Dear Richard Madeley: ‘I find it impossible to urinate in the presence of strangers’

Dear Richard,

I have a slightly embarrassing problem: I find it impossible to urinate in the presence of strangers. In a public loo I’ll stand at the urinal and the second someone else comes in, however urgent my need, I’ll freeze.

This doesn’t happen at home, and having been checked out by my doctor I’m confident everything is working on the anatomical side. It seems to be a psychological issue – and it’s getting worse.

When I was growing up this was never an issue, and I suffered no traumas that might have caused this problem. One day, it must have been in my late teens, I went to the gents and found myself unable to go. That one moment has now stretched over decades! 

It’s starting to affect my social life: places such as the cinema or theatre are especially challenging. 

The reason I am writing to you now is that myself and a couple of friends are booked to go trekking in Rwanda to see mountain gorillas. We’ll be in the wilds for five days with no toilet facilities and I’m worried about how I will cope. Any ideas how I might get back into the flow, so to speak? 

— Alex, via email

Dear Alex,

Well, you’re certainly not alone! Hundreds of readers will be nodding in wry recognition of what you describe in your letter. It’s a much more widespread problem than you may think. So let’s start with a bit of analysis, and then we’ll get on to the fix, all right?

Alex, you couldn’t be a clearer-cut example of paruresis or ‘shy bladder syndrome’ – the inability to pee when other people are around. It’s a common form of social phobia, second only to the fear of public speaking. It often begins in early life, especially at school. You say you began to experience it in your late teens – this again is par for the course. At its root is a fear of being judged by others.

The fix? Cognitive behavioural therapy. Shy bladder syndrome is a treatable condition. You can be taught to reduce your anxiety and successfully urinate in the sight and hearing of strangers. This can take just a few months; although in some cases, longer. So you should sign up for therapy at the earliest opportunity, Alex – welldoing.org offers a free therapist-matching service. Good luck!

Do you have a question for our agony uncle? Fill in the form below