Psychology of torture
||This article needs attention from an expert in Psychology. (April 2009)|
Torture, whether physical, psychological, or both, depends on complicated interpersonal relationships between victims, aggressors, bystanders, and others. Torture also involves deeply personal processes in those involved. These interacting psychological relationships, processes, and dynamics form the basis for the psychology of torture. Torture is about reprogramming the victim to succumb to an alternative exegesis of the world, proffered by the abuser. It is an act of deep, indelible, traumatic indoctrination.
The torture process to the torturer
Motivation to torture
Research over the past 50 years, starting with the Milgram experiment, suggests that under the right circumstances and with the appropriate encouragement and setting, most people can be encouraged to actively torture others.
When torture takes place, people believe they are on the high moral ground, that the nation is under threat and they are the front line protecting the nation, and people will be grateful for what they are doing.
Stages of torture mentality include:
- Reluctant or peripheral participation
- Official encouragement: As the Stanford prison experiment and Milgram experiment show, many people will follow the direction of an authority figure (such as a superior officer) in an official setting (especially if presented as mandatory), even if they have personal uncertainty. The main motivations for this appear to be fear of loss of status or respect, and the desire to be seen as a "good citizen" or "good subordinate".
- Peer encouragement: to accept torture as necessary, acceptable or deserved, or to comply from a wish to not reject peer group beliefs.
- Dehumanization: seeing victims as objects of curiosity and experimentation, where pain becomes just another test to see how it affects the victim.
- Disinhibition: socio-cultural and situational pressures may cause torturers to undergo a lessening of moral inhibitions and as a result act in ways not normally countenanced by law, custom and conscience.
- Organisationally, like many other procedures, once torture becomes established as part of internally acceptable norms under certain circumstances, its use often becomes institutionalised and self-perpetuating over time, as what was once used exceptionally for perceived necessity finds more reasons claimed to justify wider use.
One of the apparent ringleaders of the Abu Ghraib prison torture incident, Charles Graner Jr., exemplified some of these when he was reported to have said, "The Christian in me says it's wrong, but the corrections officer in me says, 'I love to make a grown man piss himself.'"
Psychological effects of Torture
There is always a question about applying diagnostic categories and descriptions of symptoms or behavior developed in Western societies to people from the developing countries with very different personal, political, or religious beliefs and perspectives. One of the most marked differences is between individualist societies where realization of personal goals often takes priority over the needs of kin and societal expectations, and collectivist societies in which the needs of family and prescribed roles take precedence over personal preferences. Another evident difference is the belief in a subsequent life in which suffering in this life is rewarded, and this has emerged in some studies of torture survivors in South East Asia.
On a different level, the development of the diagnosis of PTSD for American veterans of the Vietnam War can be understood as a political act which labeled the collective distress of a defeated USA as individual psychopathology. Proponents of this view point to the depoliticisation of the distress of torture survivors by describing their distress, disturbance, and profound sense of injustice in psychiatric terms. These are not only conceptual issues but affect treatment, since recovery is associated with reconstruction of social and cultural networks, economic supports, and respect for human rights.
The rich research on treatment of PTSDs in veterans has substantially informed treatment offered to torture survivors. It is more appropriate than extrapolation from work with civilian survivors of single events as individuals (assault, accidents) or as communities or groups (natural or man-made disasters). Some literature distinguishes between single-event trauma (type 1) and prolonged and repeated trauma, such as torture (type 2). There is no doubt that (disregarding concerns about the diagnosis) rates of PTSD are much higher in refugees than among people of a similar age in the countries where the refugees settle, and that, among refugees, rates of PTSD are even higher among those seeking asylum.
The argument that torture causes unique problems waxes and wanes, and is often associated with claims to particular expertise in treatment, and therefore claims on funding, but Gurr et al. describe how torture targets the person as a whole – physically, emotionally, and socially – so that PTSD is an inadequate description of the magnitude and complexity of the effects of torture. When the diagnosis of PTSD is applied, some survivors of torture who have very severe symptoms related to trauma may still not reach the criteria for diagnosis. Categories such as ‘complex trauma’ have been proposed, and it may be that the next iterations of the diagnostic compendia may modify the criteria.
