Hypnotherapy for toilet anxiety

It’s as natural as breathing, it’s essential to health, and everyone does it. So why
are so many people suffering from "toilet anxiety”?

The dreaded question “what if I can’t get to the toilet?” has become one of the most uttered sentences in my hypnosis clinic as scores of clients seek solutions to stop this life-wrecking worry.

What is toilet anxiety? 

Rooted in overwhelming fear of embarrassment, those with toilet anxiety report worries around a raft of matters related to bodily functions. These range from the more obvious humiliation anxieties about wetting or soiling themselves in public, through to particular worries others might “know” or “imagine” they are having a poo.

Toilet anxiety also incorporates issues of needing to go to the toilet multiple times before going somewhere, fears of using public toilets - usually in case others can hear them make noises, or smell odour, and even anxieties of others noticing the frequency and length of their toilet visits.

How does toilet anxiety impact daily life? 

Often generated by a societal “taboo” or shame surrounding those bodily functions, those afflicted are finding their lives become increasingly difficult as they place their bladders and bowels at the centre of their world and try to live their lives around their movements.

At the milder end of the scale, a typical pattern amongst those with anxieties might include a few trips to loo before going out somewhere or avoiding certain foods or drinks - particularly caffeinated tea or coffee - before travel. Some people make mental maps of where all public or accessible toilets might be. When visiting somewhere new, some might research ahead to make sure there are toilets  available.

As the anxiety deepens, safety behaviours can become more intrusive. It is not unusual to find someone routinely making “dry-runs” when attending new places or appointments; quietly turning up the day before to make sure there are toilets. Many arrive very early for appointments to leave time for a potential visit to the toilet. A lot of people will always ask for the aisle seat on planes or in theatres, cinemas, stadiums, lecture halls, meeting rooms, ceremony venues, and other types of auditoriums. Even at the cost of a restricted view or experience, this would be worth being able to make a quick dash out while minimising disruption and attention from others.

A very common trait among sufferers is a fear of being watched and judged, which of course stems from the real underlying fear that nearly always underpins toilet worries - humiliation. It, therefore, makes sense people with this anxiety feel more stressed when they are in social situations or when there are a lot of people present.

More people mean more feelings of being judged, more eyes watching them, more humiliation - and in a practical sense - more pressure for a limited number of available toilets.

“What if I can’t get to the toilet” for many now feels like a very real and obvious
problem. However, all of this still feels manageable compared with when this pattern really bites. By the time most people seek help, the safety behaviours around toilet anxieties have started to entirely dominate their lives.

Why do some people experience toilet anxiety? 

These patterns frequently begin with turning down invitations to social events or
opportunities, even if they would really like to go, and instead choosing the comfort
and safety of their own home (and toilet). Sometimes toilet anxieties start to interrupt work requirements. Despite being an inappropriate way to treat grown adults, in my opinion, some workplaces limit toilet breaks or opportunities to go.

A significant portion of embarrassment for a person frequently stems from the
embedded memory from school - 30 pairs of judging eyes and an annoyed teacher
staring while they, in their discomfort, raise their hand and publicly ask permission to urinate or defecate. While it might make sense for teachers trying to manage a busy classroom, in conditioning children to ask permission for the toilet, a person’s bodily functions are certainly further stigmatised, and this can provide the seed for toilet anxiety to grow.

Frequently reported by clients is a fear of not being “in control”. The notion that another person can control your level of comfort, embarrassment, and ultimately health, if they deny their permission, is a deep and pernicious part of this fear.

How can hypnotherapy help? 

A recent client of mine (we'll call them Cameron), came to me with anxiety about needing to urinate which had begun exactly by the route outlined above. At just 17, 
he had been caused acute embarrassment in school one particular day when he
had been denied permission to visit the toilet.

In just two years, he started to perpetually check where toilets were located, he
visited the loo up to four times before leaving the house and all his choices had
begun to revolve around his ability to pay a visit. He would experience a triggering thought while in a place without access to toilets: “What if I wee myself?” and instantly he would feel the sharp twinge in his bladder of an urge to go. This would pass, however, as soon as a toilet would become available and he would have no urge whatsoever. He had undergone various tests and checks by medics and was found to have no physical problems. It was, they said, “all in his head”.

