A new treatment is showing promise for people with for paruresis or 'shy bladder' - an inability to urinate in public restrooms or with others nearby. Developed by Monroe Weil, Ph.D., and recently described in his article in the May 2001 issue of the Behavior Therapist*, the method involves inducing relaxation by breath-holding to increase carbon dioxide (CO2) levels. E-mail copies of his article, "A Treatment for Paruresis or Shy Bladder Syndrome," are available from Dr. Weil.

Weil invites those suffering from paruresis to try the method and contact him to share their results: Dr. Monroe Weil, 14 Bond Street (#382), Great Neck, NY 11021 or mweil@erols.com. All replies are confidential. (Phone number for press contact is 212-462-9292).

The treatment was first used with a man in his early 20s. In four weeks he was to take a physical exam in which he would have to submit to a urine drug screening as part of his job application. He had suffered from shy bladder for many years, and prior therapeutic attempts had been unsuccessful in enabling him to urinate in the presence of others. It was explained that CO2 has been shown to help people relax, and he was advised to hold his breath just prior to urinating as a method of producing relaxation by increasing the CO2 level in his system. (Increased CO2 levels can do the opposite and increase anxiety in some people with panic disorder, but with higher CO2 levels than involved here. However, those with panic disorder should try breath holding at home first as a precaution.)

Initial attempts at urination were in large public restrooms, at a time of day when they were not crowded, in order to decrease his feeling of being watched. In addition, he attempted to urinate when his bladder was full to increase the likelihood of success. He reported that he felt some nervousness, but was successful. He found that it took about 30 seconds of breath holding on his first attempt. Breath holding gave him great confidence: he felt that urinating would be an automatic response which his fear could not prevent from happening. Within two weeks he quickly progressed to urinating in smaller and in more crowded men's' rooms, where his presence was noticed more. He also found that he could urinate without waiting for an overpowering urge to do so, and that his breath-holding time decreased to as little as 10 seconds, depending upon the situation.

For his employment physical, he took no chances and made sure his bladder was full. He was successful in urinating in the presence of a medical doctor and felt that a problem of many years had been eliminated.