Torture has profound and long lasting physical and psychological effects. Torture is a form of collective suffering. It does not limit to the victim. The victims’ family members and friends are also affected due to adjustment problems including outbreaks of anger and violence directed towards family members. Based on new research psychological and physical torture have similar mental effects. Often torture victims suffer from elevated rates of Anxiety, Depression, Adjustment Disorder, PTSD, DESNOS (Disorders of Extreme Stress Not Otherwise Specified), Somatoform Disorders and sometimes psychotic manifestations, nightmares, intrusions, insomnia, decreased libido, memory lapses, reduced capacity to learn, sexual dysfunction, social withdrawal, emotional flatness and periodic headaches. Based on new research psychological and physical torture have similar mental effects. Symptoms should always be understood in the context above. No diagnostic terminology encapsulates the deep distrust of others which many torture survivors have developed, nor the destruction of all that gave their lives meaning. Guilt and shame about humiliation during torture, and about the survivor’s inability to withstand it, as well as guilt at surviving, are common problems which discourage disclosure. On top of this, uncertainty about the future, including the possibility of being sent back to the country in which the survivor was tortured, and the lack of any close confidant or even of any social support, compound the stress. Some current conditions are identifiable as additional risk factors: social isolation, poverty, unemployment, institutional accommodation, and pain can all predict higher levels of emotional distress in torture survivors.
Torture is a doubled edged sword that can harm not only the victim but the perpetrators as well. Many people who engage in torture have various psychological deviations and often they derive sadistic satisfaction. For a considerable degree, torture fulfills the emotional needs of the perpetrator when they willingly engage in these activities. They lack empathy and their victim’s agonized painful reactions, screaming and pleading give them a sense of authority and feelings of superiority. After the fact, perpetrators will often experience failing mental health, PTSD, suicidal tendencies, substance dependency and a myriad of other mental defects associated with inducing physical or mental trauma upon their victims.
The perpetrator has flashbacks of torture, intense rage, suicidal and homicidal ideas, alienation, impulse deregulation, alterations in attention and consciousness, alterations in self-perception, alterations in relationships with others, inability to trust and inability to maintain long-term relationships, or even mere intimacy.
Torture survivors in healthcare settings
For the clinician, in medicine rather than in psychiatry, it is useful to recognise that symptoms of post-traumatic stress can complicate presentation and treatment. Pain predicts greater severity of both PTSD symptoms and major depression, and intrusive memories and flashbacks can exacerbate existing pain. While under-recognition and undertreatment of torture survivors is common, there are useful guidelines for good medical practice, although not specifically concerned with pain, and for good psychological practice.
Most people die during torture; many survivors are too disabled and destitute to find their way to safety. A large element of chance, and, to a lesser extent, resources and resilience, enable a minority to arrive in developed countries. Nevertheless, they often present multiple and complex problems, which the clinician can find overwhelming. For all these reasons, an interdisciplinary approach to assessment and treatment is therefore recommended, guarding against either disregarding significant psychological distress as inevitable in torture survivors or discounting physical symptoms by attributing them to psychological origin.
Rehabilitation and reparation are part of the rights of the torture survivor under the United Nations Convention, yet far less attention is paid to health needs on a national or international basis than to legal and civil claims. Collaborative efforts are needed, involving survivors themselves, to understand better the usefulness and limitations of existing assessment instruments and treatment methods. Some excellent studies exist, such as that by Elsass et al. who interviewed Tibetan Lamas on the quantification of suffering in scales used to evaluate intervention with Tibetan torture survivors.
Education of medical and other healthcare personnel needs to address issues concerning treatment of torture survivors, who will be seen in all possible settings but not necessarily recognised or treated adequately. Teaching on ethics is also important, since medical students can have worryingly tolerant views of torture, and medical and healthcare staff complicity in torture continues in many countries. Medical staff are often in a key position to try to prevent torture, and to help those who have survived.
|This article needs additional citations for verification. (June 2007)|
- "BBC NEWS | Health | People 'still willing to torture'". BBC News (London). 2008-12-19. Retrieved 2010-03-24.
- Shankar Vedantam (May 11, 2004). "The Psychology of Torture". The Washington Post.
- Weblog: The Religious Side of the Abu Ghraib Scandal | Christianity Today | A Magazine of Evangelical Conviction
- "Psychological effects of torture". Sri Lanka Guardian. 2010. Retrieved 11 May 2014.
- Amanda C de C Williams and Jannie van der Merwe (2013). "The psychological impact of torture" (PDF). British Journal of Pain 7 (2): 101–106. doi:10.1177/2049463713483596.
- McCoy, Alfred, A Question of Torture: CIA Interrogation, from the Cold War to the War on Terror (Hardcover)
- Conroy, John, Unspeakable Acts, Ordinary People: The Dynamics of Torture, Alfred A. Knopf, 2000.
- Dr. Sam Vaknin, "The Psychology of Torture",
- Dr Ruwan M Jayatunge M.D, "Psychological effects of Torture"
- Amanda C de C Williams, Jannie van der Merwe, "The psychological impact of Torture"
- Human Rights First; Tortured Justice: Using Coerced Evidence to Prosecute Terrorist Suspects (2008)