BOARDING SCHOOL SYNDROME: BROKEN ATTACHMENTS A HIDDEN TRAUMA

The aim of this paper is to identify a cluster of symptoms and behaviours, which I am proposing be classified as ‘Boarding School Syndrome’. These patterns are observable in many of the adult patients, with a history of early boarding, who come to psychotherapy. Children sent away to school at an early age suffer the sudden and often irrevocable loss of their primary attachments; for many this constitutes a significant trauma. Bullying and sexual abuse, by staff or other children, may follow and so new attachment figures may become unsafe. In order to adapt to the system, a defensive and protective encapsulation of the self may be acquired; the true identity of the person then remains hidden. This pattern distorts intimate relationships and may continue into adult life. The significance of this may go unnoticed in psychotherapy. It is proposed that one reason for this may be that the transference and, especially the breaks in psychotherapy, replay, for the patient, the childhood experience between school and home. Observations from clinical practice are substantiated by published testimonies, including those from established psychoanalysts who were themselves early boarders.     

Neoadjuvant Radiotherapy to Facilitate Immediate Breast Reconstruction: A Systematic Review and Current Clinical Trials

Annals of Surgical Oncology - Postmastectomy radiotherapy currently is used for locally advanced breast cancers that carry a high risk of locoregional failure. However, radiotherapy can have...     

Comparison of outcomes and donor-site morbidity in unilateral free TRAM versus DIEP flap breast reconstruction.

BACKGROUND: At long-term follow up we cannot easily differentiate between patients who have undergone free transverse rectus abdominis musculocutaneous (TRAM) flap and deep inferior epigastric artery perforator (DIEP) flap breast reconstruction in terms of subjective functional limitations of daily activities. The aim of this study was to evaluate postoperative outcomes and long-term subjective functional deficit in patients following unilateral free TRAM compared with DIEP flap breast reconstruction. METHODS: Sixty consecutive patients who underwent unilateral autologous breast reconstruction were included in the study, 30 of whom had undergone a DIEP flap, and 30 a free TRAM flap. Surgical and postoperative outcome data were collected and a postal questionnaire was sent to each patient at least 6 months postoperatively consisting of a short functional assessment questionnaire and a Short Form 36 (SF-36) survey. RESULTS: We found no significant difference in postoperative outcomes or in the subjective ability to perform activities of daily living, including work, domestic activities, sports and hobbies, between patients who underwent TRAM flap breast reconstruction and those who underwent a DIEP flap, and no significant difference between the groups for scores on the physical functioning, role-physical, or bodily pain scales of the SF-36. CONCLUSION: We conclude that harvesting of the free TRAM flap results in no significant difference in postoperative outcomes or in the subjective ability to perform activities of daily living compared with the DIEP flap.     

Revisiting Boarding School Syndrome: The Anatomy of Psychological Traumas and Sexual Abuse

The ABC-D of Boarding School Syndrome clarifies the anatomy of the series of psychological traumas and sexual abuses that contribute to what, in 2011, I first classified as Boarding School Syndrome. The premise is that going to boarding school at a young age may inflict emotional injuries with lasting psychological consequences. The purpose here, ten years on, is to elucidate more fully aspects of the trauma embedded in the earlier writings and in the book Boarding School Syndrome. Research over the intervening years has led to developing an understanding of this enduring harm as presented in adult psychotherapy patients. The initials ABC-D refer to the elements that constitute the multiple traumas suffered by the children: abandonment, bereavement, captivity and as a result, for some, disassociation. As a consequence, children may be vulnerable to sexual advances from paedophile adults, school bullies and the confusing, sexually charged, solace found in dormitories with other children. The accumulation of these events may have the long-term effect of distorting intimate relationships and adult sexuality.