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the spectrum of severity of paruresis

Paruresis is concerned with the fact that the ability of the individual to urinate when needed, is subject to being physically interfered with by the psychological effect on them of the environment that the person finds himself or herself in. The symptoms are that the person needs to go, but just can't. The most common manifestation is men who cannot urinate at a urinal, or women cannot urinate in a cubicle, if there are others in the same area. – even if they are "bursting" and in pain, they physically cannot do it.

However, there is a spectrum of severity of this. In its mildest form, a person wouldn't think they had a problem at all until they are expected to give an observed sample for a drugs test, and then find it takes a time to do it. At the other end, there are people who cannot urinate at home (even in a locked toilet) if someone else is in the same property. Some can't go at urinals if someone else is there, but they can use cubicles with no bother. Others can have difficulty with using cubicles if the toilet area is crowded or occupied. (Hence the problem also affects women, but to a lesser extent – probably mainly because of the different arrangements in ladies toilets.)

The circumstances in which the condition triggers can also be compounded by a combination of factors. Some men can use urinals if others are there, provided there is a degree of visual privacy provided by urinal dividers, or for example in a cubicle even with the door open, but they would not be able to do so at an open trough or to comply with an observed sample request for drugs testing. In others the degree of pressure can make the difference.

So, to a very large extent, a significant proportion of people have the symptoms of this to some extent or other. There is a grey area where, with the same symptoms, some would say that they have a problem whereas others would say they don't. It is a question of how it affects you. If you find you have to go in a cubicle from time to time, and that doesn't worry you, then it is not a problem. If you can use a public toilet only if it is otherwise deserted, then that can have a serious impact on what you can and cannot do, and where you can or cannot go. If you can go anywhere, except in front of someone observing you for a sample for a drugs test, then that's no problem – provided you are never required to give such a sample. But it is a problem if you are so required to perform and can't, and then lose your job because failure is deemed refusal, which is deemed guilt. And it isn't just stereotypical shy or timid people that get this. One sufferer is 6ft, 13 stone, #1crop, and a martial artist. Another is a Marine.

The biggest problem is that most people develop this in their early teenage years at a time when it is easy to "work around" the problem. You are only out the house at school for a few hours, you can wait till you get home. But as you get older it becomes an embarrassing problem you discuss with no-one. (Most people who resort to the Internet looking for information about this are surprised to find that they are not the only one with it). And it can become a controlling factor in your life. It is thought that up to 4 million people in the UK could suffer from it to the extent that is affects their lives.

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