That is simply not the case. These toilet problems are probably universal and quite common around the world. The reason it becomes a issue are environmental ones where complete privacy is hard to find. For example, in a jungle environment where total isolation and privacy are in easy reach one would never encounter shy bowel syndrome. Shy bowel syndrome is a pathology arising in environments where shared living spaces are tightly confined and individuals cannot find complete isolation. Germany's living environment, as with all developed countries, confine people to tight living quarters where complete isolation is a anomaly. That gives rise to pathologies not found in remote, undeveloped or underdeveloped regions of the world. The impulse for complete isolation and privacy from others when defecating or urinating is a normal one. It only becomes a pathology where individuals are unable to attain that privacy from others because of both real and artificial societal and environmental barriers built around them.
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