Another Day of Stone Walling!!!

As usual in the Corrupt city of Chicago, Illinois we see in the eyes of our trusted law enforcement establishment a real fact of fraud, delusional crime hypotheses created only as a quick fix solution to the unlawful enhanced interrogation tactics used by a deranged FBI special behavior science unit that has operated a factually fraudulent operation for over 35 years costing the honest law abiding citizens millions of dollars and the integrity of the people to even entertain their atrocious criminal actions and deranged behavior in numerous planned series of events to impede/hinder any type on professional reporting or investigation, after targeting a innocent man as a serial murderer.

If the situation was of anything and matter as they maliciously inform the public and operate in they would be producing facts to arrest or and indict on factual evidence not creating one outrageous stunt of propaganda after the other in the planned counter intelligence design of keeping a spin factor of a threat to society and the wielding of the powers of peoples fears and pulling their heart strings exploiting missing and/or dead children as their meal ticket to get the doors of the corrupt city of Chicago opened up to them and their unlawful deranged practices of law as is underlined in all texts and the United states Constitution to be unlawful and not to be tolerated…on any citizen standing on US of A soil…  The worst scars are in
the mind:
psychological torture
Herna´n Reyes*
Dr Herna´n Reyes, MD, of the ICRC’s Assistance Division, is a specialist on medical
aspects of detention and has visited numerous detention centres around the world.
Torture during interrogation often includes methods that do not physically assault the
body or cause actual physical pain – and yet entail severe psychological pain and
suffering and profoundly disrupt the senses and personality. Solitary confinement and
prolonged sleep deprivation are just two examples of these psychological torture
methods. Even psychological methods which do not amount to ill-treatment when
considered in isolation, amount to inhuman or degrading treatment or torture, when
applied in conjunction with other techniques, cumulatively and/or over a long time.
Often they are part and parcel of the whole torture process and constitute a
‘‘background environment’’ of harassment and duress. The ‘‘cumulation over time’’
factor must thus be considered as part of a system of psychological torture.
Interrogators often – sadly – take pride in the fact that they do not resort to ‘‘crude
physical methods’’ in their work, but rely only on psychological ‘‘methods’’,1
which they do not consider as torture. This calls for a discussion on what exactly is
meant by the term ‘‘psychological torture’’. The following pages will examine what
constitutes torture per se and, in particular, whether psychological methods used
during interrogation can produce effects, mental or physical, that amount to torture.
Torture may occur during detention, with the aim of punishing or
degrading and humiliating a person.2 This article will, however, focus only on
torture applied during interrogations with the aim of extracting information.
* The author would like to thank Jonathan Beynon, MD, Co-ordinator for Health in Detention of the
ICRC’s Health Unit, for his valuable comments on the various drafts of this article. The article reflects
the views of the author alone and not necessarily those of the ICRC.
Volume 89 Number 867 September 2007
During interrogations, psychological methods are used specifically with the aim of
‘‘softening up’’ and thus breaking detainees’ resistance so as to make them ‘‘talk’’.
Their use often results from a state policy authorizing them either directly or
indirectly, in the latter case by ‘‘condoning’’ them.
From the outset, it should be stressed that interrogations as such, so long
as the methods used respect the rule of law, are legitimate. These methods have
been described elsewhere,3 and include different forms of interrogation techniques
and the use of psychological ploys. The challenge is thus to determine which
methods are legitimate and which are illegal, causing pain and suffering that fall
into the category of ‘‘cruel and inhuman or degrading treatment’’ or torture. Some
of the methods used are physical methods, acting on the body and generally
producing pain; others are psychological, that is, non-physical, and act on the mind.
Some methods are recognized forms of torture; others – which also may produce pain
and suffering, but to a lesser degree – may not ‘‘qualify’’ as torture according to the
definition. Yet other ‘‘non-physical’’ methods may appear to be ‘‘minor’’ or even
innocuous when taken separately one by one. This paper will attempt to explore the
use of non-physical methods, and will consider whether and when their use can
amount to torture according to the established definition. It will in particular look
into whether the use of such ‘‘minor’’ and apparently innocuous methods, when
applied repeatedly, either singly or in combination and over a period of time, can also
amount to cruel, inhuman and degrading treatment, or even torture.
