Can hypnotherapy help with paruresis?

Several hypnotherapy services are advertised as being able to help with paruresis. Some claim they can cure the problem. But a scientific review in 2007 found that receiving hypnotherapy was no better than not receiving it. There was some limited evidence that hypnosis may ease anxiety when being tested.

The National Institute for Health and Care Excellence is the official UK body that recommends health treatments. It makes no mention of hypnotherapy for social anxiety disorders, which include paruresis. It does mention Cognitive Behaviour Therapy (CBT) as a method of choice 35 times. This is because of there is lots of evidence to support CBT and a lack of evidence to support hypnotherapy.

CBT has a good reputation for helping with social anxiety disorders. But it may help to do additional work on relaxation and calmness. So hypnotherapy may be a useful extra to CBT; and so too mindfulness meditation. This is backed up by two research papers that showed that the combination of CBT with hypnosis produced better results than CBT alone.

Hypnotherapy lets you practice imagining being in toilet situations while in a relaxed state. That sort of practice can support the CBT approach.

The things about paruresis is that we avoid going into the situation that makes us anxious, i.e. public toilets. And it also makes us anxious even to think about those situations. So we avoid thinking about them too. Hypnotherapy from someone who understands CBT may help you to get more familiar with these negative thoughts. That can boost new positive thoughts that will help in doing CBT.

The bottom line is that there is no substitute for getting out and facing these fears in an individually designed, expert-guided and manageable way using a CBT approach. Hypnotherapy alone may enable a reduction of anxiety, but many have found that such calmness does not transfer easily to real life toilet situations.

So, it is not a case of “either hypnotherapy or not hypnotherapy”. Instead more CBT alone, or CBT with hypnotherapy; and less hypnotherapy on its own.