Torture (Part VII)

Effects

The consequences of torture reach far beyond immediate pain. Many victims suffer from post-traumatic stress disorder (PTSD), which includes symptoms such as flashbacks (or intrusive thoughts), severe anxiety, insomnia, nightmares, depression and memory lapses. Torture victims often feel guilt and shame, triggered by the humiliation they have endured. Many feel that they have betrayed themselves or their friends and family. All such symptoms are normal human responses to abnormal and inhuman treatment.

Organizations like Freedom from Torture and the Center for Victims of Torture try to help survivors of torture obtain medical treatment and to gain forensic medical evident to obtain political asylum in a safe country or to prosecute the perpetrators.

Torture is often difficult to prove, particularly when some time has passed between the event and a medical examination, or when the torturers are immune from prosecution. Many torturers around the world use methods designed to have a maximum psychological impact while leaving only minimal physical traces. Medical and Human Rights Organizations worldwide have collaborated to produce the Istanbul Protocol, a document designed to outline common torture methods, consequences of torture, and medico-legal examination techniques. Typically deaths due to torture are shown in an autopsy as being due to "natural causes" like heart attack, inflammation, or embolism due to extreme stress.

For survivors, torture often leads to lasting mental and physical health problems.

Physical problems can be wide-ranging, e.g. sexually transmitted diseases, musculo-skeletal problems, brain injury, post-traumatic epilepsy or dementia or chronic pain syndromes.

On 19 August 2007, the  American Psychology Association (APA) voted to bar participation, to intervene to stop, and to report involvement in a wide variety of interrogation techniques as torture, including "using mock executions, simulated drowning, sexual and religious humiliation, stress positions or sleep deprivation", as well as "the exploitation of prisoners' phobias, the use of mind-altering drugs, hooding, forced nakedness, the use of dogs to frighten detainees, exposing prisoners to extreme heat and cold, physical assault and threatening the use of such techniques against a prisoner or a prisoner's family."

However, the APA rejected a stronger resolution that sought to prohibit "all psychologist involvement, either direct or indirect, in any interrogations at U.S. detention centers for foreign detainees or citizens detained outside normal legal channels." That resolution would have placed the APA alongside the American Medical Association and the American Psychiatric Association in limiting professional involvement in such settings to direct patient care. The APA echoed the Bush administration by condemning isolation, sleep deprivation, and sensory deprivation or over-stimulation only when they are likely to cause lasting harm.

Psychiatric treatment of torture-related medical problems might require a wide range of expertise and often specialized experience. Common treatments are psychotropic medications, e.g. SSRI antidepressants, counseling, Cognitive Behavioural Therapy, family systems therapy and physiotherapy.