On the legal definition of torture
Defining exactly what torture means seems to be as complex as defining what
shocks the conscience in the case of pornography. A US Supreme Court Justice
once said with regard to the definition of pornography,
I shall not today attempt further to define the kinds of material I understand
to be embraced [by the term pornography] … but I know it when I see it!4
There is nevertheless a universally accepted definition of torture today,
namely the one contained in the 1984 UN Convention against Torture (CAT),
2 In the case of Raquel Marti de Mejia (Raquel Martin de Mejı´a v. Peru´, Caso 10.970 Informe No. 5/96,
Inter-Am.C.H.R., OEA/Ser.L/V/II.91 Doc. 7 at 168, 1996), the Inter-American Court of Human Rights
stressed that the ‘‘purpose’’ element can include punishment or humiliating and intimidating the
person. It is not restricted to extracting information from a detainee.
3 Legitimate ‘‘psychological methods of interrogation ‘‘go beyond the scope of this paper, but the most
well-known ones can be listed here: ‘‘fear up’’; ‘‘pride and ego’’; ‘‘futility’’; ‘‘we know all’’; ‘‘good cop/
bad cop’’; silent questioning and others. See Field Manual (FM) 34–52, Intelligence Interrogation, US
Department of the Army, Washington DC, 28 September, 1992, Chapter 3, ‘‘Approach phase and
questioning phase’’, 3–10 and 3–20. Available at (last visited
9 October 2007). See also Rau´ l Toma´s Escobar, El interrogatorio en la investigacio´n criminal, Editorial
Universidad, Buenos Aires, 1989, pp. 312–30.
1 This acknowledgment was made to the author on several occasions by detaining authorities, in different
contexts, during ICRC visits to prisoners during the last two decades.
4 Justice Potter Stewart trying to explain ‘‘hard-core’’ pornography, or what is obscene. Jacobelliss v. Ohio, 378
US, 184 (1964), Appeal from the Supreme Court of Ohio (in footnote 11), available at http:// (last visited 8 October 2007).
H. Reyes – The worst scars are in the mind: psychological torture
which defines as torture any act that consists of the intentional infliction of ‘‘severe
pain or suffering, whether physical or mental’’, involving a public official and
carried out for a specific purpose.5 The Inter-American Convention to Prevent and
Punish Torture has a broader definition of torture,6 which does not have to
include the infliction of severe pain and suffering. In international humanitarian
law (IHL), torture does not have to be inflicted by or with the acquiescence of a
public official, but can be perpetrated by any individual.
Despite these various interpretations, when it comes to defining ‘‘torture’’
the main elements remain those laid down in the CAT. An important
characteristic of this Convention is that it introduces a significant difference
between the term ‘‘torture’’ and ‘‘other acts of cruel, inhuman or degrading
treatment or punishment’’ (CIDT): it bans torture completely and absolutely (Art.
2),7 while imposing on states ‘‘only’’ the obligation to ‘‘undertake to prevent’’
cruel, inhuman or degrading treatment (Art. 16). States have used this to argue
that while torture is forbidden, cruel, inhuman or degrading treatment may be
justified under exceptional circumstances. If such treatment is to be allowed in
certain circumstances, but not torture, the differentiation between these two
notions becomes important.
Other legal instruments, however, do not differentiate between the two
terms. The International Covenant on Civil and Political Rights (ICCPR), for
example, prohibits in absolute terms both torture and inhuman or degrading
treatment.8 The same is true of the European Convention on Human Rights
(ECHR).9 International humanitarian law equally forbids torture (whether
physical or mental) and cruel, humiliating or degrading treatment, as well as
any form of physical or moral coercion.10
In the practical application of the provisions, the European Court of
Human Rights has distinguished between torture and ‘‘cruel, inhuman or
5 Article 1 of the CAT defines torture thus: ‘‘1. For the purposes of this Convention, the term ‘‘torture’’
means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on
a person for such purposes as obtaining from him or a third person information or a confession,
punishing him for an act he or a third person has committed or is suspected of having committed, or
intimidating or coercing him or a third person, or for any reason based on discrimination of any kind,
when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of
a public official or other person acting in an official capacity. It does not include pain or suffering
arising only from, inherent in or incidental to lawful sanctions.’’
6 The Inter-American Convention to Prevent and Punish Torture defines torture in Article 2 as ‘‘any act
intentionally performed whereby physical or mental pain or suffering is inflicted on a person for
purposes of criminal investigation, as a means of intimidation, as personal punishment, as a preventive
measure, as a penalty, or for any other purpose. Torture shall also be understood to be the use of
methods upon a person intended to obliterate the personality of the victim or to diminish his physical
or mental capacities, even if they do not cause physical pain or mental anguish.’’
