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Back to School Time Can be Challenging for Children Suffering From Paruresis


As the summer wraps up and children around the United States begin a new school year, some children are filled with anxiety, dread, and embarrassment. Paruresis (the difficulty or inability to urinate), a widespread but seldom discussed condition, can make enduring an entire school day almost literally unbearable.

Paruresis is thought to effect as much of 17% of men, and it often begins in adolescence, when the perceived judgment of others is typically at an all-time high. For some who suffer with what is also commonly called “shy” or “bashful” bladder, it can mean being virtually any urination outside the home physically impossible due to anxiety. Considered a specific phobia by the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), treatments are available, but individuals who struggle with paruresis may not elect to seek help due to the shame or misunderstanding that accompany the condition. Traditional therapy or self-help programs such as the Paruresis Treatment System at can be incredibly helpful in making days and lives easier for those that mistakenly thought they were alone in their fear or would have to live their lives without being able to overcome their anxiety.

Rich Presta, the author of the Paruresis Treatment System states, “Everyone experiences some occasional ‘stage fright’ when attempting to use a public bathroom, but that’s not what we’re dealing with. What differentiates paruresis from normal anxiety everyone sometimes feels is the degree to which is effects life. Children who may be battling paruresis may have no idea how common it is, or what they can do about it, and it can do incredible damage by restricting almost all areas of life. My goal is to break down the barriers to treatment and help those who feel alone realize there are effective treatment strategies available.”

Severe paruresis in school aged children can also lead to complete school refusal by the child, as well as more pervasive anxiety that can spread into other areas of life, such as social anxiety or even panic attacks. In some cases the disorder may become so severe that self-catheterization is necessary.

Rich Presta’s program for treating paruresis and additional resources for parents of children facing the condition, or anyone struggling with paruresis, can found on the Paruresis Treatment System website at His work has been featured in Psychology Today and Natural Health magazines, as well as on TV such as CNN, MSNBC, and the Discovery Health Channel.


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