Counter-Conditioning a Distressing Sexual Response
Reader’s Question
This is a situation you’ve probably never encountered before and seems incredibly bizarre. Perhaps you won’t know what to suggest, but I am desperate because it causes so much inconvenience and stress to me in my daily life.
The problem is that I have a urination fetish. Whenever I urinate, I get an erection. You can imagine how frustrating and embarrassing such a situation that is. I actually know how this has come about. When I first began to explore my sexuality around age 12, much of it centered around urinating, and I deliberately aroused myself at such times. I ended up conditioning myself. But right from the beginning, it’s been a problem. I don’t watch pornography or fantasise about urination (except involuntarily in my dreams). Still, the problem refuses to subside. I am beside myself with worry, and I’ve spent countless days trying to think of ways to solve this. Obviously, there’s no chance of going to a therapist in person and I don’t want to freak out my parents.
Would you be able to suggest any techniques for me to solve this problem myself? I would be so grateful.
Our Clinical Psychologist’s Reply
Technically, what you describe is not a fetish. A fetish is the sexual arousal to an inanimate object. You do, however, accurately describe how you likely conditioned yourself to experience arousal during urination. The good news is that there is a variety of approaches that can help you “counter-condition” yourself to this arousal pattern.
I’m not sure why you suggest that there’s no chance you would see a therapist in person. Some therapists have special training in behavioral and cognitive-behavioral methods, and some are particularly skilled in counter-conditioning techniques. A behavior therapist could help you devise a plan that focuses merely on the response you want to “extinguish” — and the enterprise need not be embarrassing or so full of inordinate salacious detail that it would cause your parents alarm. Indeed, the only requirement for behaviorally-oriented therapy is that there’s a behavior you want to modify (or a habit you want to break). Techniques vary from response-stopping (stopping what you’re doing at the very moment you experience some arousal) to some mild forms of covert aversive conditioning (making yourself think about things known to inhibit arousal) whenever you plan to urinate. There are many other techniques, many of which can be used in tandem.
So, take heart. Right now, you are probably doing several things unwittingly that only reinforce the response you’d like to see disappear. But there’s no need to stress yourself out unnecessarily. With good behavior therapy, you should be able to tackle this problem. And don’t be alarmed or disheartened if, after some success, “spontaneous recovery” of your problem resurfaces. That’s par for the course and will diminish to the point of being unnoticed in time.
