, 800 yards after that!

Now the mindset. A paradoxical approach is needed here : i.e. the opposite of your gut reaction. Your mindset should be one of not caring whether or not you pee. Odd isn't it? Remember you can't make yourself pee, you can only get into a suitable situation, think to yourself you are in the right place and let things happened in their own time, not caring what happens. You can always leave and come back later.

The analogy I have started to use is walking the dog. The dog comes to a lamppost and starts sniffing. you cannot make it pee. It will decide if and when it does so. You as dog walker just stand there to give the dog a chance to go if it wants to. Before the workshop, you were like a dog walker who, if the dog did not pee after 2 seconds, would yank it away and continue walking. Dog walking is a peaceful exercise; can you think of desensing in like way?

BTW a misfire shows you are practicing.

Andrew

Re: Having trouble with mindset and gradual exposure

Posted by David on 20/11/2017, 3:05 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

Hi Andrew
Your response is really helpful, I definitely feel more at ease now when thinking about desensing and I'm going to stop going everyday to give myself a rest like you said. The problem I have with my hierarchy is that I can go in a busy toilet cubicle when the urge to pee is medium but find it very difficult to the point of having to go much lower down my hierarchy when I really need to pee so that's why i kind of go all over the place with my hierarchy, should i always pee with a full bladder and stay at that hierarchy? Also what things would be included on my hierarchy because my hierarchy is quite basic at this point, for example one of my hierarchy is just going into a middle cubicle with people either side, is that too basic? My main concern with misfires is that I'll regress because I couldn't pee, will this not be the case if I adopt the "it doesn't matter if i pee" mindset and not let it bother me? Thanks

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 21/11/2017, 10:32 am, in reply to "Re: Having trouble with mindset and gradual exposure"

I agree with Andrew that you are putting yourself under too much pressure. It sounds like you are expecting too much of yourself David.Take your time!
The middle cubicle is not too basic it is perfectly suitable.
The dog walking example Andrew has given you is a great one. Dogs don't have privacy to urinate and will know they can be seen and may even decide to go when nobody except the people they live with are walking them.

Re: Having trouble with mindset and gradual exposure

Posted by Andrew on 21/11/2017, 2:36 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

Hi David

I suspect that when you have a high urgency, the anxiety of having to empty or else gets too much. This may be because you have not yet got "reliable" enough in your peeing at medium urgency. Repetition, repetition till it becomes something you take for granted may help in this.

As for the hierarchy: where is the cubicle door in all this? There is closed and locked, closed and unlocked, and left ajar.

Misfires: accept them as normality, and more common when desensing. A situation that is easy one day, may misfire the next; subconscious issues like mood, tiredness, something about the location that your subconscious has clocked but your conscious self has not. Ride them out. Keep a simple log of each pee, in a coded form that is meaningfull only to you. That way you build up a history of pees that you can look back on. Include misfires if you wish. After a while looking back at the long list of pees and occasional misfires can be motivating.

Human memory of bad events is stronger than for good events. That is why misfires can be destabilising. The diary will help redress that balance by reminding you of the many more actual pees.

Go for it

Andrew

Andrew

Re: Having trouble with mindset and gradual exposure

Posted by David on 21/11/2017, 9:10 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

The cubicle door is closed, i tried it with the door unlocked but I don't think im up to that point right now as i still have trouble going in busy toilets like ones at motorway services. I only have a few toilets i can realistically get to in order to desense, is this a problem as im only desensing in bathrooms im used too, i do go to other ones when i have the chance buts its not as often. Also I'm having problems with these two motorway services and I keep on going but quite often have misfires, should i keep trying at toilets i have frequent misfires at to get used to them and not shy away from them or will it do more harm than good as im setting myself up to fail. Would motorway services be high on my hierarchy as they are busy or would they be lower because of the amount of cubicles available so less pressure? Thanks, David

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 22/11/2017, 9:43 am, in reply to "Re: Having trouble with mindset and gradual exposure"

I would say motorway services are high on a hierarchy because we expect them to be busier than regular toilets so we imagine ourselves as getting less privacy.
The funny thing about privacy in a service station is that say the person/s next to us does see our penis, then what are the chances we are going to see that person seeing as they will be off on their travels when they have left the building? It's not as if we will see them again and think "they know what i look like" is it but i guess we are so used to wanting our privacy in our regular enviroment that our brains are programmed to react a certain way when we feel under threat.

Re: Having trouble with mindset and gradual exposure

Posted by Andrew on 22/11/2017, 10:31 am, in reply to "Re: Having trouble with mindset and gradual exposure"

Hi David

Two things.

Door unlocked: the common source of anxiety is someone barging in, and you feeling embarrassed being there standing up. So firstly it is very common for men to use a cubicle for peeing, whether cos they want some privacy or it is too busy. Secondly anyone barging in would retreat immediately with a "Sorry".

Now you feel you would be questioned "why are you in there?" You wont, but have an answer prepared (which you will never have to use) like my answers to Dylan above. "Too busy out there" or "I prefer cubicles".

Secondly: to bridge the jump from locked to unlocked, use the faking technique. When you don't need a pee, go in the cubicle, leave door unlocked and do everything as normal except for peeing. This is to get used to being in there, without the pressure of having to pee. Repeat this exercise several times; because nothing untoward will happen, you will get more comfortable and will decide for yourself when you can introduce peeing.

I think the busyness puts them high up the hierarchy. Normally too much misfiring shows one is too high up the hierarchy; but you seem limited as to where you can desense. But see how faking helps first.

