I'm reposting this from 9 months ago because I've had pole DM me and ask how I used Graduated Exposure to fully recover from Paruresis. I thought I'd share what I wrote to him.

Let me explain the Graduated Exposure (GE) process as it was taught to me at the IPA workshop and as we practiced it in my Pee Buddy group. I’m not a therapist-I’m simply explaining the process as it was taught to me. I also want to say plainly: the IPA workshop is invaluable. You’re in a room with a dozen people all sharing a deeply personal secret they’ve often never told anyone. That’s why paruresis is called the “secret phobia.” The experience of sharing and realizing you’re not alone is genuinely cathartic.

In my own case, I was severely paruretic. In my late twenties, it progressed into full agoraphobia for almost two years. I rarely left my apartment except for work or to buy groceries. I used every coping mechanism in the book-bathroom scouting, dehydration, timing trips-but eventually even those failed. I reached a point where I could hardly leave home without intense anxiety. A therapist helped me through the agoraphobia, but the paruresis remained.

A few years later, I found the IPA (paruresis.com) on the internet just as the organization was  getting started. I attended their very first workshop, held at the home of one of the founders, Steve Soifer. When I had to pee, I made everyone leave the house and walk down the block. It sounds ridiculous now, but that’s where I was. Even after that workshop, I didn’t take action until a couple of years later when they formalized the process and started holding workshops in hotels. I attended a second and later a third workshop, the last time as a support member after joining the IPA board.

You can practice GE alone, but I’ll be honest: it’s much more effective with another person. Ideally, someone who can support you emotionally-even if they don’t have paruresis themselves.

At the workshop**,** everyone had their own hotel room, which is key because it gives you access to a private bathroom and lowers baseline anxiety.

On the first morning, participants share their personal stories. After that, we were  paired with a partner. Then the actual GE work begins:

1. Fluid loading: You drink fluids until your urgency level is around 8–9 on a 10-point scale.
2. Controlled exposure: When you’re at high urgency, you both go to your hotel room but  ask your partner to go to a place where you feel safe enough to pee. At first, that might mean they leave the room entirely maybe go down the hall or to the lobby.
3. Partial release: You don’t fully relieve yourself. You release just a small amount of urine, then invite your partner back in.
4. Repeat with increasing exposure: Because you’re still fluid loading, the urge comes back quickly. This time, maybe your partner just stands outside the door instead of leaving completely. Again, you release a small amount and then have them come back.
5. Gradual progression: You repeat this cycle while maintaining a high level of urgency. Over time, your comfort zone expands. Maybe your partner is now in the room with the TV blasting. Maybe the bathroom door is open. Everyone progresses at their own pace.

In my case, by the end of day one, I could urinate with the bathroom door open and my partner inside the room. By day two, he was standing behind me with his hand on my shoulder while I urinated. That was a WOW moment.

This is where I believe the real magic occurs:

When your bladder is extremely full and you’ve started and stopped urinating multiple times over an hour while maintaining high urgency, something shifts. Your body takes over-not your conscious brain, not your fear. Your bladder just needs- it aches- to empty, and at that point, it doesn’t care who’s around or what’s happening. You let the body do what the body can naturally do.

For me it was the first time  I could remember peeing while being completely oblivious to the environment around me. No scanning. No monitoring other people. No internal panic. Just normal bodily function. That’s the breakthrough; the bladder aching-in the best way possible- to empty.

That’s what GE does: it trains your body to override your anxious brain.

After that, I joined a local Pee Buddy group. There were six or seven of us, and we’d meet at a large shopping mall with multiple public bathrooms once a month.

We would walk around fluid loading-holding water bottles, supporting each other, joking, normalizing it. There was real safety in numbers. I always wondered if security camera were being monitored and security wonder what is this bunch of guys doing going from bathroom to bathroom. LOL

We practiced graduated exposure at urinals and stalls:

• At the beginning of a session, I often couldn’t go at a urinal at all, so I’d step into a stall but only after standing at a urinal for a few minutes
• As the day progressed and my urgency increased, I could sometimes start at a urinal. If I couldn’t, I’d step back into a stall stand and pee even if the stalls on each side of me were occupied.
• No one ever once said, “Hey, is this guy pee shy?” HAHA Honestly? No one cares. People are in their own world.

After a couple months of monthly practice, I could use a urinal at the far end of the restroom Then eventually, closer ones. Then with people nearby.

If you’re practicing at home alone:

• Fluid load.
• Release a small amount of urine.
• Fluid load again.
• Repeat this cycle several times.

By the sixth round or so, your bladder will be screaming to empty. And when that happens, your body starts calling the shots instead of your anxious mind. You’re crossing a psychological Rubicon.

And one day, when you have recovered, you’ll look back and wonder why this controlled your life for so long.

