day after day…

Posted on Monday 5 April 2010

The Office of Legal Counsel Memo that describes [and approves] the various elements of the Enhanced Interrogation Techniques, John Yoo and Jay Bybee explain that each procedure is not going to be harmful to the subject, and gives detailed descriptions of how that will be assured by certain safeguards [eg "The fingertips are kept well away from the individual’s eyes.", "Confinement in the larger space can last up to eighteen hours; for the smaller space, confinement lasts for no more than two hours.", "personnel with medical training are available and will intervene in the unlikely event of an abnormal reaction"]. The gist of the safeguards and time limits are to prevent physical harm. emptywheel‘s post [How John Yoo Negated the Mental Suffering of Death Threats in the Bybee Two Memo] shows many of the chasms in their logic, and how the real intent of the Memo is to evade and avoid prosecution.

But the protection from physical harm is a very low standard. More at issue are enduring effects on the psychology of the subject. No one is suggesting that the mental health of the enemy is the top line issue in a combat situation, or with prisoners of war. But the world seems to have agreed that humane treatment is the standard [in these wars, our leaders have repeatedly balked at this approach, calling our enemies evil, monsters, or worse]. These Memos attempt to objectify a difference between "allowable" aversive interrogation techniques and "Torture" by focusing on specific wordings in documents and some creative twists of logic about intent, or previous research. I’ll leave that argument for others who have more talent and interest in these games of word play. Frankly, they leave me cold.

There is, however, room to look at the various techniques used from another direction – might these procedures be expected to produce the kind of psychological trauma that leads to lasting mental symptoms – that syndrome we call P.T.S.D. [post-traumatic stress disorder]. There are problems in trying to objectively answer that question:

  • Psychological Trauma versus "a bad thing": There are lots of "bad things" that can happen, events or situations that may alter the course of a life significantly. Such things fit the term "traumatic," often used to describe them in everyday parlance. But Psychological Trauma doesn’t just mean "a bad thing." It means something that happened that resulted in an enduring syndrome with:
    1. Altered States of Consciousness: [dissociation]
    2. Trauma Specific Fears:
    3. Re-enactments: [of the trauma]
    4. An altered view of the self and the world:
    5. A unique mental illness: The first four are from Lenore Terr. The last one is my own. Each case is unique since the illness is built around the specific event itself.
  • Evaluation the Trauma itself: In this way of thinking, one could only tell if an event was traumatic after the fact [it caused P.T.S.D.]. We can do a little better than that. Psychological Trauma results in a disruption of psychic function – dissociation, "going blank," "losing my mind." In fact, many clinicians [me] think that is the central "lesion." Losing the use of one’s mind is, in effect, a psychic death – an terrible event from the subject’s perspective.
  • You can’t diagnose Psychological Trauma from the kind of event: Since it depends on the internal effect on the psyche, the same event affects individuals differently. For many, rape was a Psychological Trauma [their consciousness was interrupted]. But for others, it was a "very bad thing" in that they did not "lose their minds." And there are plenty of cases where it doesn’t seem like the event was "enough," but it was in the context of the particular person’s life and mind. The proof is in the aftermath.
  • The context has a lot to do with whether or not an event is traumatic: During World War I when this diagnosis first came into being, they made a number of salient observations. Freud [and others] noted that sudden, unexpected events are more likely to be traumatic – the mind has no time to adjust. There were two kinds of cases. The acute ones that had their onset in the heat of combat or shortly thereafter. Back then, they were called the ‘hysterical’ type. Then there were the cases that arose in soldiers who had been in combat for many months. They became increasingly tense, and then "broke," often in minor circumstances – the ‘neurasthenic‘ type. Several other observations from those days. The soldiers with shell shock almost never had physical wounds. This was so striking that P.T.S.D. is often called "the wound that doesn’t show." After the War, people looked at what seemed to protect people from war neuroses. The answer was surprising: adequate sleep, decent food, clean clothes, buddies. That lead to the term Combat Fatigue as a factor in the illness.
Although it sounds ephemeral with lots of variables, the syndrome is really quite well defined and pervades the life of sufferers in surprisingly global ways. The afflicted spend their lives trying to "prevent the past," often unaware that it’s happening. They’re hyper-vigilant, scanning for signs "it" might happen again. The fears, repetitions, and dissociations are often unseen by others [and unknown even by the subjects]. And the altered view of self and the world [I’m broken; the world’s not safe] can discolor every aspect of life.