Thankfully, after a few hypnotherapy sessions, Cameron’s anxieties ceased before they caused much more damage to his life potential.

Quitting successful careers and well-paid employment or choosing work purely
on the basis that it doesn’t trigger this dread is also a common story among my clients.

A former nurse - we'll call her Gill, aged 62- had to quit her career and take an admin job because of her anxieties about not being able to “nip to the loo” while on shifts. Unable to take a ride to work in case she was “stuck in traffic” and “messed” herself, she ended up renting a flat no more than 15 minutes’ walk from her home just to make her commute as short as possible and within her control. Even so, every day she would set off towards work and then U-turn after a few moments when she had that familiar thought about needing the toilet. She did this three or four times every trip. Going anywhere else had become too much of an ordeal and her life shrank to her four walls, a walk across a park, and a poorly paid office job well below her skill set.

After 30 years of living with this anxiety, resolving Gill’s issues have taken some
time. While not yet fully free of her fear, Gill has now been able to move house and
lives two train journey's from work, which would have been impossible for her before. She now says 60% of her commutes to work trigger no twinges or thoughts about the toilet at all. We’re still working on the other 40% but her life has broadened in its range and she’s now able to travel and accept invitations without automatically saying “no”.

Like many, Gill came for hypnosis as a last resort. She had tried Cognitive Behavioural Therapy (CBT) but each time she had forced herself out of her comfort zone as per the instructions, the anxiety became overwhelming and had triggered the stomach-churning sensation of the “need to go” immediately.

Although well-intentioned, she said that particular therapy had made her worse
and there is a fundamental reason why this would be the case. Understanding the flight-or-flight response which is triggered in anxiety-provoking situations is key to understanding why toilet anxiety seems to take such an all-controlling grip on its sufferers and why exposure therapy is unlikely to help.

When the body is preparing to fight or run in survival mode, it diverts energy
away from the digestive system and into the arms and legs for a fight for its life.
That, plus the body’s need to shed itself of any additional weight - like urine or
faeces - to run away faster, causes the sensation of “butterflies” in the stomach and
loss of control in the bladder and bowel.

In an anxiety-provoking situation, most people are likely to feel a sensation of
suddenly needing to go to the loo. The problem arises when the person “misinterprets” the stomach, bowel and bladder sensation in an anxiety-provoking situation as being about needing the toilet, rather than as just being a natural part of a bigger set of sensations.

Gill’s problems had no root in ever needing the toilet and she has no bowel or
bladder issues. They began with a car accident when she was a passenger in a vehicle that accidentally struck and killed a child. Understandably, the next time she was a passenger in a car she felt anxious in case it might happen again.

As part of her anxious feelings, she experienced discomfort in her bladder and
bowel. However, Gill interpreted this signal as a fear that she might not make it to the toilet, rather than associating it to its true origin: the sudden, shocking death of the child. This feeling subsequently triggered every time she was in a car and, over time, her mind became much more preoccupied with the distress of soiling herself, rather than the risk of another car accident that had never happened since.

As a result, any therapy which asked to her experience her anxiety triggers in real
life would only trigger the vicious cycle of anxiety which would cause an urgent
feeling of needing the toilet, which heightens the anxiety about not making it to the toilet, which, in turn would, increase her anxiety.

Hypnosis has helped by aiding clients to decouple their genuine feelings of anxiety
from the sensations of needing the toilet.

In my practice, I use a combination of suggestion, reframing, and certain NLP
techniques to calm the underlying anxiety and change perception of the issues from
anxiety-provoking to feelings of being completely in control. It is not the most simple of issues to resolve as every client has a different manifestation, albeit with many similarities in their patterns.

However, nearly all clients report marked improvements in their daily living after
just a few sessions. As a general guide, I see clients for this between four and six times.

If you are struggling with this, I offer a complimentary consultation either in-office or on Zoom. Subsequent sessions begin at £89 each.

For more information or to book, visit my profile below.