School refusal syndrome

School refusal was a condition usually found in younger children in primary school. FILE PHOTO | SHUTTERSTOCK

My daughter collapsed suddenly on the day she was due to go back to boarding school. My sister says it’s a psychological condition. I am not sure. 

As a young doctor doing post-graduate studies in the UK in the late 70s, we were taught about the then commonly occurring condition we called, school refusal.

This was a condition usually found in younger children in primary school but in some ways was rather similar to what I suspect might be going on in your daughter.

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Some form of underlying stress is usually at the core of the challenge in these situations. That is possibly what your sister is alluding to.

At the time of my studies, a seven- or eight-year-old child would be brought to us with the history that, just before setting off to school he developed abdominal pain, headache, or even complaints of feeling faint.

Other children would, like your daughter go as far as collapsing and having to be put back to bed. By 10 am the same day, the child would be back to normal and would be fit as a fiddle and playing normally.

He would miss school that day meaning that he got to spend the day with his mother and younger siblings. All the symptoms would disappear as soon as they had no more pressure to go to school that day.

In severe cases, this “school refusal syndrome “could go on for many months with such children falling back in their studies. The result would be even more pressure on the child and the parents.

Coming back to your daughter, and using a similar way of reasoning, and accepting that your sister might have gone through a similar experience, the first thing you must do is to realise that contrary to what other people might tell you, your daughter is NOT pretending and that there is ‘something’ she is communicating to you about her distress.

Depending on the nature of her relationship with her aunt, you might try and get them to get talking about what seems like a common experience.

You will be surprised at how effective some of these ‘home remedies’ can be.

A few years ago, we came across a case in which a girl who was in her last term of Form four was unable to get out of bed without support and therefore could not go back to school.

When seen by a specialist, it became clear that as a top performer, she had experienced more pressure than she could cope with and hence the apparent paralysis.

Herself, she wanted to get an A and go on to university and become an engineer like her aunt who she admired a great deal and after whom she had been named.

Her parents had their expectations of her. She had to prove to the world that girls are as good as boys and because her brothers were top performers, she was expected to emulate them if not better their performance.

Since she had always come first in class since she was in Form one, the teachers kept reminding her that she was the flag bearer for the entire school. The pressure to perform was relentless.

The girl had caved in under the weight of the pressure put on her from all directions.

As for your collapsing daughter, take the matter seriously and to the extent possible seek help from a mental health specialist as soon as possible.

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The examples given here are only illustrative and different children will collapse on the day they are supposed to start for different reasons.

Remember that any delay in getting the correct cause of the collapse will lead to a delay in intervention which will possibly make a difficult situation worse.

Send your mental health concerns to [email protected]