When most people think of torture, the first thing that comes to mind is unimaginable, unendurable pain. Physical pain is, however, the one thing that tends to remain in the torture chamber, the hidden cells of illegal prisons after the victim has left. As terrible as the physical after effects of torture may be, the real horror is what remains in the mind.

Unfortunately, and in spite of the United Nations, Amnesty international and the Geneva Convention, torture is still practiced all over the world today, most often by all kinds of governments, may they be democratically elected or not:

Torture is widely practiced throughout the world. Recent studies indicate that 50% of all countries, including 79% of the G-20 countries, continue to practice systematic torture despite a universal ban. (Carinci, 2010)

Perceptions of horror vary depending on contextual elements. For example, institutionalized torture that comes from within one´s own country is experienced very differently from isolated acts of torture perpetrated by non-state criminals. A feeling of helplessness is central to the torture cycle, according to Metin Besoglu, one of the world´s leading experts on the subject of torture and mass violence trauma, and this helplessness is much more dramatic in a situation where an individual knows he is facing an all-powerful enemy, such as the state or a terror regime.

Studies by Besoglu and his collaborators have also determined that political activists tend to suffer more attenuated psychological trauma. This is due to the fact that a strong belief in ideas or a solid religious faith seems to make the individual´s feel less powerless in front of the victimizers, and the feeling that one is not in control has been demonstrated to be one of the prime stressors of torture, and ultimately, a prime cause for its severely traumatizing effects.

While some earlier research tried to identify a “torture syndrome,” the current literature suggests that there isn´t sufficient evidence for this, and that the disorders associated with torture experiences can be classed under the PTSD (post-traumatic stress disorder) and CTD (cumulative trauma disorders) umbrella.

In his article Surviving Torture, after having tended to thousands of torture survivors all over the world, Mollica advises that the focus on PTSD often makes physicians forget that the main problem encountered in this population is depression, while he also observes that professionals are sometimes afraid to ask the right questions, because they are perhaps not sure how to deal with the information about such traumatic events, or they are afraid of “opening a Pandora´s box.”

In fact, post-torture symptoms range from the prevalent chronic pain, which is often connected to actual musculoskeletal damage, to neurophysiological damage associated to head injury, trauma congruent hallucinations and anhedonia. Family trauma is also very common; for example, it has been shown that

Children of tortured parents reveal more psychosomatic symptoms, headaches, depression, learning difficulties and aggressive behavior They manifest more severe ADHD, enuresis, and trauma related psychotic symptoms, developmental arrest or delays.

Surprisingly enough, research has also put forward the notion that torture survivors display some positive psychological traits, when compared to control groups. Namely, they are better equipped to grow out of the traumatic experience, more resilient and more tolerant to adversity than those who haven´t suffered tortured, while involved in the same violent environment. This is again attributed to the commitment to a collective cause and the presence of a strong belief system.

Behavioral intervention, including exposure to those situations which foster fear, has been seen to obtain very positive effects, such as PTSD and depression reduction, after even one single session. Surprisingly again, this has been the case even when the treatment takes place while the subjects are still living in an environment where they may still risk being tortured.

These findings come from a study of former Yugoslavia war survivors, which also indicated that redress and the reinstitution of a sense of justice in the world are not enough of themselves to significantly help torture survivors` psychological healing process. According to this paper by Besoglu and collaborators, regardless of any political and judicial changes that benefit the victims, “recovery from PTSD appears to require specific interventions designed to enhance sense of control over traumatic stressors” (Abildgaard, 1984).

In his article You can´t fight violence with violence, Besoglu explains how the trauma of torture and other types of mass violence commonly beget more violence. According to the same study of former Yugoslavia conflict victims, the greatest desire for vengeance was seen in people who had had loved ones tortured, raped, killed or imprisoned. Besoglu explains these violent instincts as follows:

[R]etaliatory aggression attenuates the feelings of helplessness that arise from trauma. For an intuitive understanding of those feelings, simply imagine your home suddenly being raided by invading forces and your loved ones being humiliated, imprisoned, tortured, raped or killed.

It would seem that, as if it wasn´t bad enough of itself, torture can not only destroy a family, and even a whole generation (i.e. during the Latin American dictatorships of the 1970´s), it is also a seed for new violence, planted on extremely fertile ground.

References

Carinci AJ, Mehta P, & Christo PJ (2010). Chronic pain in torture victims. Current pain and headache reports, 14 (2), 73-9 PMID: 20425195

Abildgaard U, Daugaard G, Marcussen H, Jess P, Petersen HD, & Wallach M (1984). Chronic organic psycho-syndrome in Greek torture victims. Danish medical bulletin, 31 (3), 239-42 PMID: 6744953

Mollica, R. (2004). Surviving Torture New England Journal of Medicine, 351 (1), 5-7 DOI: 10.1056/NEJMp048141

Kira, I. (2002). Torture Assessment and Treatment: The Wraparound Approach Traumatology, 8 (2), 54-86 DOI: 10.1177/153476560200800203

Basoglu, M. (2005). Psychiatric and Cognitive Effects of War in Former Yugoslavia: Association of Lack of Redress for Trauma and Posttraumatic Stress Reactions JAMA: The Journal of the American Medical Association, 294 (5), 580-590 DOI: 10.1001/jama.294.5.580

Kira, I., Templin, T., Lewandowski, L., Clifford, D., Wiencek, P., Hammad, A., Mohanesh, J., & Al-haidar, A. (2006). The Effects of Torture: Two Community Studies Peace and Conflict: Journal of Peace Psychology, 12 (3), 205-228 DOI: 10.1207/s15327949pac1203_1