What is the breath-holding technique?
Does it work for everyone?
technique is thought to work because an increase in carbon dioxide in the
bloodstream has been reported to reduce anxiety and induce relaxation in some
patients. This technique is well
suited for people who can usually urinate around others once they get a stream
started, but have difficulty starting the stream. Monroe Weil, Ph.D. reported using it successfully in three
A brief description of the technique follows.
- Discuss this technique with your physician first before using it.
Even after getting an OK from your doctor, if you experience any kind of
abnormal reaction be sure to let your doctor know before proceeding any
further with this technique. Before
attempting to use breath holding in a restroom, practice holding your
breath. Start out holding for 10 seconds, then 15, increasing the time in
gradual increments. Practice often in different settings. Pay attention to your bodyís response to holding your breath.
If you are feeling anxiety or panic while not in a restroom, youíll
need to do more practice. Since
the issue weíre dealing with is anxiety while urinating, it wonít be
productive to do something in a restroom that is increasing your fear. When you can hold your breath for 45 seconds and feel calm during the
process, you are ready.
first attempt should be in a place where you can feel comfortable, such as
at home or an empty public restroom, so that you can be free of distractions
or anxiety triggers. If the
technique is working you will experience it in a variety of ways. Some describe it as the "pelvic floor dropping", or an
unstoppable relaxation of the urinary sphincter muscle; others say it will
make you feel temporarily incontinent. Your level of urgency should be moderate to strong, but not extreme.
Take your position either in the stall or urinal, breathe normally, and then
exhale about 75% of your breath. Do
not take in a big gasp of air before exhaling. Youíll have too much oxygen in your lungs and it will blunt the
effect. Itís also important
to not exhale completely. There
needs to be some air left in the lungs. When holding your breath, pinch your nose if you have to.
After about 45 seconds you should experience the pelvic floor
"drop" and your stream will start. Once the stream starts if you start clamping up just
exhale again and your stream will return. If your lungs are empty, you may need to take in a small breath and
then resume holding it.
you find the technique helps you start urinating, with practice it will work
at any level of urgency, in every place. Continue practicing and eventually it should be possible
to reduce the time required to start urinating. Some people start holding their breath as they approach
the restroom so the time required at a urinal or stall is reduced
people using the technique report that it works best if a person has a low
level of anxiety in the restroom. A
period of graduated exposure and support group work may be needed to reduce
the level of fear in a public restroom to the point where the technique
begins to work. So if you are
trying it and not getting any results, continue with your recovery program
and try it again a few months down the road.
The amount of reduction of the tension in the bladder neck and
sphincter provided by breath holding may only be enough to offset a certain
level of anxious tension in those areas.
If a person is freaking out in the restroom, no amount of breath
holding might work.
Some additional notes on breath holding:
If you find the technique useful, after practice it will
work even with a low level of urgency or none at all. At this point if it is necessary to empty the bladder in a
crowded situation, before a trip, or to avoid waking up at night, breath holding
works every time.
During the practice period, some people who reported a
great deal of fear holding the breath for a long time have persisted and found
that the desired effect on easing urination happens once they overcome the fear.
If this applies to you, try to stay with the practice and get past the
fear. Many believe they will faint
if they hold their breath for too long, but that is not a serious danger. If you have the level of control to starve yourself of air to the point
of fainting, once you faint youíll start breathing again. If youíre very concerned, then try holding your breath at a doctorís
office where emergency help is available. Most
people report they can urinate after around 45 to 60 seconds of breath holding. Thatís a long time, but if you are healthy itís not dangerously long.
There is one side effect of the technique, which is that it
can also relax the anal sphincter. So
if a person needs to deal with that, visit a stall and take care of #2 before
practicing at urinals.
Below is a personal account from someone who has tried this
technique and uses it successfully:
This would not be complete w/o a sports analogy.
When I first started skiing really steep slopes, almost extreme terrain,
I was with a group of very good skiers. I'm
a good black diamond, mogul skier and these folks were way above that.
Our ski instructor/guide told me that the only way I could get down the
slope was to have courage. I had to
trust my ability to slow my skis with all the techniques [I] had previously
learned. You must have the courage
to see this through. It is worth
it, trust us! You will not faint or
pass out but you probably will gasp for air, at that point you are close.
Very close, stay with it. If
you do gasp for air, just suck in a little and hold your breath again.
For those of us doing it
properly it works every time in every condition. For me troughs at Steeler games, planes, bars, everywhere.
As a matter of fact sometimes I'm very tense just from holding my breath
and being stiff or whatever, but I know if I see it through it works.
Once the stream starts if you start clamping up just exhale again and
your stream will return. For those
of us practicing for years, usually once our stream starts we can keep it going.
Over time a lot more people
will become comfortable with the technique.
Again, it does not improve your primary AP, although my secondary AP is
almost non-existent. I find myself
making plans and doing things with people and places that I would have avoided.
I'm not thinking about AP. Then
later it dawns on me "oh my gosh, I just decided to go to such and such
with so and so w/o thinking about where I'm going to pee. Pretty Cool.
One warning about using this technique: In some individuals with panic disorder, it has been reported that
elevated levels of carbon dioxide can cause symptoms of increased anxiety and
panic. If you notice this happening
and the symptoms do not improve with practice, then the technique may not be
useful for you, or wonít become useful unless the panic disorder is treated.
Weil, Monroe Ph.D. ďA
Treatment for Paruresis or Shy Bladder Syndrome.Ē The Behavior
Therapist 24.5(2001): 108.