Graduated Exposure Therapy For Shy Bladder

Graduated exposure therapy for shy bladder. The first thing we’ve already learnt about shy bladder syndrome is that it’s all in the mind. It’s not a physical condition but a type of anxiety. Graduated exposure therapy is a proven, recognised treatment for many kinds of anxiety and can work particularly well for paruresis – especially when in conjunction with other treatment options.

So, remember, when it comes to paruresis, there is nothing physically wrong with your urinary tract. Instead, it’s your own subconscious mind that’s standing in the way.

An exact trigger may not always be evident right away. There might have been some repressed memory or some embarrassment in your past, pertaining to the act of peeing, that has now taken over your life as shy bladder. The embarrassment that you felt back then has now reached massive proportions! It’s grown to the extent that the very thought of having to pee brings on a panic attack!

Whatever the initial cause it’s simply this that’s preventing you from being able to release the flow! Graduated exposure therapy works by building confidence and therefore reducing this anxiety until it no longer has any negative effect. Let’s explain exactly how it works.

Graduated Exposure Therapy For Shy Bladder


Of the many different cures for paruresis, graduated exposure therapy is one of the more successful. In fact, it is said that 8 out of every 10 people suffering from shy bladder have greatly benefited by this therapy.

It can be a stand alone treatment program or it can support an additional form of treatment. In effect, it can be used to practice and put other treatments into action. These additional treatments include:

  1. Hypnosis For Shy Bladder.
  2. Cognitive Behavior Therapy For Shy Bladder.
  3. Breath Hold Technique For Shy Bladder.
  4. Other Treatments For Paruresis.

In my own case graduated exposure therapy was included within the treatment program I adopted and I supported it with hypnotherapy:

So – back to G.E.T. …

What Is Graduated Exposure Therapy For Shy Bladder?


Graduated exposure therapy for shy bladder, as the name suggests, it is a cure that works gradually. It’s a step by step program that basically needs you to try and pee in increasingly difficult places and scenarios. Hence gradually exposing yourself to more difficult environments in order to be comfortable in stages.

There are plenty of books and treatment programs that will allow you to work at this yourself or you may want to take advice and guidance from a certified psychologist. We always recommend this latter option as working with a trained professional does tend to produce better results and faster.

GET Preparation

  • First, you will need to make a list of the places to pee in. To make a written list in ascending order of difficulty. It should start from the easiest environment and moving on to the most difficult spot. The most difficult location is probably a busy public urinal with urinals close together with no screen between them. This is a place of nightmare to most Paruretics where you have the least amount of privacy. The easiest location will obviously be your home loo but after this would come a quiet, familiar restroom where you are rarely disturbed, there’s plenty of space between urinals which are screened. Somewhere you know the chances of being disturbed are minimal and that having someone standing right next to you slim.
  • When making the list you’ll need to make sure you can easily access these locations and you’ll need to assign a very minimum of one hour per week to practise in these venues.
  • Next, you will most likely be asked to get a ‘pee partner’ or “pee buddy”. I know … that sounds weird – right? Basically, all we’re talking about is a support system so to speak. Someone who will be there alongside you to keep you calm, motivated and to “practise” with. This could be a family member, a close friend or even a therapist.

Build Up Gradually

  • Practise peeing with your pee partner in close proximity. This gives you the feel of a public toilet. You could ask your pee partner to stand outside the toilet at the beginning, and then get him to stand close to you while peeing. This graduation will depend on how comfortable you get with peeing in the presence of another person.
  • The next move is to make as much noise as you can when you’re peeing. Get used to the sound of the pee hitting the water in the urinal. This should be done with your pee partner in hearing distance.
  • Now work your way up and try peeing in a quiet but public rest room with your pee partner nearby. Just as you practised at home, get your partner to stand outside the door, and as your comfort level increases, get him to stand near/beside you as you pee.
  • Move up the list of urinating locations until you can cope with anything!

But A Word Of Caution!

  • This whole thing is going to take a while: Don’t expect results overnight or even within the week or two. But don’t give up. Perseverance is the key to overcoming paruresis.
  • Go slow: Take your time, don’t pressurise yourself, or you could make matters even worse than before.
  • Practise deep breathing with will help you relax. Long slow deep breath in through the nose to the count of four, hold it in for a count of two. Breath out slowly to the count of four through the mouth. You’ll be surprised how this can relax you which really helps.
  • Practise with your bladder full. That way you will naturally feel the need to pee during the practise sessions. Again, this will help considerably.
  • Don’t spend too long trying to urinate. If it’s not happening after about four minutes then stop, take a break and try again. If it still doesn’t happen the consider taking a step back in difficulty to re-build the confidence again.
Now that you know what Graduated Exposure therapy for shy bladder is, the next step is to contact your doctor to chat through your plans and to ensure there is no physical cause of your inability to pee. Alternatively, get in touch with a trained psychologist and take the advice and support of an expert. If you’re intent on going alone then read up on the subject and maybe consider one of the self-help paruresis treatment programs, most of which incorporate graduated exposure therapy within the programs. Oh, and think who you could potentially recruit as your pee buddy!

Remember, you are not alone in this, and you are certainly not abnormal – it is a problem yes, but it’s a problem that can be tackled…And with the right kind of treatment, you can overcome shy bladder.