One particularly common issue is that anxiety about going to the toilet can mean that it actually becomes physically impossible to go due to muscle tension. It’s a condition which has many names and applies to both urination and defecation. Being unable to urinate due to anxiety usually comes under the names of Paruresis, Shy Bladder Syndrome, Bashful Bladder, Urophobia and several other names, while being unable to defecate due to anxiety comes under the names of Parcopresis, Psychogenic Fecal Retention and Shy Bowel

As far as I know, being unable to urinate is a far more common problem than Shy Bowel and can be particularly problematic given that often we need to urinate several times a day. The problem can end up causing a restrictive lifestyle for a person meaning they do not travel far from their home or meaning that they do not go out for too long in case they need to urinate. People may also develop unhealthy habits such as restricting their fluid intake to manage how often they need to go. In more severe cases people may be so unable to urinate that they still cannot go even when they are in pain and in some cases this can cause damage meaning complications for them in the future.

Research seems to indicate that this problem is equally split between men and women, although it seems men are more likely to seek help with it. Although essentially the problem is the same for men and women – anxiety causing tensing making it physically impossible to go – there are some distinct differences. This is mainly due to the differences in male and female public toilets. Due to the exposed urinals that are commonly found in men’s toilets, men are more likely to be concerned with issues such as performance, other people seeing their private parts, etiquette and technique, while women can be more concerned with issues such as being overheard and taking too long when there is a queue. There is an amusing game that I am sure many men can relate to on the UK Paruresis Trust website. Just click on this link to play it. For my friends in the US there is the International Paruresis Association, although unfortunately they do not have any games to play.

Some people may not have so much or an issue about being unable to go, but may just get anxious about using public toilets in general. This was an issue for me and was something I developed at school, although it also extended to using toilets anywhere, including my own home sometimes. I seem to remember it started when some of the boys at my school realised that it was quite amusing to push someone on the back while they were using the men’s urinal trough meaning they had to put their hands on the splash-back to prevent them falling into it. After experiencing this one or two times and seeing it happen to several others I started getting anxious about using the toilets. As a consequence I stopped using them and would only go when I was really desperate. I remember I would often try and go the whole day without going which was quite uncomfortable at times. I have also suffered with Paruresis at times meaning I could only go when a cubicle was available, when I was really desperate or when no one else was in the toilet room. That is probably more about me than you wanted to know, but hopefully it is helpful for those who have experienced similar issues.

Both Shy Bladder and Shy Bowel are both considered a form of social anxiety, although Toilet Phobia can be related as well as unrelated to social situations. If you are struggling with Paruresis then there is a book called Shy Bladder Syndrome: Your Step-by-step Guide to Overcoming Paruresis which you may find useful. You may also like to try contacting the UK and US organisations linked above who offer workshops and may be able to put you in contact with a support group. Typically the recommended treatment is Cognitive Behavioural Therapy, as it is with many issues relating to anxiety, although in the case of Paruresis there is an option to use a Catheter which is basically a tube that can be inserted into the urethra past the muscle that keeps the bladder closed meaning it can empty through the tube. Although this is not a very attractive option for many people, if you are desperate (literally) then it might be a serious consideration.

For myself, the main fear I had around eating was noise. Could people hear me munching and crunching and was it really annoying them and even making them angry at me? I was not really clever enough to avoid noisy food and always used to end up with an apple, a bag of crisps or something else with a noisy bite or wrapper. I remember working in an office and sucking each crisp before I chewed it and trying to bite apples slowly so I did not make any noise. Another strategy I employed was to crunch quickly to get it over with. I used to imagine the people behind me getting more and more irritated by my crunching until they just wanted to explode and shout, ‘JUST SHUT UP WITH YOUR STUPID CRUNCHING YOU ****’. I did not want to draw any attention to myself, but of course I probably did through my unconventional eating habits because people tend to notice what is novel and blot out the rest. I really would have been much better off just eating normally.

As I said above, not all eating fears are the same and I have come to realise that my main eating fear was less common than the usual ones people have. Most common seems to be concerns over shaking or messing up when bringing the fork to ones mouth. People will often avoid difficult foods such as peas that might make their shaking more noticeable and stick to safe food such as mashed potato. Another common problem related to shaking is holding drinks and tea cups where the shaking might be more noticeable and there is a possibility of spilling tea everywhere. If shaking is a worry for you then you might find my ‘shaking and tension‘ post interesting.

Really anything that might cause embarrassment can be a problem, including slipping with your knife and shooting a tough bit of steak across the room, spilling soup down your front, making slurping noises,  and missing your mouth with your fork. People also commonly worry about etiquette like what to wear, what knife and fork to use, and am I eating too fast or too slow?

The consequences of all this are usually that the person starts to associate a lot of stress with meal time and starts to adjust their life around their fears. This might mean skipping meals, only feeling able to choose ’safe’ foods, declining invitations to restaurants, or eating in secret. This can then be noticed by other people who might be concerned or who might find it difficult when it affects their plans. Usually people do not want to explain what is really going on and sometimes even when they do other people might not understand the severity of their fears and that they cannot simply switch them off. This can then result in further stress being associated to eating fuelling the anxiety that surrounds it.