7 Article 2 (2) of the CAT states that ‘‘No exceptional circumstances whatsoever, whether a state of war or
a threat of war, internal political instability or any other public emergency, may be invoked as a
justification of torture.’’
8 ICCPR, Articles 4 and 7.
9 European Convention for the Protection of Human Rights and Fundamental Freedoms, Article 3: ‘‘No
one shall be subjected to torture or inhuman or degrading treatment or punishment.’’
10 See Article 3 common to all four Geneva Conventions of 1949, and Article 17 of the Third Geneva
Convention of 1949 relative to the treatment of prisoners of war.
Volume 89 Number 867 September 2007
degrading treatment’’ by attaching a ‘‘special stigma’’ and ‘‘particular intensity and
cruelty’’ to torture.11 In the early case of Ireland v. UK, methods such as hooding,
sleep deprivation, wall-standing and constant noise were considered not to
amount to torture.12 Conversely, in the discussion whether similar methods used
by the Israeli General Security Service for interrogating suspected Palestinian
terrorists in the late 1980s and 1990s amounted to torture, the UN Committee
against Torture and the Special Rapporteur on Torture found that these methods
did constitute torture.13
In more general terms, it is possible to differentiate between the two
notions by referring to the UN Declaration of 1975, which defines torture as an
‘‘aggravated form of cruel, inhuman or degrading treatment’’.14 Torture thus
implies the infliction of more severe suffering or pain – arguably a very subjective
The definition of torture, as opposed to cruel, inhuman or degrading
treatment, is thus not very clear and a constant issue of debate. An interpretation
in good faith of the relevant human rights instruments, however, makes the
differentiation between these notions legally irrelevant, as the intention was to
prohibit both torture and inhuman or degrading treatment, and not to allow states
to circumvent the absolute prohibition of torture by classifying methods as cruel,
inhuman or degrading, rather than as ‘‘torture’’.
Defining psychological torture
The term ‘‘psychological torture’’ can relate to two different aspects of the same
entity. On the one hand, it can designate methods – that is in this case the use of
‘‘non-physical’’ methods. While ‘‘physical methods’’ of torture can be more or less
self-evident, such as thumbscrews, flogging, application of electric current to the
body and other similar techniques, ‘‘non-physical’’ means a method that does not
hurt, maim or even touch the body, but touches the mind instead. Just as readily
recognizable as methods of torture in this category are prolonged sleep
deprivation, total sensory deprivation or having to witness the torture of family
members, to cite only three examples. On the other hand, the term ‘‘psychological
torture’’ can also be taken to designate the psychological effects (as opposed to
11 Ireland v. United Kingdom, App. No. 5310/71, ECtHR, Strasbourg, 18 January 1978, para. 167.
12 Ibid., para. 168. However, the Commission on Human Rights, through which cases had to pass before
submission to the Court, had found that the acts did constitute torture, a position which many would
support today.
13 Israeli Information Centre for Human Rights in the Occupied Territories (B’Tsalem), ‘‘Legislation
allowing the use of physical force and mental coercion in interrogations by the General Security
Service’’, Position Paper, January 2000, available at
Position_Paper_Eng. doc (last visited 15 October 2007).
14 This UN Declaration does not clearly define such treatment, except for this comparison to torture. See
UN Declaration on the Protection of all Persons from being Subjected to Torture or Other Cruel,
Inhuman or Degrading Treatment or Punishment, General Assembly Resolution 3452, available at (last visited 7 October 2007).
H. Reyes – The worst scars are in the mind: psychological torture
physical ones) of torture in general – torture ‘‘in general’’ meaning the use of
either physical or psychological methods, or both. There is sometimes a tendency
to merge these two separate concepts into one, which leads to confusion, between
methods (or ‘‘input’’, as it were) and effects (or ‘‘output’’). This confusion has led
some authorities to deny the very existence of ‘‘psychological torture’’ as a separate
It has been stated that it can be difficult to define torture in general. It is
even harder to define ‘‘psychological torture’’. As has been seen, the definition of
torture is firmly based on ‘‘severe pain and suffering’’. The fact that this notion is
qualified as being both ‘‘physical and mental’’ is a recognition that both aspects go
together. Physical torture produces both physical and mental suffering; the same
applies to psychological torture. It therefore becomes difficult to isolate
psychological torture per se as a separate entity and define its different features.
