Paruresis: back to reality

For some paruresis sufferers lockdown has brought unexpected relief from the persistent worry about where they might find the next toilet they feel safe to use when out and about. Spending most of our time at home, without visitors, means that peeing has become a less-stressful activity, to be carried out with the same lack of concern enjoyed by the rest of the population. But some people are expressing an underlying anxiety about what will happen after lockdown is lifted and we are free to leave the house out again. Will they find that their paruresis has disappeared? Or might they find that it returns with a vengeance when they venture out into the world? What can they do in the meantime to keep anxiety at bay, and prepare for the long-awaited return to "normal" life?

Magazine articles and celebrity health gurus tell us that we need to take slow deep breaths to reduce anxiety. But is it enough to take a few slow deep breaths when we enter a toilet cubicle and expect that to calm us down sufficiently?

Well, as in so many things, practice makes perfect. The more you can practice slow deep breathing when you're not in a challenging situation, the more effective it will become when you are. It will gradually become easier to enter a state of increased relaxation and you may be able to apply that technique when you find yourself faced with a challenging toilet situation.

There are lots of different breathing techniques – however the one we recommend is to breath in slowly through the nose, hold the breath for a comfortable pause, then exhale slowly through pursed lips, feeling your abdomen deflate and your shoulders drop. Listen to the sound of your breathing; you might like to count slowly as you breath in and out to ensure you don't rush it. You could experiment with gently putting your hands over your ears to get a "seaside effect" which will enable you to hear your own breathing better. This will also help to reduce the level of other sounds, and with your eyes shut you could be in your own little world.

You'll get maximum benefit from this breathing technique if you practice it every time you use a toilet, even ones that you feel are "safe"; that way the breathing gets linked to peeing.

Try to practice the breathing technique regularly at other times too, when you are in a relaxed place. Eventually you could try practicing in a different slightly tense situation which doesn't involve peeing, when it doesn't matter: for instance a tense moment in a thriller on TV.

Try to combine your new-found breathing techniques with a more positive attitude and you will be giving yourself the best chance of leaving lockdown prepared for recovery from paruresis.