Avoidant Paruresis (DSM IV Diagnostic Code 300.23): Otherwise known as the inability to urinate while others are present. This most often happens in public restrooms, but can even extend into the home, with family members.

While it might sound like a simple thing, it can become quite troublesome, especially when on buses, airplanes, or trying to get out that urine sample that one needs for a job. The severity can range from minor fright to the complete inability to urinate, causing the person to wait until the entire restroom is empty before proceeding, which can sometimes be a very lengthy process in some places.

At the extremes, it can cause a person to withdraw from society, as they are unwilling to stray too far from home, reluctant to take vacations, spend a day at the zoo with the children, or watch a matinee.

Treatment is available in a variety of methods. General books on cognitive behavioral therapy could be useful, as more and more therapists are recommending this to their patients in a variety of anxiety disorders and chemical imbalance situations. The disorder is most common among men, likely caused by the common use of urinals without sheilding, increasing the amount of "exposure" that one feels.


J.A. Hatterer, AM J Psychiatry 147 (1):109-111, 1990)
I.M. Marks, Fears Phobias and Rituals, 1987, Oxford Press pp. 388-389.)
DSM IV 300.23
Steven Soifer, M.S.W, Ph.D, President of the International Paruresis Association (IPA).