A report by Physicians for Human Rights (PHR) in 2005 broke new
ground by providing a definition of the term ‘‘psychological torture’’, based on the
interpretation formulated in the United States Code (USC) – the codification of
the general and permanent laws of the United States – of the prohibition of
torture.15 The Code’s interpretation refers to
‘‘severe mental pain or suffering’’ caused by the threat of, or actual,
administration of ‘‘procedures calculated to disrupt profoundly the senses or
Here the effects that will qualify as torture are clearly defined. If the
methods used during interrogations – in this case, what PHR calls ‘‘psychologically
coercive tactics’’ – produce the said effects, then those psychological methods do
indeed qualify as constituting ‘‘psychological torture’’. They are used to break
down any will prisoners may have to resist interrogators’ demands, and are
discussed in detail further on.
Similar to the definition of torture in the CAT, this definition requires a
measurement of the gravity of suffering, as the methods must be calculated to
disrupt ‘‘profoundly’’ the senses or the personality, and the effects they produce
must be ‘‘severe’’ mental pain or suffering. The difficulties linked to measuring
mental pain and suffering now need to be considered.
15 Federal Criminal Anti-Torture Statute, 18 USC, Section 2340: ‘‘(1) ‘‘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 physical control; (2) ‘‘severe mental pain or suffering’’ means the prolonged mental harm
caused by or resulting from (A) the intentional infliction or threatened infliction of severe physical pain
or suffering; (B) the administration or application, or threatened administration or application, of
mind-altering substances or other procedures calculated to disrupt profoundly the senses or the
personality; (C) the threat of imminent death; or (D) the threat that another person will imminently be
subjected to death, severe physical pain or suffering, or the administration or application of mindaltering
substances or other procedures calculated to disrupt profoundly the senses or personality;’’
available at
(last visited 15 October 2007).
16 Break Them Down, Report by Physicians for Human Rights (hereinafter PHR Report), Washington,
D.C., 2005.
Volume 89 Number 867 September 2007
Measuring mental pain and suffering
The threshold that must be reached for acts to amount to torture is, as mentioned
above, the causing of severe pain and suffering. The Convention against Torture
explicitly prohibits the infliction of severe physical or mental (or psychological)
suffering. Physical forms of pain and suffering are more readily understood than
psychological forms, although physical suffering may also be hard to quantify and
measure objectively – defining severe pain and suffering involves an assessment of
gravity that is difficult to make, as these notions are highly subjective and may
depend on a variety of factors, such as the age, gender, health, education, cultural
background or religious conviction of the victim.17 How should the distinction be
drawn between different levels of pain: mild, moderate, substantial, severe, intense,
extreme, unbearable, intolerable, excruciating, agonizing …? – And the list could
go on …
An objective assessment of psychological suffering is especially difficult.
Sir Nigel Rodley, former UN Special Rapporteur on Torture and one of the leading
experts on the subject, has stated,
[T]he notion of ‘‘intensity of suffering’’ is not susceptible of precise gradation,
and in the case of mainly mental as opposed to physical suffering, there may
be an aura of uncertainly as to how … [to assess] the matter in any individual
This aura of uncertainty is problematic, as it has been used to exclude
certain treatment from being qualified as torture. As far as physical pain and
suffering are concerned, it is perhaps useful to recall that the debate has at times
gone well off track. In Jay Bybee’s famous (some would say ‘‘infamous’’)
memorandum (Bybee memo) of 2002, which sought to qualify the definition of
torture for purposes internal to the US government, the severity of pain or
suffering necessary for any method of interrogation to ‘‘qualify’’ as a form of
torture had to be of a ‘‘high level of intensity’’.19
With regard to physical suffering, the author of the memorandum defined
‘‘severe’’ as having to
17 See Cordula Droege, ‘‘In truth the leitmotiv: the prohibition of torture and other forms of ill-treatment
in international humanitarian law’’, in this issue, pp. 515–541.
18 Report of the Human Rights Committee, GAOR, 37th Session, Supplement No. 40 (1982), Annex V,
General Comment, 7(16), para 2.
