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Toilet Phobia

This page created 1 October 2012
By Tania (ADAVIC Volunteer)

Toilet phobia is a far more common condition than you may think. In fact, it is one of the most common, yet by far the least talked about, of all the phobias! People will discuss all sorts of phobias; they seek help for many of them, but never mention the problem they are having with going to the toilet. For most of us, going to the toilet is a very private and delicate matter, so it is very understandable therefore, that when there is a problem, many people do not want to discuss their condition or seek help. As we all need to go to the toilet several times a day, it is a phobia that is hard to avoid and extremely intrusive to a person’s life.

Toilet phobia is an umbrella term for a variety of issues related to using, or difficulties using, the toilet. Public awareness of toilet phobia is very low, and it is hardly recognised by the medical and mental health community. It is an issue that many   people wish could be more openly talked about, but as previously mentioned, not many are willing to talk. In the UK alone, more than four million people are affected by some problem related with going to the toilet. In Canada, the figure is seven percent, however, exact statistics are not known, as most people refrain from discussing the problem.

Toilet phobia, from a medical perspective, is classified as an anxiety disorder. There are many different forms of it. In addition, it is rare that the toilet phobia occurs by itself. The most common conditions it overlaps with are social phobia, OCD, agoraphobia and panic disorder. The fears may be related to: not being able to urinate or defecate, or to have an accident in public,  being too far from a toilet, to be locked in such a small space, to be heard or seen, to be scrutinised, to cleanliness and infection; etc.

Some of the most common conditions to do with toilet phobia are:
  • Social phobia - worrying about being seen or heard in the toilet
  • OCD - worries about bacteria, contamination etc.
  • Parcopresis - fear about defecating in a public place
  • Paresis - fear about urinating in a public place
  • Panic attacks
  • And there are other specific phobias related to going to the toilet – i.e. small rooms, public places etc.

There are many differences, but all of them have one thing in common, namely difficulty in using the toilet. Toilet phobia can affect anyone. It can disrupt a life mildly, but more often than not, also significantly. Many people experiencing toilet phobia engage in avoidance behaviours, which can be very limiting and dangerous to their health. It can damage relationships. It can affect family members who have to accommodate specific needs. It can isolate people; stop them from going on social outings, to friends’ houses, on holidays, or indeed anywhere. It can restrict employment opportunities. In fact, many people become housebound. Others change their eating and drinking patterns to an unnatural and unhealthy level, so they can avoid using the toilet. Others are unable to give urine samples. The list goes on and on…

So, where does this come from and what can be done about it?

The causes are wide and varied. They range from having experienced a specific trauma, to learnt behaviours, or instead, they may be related to another anxiety disorder.
Minimal research has been completed to date, as it is such a barely recognised condition. However, reducing general anxiety levels is definitely at the top of recommendations.  
According to the ‘National Phobics Society’, coping is improved by making contact with other sufferers and by talking therapies. Generally, cognitive behavioural therapy (CBT), is the most accepted treatment method. A psychologist or counselor who offers CBT can help support the person and set up a plan of working with unhelpful thoughts. They will most likely set small tasks to achieve each week and help break the cycle through graduated exposure. However, other therapies that have been used include clinical hypnotherapy, counselling, lifestyle changes and guided self-help. All can help manage the condition.

Knowing you are not alone can help and so can information about the condition. Support groups, internet chat rooms and help lines all provide communication and information. Books and DVDs are another possibility. The ‘National Phobics Society’ has put out a booklet on the internet called, ‘Toilet phobia - Breaking the Silence’, which is very informative.

Here are some references and helpful sites:

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