Torture is a Form of Trauma; Trauma Causes PTSD

ETHICAL PRINCIPLES OF PSYCHOLOGISTS AND CODE OF CONDUCT

PRINCIPLE F: SOCIAL RESPONSIBILITY

"Psychologists are aware of their professional and scientific responsibilities to the community and the society in which they work and live. They apply and make public their knowledge of psychology in order to contribute to human welfare. Psychologists are concerned about and work to mitigate the causes of human suffering. When undertaking research, they strive to advance human welfare and the science of psychology. Psychologists try to avoid misuse of their work. Psychologists comply with the law and encourage the development of law and social policy that serve the interests of their patients and clients and the public. They are encouraged to contribute a portion of their professional time for little or no personal advantage."

See also Ethics and National Security.

You grow up thinking you know what the word Torture means, but really, you don't know what that word refers to until a day comes along when you get it; you begin to understand that you previously had no idea what torture really involved, mostly because up until that point the word was defined intellectually in your mind; there was no pain attached to it, no screaming. It wasn't quite real before, and now suddenly and in an unwanted manner, it has become more real.

You start to understand what torture means when you experience it either first hand (God Forbid), or (not quite as Terrible, but still very unpleasant) when you speak to people who have been tortured or who have witnessed torture and they tell you their story.

For me, the first moment when I began to understand about torture was a moment during my Psychology Internship. I was a junior therapist in a small group therapy session for Vietnam veterans with Postraumatic Stress Disorder (PTSD). I was a short-termer in that group, there for six months only and because I was the new guy, and because I was 'authority' it took a long time before I was trusted by the patients in the group. Somewhere in the middle of those months, a more quiet participant started talking about an atrocity he had witnessed during his service. A man he knew had been flayed and left alive to die by the enemy. As the story was told, I found myself in eye contact with this man, who was holding it together fairly well, but was also weeping in a controlled manner. And I began weeping too, because it was Horrible, this story being told. In retrospect, I was being tested to some extent. "Can this green therapist handle the real stuff or will he fall apart?, Can we rely on this guy?" were perhaps the unspoken thoughts in the room. I left that experience thinking I had failed the test with my weeping. After supervision (a process where you review your work with an experienced senior clinician), however, I came to the realization that I had probably not failed the test entirely. I had cried for sure, and should have managed more restraint. A therapist's restraint in the face of strong emotions is a container of sorts – part of the safety net that a therapist is supposed to be providing for patients. At the same time, I didn't lose it entirely, just like the veteran did not lose it either. And by crying, I supposed that I had shown, in a manner that no amount of therapy technique could have communicated that I cared; was engaged; thought what he had experienced was Horrible; felt what had been experienced to be Horrible; was not judging the man for what he saw or how he reacted.

I'd like to say that this moment was a positive turning point in the group, but I don't know that it was. Frankly, I don't remember the details of what came after that moment very well anymore. This happened a long time ago now. The memory of the man's story and his eyes and tears is a lot more burned into my mind today than what happened in subsequent therapy sessions in that group.

If you want to kill a soldier you've captured, you don't flay him; there are far more efficient methods available. You flay someone if you want to torture and brutalize that person so as to terrorize the other people that guy is with. And the method worked, because the fellow who told me the story was traumatized in part by that event.

It has been said that torture represents an attempt to destroy a person's soul while keeping their body alive enough so that they have to suffer through the memories. That is a dramatic way of putting things, I suppose, but the description does seem to fit. Torture is at best a brutal tactic designed to terrorize your opponent. It is at worst a form of unrestrained sadism and gratuitous violence that perpetrators undertake, I think, because the act of torturing says something about who is powerful and who is weak. What is the nature of this power? It is the power to compel victims to never ever forget that the torturer has wholly and utterly owned and enslaved them. The act of torture contains the power to break someone's mind so that beauty and innocence and joy and the things that redeem the world go away to be replaced by ugly memories of humiliation, pain, brutality and loss. Just witnessing the result of this process can be traumatizing.

Psychologists sometimes talk about something called the Just World Hypothesis, which is a sort of core belief that most people have that goes something like, "I am safe in the world so long as I do good. Events in the world operate in a lawful and non-chaotic manner, and if I am a good person in the world, I can expect that the world will treat me fairly". When a trauma comes along (any trauma will do) you have a situation where your Just World Hypothesis is suddenly contradicted by an overpowering event that says, "YOU ARE NOT SAFE. YOU ARE NOT IN CONTROL". When this happens, the Just World beliefs break, and what is left behind is a very nervous, very frantic, very frightened person.

Any random car accident can become cause for the Just World to break, but most of the time, after a period of shock and fear, many people climb back on the horse, so to speak, and start driving again. The Just World breaks but then reassembles itself resiliently. This reassembly is not a given, however. One way to describe what occurs in PTSD (when the situation becomes clinically relevant) is to say that in such cases, the Just World breaks and then remains broken.

I've written about PTSD before, so I won't go into it at length here. Suffice to say, classical PTSD has three clusters of symptoms: hypervigilance, intrusions, and arousal.

First, when you have PTSD you get hypervigilant for threats. Since the world has become radically unsafe, you start acting in ways that might help preserve your safety like: avoiding people; staying way from open windows; hitting the deck every time you hear a helicopter. At least these are ways that some Vietnam veterans did it. Other people think you are crazy, but, heck, you are crazy from the perspective of other people when you have PTSD. Their Just Worlds are still intact while yours has broken into bits. You see threats as real that they disregard as implausible. You know that a car accident can happen at any moment; that you could be tortured (or witness the results of torture) again. Others may know that these things are possibilities too, but they only know them intellectually, so they don't really know what they are talking about.

Second, people with PTSD suffer from intrusions. Memories of traumatic events come to them unbidden, and at the worst times. Nightmares, waking nightmares, even hallucinations in the more severe cases, each recreating the trauma in unwanted detail. If your trauma is a car accident, you replay the car accident. If your trauma is torture, you replay the torture. Think about having to live like that; having to replay a capricious and excruciatingly painful episode in your life, one where you lose everything, again and again.

Thirdly, PTSD involves arousal. Your whole body becomes hypersensitive and jumpy compared to how you used to be. Your baseline arousal rate elevates. Your threshold for perceiving danger lowers to the point where you experience false alarms that you are in danger all the time. Your emotional fuse gets shorter too. You lose a good deal of the patience you used to have. You are upset all the time.

A good number of people who are tortured for any length of time, or in any depth will go on to develop PTSD. No way around it. Torture is an effective method for creating disabling and more or less permanent emotional illness.

The terrorists who today are trying to harm America are not above using torture as a tactic to traumatize and terrorize. I don't like that this is true, but I can accept it as part of what makes them terrorists. What I do not accept is that America ought to be in the business of torturing people. I cannot get behind a policy that will unnecessarily add to the amount of emotional illness and human suffering experienced not just by the enemy combatants so treated, but also for the many other people who inevitably will become involved and emotionally harmed as a side effect of this ugly process; the counterparts of the veteran that I worked with at the VA way back when.

The Ethical Code that all American Psychologists subscribe to when they join the American Psychological Association suggests that Psychologists should work to mitigate the causes of human suffering, and to encourage the development of law and social policy that serve the interests of their patients and clients and the public. Speaking as a Psychologist, then, and also as a human being, I don't think it is right for the United States to have a pro-torture policy. How can we possibly win a "war on terror" by creating more terror in the world? Even if we "win" by using such a tactic, we have already lost our souls. I pray that our leaders will recognize this and reverse their present course.