19 Memorandum from Jay. S. Bybee, Assistant Attorney General for the Office of Legal Council at the US
Department of Justice, to Alberto Gonzales, Counsel to the President (1 August 2002), in Karen
Greenberg and Joshua Dratel (eds.), The Torture Papers, Cambridge University Press, Cambridge, 2005,
pp. 172–218. It should be noted that debates internal to the US government that began with the issuing
of ‘‘Internal Memos’’ by the Office of Legal Council (OLC) have come to light, mainly in the aftermath
of well-publicized scandals, such as the graphic ill-treatment of detainees at Abu Ghraib. Such openness
in discussing the inner reasonings behind the development and wielding of certain methods of
interrogation in the interest of national security is certainly not present in most countries. Many other
governments would undoubtedly have a great deal to ‘‘contribute’’ to these arguments, either in the
light of what they have done or condoned in the past, or what they may be doing at the present time, but
do not ‘‘share’’ their lines of reasoning thus openly.
H. Reyes – The worst scars are in the mind: psychological torture
rise to a … level that would ordinarily be associated with a sufficiently serious
condition or injury such as death, organ failure or serious impairment of
bodily functions.20
The reasoning that pain, in order to qualify as ‘‘severe’’, has to produce
permanent damage and impairment may be valid for insurance compensation.21
But it is most certainly flawed for any definition of torture, for which there is no
requirement that the pain and suffering be long-lasting, let alone permanent. The
use of domestic legislation for assessing insurance claims has no bearing
whatsoever on the interpretation of international law prohibiting torture.
Suffering from illness and suffering from torture are two completely different
things. Besides being flawed, the threshold proposed for physical pain is also
extremely high and does not take into account mental suffering.
With reference to psychological torture, another most extraordinary
condition was proposed in the same Bybee memo,22 suggesting that in order to
constitute ‘‘severe mental pain or suffering’’ there had to be ‘‘prolonged mental
harm’’, ‘‘of substantial duration’’, ‘‘lasting months or even years’’. This meant that
any objective qualification of psychological suffering had to be proven to be longlasting.
The ICRC visits prisoners around the world, and encounters many who are
still under interrogation in situations where torture is being used. According to the
above interpretation, any meaningful assessment of ‘‘prolonged’’ damage would
thus have to be done months or years after the fact, which would defeat the very
purpose of qualifying a situation of ongoing torture as such.
Post-traumatic stress disorder (PTSD)23 found in prisoners subjected to
coercive interrogations would certainly qualify as ‘‘significant’’ psychological harm
of ‘‘significant’’ duration. This diagnosis, however, can only be made if the
symptoms have been present for more than one month and requires suitable
conditions and sufficient time for interviewing the person. These optimum
conditions are very difficult to secure whilst prisoners are still in custody, all the
more so if they are still under interrogation and are thus being subjected to
ongoing stress! Acts deliberately causing PTSD thus might qualify under the Bybee
memo as torture, but that qualification would require waiting for a proper
assessment several months or years down the line to determine what was
happening to prisoners not yet released at the time such acts were perpetrated.
This not only constitutes an unnecessary barrier to the classification of certain
20 Ibid., p. 176.
21 Ibid., p. 176. The memorandum specifically mentions that ‘‘the phrase severe pain applies in statutes
defining an emergency medical condition for the purpose of providing health benefits’’.
22 Ibid., pp. 195 ff.
23 The discussion of whether torture produces PTSD is a complex one and goes well beyond the scope of
this paper. PTSD as originally defined was meant to apply to extreme situations, in fact ‘‘near-death’’
situations, which resulted in serious psychological trauma to the victims. This would for example be the
case of someone who survived an air crash, or who narrowly survived dying in a fire. The common
denominator differentiating these ‘‘near-death’’ situations from torture is that torture is ‘‘man-made’’
and intentional. The PTSD-like effects after torture are consequently different. The debate among
specialists today has, however, largely blurred this distinction.
Volume 89 Number 867 September 2007
psychological effects as amounting to torture, but defeats the very goal of any
psychological evaluation for the purpose of rehabilitation.
In the following description of what has been called ‘‘input’’
(psychological methods of torture) and ‘‘output’’ (psychological effects of those
methods), the issue of ‘‘psychological torture’’ will first be considered from the
‘‘input’’ point of view.
