This is the third in a series of videos on paruresis
also known as shy bladder syndrome. It's best to watch the series in order, so if you've not seen
the previous videos there is a link appearing at the top of the screen right about now.
This video deals with negative thoughts. In the last video i spoke about the harm
that safety behaviors do. These safety behaviors are driven by negative thoughts.
The first step to dealing with negative thoughts is identifying them.
Cognitive behavioral therapy identifies different types of thinking errors. Common thinking errors
in paruresis are shoulds and oughts. For example a man ought to be able to pee in front of others.
Mind reading. For example, she's thinking why can't I hear the woman in the next cubicle peeing.
Catastrophizing. If i tell my friend he will laugh,tell everyone in work and I will have to
leave my job. Generalization. Everyone will laugh if i tell them about my shy bladder.
The best way to deal with negative thoughts is to put them on trial
and examine the actual evidence rather than the emotion that they bring.
First write down the thought, then write down the evidence for that thought being true.
Then write down the evidence against that thought being true.
Then try to reach a balanced statement that includes both the evidence for and the evidence
against. Starting the balance statement with the words 'even though' can be quite helpful.
Here is an example. The thought on trial is if someone notices I can't urinate they will mock me.
For the evidence for, ask has anyone ever mocked you. Some people with paruresis may
have experienced being mocked but for most people it is just a perceived fear rather than a reality.
In this example Larry writes brad once scoffed that I peed behind a tree when everyone else
used the public toilet. Incidentally this is an interesting point. Brad's comment came not from
Larry's inability to urinate in the public toilet but from his safety behavior of using the tree.
This is often the case. It's the safety behaviors that people are more likely to find unusual
than someone not urinating. For the evidence against, ask yourself how many times have you
witnessed someone commenting that someone is not urinating at a urinal or in a cubicle.
You learned in the first video that seven percent of the population may have paruresis , so if the
thought is true then you should hear people constantly being mocked in public toilets.
So in the evidence against Larry writes I have never heard of anyone being mocked
due to failing to pee in a public toilet. Let's look at this thought a bit closer. You may have
friends who do poke fun at each other but you may well be avoiding public toilets in places
where your friends are not present. Imagine this scenario. You are in an airport toilet. One guy
says to a complete stranger why aren't you peeing, I've almost finished and you've not even started.
Who would most people think is strange, the guy who takes longer to get started or the
guy observing and commenting on a strange's toilet habits. I know which one i would think is strange.
So in writing the balance statement Larry writes
even though brad once mocked me for using the tree I have never seen anyone being mocked
for not being able to pee in a public toilet. By including the evidence for and evidence against
Larry has come up with a balanced thought. Here's another example Larry thought that if I tell my
best friend he will laugh, tell everyone in work and I will have to leave my job.
For the evidence for, he wrote brad laughs at me when I say something stupid.
Now when you're looking for the evidence against, think of someone close to you.
Would they really do that to you. While many people with paruresis keep it a secret for years
some people do choose to confide in a friend or relative.
Have a look at the UK paruresis trust forum. You will find some stories from people who
have confided in people and the results are very different from Larry's prediction.
So in evidence against Larry writes
people who have told someone, report that no one seems to think it's a big deal.
So for the balance thought Larry writes even though Brad sometimes laughs at me,
most people don't seem to think it's a big deal. If you are struggling to find
evidence against then you may need to do an experiment to gather the evidence you need.
Behavioral experiments are a really powerful tool in combatung anxiety disorders including paruresis
and they are the subject of my next video in this series. The link should appear around about now.