I hope by writing this post you can at least know that you are not alone with these fears and that they are actually very common. I am planning to address how to overcome them in my audio product, but I would encourage people to start seeking help with them now rather than waiting as since eating is so fundamental to our lives, such fears can have a big impact. Also, going hungry is known to make people more susceptible to feeling emotional and anxious, so skipping meals or not eating properly can heighten anxiety overall.

We can agonise over keeping our most personal problems private, trying to not let others know the secrets. We may even start to shape our whole life around them. But then when the pain gets too much and we have no choice but to bring them out in the open, we grit our teeth and wait for the worst reaction only to be met with a rather surprised reaction of, ‘me too!’ or a more casual account of how the other person also used to have the same problem, or knew someone who did. I guess we are all just human after all, and humans are human like!

Social anxiety is a very common anxiety problem, but most people struggling with it think they are the only one until they are fortunate enough to stumble across a website on the internet or accidentally find out in some other way. People with social anxiety are very secretive about their fears, have often crafted a well rehearsed act to hide them, and many just do not go out and meet many people, so it is not really surprising that they each feel like they are the only one even though there are many others near by going through the same.

Research on the prevalence of social anxiety disorder has quite varied results, but even at the most conservative level of 2% of the population, that is 1.2 million people in the UK, 6 million in the US, and 134 million globally. Some estimates are almost four times this number. Suddenly this very personal problem does not seem quite so personal. This is echoed in the support groups I facilitate where although everyone’s fears are slightly different, there is also a huge degree of similarity, right down to the most intimate details.

Carl Rogers quote of, ‘the most personal is the most universal’, is well demonstrated in Derren Brown’s Trick of the Mind 3 series, episode 1 (watch it here, 14 minutes, 55 seconds in), where he gives each person from three groups of people from three different countries a personal psychic reading. To their surprise it is very accurate, but then to their amazement, they all have exactly the same reading.

To access it, just login to the Free Downloads Area, or if you are not already a member then it only takes a minute to Register Your Details. I promise you will not get lots of spam emails and the only emails you will get are occasional updates from Socialanxiety.co.uk. You can delete your account yourself at any time.

Click the play button below to listen to a sample of the audio.

It is true that many people with social anxiety lack social experience and may not have had the opportunities to hone their social skills, but there are also many people with social anxiety who have perfectly acceptable social skills. This gives us our first reason to doubt that social inadequacy is the problem for people with social anxiety. A second reason is the fact that there are many people in the world who are very confident in themselves, but yet have atrocious social skills. Surely, if social anxiety was caused by a lack of social skills, then all people who lack social skills would experience social anxiety, and conversely, all people with social anxiety would lack social skills, but this is not what we find.

Instead, what is usually the case is most people with social anxiety believe they are socially inadequate, because of their struggles, but it is actually their anxiety that causes their struggles rather than a lack of skill. This means problems with socialising are a symptom of social anxiety rather than a cause of it. What people with social anxiety experience is usually more like hindered social ability, rather than social inadequacy. It is the way anxiety causes symptoms such as poor concentration, and also how we react to anxious feelings (i.e. avoidance) that stop us interacting with people effectively, not poor social skills. Once the anxiety is absent most people find that their natural ability to socialise shines through, or at the very least, improves greatly.

People can easily get caught up in trying to read social skills books to learn the ‘correct’ social rules that it seems everyone else seems to know, but this can mean people with social anxiety end up trying to achieve social perfection before they have had much social experience.  This is a recipe for feelings of failure and anxiety. Really, social skills need to be learnt through a trial and error process where mistakes are made and sense of what works is developed.  A well written social skills book may help to some degree, but nothing beats experience and books on social skills will not remove the anxiety.

Confidence is developed through learning that we can cope with our mistakes rather than through being socially perfect. This is a key point as many people with social anxiety are trying to achieve social perfection to gain confidence, but that is fairly unattainable as well as unstable. It only takes one mistake for it all to come crashing down, so better to be confident about your mistakes rather than your abilities.

As already mentioned, people with social anxiety really can lack social skills due to a lack of experience, and improving them can help in some ways, but doing this should not be seen as a solution to social anxiety. In fact, putting lots of effort into improving social skills with the aim to overcome social anxiety can do more harm than good. This is because however hard they try to improve socially, they still experience anxiety, which then carries on affecting their ability to socialise. Since they do not make much progress, feelings of frustration and hopelessness can set in which only feeds their sense of inadequacy further. This can then increase anxiety in social situations and make socialising even harder. It is a paradox where the thing that seems it should help, only makes the situation worse.

Make sure you are not feeding your sense of social inadequacy with social skills books and tips.