Psychological methods used during interrogations
Psychological methods used during interrogation are those that cause disruptions
of the senses or personality, without causing physical pain or leaving any visible
physical sequelae. These non-physical methods are many and their use is
widespread. They include:
sleep deprivation;
solitary confinement;
fear and humiliation;
severe sexual and cultural humiliations;24
the use of threats and phobias to induce fear of death or injury;
use of other ‘‘techniques’’ such as forced nudity, exposure to cold
temperatures, light deprivation, etc.
The US Department of State, in its Country Reports on Human Rights
Practices 2004,25 quotes a report by the US Committee for Human Rights listing
various psychological methods which it describes as torture:
[M]ethods of torture included … prolonged periods of exposure; humiliations
such as public nakedness; confinement to small ‘‘punishment cells,’’ in
which prisoners were unable to stand upright or lie down, where they could be
held for several weeks; being forced to kneel or sit immobilized for long
Although many examples mentioned here will be from the context of US
detention in the so-called ‘‘global war on terror’’, there are many other contexts in
which ‘‘aggressive psychological techniques’’ amounting to torture are likewise
used or have been used. Harsh techniques employed by the East German secret
police or ‘‘Stasi’’, for example, have been documented since the fall of the German
Democratic Republic. The use of various forms of humiliation, degrading
treatment, threats, hunger and cold, isolation and other psychological methods
24 In the PHR Report, above note 16, which deals with US detention, the effects of these sexual and cultural
humiliations are considered in relation to detainees of the Muslim faith.
25 Report for North Korea, Country Reports on Human Rights Practices 2004, released by the Bureau of
Democracy, Human Rights, and Labor, 28 February 2005, available at
2004/41646.htm (last visited 15 October 2007).
26 The first two methods cited here, forced nudity and solitary confinement in a small cell, are typical nonphysical
methods. The latter two, forced positioning and immobilization, are on the borderline between
physical and psychological. Their psychological effects are certainly deeper than the physical ones.
H. Reyes – The worst scars are in the mind: psychological torture
during interrogations was found to cause ‘‘persisting and paranoid anxieties, rearousable
by specific situations; persecution dreams, mood disturbances, suicidal
tendencies, and shattering of confidence’’.27
As pointed out above, consideration must be given not only to what is
done to a person, but to the overall situation and circumstances and the individual
susceptibilities and vulnerabilities. The ethnic and religious contexts certainly have
to be taken into account. Any of these factors will of necessity be subjective and
case-related. The discussion of torture cannot merely be narrowed down to ‘‘acts
causing pain and suffering’’ in an abstract sense.
Apart from the psychological methods which cause disruption of the
senses and personality, there are other methods used during interrogations which
in themselves are not deemed to be a form of psychological torture. They could be
termed ‘‘minor’’ or ‘‘innocuous’’ methods; they can, however, become coercive if
used over prolonged lengths of time. These ancillary methods can also produce a
situation of duress that can in fact amount to a form of cruel, inhuman and
degrading treatment, and in some cases even torture. They are considered later on
in this paper.
Psychological effects of torture
Torture in general, meaning the use of psychological and/or physical methods of
torture, has been shown to have ‘‘destructive health consequences on detainees’’.28
The use of these methods in many ways makes detainees feel responsible for what
is happening to them, inducing feelings of fear, shame, guilt and grief, as well as
intense humiliation.29 On a more clinical scale, victims of psychological torture
present symptoms associated with anxiety disorders. These symptoms are
described further on and undoubtedly cause disruption of the senses and
personality as stated by Physicians for Human Rights. The many negative effects
on health of psychological torture have been documented widely by others as
It has thus been proven that psychological methods can be extremely
coercive, constitute torture and be unlawful. The first UN Special Rapporteur,
27 See Uwe Peters, ‘‘U¨ ber das Stasi-Verfolgten-Syndrom’’ (The Stasi persecution syndrome), Fortschr
Neurol Psychiatr, Vol. 59, No. 7, July 1991, pp. 251–65. See also Christian Pross, Social Isolation of
Survivors of Persecution in a Post-totalitarian Society, Behandlungszentrum fu¨r Folteropfer, BZFO/Arch,
Berlin, 1995, p. 346.
28 ‘‘Health consequences of psychological torture’’, PHR Report, above note 16, pp. 48–51.
29 These same symptoms and effects have been encountered by ICRC staff in their visits to prisoners in
many countries. The ICRC documents torture in order to make official representations to the states
responsible, in order to try to put a stop to such practices.