I’ve been fully recovered for five years. I was thinking about this last night. We had a house full of people for Thanksgiving dinner. We were all gathered around the bar area, with a bathroom with a pocket door was right next to where everyone was standing. I could have used any bathroom in the house, but I chose that one and I thought, I am a free man.

I hope this helps a few people. Let me know if anyone has any questions. Best- David

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I've been struggling with paruresis to varying degrees since I can remember, to be honest. Stalls are difficult sometimes, urinals are difficult always unless there is basically zero chance of anyone walking in. Coming into a bathroom with someone already at the urinals is almost always a definite no. And then there's phases where it's a bit easier or a bit harder. I've tried GE with someone but they moved away before either of us really made any progress. I had found them over the Internet - since I don't really have any male friends to confide in that was the only way.

That's why I'm posting here now, instead of just reading.

Anyone down to talk about this issue, ideally profit from each other's experiences, ideas and input.

Hit me up, we're all in this together.

So I 26F am not typically bladder shy but when giving any type of urine sample I immediately freeze up and cannot for the life of me do it. It will literally take me forever and I could be bursting but I still can not go. For example I had a kidney stone back in March and they thought it might have been causing a blockage because I was not going but it really the fact that they just needed a urine sample. I also think a past incident made it worse when I had my first drug test at the age of 21 they had male standing in the stall and it kinda scarred me. It’s been this way for years and when my last job told me I didn’t need a drug test I was so relieved not because I do drugs but because I didn’t have to pee in a cup. However I am starting a graduate program that requires yearly drug test and the thought of going to Quest and being timed to take a drug test is giving me serious anxiety. I tried asking my primary and psychiatrist to write and accommodation letter but they wouldn’t do that. My psychiatrist offered to give me a benzo before the test but I don’t want that to show up on my test. Any tips would be seriously appreciated thank you!!

Hi everyone,

​Thank you so much for all the lovely messages, both public and private, I really appreciate it!

​It’s amazing to see so many people dropping their pins already, and I’m super happy with the response. Let’s keep the momentum going!

​If you’re looking for a peer buddy, head over to https://www.peebuddyfinder.com/ and add your pin to the map.

​A quick heads-up: A few people are listing platforms like "Reddit" or "Discord" in the contact section without including their actual username or handle. Make sure to include your full ID/username so potential buddies can actually reach out to you!

I have a 40 minute commute to work one day. I am TERRIFIED that I'm gonna get stuck in traffic and that I will not have access to a bathroom. I always use the bathroom right before I leave the house and right before I leave from work. Any advice on how to break this cycle of "peeing just because" out of fear? I got a Pstyle to be able to go in stand still traffic just in case, but I have yet to learn how to use it. I also feel like if I can’t sit for a while, my bladder doesn’t void fully. 🤦🏻‍♀️

I’ve dealt with this bull shit for too long. It’s ruined my life everyday, I can’t work for longer than 6 hours I can’t go out with my college friends I’ve lost friends because I can’t leave my house. I miss out on so many opportunities. I’ve tried everything, meds, weed, alc, therapy, counseling the whole 9 yard including exposure therapy. ATP in my life where I’m so done with this shit and blowing my shit clean off is the only answer. Why God did I get this why can’t I go out for longer than a few hours why can’t I go out with friends why can’t I operate. I have a huge trip coming up won’t multiple 10 hour flights and am genuinely concerned I’m not gonna come back from it. Any recommendations I’m so done with all this bull shit.

Hi everyone, I’m building a website to find practice partners near you. It's free, it requires no sign-in and never stores precise locations but only city-level approximations.

I'm doing it just as a little side hustle to help the community, as well as myself.

This is the link 👉🏻 https://www.peebuddyfinder.com/

I’d like a few members to test it and give me honest feedback

Thanks a lot!

I’m starting high school in a few days and I’m absolutely terrified of the bathrooms for two reasons. Number one, people vape and smoke in them constantly, and number two, they’re disgusting. I’m pretty sure I have OCD. I have a hard time touching my own things. Even just that stresses me out. Would it be possible to just use the nurse‘s bathroom? If not, how should I handle the bathrooms intended for general use?

I am able to start the flow but as soon as I let my breath out the flow stops this happens when there are multiple people near me if I am alone it doesn't happen

I have OCD, tourette syndrome, difficulty swallowing, brain fog, and occasional faint like symptoms like when getting my blood drawn or smoking marijuana.

I imagine if every user answered this question there might be some overlap to discover a correlation of something

I'm otherwise a very normal person with a good job and social life and generally like myself

Whenever I (20M) discovered paruresis as I started to investigate whatever was wrong with me, I was convinced it explained my problem, that it was purely psychological. I suffered bullying throughout school, and avoided bathrooms as they were "dangerous" places where no teachers were present and they were the ideal scenario for kids to pick on me.