Last Saturday, 37 year old Jamie Pugh, described as possibly ‘the most nervous contestant we’ve ever had’, sang ‘Bring Him Home’ from Les Miserables, and he sang it very well! He sufferers from severe stage fight (a common form of social anxiety) and wanted to go on the show to confront his fears. He gave the distinct impression that overcoming his fear of stage fright was much more important to him than winning the contest, although I am sure he would like to win too! I am sure anyone struggling with severe social anxiety knows only too well that overcoming it would be a bigger prize than singing in front of the queen. You can see Jamie’s performance by clicking on his picture below.

Some of you might be wondering that, if he has social anxiety, then how could he do something so bold? The answer to that really is, we do not know, only Jamie knows, but there are some distinct possibilities. Firstly, while some people with social anxiety find almost all social situations painful, for others only specific situations will fill them with fear and dread. They do not necessarily feel less anxiety though, it is just that they do not feel so vulnerable in other social situations. Secondly, while some people are mostly avoidant and hardly ever enter the situations they find most anxiety provoking, others will be determined to not let social anxiety hold them back and will endure experience after experience of painful anxiety to carry on with life. It sounds likely though that Jamie has been avoidant up until this point and now his desires to fulfil his dreams, and possibly a little encouragement from family and friends, has driven him to face his worst fears.

Like many people with social anxiety, Jamie’s worst fear is that his performance will leave him in a vulnerable position. He states that he fears he will just freeze and not be able to perform, but the fear will go deeper than this. Most likely he not only fears that freezing will mean he could miss his opportunity, but more so that he will be judged negatively and ridiculed for appearing vulnerable, which is actually quite possible given the judges comments to other contestants. But respect where respect is due and despite Jamie’s nervousness on stage, his talents are recognised by both the audience and judges. In fact, it is quite likely that his vulnerability will inspire compassion and the public will not only vote for his talent, but also because they want to see his life change for the better. It will be up to Jamie now to put in the work to boost his confidence as I suspect it will take more than one performance to shift his lack of self-belief, but I hoped to be proved wrong.

He will have to work hard on giving himself encouragement, having faith in his abilities, having faith in the public to be kind and trusting himself to cope with whatever is to come. It will most likely be a fear that he cannot cope with rejection that is the even deeper root fear that lies behind his fear of being judged negatively. Social anxiety is not so much a lack of trust in other people, but more a lack of trust in ourselves to deal with the situations that go wrong for us. When he can learn to take actions that reflect the mindset of self-belief his confidence will grow and his fears will fade. As with so many people struggling with social anxiety, Jamie obviously is very harsh on himself at the moment and this is reflected in his inability to accept and enjoy praise. You can see the disbelief on his face as he tries to process the extended applause the audience and judges give. It is such contrast to what goes on inside his head and how he views himself that it is almost hard for him to bare. He cries as for this this brief moment he feels loved enough to let his guard down and be vulnerable, I just hope for his sake that he can learn to leave it down and place trust in not only himself, but also other people. Best of luck to you Jamie.

The obvious question is, since she’s never been kissed, does she have social anxiety? Given her cheeky attitude on and off stage you would think probably not, but social anxiety is complex and very individual for all experiencing it. You could blame her lack of love on something like her fuzzy hair and unplucked eyebrows, but I think that would be a shallow view to take. One also might be swayed towards thinking it was for religious reasons given her involvement in church, but the way she said it suggested a cover of sadness and regret, dismissing that it was something done through personal choice.

Although the underlying fears are very similar, there is often a lot of variation in social anxiety. Some people with social anxiety can be very socially confident in many social situations, but then terrified in others. It is not uncommon for people to be very sociable and outgoing but then crumple when attempting to become intimately involved with someone they are attracted to, or similarly, when they have to do public speaking. Some people might be more comfortable in pairs while others might like the camouflage of a large group and while most people go very quiet, some others talk endlessly in fear of uncomfortable silences.

Of course it could be that she had social anxiety but has recently overcome it enabling her to suddenly fulfil her dreams, or a reason completely unrelated to social anxiety. At the end of the day, only one person really knows the truth, and that is Susan herself. Whatever the reason, I am sure it will not be long now before she does find love, especially with a voice like hers. Let us hope they are everything she desires them to be and she fulfils all her dreams.

If you have not heard of him, Stephen is one of, if not the best selling personal development author in the world. He is very popular in the business world, although what he teaches is equally applicable to all people. The focus of his work is quite limited, but it is so profound that it does not require expansion. There is infinite wisdom to be gained from his timeless principles.

I was lucky enough to stumble across his work when I was overcoming my social anxiety and it definitely played a significant role in the changes I made back then. I started listening to his “Seven Habits of Highly Effective People” audio book and found only true wisdom that challenged how I had been living my life.

What he teaches does not focus on helping people with social anxiety or even mention it at all, but it is well worth learning. Do not expect to find quick fixes or magic answers, his work  is for serious students who are willing to put in the effort to create the life they desire. As you may know by now, I am not into quick fixes as they generally do not fix anything and only delay the process of change,  so I would encourage you to become a serious student of life. I promise, the rewards are far greater than the effort invested.

I shall leave you with the blog entry I read today. It is so true and timeless, as is all of Covey’s work. I hope you recognise the wisdom in it.

Find Success by Doing the Things You Dislike