Agony uncle

Dear Richard

I have a slightly embarrassing problem: I find it impossible to urinate in the presence of strangers. In a public loo I’ll stand at the urinal and the second someone else comes in, however urgent my need, I’ll freeze.

This doesn’t happen at home, and having been checked out by my doctor I’m confident everything is working on the anatomical side. It seems to be a psychological issue – and it’s getting worse.

When I was growing up this was never an issue, and I suffered no traumas that might have caused this problem. One day, it must have been in my late teens, I went to the gents and found myself unable to go. That one moment has now stretched over decades!

It’s starting to affect my social life: places such as the cinema or theatre are especially challenging.

The reason I am writing to you now is that myself and a couple of friends are booked to go trekking in Rwanda to see mountain gorillas. We’ll be in the wilds for five days with no toilet facilities and I’m worried about how I will cope. Any ideas how I might get back into the flow, so to speak? — Alex, via email

Dear Alex

Well, you’re certainly not alone! Hundreds of readers will be nodding in wry recognition of what you describe in your letter. It ’s a much more widespread problem than you may think. So let’s start with a bit of analysis, and then we’ll get on to the fix, all right?

Alex, you couldn’t be a clearer-cut example of paruresis or ‘shy bladder syndrome’ – the inability to pee when other people are around. It’s a common form of social phobia, second only to the fear of public speaking. It often begins in early life, especially at school. You say you began to experience it in your late teens – this again is par for the course. At its root is a fear of being judged by others.

The fix? Cognitive behavioural therapy. Shy bladder syndrome is a treatable condition. You can be taught to reduce your anxiety and successfully urinate in the sight and hearing of strangers. This can take just a few months; although in some cases, longer. So you should sign up for therapy at the earliest opportunity, Alex – welldoing.org offers a free therapist-matching service. Good luck!

Dear Richard,

Shy bladder syndrome is a common social phobia – at its root is the fear of being judged

I have had a difficult life, having experienced domestic violence as a child, the deaths of half my immediate family in my 20s, a lengthy controlling relationship and mental health issues. All of which I have managed to overcome with therapy, medication and the love of my child and my grandchild. Now in my 60s, I do not have many friends as, not trusting people, I take a long time to g et to know them.

My dilemma is with an old ‘bestie’ from childhood. She has made it clear that I am only acceptable company if I am cheerful all the time. At school, I played the clown and was popular. No one knew what was going on at home and it was exhausting. She has no idea who I am and seems to disapprove of my having had therapy.

I left home and we lost touch. Decades later, she suddenly

Why should you have to justify your experience of therapy? Whoisshe to call the shots?

phoned me each time one of her parents died. I offered compassion for her loss but she didn’t like what I had to say, having a sudden outburst of indignation when I mentioned bereavement counselling.

This would all be well and good except that she has invited me to join her on a short cruise in the spring, and I have accepted. It seemed that she was lonely, and it was a very kind gesture. Only I don’t want to be the light-hearted person she probably still expects me to be, and I don’t want us to argue about therapy in the middle of the Baltic. But if I try and lay this out for her in advance of the trip, suggesting that unless we reach some sort of accord on these issues it’s best if I cancel, then I’ll feel as if I am holding her to ransom. What should I do? — Arnold, Manchester

Dear Arnold

What should you do? I think I speak for most of my readers who’ve just read your letter. All together now: ‘CANCEL!’

Of course you can’t go on this trip with your ‘friend’ (inverted commas intended). It’ll be an unmitigated disaster. Here’s why. You say, for historic (and moving) reasons, that you have few friends. Well let me tell you something about true friendship, Arnold. Like true love, it’s unconditional. Your ‘bestie’ has laid down absurd pre-conditions for her friendship with you. You are only ‘acceptable company’ if you are ‘cheerful all the time’. What arrant nonsense! No one is cheerful all the time! I’m certainly not. I don’t know anyone who is.

And why should you have to justify or even deny your experience of therapy? Who is she to call the shots on how someone who’s been through what you have should process the experience?

I find it most instructive that this person only ‘reaches out’ to you when she is faced with a crisis of her own. Now, you say, she’s lonely, and wants your company on this cruise – but only on her terms! She’s willing to pay for you, but only if you’re ‘Mr Cheerful’ throughout the trip. I don’t call that ‘a very kind gesture’, Arnold. It’s controlling behaviour, pure and simple – and I think you’ve had enough of that, haven’t you?

I suppose you could tell her that you’ll only join her on this trip if she takes you as she finds you: that is, on your own terms. But I predict a frosty response.

You say it takes you a long while to develop new friendships, so your time is precious. Don’t waste any more of it on this shallow user.

Dear Richard

Our 32-year-old son told us that he identifies as non-binary feminine and wished to undergo hormonal treatment to become a woman. (I’ll use male pronouns for now, as the treatment has not started.) He has undertaken 18 months of counselling with an NHS gender dysphoria specialist and has now been referred for further treatment.

My wife and I love our son and have told him that we will always support him. However, his sister, and more specifically her partner, have concerns. My daughter’s mostly surround the possible side effects of the medication.

Her partner, however, is somewhat less enlightened and I believe that his concerns are based on ignorance.

Is there a direction in which you can point us (our son-in-law) to assuage these misgivings? — Anon, via email

Dear Anon

I think you are attaching too much importance to what your son-in-law may or may not think about this unfolding family story. Frankly, at this stage he’s peripheral to it. The important players are your son, his sister, and you and your wife. All four of you are on board and sympathetic to your son’s resolve to transition. Your daughter’s concerns are purely technical/medical, and nothing to do with the principles behind the decision itself.

I suppose you could consult various sympathetic agencies and point your son-in-law in their direction – but be prepared for him to react negatively against what he perceives as being ‘managed’. In any case, at this stage I don’t think it’s necessary. He’s not making any silly threats or drawing lines in the sand. He’s just grumbling, largely out of ignorance.

I’m a great believer in the power of fait accompli. In this case, the four of you should take strength from your unity of purpose and mutual support. You’ll see this thing through together. Your sonin-law clearly needs more time to adjust to this new reality, so carry on leading by example. I’d be surprised if he doesn’t fall into line: force majeure, and all that. But I think you’ll carry the day.

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