Andrew

Andrew

Re: Having trouble with mindset and gradual exposure

Posted by David on 22/11/2017, 7:25 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

Thanks, thats really helpful from both of you, i really appreciate it. Is it possible for you to explain how I could properly do a hierarchy plan so i know im desensing at the right level in order to maintain consistency and progress a lot better so im not all over the place like the marathon analogy you used, as im a bit wary that i could be trying at a level im not yet ready for or im getting ahead of myself trying to progress too quickly. I have about 10 bathrooms I can get too but they are all very different so i have a good variety for the types of situations i can desense in and the difficult of them varies which is good, is that enough to properly desense because I could get to more if it helps me? Is peeing in a situation that is really easy still desensing, so if i pee in an empty bathroom is that still a successful pee despite it being incredibly easy? Thanks for all the help and advice, David

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 23/11/2017, 10:34 am, in reply to "Re: Having trouble with mindset and gradual exposure"

What i do if i find myself in an empty bathroom when desensing is to let a small amount of urine out and wait until someone comes in and stands in the vacinity.
Seeing as you are holding urine in your bladder or even in your penis, you should be ready to let it out anytime so when someone is near by you may be able to go automatically.
Regarding a hierarchy plan, maybe 10 bathrooms is too many to start off with?
Write down at home a description of each bathroom, for example:

Mall bathroom: 10 small urinals with dividers
Work bathroom: 5 urinals without dividers
Bar: 3 troughs
Public convenience: 7 big urinals with dividers
Freeway services: 20 small urinals without dividers

You can code this in a diary by initialling each one, for example:

M.B: 10 s.u.w.d
W.B: 5 u.w.d
B: 3 t's
P.C: 7 b.u.w.d
F.S: 20 s.u.w.d

Begin using the one's you find less intimidating or plan your route like a map by listing the one's closest together, for example:

Use the bathroom at work, drink some water for about 30 minutes before lunch, go out for lunch, use a public convenience, have lunch, and finally go to a public convenience within 10 minutes prior to returning to work after you have had your drink and your level of urgency has risen.

If you think you can try something like this then have a go.

Re: Having trouble with mindset and gradual exposure

Posted by David on 24/11/2017, 9:50 am, in reply to "Re: Having trouble with mindset and gradual exposure"

that's not a hierarchy plan, I'm talking about one to help me desenese at the correct level consistently not just a description of the bathroom, is it possible to give an example of a hierarchy plan for using a cubicle with a locked door, Andrew? Is peeing in an empty bathroom still a successful pee? Thanks

Re: Having trouble with mindset and gradual exposure

Posted by Andrew on 27/11/2017, 2:27 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

David

Identify the things that trigger your anxiety, or stop you peeing. Put each in order of perceived difficulty e.g.
door: locked, unlocked, cracked open, ajar, fully open
type of cubicle: solid walls and doors down to floor, gaps at floor level, gaps round door
number of cubicles: lots, two, one
busyness: quiet, moderate, busy
neighbour: adjacent cubicle unused, in use.

Start with the easiest setup for you and write it down. e.g. locked door, solid walls, lots of cubicles, quiet toilet, adjacent cubicles unused.
Then alter one of the components (say door) and change it to unlocked and write that scenario down.
then alter that one again to say cracked open; or leave it unlocked and change one of the others.
And so on

Find a suitable location, fluid load, go into it and do a 3 second pee (in order to keep a reserve).
If that was a bit uncomfortable, you need to repeat it until it is comfortable; when comfortable, move up a step in your list above. You can either leave and return in say 5 mins, or stay in the cubicle and change the item (in this case unlock the door).

I hope you see that it is an incremental approach; each step introduces the minimum possible amount of anxiety. You now see that it is not a quick process, so have no expectations. Just accept progress will happen.

Hope that helps

Andrew

Re: Having trouble with mindset and gradual exposure

Posted by Karl on 28/11/2017, 12:07 pm, in reply to "Re: Having trouble with mindset and gradual exposure"

This is why i see it as a hiearchy plan David.

The 10 hiearchies of challenge are:

1. Proximity
2. Being heard
3. Hearing others
4. If using a cubicle it depends if the door is locked, shut, ajar, or open
5. In the line of sight of someone else
6. Sitting or standing
7. Nature of the person i.e friend, colleague, stranger, aquaintance
8. Level of urgency
9. Surrounding activity i.e quiet, some people, busy
10. Time pressure

You can begin and continue these challenges in a private cubicle if necessary.

If you enter a bathroom you know has 5 urinals you know that no's 1,2,3,5,7,& 9 can apply. Proximity will be closer if other men are there or come in after you and this means you could be heard and hear others.
Amongst these men could be someone you know which may increase your anxiety levels.
If the bathroom is busy the noise of men coming and going can be distracting and you are more likely to come into someone's line of sight. Line of sight can also depend on the design of the bathroom i.e if you have to stand sideways and men have to walk past you to stand along side you somewhere.
If you enter a bathroom that has 20 urinals your hiearchy of challenge could be the same or it could increase if the bathroom gets busier and the same hieararchies apply. If the bathroom is quiet then of course your proximity could be a bigger distance, you won't be heard, and your anxiety level won't be as high.
If you are using a bathroom for cubicle use and there are just 3 cubicles your hiearchy level could be higher than if there are 10 cubicles. This is because the other cubicles are more likely to be engaged if there's just 3 so no's 1,2,4, and 9 can apply. If there are 10 cubicles the proximity is less likely to be either side of you so men won't be able to hear you and your surrounding activity will be quieter.
If you want to use a cubicle as a urinal with big privacy screens then you can try urinating with the door unlocked, ajar, or open. If you have the door open the hiearchy will be at it's highest because you will have anxiety as to what men are thinking of you not using a urinal. If the door is unlocked or ajar the hiearchy of challenge is that no-one will know your'e in there so may enter the cubicle thinking it is vacant thus increasing your level of anxiety.

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