The most well documented current treatment is based upon cognitive-behavioural therapy, of which the aim is to reorganise the "abnormal" emotional schemes arising from the anxiety generating elements that trigger this problem. It can be thought of as being three separate interlinked components:

• "cognitive": an attempt to modify the abnormal thoughts and ideas around the object of anxiety, e.g.: "when I use a toilet, everybody looks at me and wonders what I'm doing"
  
  
• "behavioural": step by step desensitisation by very gradual exposure to the feared situation, the aim being to achieve a series of little successes, and thus reassure the subconscious mind that it is " safe " to urinate in a situation that previously led to panic and failure. This can be thought of as relearning urination in a social situation.
  
  
• "relaxation": learning techniques that facilitate relaxation, both mental and physical. Click here to view a sphincter relaxation exercise

It is possible to practise alone, or with the help of a psychologist. Alternatively, some sufferers have been able to meet with "buddies" who can accompany them on desensitisation trips, and offer support. There are many books, general or more specific, that can help in the desensitisation process. With time and dedication, such approaches have been shown to yield positive results, although it must be stated that such progress is very much attendant on the individuals' determination.

In order to relieve the urine retention if it is too severe, it is possible to perform self catheterization. It is however essential to seek medical advice and supervision to learn such a technique, which, although well tried and tested, must be done properly and safely.

Drug treatments reported in medical literature are the subject of much debate, and produce poor results.

Finally, there exist little tricks that often work for individuals. An example would be to perform mental calculations, to divert the " anxious" part of the brain while trying to void. The received theory at present is that. Although such approaches are useful as survival tactice, they can simply prolong the condition by avoiding confontation with the actual feard situation itself.

This list is certainly not complete: if you have yourself found techniques to overcome the problem, you are more than welcome to share them on the messageboard.

A recent publication offers a succinct summary of treatments for Paruruesis as well as an appraisal of current theories concerning the causes, therapies and implications for sufferers and their families. The book is entitled " Shy Bladder Syndrome" and is available in many bookstores, including the online ones (here under, a direct link to Proxis). Other recommended publications include "Free 2 Pee" by C. McCullough, and the Phobease Literature by Howard Liebgold.