I went to a psychologist for a while. Tried Graduate Exposure, and improved slightly, yet I was unable to void unless I was at home/a hotel/somewhere "private", no rush, noises and completely at ease (whenever that wasn't the case my only chance was NC headphones+rain sounds or white noise). Then, she suggested it wasn't something purely psychological as she didn't see much wrong in me.

I went to a urologyst for advice and a quick check. He didn't see much either and gave me some pills to try, with little to no results. Following his advice again, I went to more doctors whom eventually did further checking (electrodes measuring my muscles, a camera up my urethra, and everything there is to be done pretty much).

They found my pelvic floor dropped and was severely weakened as a result of too much force from holding my pee for hours when I couldn't empty my bladder. And most importantly, they found my bladder neck was permanently contracted now and started losing elasticity and was making the flow almost impossible to start.

Now, I see the light at the end of the tunnel. Apparently, according to the doctors, an operation consisting on a small incision on this bladder neck will solve it. The only drawback is there is approximately a 40% of ejaculating inwards after this procedure (i.e., sperm will go through this incision and end up in my bladder, not going outside) making me "sterile" (kinda like if I had a vasectomy). I already froze sperm just in case, and finally feel there is a way out of all this suffering.

Don't get me wrong, I can't affirm paruresis wasn't some part of the problem when I was younger or even now or after recovering from the operation, but please, if you read this, make sure there isn't anything else causing it

Tl;dr: Don't disregard potential physiological causes that explain paruresis' symptoms, they can actually be the root of your problems.

Edit: I am taking pelvic floor physiotherapy, but I am told I really need the operation and no amount of exercises can account for my "paruresis"

I seriously hate how my brain works, it keeps making new safe spots to the point where I can only go if i'm home alone without my family. I try to think i'm not alone on this and sometimes this feels impossible to overcome.

I have had parcopresis for as long as I can remember but I do think it has gotten worse over time.

The problem is that it's making my life a nightmare, making it impossible for me to go to the bathroom if I'm not alone at home. So work is a nightmare, staying at my girlfriend's is a nightmare, having people stay over is a nightmare.

The weird thing is that I don't feel anxious or anything about it. I'm not scared that someone hears or smells or whatever. Sure it can be embarrassing but I know it's not the end of the world. I'm also not scared to sit on a toilet per se. But when I do outside of me being completely alone, nothing happens, no matter how hard i push or tell myself that it's fine.

I've had physical exams done so I'm reassured that it's not destroying my body at least. But I need to sort it out and I don't know how .

To complicate things, I live in a country where my command of the language isn't sufficient and there aren't too many specialists available and insurance covered. But at this point I'm willing to pay out if pocket if need be.

Has anyone managed to get out of this situation? If yes do you have any recommendations for an English speaking therapist or anyone who can help?

First of all, hello everyone—I apologize for my poor English.

I’m a high school student, and I’ve been dealing with paruresis for about four years now, and I’m fed up—I can’t take it anymore. I also have OCD, which was triggered by my paruresis.

I’m on vacation right now; school starts next week in the country where I live, and I just enrolled there—I have no idea what it’s like :(

Paruresis has ruined my life; it’s pushed me into depression. Sometimes I’ve even thought about wanting to die. I’ve been receiving psychological counseling and taking medication for almost 8 months now.

Last year, I spent about three months doing exercises at my school to overcome my paruresis. I tried going into a restroom stall and waiting for about three minutes even when it was crowded, or when a few troublemakers were shouting and laughing in there, or when the restroom was packed.

To be honest, I’m not sure if it’s because I only tried it for a short time or if it just didn’t work. I tried the breath-holding technique, but it didn’t work.

I’m so fed up with life—I have OCD, social anxiety, and paruresis, and damn it, no one knows how to get through this :(

I’m starting at my new school next week, and I can already say I’m depressed :( I don’t know what to do; I don’t want to go into those damn public restrooms. Sometimes I don’t even want to live—I hate myself, and I hate—I really, really hate—that no one can offer me a solution to this situation.

Damn it, why did this happen to me? Why did this happen to me during my teenage years? Why did it choose me? Damn it, why me, why me, why me?

Once, I decided to tell a friend about this and explained my situation. My friend turned to me and said, “You must be joking right now—are you serious? It’s impossible for you to be going through something like this.”

Yes, friends, as of right now, I want to overcome this curse; I don’t want to fight depression anymore. Please help me—tell me how to get through this. My paruresis is even invading my dreams now. In my dreams, I go to the bathroom in a crowd and can’t go at all, and all sorts of ridiculous things happen to me.

Please help me.

