What part of torture don’t you understand?

Currently torture is defined primarily by national and international statutes that are largely the work of lawyers. There’s been some talk of late in the torture treatment field about moving beyond legal definitions of torture, to something more amenable to public health and psychological practice. Why are legal definitions inadequate? Consider the United States’ version:

“torture” means an act committed by a person acting under the color of law specifically intended to inflict severe physical or mental pain or suffering (other than pain or suffering incidental to lawful sanctions) upon another person within his custody or lawful control

18 U.S.C. 2340(1)

On the face of it, it may seem that this could be easily applied to assessment. But look closely. Central to the definition is “an act.” Where are the conditions surrounding that act that makes torture so terrifying? There’s really not much here about what exactly constitutes severe suffering, and attempts to clarify (there have been a few, including an infamous one written by the Bush Administration’s John Yoo and Jay Bybee a few years ago) have not provided much to those of us interested in treatment (and indeed, that has never been the purpose of these clarifications). If we are going to work with survivors of torture to address the psychological consequences of torture, we need a different approach to conceptualizing the phenomenon.

Enter the social scientist. In a recent paper in the American Journal of Orthopsychiatry, Metin Basoglu argues that it is the cruel, inhuman, and degrading aspects of torture experiences (which, in the true social science tradition of giving key constructs acronyms, he refers to subsequently as “CIDT”), and not the physical abuse per se, that makes torture the terrifying and so often damaging experience it is. Basoglu is the torture treatment field’s most prominent and most rigorous researcher, and his structured interview protocol, the Subjective Interview for Survivors of Torture (or SIST), is the best assessment for survivors I’ve come across. In his recent article, Basoglu used a principle components analysis of subjective ratings of particular torture experiences which he collected using the SIST in Turkey and the former Yugoslavia in the 1980s and 1990s (respectively) to identify components of torture, and then examined how these components predicted posttraumatic stress disorder (PTSD). The components that related to the context of the physical abuse (i.e., CIDT) predicted participants’ PTSD diagnoses, and, notably, the components comprised of the physical abuse itself did not. (This finding is paralleled, interestingly enough, by findings in the domestic violence literature.)

In addition Basoglu’s important point about the psychological aspects of torture, the article is notable within the torture treatment field more broadly in that it provides an approach to torture that is contextual. The vast majority of the literature on torture ignores context, opting instead for measuring torture in a population by asking about the occurrence of a list of acts that are presumed to be torture in any context. While some of these acts have face validity for torture in virtually any context (e.g., electrocution of genitals), many do not outside of particular contexts (e.g., beating). Ignoring contextual criteria probably means that many torture surveys have overestimated the number of individuals who are identified as having a torture history in a given sample as being tortured – at least among those who report being subject to these acts (it may be that many people do not admit to being abused by authorities because they fear reprisals, in which case the prevalence of torture would be underestimated).

Basoglu’s contribution is summed up nicely in the following paragraph in his discussion:

Much of the debate on torture has centered on whether particular forms of CIDT (e.g., asphyxiation/suffocation, sleep deprivation, forced stress positions, etc.) constitute torture. Although the present study showed that these stressors contributed to the traumatic process… no single stressor, taken independently, predicted long-term psychological damage. This does not necessarily mean that these events do not have adverse effects in their own right. It simply implies that their traumatic impact is also dependent on contextual processes. Thus, contextual factors need primary attention in any consideration of what constitutes torture. A focus solely on particular methods not only detracts scientific, legal, and public attention from this important issue, but also misleads many people into thinking that it is possible to single out a particular captivity event and decide on whether or not it constitutes torture simply by imagining its impact or extrapolating from own life experiences with ostensibly similar events. (Basoglu, 2009; p. 142)

I look forward to further development of contextual understandings of torture in our field.

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