This guide requires a second person to help and support you during the treatment. It is important to choose someone who understands your problem, who has a lot of patience and who will be able to give you the support that you need over an extended period of time. There are also self-help workshops held around the country which practice exposure therapy and you may want to attend one of these first before trying this exercise on your own.

Before you begin, it is advisable to seek out a doctor’s advice first to ensure that your symptoms are not caused by something physical. As a general rule, you have paruresis if you are able to go at home easily but you find it difficult to go or are unable to go in social situations.

Exposure Therapy involves several sessions. Each session will involve several attempts at urinating. This means that a substantial amount of urine is needed. Because of this you must try to drink a lot of fluid (preferably water) before the session. Most people will only be able to succeed using this therapy if their need to urinate is high at the time of the session - it is a good idea to try and ensure that the urgency is fairly high, but not extreme.

It is also important to try and have a back-up plan. The most common of these is the use of a catheter. Ensure that you are comfortable using a catheter before you start the exposure therapy sessions.

In your first session, you will need an isolated bathroom where you feel comfortable. Ask your buddy to wait away from the bathroom but on the same floor - somewhere where they will not be able to hear you urinate. Once your buddy is in place, try to urinate. If you are able to star the flow, continue the flow for 3 seconds and then stop. Take a break for 5 minutes. Now, try again. If you are a paruretic who does not like the noise of urination, try to make your urine flow as loud as possible to desensitize yourself to the sounds. Do not use any background noises such as a running tap as you go. If you are unable to urinate after 2 minutes, take a break for 3 minutes and then try again. If you are still unable to urinate, have your buddy move further away - maybe a different floor or even outside the house. Remember it is also important to relax - check out our relaxation techniques with hints and tips on how to do this.

When you have successfully urinated a couple of times, move your buddy closer. Typical ’steps’ are:
- Just outside the bathroom door with the door locked
- Just outside the bathroom door with the door unlocked
- With the bathroom door slightly ajar
- With the bathroom door wide open
- Standing just inside the bathroom
- Standing directly behind you.

If you do not have a buddy to practice with, or you have reached the ‘top step’ with your buddy, try setting yourself a series of steps such as:
- Trying to go when people are outside the bathroom
- Trying when there is one person in the bathroom
- Trying when there are multiple people in the bathroom
- Trying when someone is in the stall next to you.

With each step, after you have successfully urinated a couple of times, move up to the next step. The ideal which you are aiming for is being able to urinate freely in a public bathroom with a lot of people in the bathroom with you.

If you find one step is giving you a lot of bother, try breaking the step down into smaller steps. Just a couple of centimetres can make the difference and will help to boost your confidence.

For the best results, it is advisable to practice several times a week for up to an hour. Longer sessions are generally more helpful than shorter ones. You may need to keep drinking fluids throughout the session to ensure that you have enough urine. Be prepared for some inconsistency in your progress - it’s entirely normal! Most people will experience ups and downs with how close they can let their buddy get to them in each session and it is nothing to concern yourself about.

This therapy normally takes around 12 sessions, although each person will be different - some people will require more sessions, some less. It is important to go at your own pace. Although this treatment has helped many people overcome their paruresis there is no guarantee it will cure yours. Check out the other pages on our site to see if there are other techniques that can help you.

On extremely rare occasions, you may find that you are unable to urinate even after your buddy has gone home and you are on your own. If this happens it is imperative that you seek medical treatment immediately otherwise you risk damaging your health.

If you feel that you have tried all the self help available, seek advice from your doctor who may be able to advise you on other techniques to try, or may be able to prescribe you medication to help lessen your anxiety.

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