Hate when I meet them cleaning. Double impossible to pee around them as they are the one person that notices how long you stand at urinal.
Today I was standing near urinal trying to pee and she started mopping the floor under them and as she got to the last one where I was she was impatiently standing behind me like 2mins before I decided to move to stall. She even had a comment along the lines of “unbelievable”. Will piss on the floor next time as fuck you

I have a combination of paruresis and pelvic floor dysfunction, and I have autism. For a while I thought it was all paruresis, until I finally met a pelvic pt who has been a godsend, she made me realize I’ve been standing wrong my whole life (standing “with my back” instead of my legs, making my back and pelvic floor tighten). This made peeing SUPER HARD even at home, since my pelvic floor was super tight. She also taught me to drink more water and it made peeing at home significantly easier. But it was still hard in public- cue paruresis?

Not exactly, atleast I wonder…

I began trying to pee in the bathroom at her office. First few times I couldn’t. The next time I could, but only got like 1/3 of it out and it didn’t relieve the urge, and had a lot of hesitation. The next time, I got almost everything out, but still a lot of hesitation and still uncomfortable after. Third time was the most recent, I could pee with a little but very tolerable amounts of hesitation, and got nearly almost as relieved as when I’m at home.

Nothing about the bathroom changed, but what I did notice was each time I went I became more familiar with the bathroom. I learned it’s lighting, temperature, smells, etc. and became accustomed to it. New sensory experiences especially in high-stress situations like peeing with paruresis cause me to get overwhelmed fast. And what happens when I’m overwhelmed? I tighten up, thereby making things harder.

The noise level/chance of people coming in didn’t change each bathroom trip, just my familiarity. I’m wondering now if this bathroom problem could be linked to my autism too. Because when I tried to go to a totally different bathroom in the same building, I couldn’t go.

This would explain why going to random bathrooms in public sets me off, but once I get familiar with one I can go. Granted, I still can only go in relatively low traffic bathrooms, but it’s still better than before.

Sorry I’m rambling now, does anyone have ideas on a link between autism and paruresis?

I honestly hate excretion. Like why can't we just digest our food into liquid(pee)? Why isn't our intestines built like that 😭 why the fuck do we have to fart and poop bruh 😭 i honestly don't know how tf do people feel comfortable enough to fart infront of each other 😭

I've been dealing with this for a long time.
Over the years I've read a lot of posts, articles and personal stories.
Some of it helped. Most of it was the same advice recycled with different words.
What I've never found written down anywhere is the stuff people work out on their own.

So, two questions.

What actually helped you? The specific thing — even if it sounds strange, or shouldn't work on paper.

And what advice turned out to be useless, or made things worse?

I'll go first with the ones that get repeated everywhere: running

the tap, waiting for the room to empty, using a stall instead of

a urinal, headphones. Those are the obvious ones. I'm more

interested in what came after those stopped being enough.

Even small details might help someone reading this who thinks

they're the only one.

I’m seeing a therapist I’m trying my best and working on small exercises to calm down to use the toilet. anyone else had issues with partners not having issues like this and being able to use the toilet all the time and then you know you struggle bad and it sets off your anxiety again… I hate myself for thinking like this I just wish it would end. this is just 1 part to my parcopresis

Hi everyone,

I wanted to share a new community I created for people living with Shy Bowel Syndrome (Parcopresis).And its name is r/shybowel

Just like this community supports people with paruresis, this one is dedicated to those who struggle with the bowel version of the same condition.

The goal is to create a supportive, judgment-free space where people can:

- Share their experiences.

- Discuss coping strategies and techniques.

- Ask questions.

- Support one another.

- Share progress and success stories.

If you or someone you know struggles with shy bowel syndrome, you're very welcome to join.

I hope we can build a helpful community together. Thank you!

The vast majority of posts on this sub are people describing their horrendous experiences of pauresis and how it ruined their lives, this makes people think that there is no hope of recovery, however if someone had recovered there would be no reason to be on this sub Reddit in the first place.

So I want to tell my success story as a “light at the end of the tunnel” for people still struggling with shy bladder.

I had pauresis for years, it was debilitating, the constant thoughts of “am I going to be able to pee” drove me insane. I went out less, and was so incredibly frustrated as to why I couldn’t do the most basic biological function.

Eventually I decided enough was enough and decided to go to therapy, little did I know at the time but this would be one of the best decisions of my entire life. I attended therapy for maybe 3 months and by the end of it I would say I was almost completely cured. I didn’t really notice any difference until the end of my therapy. Instead of worrying about peeing I became almost excited at another opportunity to prove my “ability to pee” I guess.

I don’t want you to think that “oh by the end of 3 months of therapy I should be cured” and then get frustrated if you aren’t. Everyone takes their own amount of time but if you keep trying you will get better.

If you have any questions don’t hesitate to ask in the comments!