30 See Pe´tur Hauksson, Psychological Evidence of Torture, CPT, Council of Europe, 2003, p. 91; see also
Metin Bas¸og˘lu, Torture and its Consequences, Cambridge University Press, Cambridge, 1992, and
Psychological Evidence of Torture: A Practical Guide to the Istanbul Protocol for Psychologists, Human
Rights Foundation of Turkey (HRFT), 2004.
Volume 89 Number 867 September 2007
Professor Peter Kooijmans, accordingly made a statement in which he merged the
methods and effects of torture:
This distinction [between physical and psychological torture] seems to have
more relevance for the means by which torture is practised than for its
character. Almost invariably the effect of torture, by whatever means it may
have been practised, is physical and psychological … A common effect is the
disintegration of the personality.31
The Istanbul Protocol
Both the physical and psychological effects of torture are comprehensively
discussed, analysed and fully documented in the Manual on the Effective
Investigation and Documentation of Torture and Other Cruel, Inhuman and
Degrading Treatment or Punishment, a landmark publication otherwise known as
the Istanbul Protocol.32
Compiled over several years by a wide selection of experts from many
countries, the Istanbul Protocol considers virtually all aspects of torture and its
consequences and establishes a procedure for governments or independent bodies
to conduct a standardized investigation of the use of torture. It also broke new
ground by covering issues that had never been fully acknowledged before.
The Istanbul Protocol states categorically that torture, to be qualified as
such, need not leave any visible scars or marks. In a nutshell, it states that torture
without any visible physical evidence is nonetheless torture and therefore can still
have severe consequences. In other words, torture is not a ‘‘WYSIWYG’’ issue.33
The ‘‘size of the scars’’ has no relation to the extent of the trauma: the fact that no
scars are left therefore does not mean the person was not tortured. For many
decades, numerous courtrooms tended to dismiss allegations of torture on the
grounds that the plaintiffs had ‘‘nothing to show’’ on their ‘‘allegedly tortured’’
bodies. The Istanbul Protocol officially establishes34 that absence of evidence is not
evidence of absence,35 thus affirming that torture is torture, even if it leaves no
31 Report of the Special Rapporteur on Torture and Other Cruel, Inhuman and Degrading Treatment or
Punishment. UNGAOR, 59th Session, Agenda Item 107(a) 2004, UN Doc. A/59/324, para. 45.
32 Istanbul Protocol: Manual on the Effective Investigation and Documentation of Torture and Other
Cruel, Inhuman or Degrading Treatment or Punishment, Professional Training Series No 8/ Rev.1,
Office of the United Nations High Commissioner for Human Rights, Geneva, 2004, available at (last visited 15 October 2007).
33 Abbreviation borrowed from computer engineers: WYSIWYG 5 ‘‘what you see is what you get’’, in this
case meaning that a victim of torture may well have no scars or traces at all on the body, but this in no
way diminishes credibility, which must be established separately. See Michael Peel and Vincent Iacopino
(eds.), The Medical Documentation of Torture, Greenwich Medical Media, London, 2002, ch. 5.
34 Istanbul Protocol, above note 32, ch. V, p. 160: ‘‘To the extent that physical evidence of torture exists, it
provides important confirmatory evidence that a person was tortured. However, the absence of such
physical evidence should not be construed to suggest that torture did not occur, since such acts of
violence against persons frequently leave no marks or permanent scars.’’
35 Paraphrasing Carl Sagan in a different context; see The Demon-Haunted World: Science as a Candle in the
Dark, New York, 1996.
H. Reyes – The worst scars are in the mind: psychological torture
physical traces at all. By extension, psychological methods of torture, which are
not expected to leave any ‘‘physical marks’’, also constitute a form of torture. This
had of course already been common knowledge for many years in centres for the
rehabilitation of torture survivors, where torture was found to have produced
serious trauma and health problems without leaving any physical evidence.36 The
late Professor Sten Jacobssen, a Swedish expert on torture, always stressed that
‘‘the worst scars are in the mind’’.37
The Istanbul Protocol also says that a victim’s testimony on the torture
experience may be patchy or ‘‘muddled’’. It may be imprecise in time, location, or
in its details – or all of the above – and this can be quite normal after torture.
