Breath Hold Explained

It’s day 51 in my Shy Bladder Desensitization, and day 27 in my Breath Hold Practice. I’ve been alternating between using a Pee Buddy to pee at home, and using Breath Hold otherwise.

Some days it really feels like Breath Hold is working, others I have a hard time holding my breath to accomplish anything. It seems pretty random to me. I still feel like there’s something missing, so let’s take a closer look at this method called Breath Hold (BH).

What it is that people are saying about Breath Hold and how does it work?

I’ve read a good amount about the subject from different Pee Shy Books.

Books About Paruresis

I’ve visited Forums (on the IPA). I’ve read Blogs (Zen And The Art Of Reality). And even corresponded with readers who left helpful tips..

So What is Breath Hold?

Breath Hold is basically a technique that says: If you hold your breath long enough, you WILL PEE!

Sounds amazing… And it can be, with practice!

To take it further, let’s look at…

Zen And The Art Of Reality

Zen And The Art Of Reality is written by Max (known as Paruretic Max). He’s a great guy who also runs a YouTube Channel called Paruresis Exposed. He goes into great detail about Breath Hold and even wrote a post with the Instructions for the Breath Hold Technique. He lists 7 steps to obtain BH, and because it works so well, he describes himself as a Recovered Paruretic.

I won’t copy his instructions (you can get them here!) but I will paraphrase

  1. Take a Deep Breath and Relax
  2. Exhale 75% of the Air in your Lungs
  3. Hold your Breath and Keep your Body at ease
  4. Hold your Breath until you want to Gasp for Air
  5. Continue Holding your Breath Beyond this Point for a few Seconds
  6. Your Pelvic Floor will Drop and you will finally Urinate
  7. Wait until Full Stream before you smoothly inhale air again

Max makes it sound so easy. It’s NOT! I’ve been working on this for almost a month and I still don’t know what to make of it (Max says it took him months to master).

In fact, in the beginning, it wasn’t easy for Max either.

Paruretic Max Learns Breath Hold

Back in July of 2010 when Paruretic Max was learning Breath Hold and was having problems like me. He says on the IPA (International Paruresis Association) Forums (which I suggest you sign up for, my user name is PeeShyRichard):

I have been making a serious effort to try to learn the BH lately and I feel I’m making progress. I am getting used to hold my breath and the gasping for air feeling. Despite my successes I am still not able to get it to work.

Dominic M. (who already learned Breath Hold) replied with this message:

Ok first of all, you will start feeling the gasping for air after 10-20-30-40 seconds, depending on your condition. In the beginning it’s a bit uncomfortable, and it’s a bit like a wave during those 10-15 seconds. Your natural reflex would be to put pressure on your lungs, or your abs to counter this feeling, but it’s very important not to do that! So, then it gets a little less hard, little bit more, etc… It’s a strange feeling to describe. But most importantly, you cannot try to fight it with your body. You just need to go with the flow. Sometimes swallowing can make it a bit more comfortable. Just don’t exhale or inhale anything. So, make sure you really know what the gasping for air is, and get used to it. As long as your body stays calm and relaxed, you will not have any problems related to a lack of oxygen. So, get used to gasping for air, for as long as you can.

When you can do that for 10-15 seconds, you will feel that somehow urine started travelling down. If you’re in low stress situations, it will only take a second or two for it to make it’s way to the toilet, just like you would normally pee. In low stress (or no stress) you can even start breathing at this point, but not when you are still learning. In high stress, it can take 5-10 seconds. You feel that its going down, but that it takes a while. As long as you stay relaxed and hold your breath, it will continue it’s path. The moment you breath, everything can stop. So in those situations it’s important to hold the breath until you really have a good full stream.

He also links to his video on YouTube talking about the right and wrong ways to do Breath Hold. See it here!

As Paruretic Max continues his recovery progress, Dominic M. gives more helpful advice:

Basically I focus on something stupid like a ticking clock, or something at the wall. I focus my eyes (or my ears), but clear my mind and basically wait until breath hold makes me pee. I think most people who try it first stop after a few seconds of gasping for air, or make it longer, but can’t keep their body relaxed anymore. I still remember having the same problem when I first tried BH, and I gave up on it very soon. But I honestly think that if you practice on holding your breath in front of the toilet at least once a day, you don’t even have to have urgency, that you will learn very fast.

Paruretic Max Breath Hold Success!

Taken from the IPA forums on Wed. Oct 06, 2010, Paruretic Max shares his success story:

So I have been working on the breath hold for a little bit now (a few months), and have now been able to get it to work in even very high stress situations.

The breakthrough for me was last night (I guess 2 nights ago 10/5), when I went to a concert. I went to see Primus (the greatest show I have ever see.) Despite emptying my bladder before hand (lol Paruresis 101), I had an urge to go when I got in. Even though I had relatively low urgency, I decided to try before it got too crowded. I got in there and it was a large restroom, maybe 6 or 7 urinals, and 5 stalls (don’t remember the exact numbers). Anyway I stepped into one of the crowded stalls with people in both stalls next to me, held my breath, and peed in about 40 seconds. Needless to say, I was ecstatic. I then watched Primus play and amazing set, then intermission came and I had to pee. This time a full bathroom with people waiting behind me. No matter, I stepped up with BH, and pissed.

Then today (yesterday) at school, I walked into a full bathroom this time going to a urinal, with no dividers, and peed with people and noise all around me. A great feeling indeed.

