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ISTANBUL PROTOCOL VI. PSYCHOLOGICAL EVIDENCE OF TORTURE AND ILL-TREATMENT

A. General considerations is a means of attacking an individual’s fundamental
modes of psychological and social functioning.
1. Central role of the psychological evaluation Under such circumstances, the torturer strives not
only to incapacitate a victim physically but also
491. It is a widely held view that torture is an extraordinary to disintegrate the individual’s personality. 449 The
life experience capable of causing a broad range of torturer attempts to destroy a victim’s sense of being
physical and psychological suffering. Research and grounded in a family and society as a human being
clinical experience have shown that psychological with dreams, hopes and aspirations for the future. By
sequelae of torture are often more persistent dehumanizing and breaking the will of their victims,
and protracted than physical sequelae 447 and torturers offer a horrific warning for those who
documentation of torture frequently takes place later come in contact with the victim. In this way,
when the physical lesions have already disappeared. torture can break or damage the will and coherence
These circumstances confer upon the psychological of entire communities. In addition, torture can
evaluation a central role in evidencing torture, holding profoundly damage intimate relationships between
perpetrators responsible and claiming redress. Most spouses, parents, children, other family members
clinicians and researchers agree that the extreme and between the victims and their communities.
nature of the torture event is powerful enough on its
own to produce mental and emotional consequences, 493. It is important to recognize that not everyone who has
regardless of the individual’s pre-torture psychological been tortured develops a diagnosable mental illness. 450
status. The psychological consequences of torture, However, most victims experience profound emotional
however, vary according to the nature of the harm reactions and psychological symptoms often also
inflicted and the context of personal attribution of including serious cognitive and behavioural changes.
meaning, personality development and social, political The main psychiatric disorders associated with torture
and cultural factors. For this reason, it cannot be are PTSD and depression. While these disorders are
assumed that all forms of torture have the same present in the general population, their prevalence,
consequences in every individual. For example, the though varying among studies, is much higher among
psychological consequences of a mock execution are torture survivors. Epidemiological studies with
not the same as those due to a sexual assault, and torture survivors and refugees show prevalence rates
solitary confinement and isolation are not likely to of 23–88 per cent for PTSD and 28–95 per cent for
produce the same effects as physical acts of torture. depression. 451 The high variability among studies is
Likewise, the effects of detention and torture on an likely due to different population samples (including
adult will usually not be the same as those on a child. studies with torture survivors seeking treatment),
Nevertheless, there are clusters of symptoms and different assessment methods, coexisting stressors
psychological reactions that have been observed and and other factors. However, the unique cultural,
documented in torture survivors with some regularity. social and political implications that torture has for
each individual influence the ability of that person to
492. Perpetrators often attempt to justify their acts describe and speak about it. Such effects on the victim’s
of torture or ill-treatment by the need to gather ability to make sense of and describe the experience of
information. Such conceptualizations obscure the torture must be considered especially when performing
purpose of torture and its intended consequences. an evaluation of an individual from another culture.
One of the central aims of torture is to reduce an Cross-cultural research reveals that phenomenological
individual to a position of extreme helplessness and or descriptive methods are the most useful approaches
distress that can lead to a deterioration of cognitive, when attempting to evaluate psychological or
emotional and behavioural functions. 448 Thus, torture psychiatric disorders. What is considered disordered

447 José Quiroga and James M. Jaranson, “Politically-motivated torture and its survivors. A desk review of the literature”, Torture, vol. 15, No. 2–3 (2005).
448 José A. Saporta and Bessel A. van der Kolk, “Psychobiological consequences of severe trauma”, in Torture and its Consequences: Current Treatment Approaches, Metin
Başoğlu, ed. (Cambridge, United Kingdom, Cambridge University Press, 1998), pp. 151–181.
449 Almerindo E. Ojeda, ed., The Trauma of Psychological Torture (Westport, Praeger, 2008); and Pau Pérez-Sales, Psychological Torture: Definition, Evaluation and Measurement
(Routledge, 2016).
450 It should be kept in mind that the qualification of an act as torture is not dependent on the existence of subsequent prolonged mental harm. See, in this respect, Manfred
Nowak, “What practices constitute torture?: US and UN standards”, Human Rights Quarterly, vol. 28, No. 4 (2006), pp. 809–841.
451 Hiba Abu Suhaiban, Lana Ruvolo Grasser and Arash Javanbakht, “Mental health of refugees and torture survivors: a critical review of prevalence, predictors and integrated
care”, International Journal on Environmental Research and Public Health, vol. 16, No. 13 (2019).

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