What is Paruresis (Shy Bladder Syndrome)? - Podcast | Anxiety and Depression Association of America, ADAA

Audio File

ADAA sits down with Dan Rocker (International Paruresis Association (IPA)) and ADAA Member Ruth Lippin, LCSW to discuss paruresis, or Shy Bladder Syndrome. In this podcast we review what paruresis is, how it can impact ones life, and what treatment options are available.

What is Paruresis?

Lippin: So paruresis is the inability to urinate in public restrooms, or in situations where other people are present. It is a social anxiety disorder, and there is generally a fear of judgment associated with it.

Rocker: It's a diagnostic feature. As you point out of social phobia, it is in the DSM 5. So if people are looking for some legitimacy paruresis and shy bladder are in the DSM 5 by name. And at the IPA, the International Paruresis Association, we like to conceptualize paruresis as really having kind of two components or facets: the first of which is just the actual functional inhibition of urinating initiating a stream, while under a time pressure, or when people can hear you or when people can see you to be attempting to urinate. And that's the primary paruresis. The secondary paruresis, which is something that accrues tends to accrue to people who have primary party resists, is all the negative thoughts, feelings, self evaluation, and shame because of having the disorder, and almost everyone who's going to present for treatment is going to come in with both primary and secondary paruresis."

Ruth Lippin, LCSW, JD

Ruth Lippin, LCSW, JD is a licensed clinical social worker who has had a private practice in New York City for the past 20+ years specializing in the treatment of anxiety and related disorders. Ruth utilizes Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and other related evidence-based practices, such as Acceptance and Commitment Therapy (ACT) and Mindfulness to treat her clients. She works with children, adolescents, and adults. A graduate of Columbia University School of Social Work, she was trained in CBT for anxiety disorders at The Anxiety & Phobia Treatment Center at White Plains Hospital in Westchester, New York. Ruth is also a graduate of the International OCD Foundation’s (IOCDF) Pediatric Behavioral Training Therapy Institute. Additionally, along with two colleagues, she created a 12-part online series to train master level clinicians in CBT that can currently be seen on the PESI website. Ruth is a member of ADAA where she has served on numerous committees and is currently the co-chair of the ADAA Child and Adolescent Special Interest Group. Ruth is a recipient of the ADAA's 2012 Clinician's Outreach Award. She is a professional member of the Association of Behavioral and Cognitive Therapies (ABCT) and is currently on the Board of the NYC-CBT Association. Prior to becoming a therapist, Ruth had a successful career as a public interest attorney in New York City.

Ruth and ADAA

"I feel privileged to be a founding fellow of the ADAA. I joined ADAA over 20 years ago and have considered it my professional home ever since. I have worked on numerous committees throughout my time as a member and am currently the co-chair of the Child & Adolescent SIG. I have also truly enjoyed being a mentor in the Career Development Leadership Program (CDLP) where I have been able to support others in building their careers.

To be part of such a dedicated community of fellow clinicians and researchers treating anxiety disorders, OCD and depression has been invaluable to me. It has allowed me to stay current with the research and cutting-edge treatments and it has provided me with numerous opportunities for continuing education. But more than that, it has given me colleagues (some of whom are now good friends), across the country, that I can collaborate with and always turn to for advice and support in respect to my professional endeavors. However, I would be remiss if I did not mention what is the highlight of every year—the annual ADAA conference which I have sorely missed during COVID-19. It is a time to learn, get reinvigorated about the work you do and to reconnect and have fun with fellow ADAA members!

Finally, I am still pleased that in 2012 I was honored, along with Elizabeth Dupont Spencer and Kimberly Morrow, with the ADAA 2012 Clinician’s Outreach Award."

Dan Rocker, LCSW-R

Dan Rocker, LCSW-R, is a psychotherapist in private practice in New York City. He's President of the International Paruresis Association and specializes in paruresis treatment; he is also a family and couple therapist who has completed post-graduate training at the Ackerman Institute for the Family.