Unconsciously or even deliberately ‘‘forgetting’’ about torture is often part of a
person’s coping mechanisms. This, too, has been known for several decades
among people working to help torture victims and applies to both physical and
psychological forms of torture.38
The Istanbul Protocol rightly considers torture as a holistic process that
can involve both physical and psychological methods, producing both physical
and psychological effects. This reality was first stated and documented by medical
researchers in Toronto (Federico Allodi et al.) and Copenhagen (Inge Genefke
et al.), in the first rehabilitation centres that began to work systematically and
scientifically with survivors of torture some thirty years ago.
There is, however, a gap in this holistic approach. It lies in the fact that in
considering the effects of torture, the Istanbul Protocol took an evidence-based
approach and furthermore describes the effects of torture in general. It does not
separate the effects caused by ‘‘purely physical methods’’ from those caused by
methods that are ‘‘purely non-physical’’. This could seem to be a non-issue, since
in most torture situations both types of methods are combined for interrogations.
Is it not artificial to want to separate the effects of the physical from the effects of
the psychological, having clearly stated that torture is a holistic phenomenon and
that both methods produce both types of effects? How can separating them help to
clarify the entity of ‘‘psychological torture’’?
The reason for considering the effects of ‘‘psychological methods’’
separately is to see whether these methods alone – that is, without any physical
assault – produce ‘‘pain and suffering’’ that reach the threshold of cruel, inhuman
or degrading treatment or torture.
In the last two decades the use of torture has followed two different paths.
In some states torture continues, even today, to be physical and very brutal.
36 Hauksson, above note 30, p. 91.
37 Personal communication to the author from Prof. Sten Jakobsson, Kaorlinska Institutet, University of
Stockholm, at the IVth International Symposium on Torture and the Medical Profession, Budapest,
October 1991.
38 Physical torture has psychological effects as well as physical effects, and psychological torture likewise
produces both psychological and physical effects. See Anne Goldfeld, Richard Mollica et al., ‘‘The
physical and psychological sequelae of torture’’, Journal of the American Medical Association, 1988, pp.
2725–9; see also Metin Bas¸og˘lu, Murat Paker et al., ‘‘Psychological effects of torture: a comparison of
tortured with nontortured political activists in Turkey’’, American Journal of Psychiatry, No. 151
(January 1994), pp. 76–81.
Volume 89 Number 867 September 2007
Leaving physical evidence on the bodies of the tortured has not troubled those
oppressive states where impunity is widespread and the perpetrators have no
reason to fear prosecution, let alone condemnation, for following what is de facto
(although usually unwritten …) state policy. But this situation is not the subject of
the present analysis.
Other states, while also choosing narrowly to interpret torture as implying
only physical acts, have increasingly changed their practices owing to growing
accountability or perhaps to moral or other pressures and are thus resorting more
and more to coercive psychological methods in their interrogations.
The point here is that states that use torture seek to narrow the definition
thereof, taking into consideration only its physical ‘‘severe pain and suffering’’
aspects. As the person is not assaulted, the reasoning goes, the ‘‘severity of pain
and suffering’’ criterion (here meaning physical only) is not met. This line of
argumentation is effectively used to manipulate wider public opinion, which has
largely come to consider torture to be mainly a ‘‘physical phenomenon’’, thus
accepting the (flawed) reasoning that without physical assault there is no torture.
The psychological effects of torture – that is, of all methods combined,
both physical and psychological, described in detail in the Istanbul Protocol and
many other medical publications – are well known.39 Those most frequently
encountered are
re-experiencing the trauma (flashbacks, nightmares, stress reactions, mistrust
– even of family members – bordering on paranoia);
avoidance of anything recalling the torture experience (also called emotional
hyper-arousal (irritability, sleep difficulties, hyper-vigilance, constant anxiety,
difficulties in concentrating);
depressive symptoms, and what is known as depersonalization (acknowledged
atypical behaviour, feeling detached from one’s body).40
It is thus virtually impossible to determine from the Istanbul Protocol
alone what types of non-physical methods of ill-treatment41 produce what
symptoms and effects, and thus by extension determine what non-physical
39 Compare Federico Allodi, Glenn Randall et al., ‘‘Physical and psychiatric effects of torture’’, in Eric
Stover and Elena Nightingale (eds.), The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and
the Health Professions, Freeman & Co., New York, 1985, pp. 58–79.
40 Istanbul Protocol, above note 32, Bas¸og˘lu et al., above note 38, pp. 72–82; see also Hauksson, above note


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