#1, a phobia is nothing to feel bad about having. All it means is that you experience a very severe anxiety response when you are around something that doesn't make other people nervous. For example, some people are afraid of heights, others of spiders. A phobia is usually only a problem if it impacts the way someone lives. And there are ways to overcome phobias as well.
Parcopresis (and paruresis, which in my case are related) are also phobias; it's just that not that many people experience them, so it is hard for sufferers to find people to relate to. For example, most people view the bathroom as a relaxing place; people talk at urinals; while people don't usually talk in stalls, I have seen (in my dorm) friends talking with other friends right as they walk in to the stall to take a dump, and sometimes they even continue the conversation on the toilet. For people like this, it is a kind of pleasant experience, like sitting in the armchair. And as hard as this is to believe for parcopresis sufferers, people expect people in the bathroom to fart, to grunt, and they don't think anything of someone who does that.
For anyone with parcopresis or paruresis, however, the bathroom is a place associated with a lot of anxiety; this anxiety only builds over time. Phobias build with avoidance. It is here that I will share my personal story.
Parcopresis started for me when I was 16 or 17. In elementary and middle school, I didn't usually use the bathroom at school, though I do have some recollections of public bathrooms. I got paruresis probably in middle school; I remember after a movie waiting in a line to use the urinal, and when it was my turn, it just wouldn't come out. [I have a memory of peeing on the wall at a restaurant in 3rd grade with my brother and cousin around; I don't know if this contributed].
I'm not sure if this is important, but I was the farter of my class in elementary school; also, it would usually take me around 15 minutes in the bathroom. [I think parcopresis has to do a little bit with the bathroom being a ritual.]
On my summer program after 10th grade, I wasn't comfortable pooping in my dorm room's bathroom, but i didn't really notice it; whenever I had to use the bathroom, without really thinking about it, I used the bathroom by the office building or a different one that might've been a 2-3 minute walk. Also, I usually wouldn't poop during school, but after school; I had to go to a building across the street after school, and I would often wait to poop there, not really thinking about it but doing it unconsciously.
I would call this a low-grade parcopresis; intervention at this stage is necessary, but very easy.
After 11th grade, I definitely started noticing parcopresis; this time I went to a summer program, and I definitely noticed I couldn't poop when someone else was in the neighboring stall. No big deal; I would wait, and they'd usually be gone in a little while.
During 12th grade, I received new stepparents and stepsiblings and we moved to a new house. I coudln't poop in the bathroom there when other people were around; this is when it started becoming a big issue. As I had a car then, sometimes I would drive to my mom's house to poop.
I would call that mid-grade parcopresis. Definitely intervention is needed. I also had a lot of psychological problems at hte time, with self-esteem at school, loneliness, divorced parents, feeling of lack of friends, etc. Intervention at this stage would've been very good, and probably effective.
Then I went to college. of course, parcopresis builds over time with a principle called avoidance; so I avoided using the bathroom a lot, held it in when I needed to, etc. This process continued for around 2-3 years, to the point that when I went back home, a bathroom I had previously been okay with I was no longer; I couldn't hvae anyeone else in the house, and even then I was worried someone would ring the doorbell. [I didn't stop and think why I should worry; it seemed very reasonable to worry]. I started incompletely evacuating, and having to wipe every few hours, or also smelling really bad.
THis is extreme parcopresis, and intervention is critically necessary before your systems stop working. Mine continued working semi-normally for around a year, year and a half. Unfortunately, by the time I started getting help, my bowels had changed, and I am still not fully recovered from the physical effects of essentially enco-presis.
Note that situations I was okay in just starting off at college--e..g no one else in the bathroom--a few months later I wasn't. I looked for handicapped bathrooms; when I was in those, I was worried someone else would need in.
I could go a lot more in detail, but it woudl take a lot of my time.
Basically, I decided i would have to go home or get help, so I got help. As I was studying abroad at that time, I got a CBT professional in the country I was studying in. He was effective, but wasn't very empathetic; later, I would return to America and also use a PhD at my school's counseling center, who was empathetic, but didn't really use the CBT methodology. I also learned biofeedback relaxation technique, which could've been kind of helpful, but by no means cures it; along the way, before getting help I listened to:
http://www.hypnosisdownloads.com/health-issues/parcopresis-treatment. It didn't really help me.
I could go into much more detail, but basically, the program I would recommend is as follows:
-Tackle your paruresis. This is easier to expose yourself to and make quicker progress. I foudn the following download very helpful, and it is a track that helps much more with parcopresis than the otherone (at least for me):
You will get into the hang of listening to them; I fall asleep when listening to it, so I'm not sure if it is as effective as it could be. I made a point to listen to it for every day for 2 months or so, and i have seen great improvement with paruresis.
That isn't enough, though. You also have to expose yourself. Get the hang of the breathholding technique, which is: hold your breath for 20 seconds, filling up your lungs, then walk up to the urinal, and exhale. Don't breathe in; youw ill start peeing before you pass out. It isn't very comfortable,a nd honestly, it only works if it's a situation you are a little uneasy in, but if it is way past your comfort zone, I wouldn't recommend it. Start slowly.
As far as CBT goes, you have to do it. Try a few different therapists; it's worth it, and it's the most important thing you can do for yourself.
-It is easy to think you are cured once you are successful in a place where you failed in the past. Beware of that, however; until you are able to poop in a public stall, with someone on either side of you, and until you don't think about the bathroom at all during your day, you aren't past this. You need to keep working.
-For me, it's at the 1 year point, and I think I am mostly over it, but it is hard to tell, because I kind of had pelvic floor dysernegia. THe gastroentoologist said it woudl get back to normal within 6 months, but I had a setback in terms of my parcopresis, so it is still waiting to get back to normal.
-With your CBT: you will have to express your fear. It is very hard to do so, because it is more of an unconscious thing. Still, do that. Mark bathrooms on a scale of 1-10, 10 being the hardest. Push yourself a little. Record yourself telling a story full of details about the surroundings of how you walk into a public bathroom and your worst fear happens. Listen to it.
-Be relentless with your CBT. It will hurt, but it is necessary. Eat a lot of Fiber, eat a lot of vegetables, exercise, take a laxative, and that will help, but be careful that you don't get addicted to it; having a strong need to go will help. Try a hard bathroom at least once a day.
-Note: it is also important to empty yourself fully, so try to find a situation where you can try a hard one, but have a safe one a short time later. This is easy to achieve at a college, when you shoudl have a variety of alternatives.
-Also note: it is hard to control situations. If there are more people in there, if someone is talking, if there is less background noise, it gets harder. Still, make a commitment to always use that.
In the mornings, I made a comitment I was going to use my dorm's bathroom. I used it every day, and it took 2-3 months for me to get reasonably comfortable, but you just have to keep at it.