The Lingering Effects of Torture

WASHINGTON, July 3, 2009 — -- Like many of the other inmates interrogated at Guantanamo Bay, Adeel's personal nightmare did not end when he returned home.

Today, in his native Pakistan, the sound of approaching footsteps or the sight of someone in a uniform can trigger bad memories and set off a panic attack. The former teacher and father of five now thinks of himself as a suspicious and lonely person.

"I feel like I am in a big prison and still in isolation. I have lost all my life," he told psychologists working for the non-profit Physicians for Human Rights. They diagnosed him as having post-traumatic stress disorder (PTSD) and severe depression.

Newly emerging research on large numbers of torture survivors shows that anecdotal stories like these are common and suggests that "psychological" forms of torture -- often thought to be milder than the direct infliction of physical pain -- can in fact have serious long-term mental health consequences.

Adeel's story is similar to those of other prisoners who may be released this year as President Obama pushes to close the facility. Adeel spent four years in U.S. custody, first at the Bagram Theater Internment Facility in Afghanistan and then at Guantanamo -- and was freed in 2006, never having been charged with a crime.

Adeel said that while in U.S. custody he was sexually humiliated and wrapped in a hood, goggles, earphones and gloves that cut off his senses during a 24-hour flight. His descriptions of what happened match many of the practices that U.S. officials said were used at the prisons. Adeel said he was kept in isolation in a chilled cell, blasted with loud music to prevent him from sleeping, and forced to stand motionless in the hot sun for hours.

"For two months, I couldn't sleep because there was a very strong light. ... If you fell asleep just for a few minutes they played very loud American music, so you could not sleep," the man who now goes by the alias Adeel recalled in a recent report by the Physicians for Human Rights.

Memos sent in 2002 from the U.S. Department of Justice to the CIA, released earlier this year by President Obama, describe these and other interrogation techniques -- such as tossing prisoners against flexible walls and using waterboarding. These techniques, which leave few physical marks, are also used to toughen American troops undergoing Survival, Evasion, Resistance and Escape training.

After consulting with the military officers who run these programs, the CIA concluded "none of these [officers] was aware of any prolonged psychological effect caused by the use of any of the ... techniques either separately or as a course of conduct," according to one of the memos.

Psychologists and neuroscientists, on the other hand, tend to argue that techniques do cause long-term harm. But what can science actually show about the effects of "psychological" torture on civilians like Adeel years after their real-world interrogations?

Linking a specific form of torture directly to long-term psychological problems is very difficult to do because of the ethics of experimenting on humans. Because scientists cannot torture subjects in the laboratory and check for long-term effects, they study real-world survivors of torture, such as refugees from war-torn countries and former prisoners of war, each of whom has experienced a variety of traumatic experiences.

Doctors who work with these victims often rely not on scientific studies but on their own personal observations to assess the long-term impacts of a particular experience.

Harvard psychiatrist Stuart Grassian, who studies prisoners put into solitary confinement, believes from his own personal experience that "people [put into solitary confinement] become loners." Years after being removed from solitary confinement, "they tend to become irritable, hypervigilant, jumpy, fearful and chronically tense." But when asked to testify in a class-action suit against a "supermax" prison that used solitary confinement, he found few scientific studies to support these beliefs.