In the early treatment sessions, the therapist stands outside the restroom and reassures the patient that no one will enter. Once the patient is calm enough to start urinating, the therapist gradually moves closer and closer. Eventually the patient is able to use a urinal even as the therapist stands directly behind him.
I might even fidget around or make nasty comments about how long its taking, or even bump against the patient to simulate a real-life situation, Himle says. As the final session nears, the patient and therapist seek out the ultimate challenge: a Michigan football or basketball game or a concert, wherever people are lined up and waiting to get in, Himle says.
Throughout the therapy, patients also are assigned homework in which they practice relieving themselves in progressively difficult public settings.
To date, Himle has treated about 50 patients, three-quarters of whom have achieved substantial relief from their phobia. These patients tend to do very well with treatment; usually within six to 10 sessions they are pretty much on their way, he says.
For more information about treatment for bashful bladder syndrome, call the U-M Anxiety Disorders Program, 764-5348.