I would like to give a big shout out to Dominic M, who helped me learn the BH.

Also a message to all you paruretics: GIVE BREATH HOLD A TRY! It has been huge in my recovery process. If you would like, send me a PM (on the IPA forums) and I will give you my contact information and I will help you with it.

Also NOTE TO THE IPA: I would be very happy to volunteer teaching the breath hold at a workshop if needed. I live in Atlanta, but would be willing to make somewhat of a drive under the right circumstances. I just wanted to offer.

I am going to post some videos soon about how I do the BH, and also will become more active on this forum.

Which he does in his YouTube Channel (along with Dominic) called Paruresis Exposed.

Dominic M. responded to Max’s Success:

That’s so great to hear. First of all for you, because it will change your life forever. Now you just need to learn to time your BH in advance so you can limit/optimize your time at the urinals.

And I also hope it will motivate other people to learn BH. It really isn’t so hard

Max Continues to Help

Parureticmax (Who holds the IPA title: Certified Successful Breath Holder) continues to help people struggling with Breath Hold on the Forums… He offered one Paruretic this sound advice:

Try holding your breath a bit longer even after you have a full stream going. I noticed early on when I was learning the breath hold that if I took a breath right as the stream was starting, then it would cut off. Let yourself get a full stream going and then give a a few seconds, then you should have no issue keeping the stream going.

WOW! Great Stuff! Congrats Max!

I learn more with Dominic M

Dominic M. has really helped tons of people Recover from Paruresis using the Breath Hold technique. I’ve reached out to Dominic here and he even created a new video called “Shy bladder – Breath Hold in Action” for me. I greatly appreciate the help and response.

I’ve talked to Dominic through emails last year (before I started my recovery) and asked him this (It was long winded and held a million questions, poor Dominic):

I have a question about your Pee Buddy. Did you go to the group meetings to find one? Did you go through all the GED and CBT steps? What happened that pointed you towards Breath Hold? I’m just wondering because if I can skip everything and just do BH, then I’m on the right path. Did your pee buddy ever learn how to do BH? If not why?

Dominic Replied:

Before I learned BH I went to an IPA workshop in Germany, led by Steven Soifer. I learned a lot about Paruresis, which is basically what CBT (Cognitive Behavioral Therapy) does, and it liberated me greatly. When I came back from the workshop, I told my best friend about my problem and how it impacted my day to day life. I felt really great being able to share this afterwards. There was another guy from Belgium on the workshop, and we decided to keep doing GET (Gradual Exposure Therapy) together at his place. In the second meeting, I locked up, and decided to hold my breath. That’s when I discovered breath hold. So it’s really hard for me to say if you need GET and CBT or not, because I’m sure I needed it to come to the point where I am now. If you are ok with not being to able pee at many places without BH, then you don’t need GET. And regarding CBT, I think it’s very important to understand how paruresis works and what mistakes a paruretic makes in his brain. So I can really recommend Steven Soifer’s Book: Shy Bladder Syndrome (Richard: which I then bought on Amazon). My Pee Buddy didn’t learn unfortunately, but I think he also didn’t want to put in the effort. He still manages his life around Paruresis, but he became a lot better.

I must say that lately I limit my interest in Paruresis at trying to help others at the IPA forum. You have to understand that Paruresis is only a very small part of my life anymore, and I doesn’t influence my actions. I’m free as a bird now! :)

Thanks much Dominic! You’ve helped me more than you know!

Other people on the forums give further advice that may help…


BeserkPencil (great name) say this:

  • While breathing normally, just exhale 75% of your breath while walking 10 seconds to the pot. By the time you get there the exercise of walking will make you gasp for air.
  • Right before the pelvic floor drops involuntarily, take in a small (tiny!) gasp of breath to override the PF drop.

Shy Bladder Comments

Others have said the same thing. Like the College Kid (aka Jordan) who leaves comments on my posts here. He says:

The magic of the breath hold is once you get it, it starts coming faster and faster over time and you can hold it while walking up to the plate to get yourself out of breath faster.

Another great thing is that once it starts coming fast, you can sense when the pelvic floor will drop, and then you will notice that if you take a tiny “sip” of air (like 1 ml) the moment before the PF drop, then it will allow you to relax naturally at that point and will keep you from gasping like you normally would after you inhale. Very stealthy, so long as no one you know is trying to talk to you, there is a long line, or you have to go #2.

It’s all very inspiring stuff!

And it can even work on Women! I found this out when I read this book…

Bathrooms Make Me Nervous

In her great book Bathrooms Make Me Nervous Carol Olmert gives great instructions on the Breath Hold technique as well. I’ll paraphrase her practice advice, but I suggest you pick up her book, it’s well worth the money!

  1. Practice Holding your Breath at home first (increase to 45 Seconds)
  2. Load up on Fluids
  3. Exhale 75% of your Breath (without gasping in air first). Wait until your Pelvic Floor Drops and you begin to Urinate
  4. Practicing will further Reduce the Start Time


Seriously! I’m still working on this method and practicing it every single day. I do feel like I’m getting somewhere. And you’ll be the first to know when my breakthrough finally happens.

It’s exciting to think about!

Hopefully this advice and post will help others out as well. Breath Hold sure does sound like a Miracle Cure… But can it help me Pee in Public?

We’ll find out soon enough.

Good Luck! :)

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