It is absurd for John Yoo, Jay Bybee, or anyone to say that these techniques will not lead to long term psychological sequelae. He simply can’t know that. The detainees are "primed" for trauma. They’re isolated from their own kind. They don’t know where they are. They are being "worked on" by people to get them to say things they either don’t want to say or don’t know. The Combat Fatigue analogy would work well here. And:
The interrogation team would use these techniques in some combination to convince Zubaydah that the only way he can influence his surrounding environment is through co-operation. You have, however, informed us that you expect these techniques to be used in some sort of escalating fashion, culminating with the waterboard, though not necessarily ending with this technique. Moreover, you have also orally informed us that although some of these techniques may be used more than once, that repetition will not be substantial because the techniques generally lose their effectiveness after several repetitions
So, before looking at these techniques in isolation, let’s consider the whole scene. What’s the point of doing these things at all? It’s to put the subject in a state that is either so painful or so frightening that they will do anything to make it stop. Another way to say that more simply is to "traumatize" them. Likewise, the sum is greater than the parts. The more times these things are repeated, or used in combination, the more likely the chance for psychological deterioration. Two of the techniques strike me as pretty benign from a psychological point of view when considered in isolation:
  • Wall standing:
  • Stress positions:
Both are  painful and monotonous, but on their own, unlikely to be traumatizing. Both could, however, contribute to the kind of fatigue that primes one for traumatic experience. But the next four seem more virulent.  They were applied suddenly, unexpectedly. In fact, that’s the whole idea behind them. They had several ways of thinking about them. Learned helplessness – a term they borrowed from experimental psychology. Intermittent, unpredictable negative experience leaves the subject listless, hopeless that they can respond. They also spoke of dislocation of expectation interventions – a fancy way to say "shock." The sudden unexpected attack, being hurled against a wall, can be very psychologically disorganizing. In the right state of fatigue and confusion, even these seemingly simple techniques could initiate dissociative mental states.
  • Attention grasp:
  • Walling:
  • Facial hold:
  • Facial slap:
But this last group of four techniques seem to me to be specifically designed to create traumatizing psychological situation. What causes the mind to go numb and shut down? The felt internal signal to danger is anxiety/fear – mobilizing body and mind to respond. But if no response is possible, the feeling escalates. At some point, it becomes panic or terror.  And at some even later point, the mind turns off. It’s the kind of thing they try to show in movies with blurred lenses, weird lighting, silence or odd sounds. In the fog that follows, consciousness evaporates. After the fact, memories are absent or vague snatches. Each of these next techniques can initiate such a sequence. In addition, the sensory deprivation  [and/or the sensory overload] of any of them can result in psychosis – a break with reality where thought and perception become blurred and intertwined. Psychosis, like dissociation is another form of "losing one’s mind." Such experiences are horrible, the stuff of Psychological Trauma, and people will do anything to avoid them. They also can leave a lasting imprint on mental life [eg P.T.S.D.].
  • Cramped confinement:
  • Confinement with insects:
  • Sleep deprivation:
  • Waterboarding:
So these enhanced techniques are, of course, torture. Why else do them? But more than that, their obvious raison d’être is to produce mental states that are so aversive that a person will do anything to avoid them, and emotional states of that intensity are the kind that can leave a lasting imprint in the form of P.T.S.D.

In the Wikipedia entry for Abu Zubaydah, there’s an ABC photograph published in the Washington Post. It was reportedly taken by the C.I.A. during his interrogation. It is not possible to look at this picture and say this man is not being tortured. If you showed this picture to a group of clinicians familiar with Psychological Trauma and asked, "Is it highly likely the man in this picture is going to have P.T.S.D. from whatever is being done to him?" The answer will be a resounding "Yes!" The sanitized language in the Torture Memos just does not address the effect of these techniques applied as they actually were – multiple techniques, back to back, day after day.

  1.  
    April 5, 2010 | 10:50 AM
     

    Mickey — you are making an important point that I have not ready anywhere else about the psychological traumatic state. They were so focused on the limits of physical trauma — but what they were also doing, as you say, was setting up the specific and actual conditions to produce psychological trauma.

  2.  
    April 6, 2010 | 11:00 AM
     

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