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Treating Victims of Torture and Violence

Treating Victims of Torture and Violence: Theoretical Cross-Cultural, and Clinical Implications

Peter Elsass
John Andersen
Harald Fuglsang
Copyright Date: 1997
Published by: NYU Press
Pages: 214
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  • Book Info
    Treating Victims of Torture and Violence
    Book Description:

    Torture is among the most disturbing and psychologically devastating of human behaviors. It dehumanizes its victims, leaving them with serious and lasting psychological wounds. Like other psychological trauma, torture frequently leaves in its wake denial and silence among both perpetrators and their victims. This communicative void creates a public and mental block that can make treatment of torture survivors very difficult. Treating Victims of Torture and Violence is the definitive manual for therapists treating victims of torture, prisoners of war, and casualties of forced migration. Divided into five sections dealing with basic concepts of torture--violence and aggression, the torture syndrome, psychotherapeutic treatment, the cultural psychology of torture syndrome, and cultural psychological treatment-- Treating Victims of Torture and Violence employs both classic psychoanalytic and cognitive- behavioral methods. Realizing that torture victims are frequently from different cultures than those of their therapists, Peter Elsass provides in-depth aid to therapists dealing with a multicultural clientele.

    eISBN: 978-0-8147-2296-1
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
  3. Preface
    (pp. xi-xiv)
  4. Introduction
    (pp. 1-9)

    Torture is among the most gruesome of human manifestations, particularly because it does not have its origin in animals, primitive man, or pre-culture. On the contrary, it is planned, and it stems from social order. It is a display of force, the aim of which is to break an individual’s judgment. As a consequence, it breaks down parts of the victim’s personality. The greatest challenge to the torture survivor is therefore to remain a human being under these inhumane conditions.

    Torture gives an insight into some terrifying contradictions. For instance, torturers are not particularly perverse or sadistic: they are often...

  5. 1 Torture, Violence, and Aggression: Scientific Difficulties in Containing the “Absolute Evil”
    (pp. 10-28)

    “Torture” is relatively simple to define, and in practice there is seldom any doubt as to whether a person has been exposed to torture (Genefke 1993a, b, Montgomery & Foldspang 1994).

    In the United Nation Convention of 10 December 1984, torture is described as follows:“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...

  6. 2 The Torture Syndrome: A Diagnostic Description of the Trauma-Provoked Condition and a Psychodynamic Understanding of the “Unbearable Helplessness”
    (pp. 29-59)

    The number of scientific articles that have been written about the psychological and social sequelae of torture are increasing with great speed. For example, a “Medline, Psychinf” search by Somnier et al. (1992: 56) gave about 150 references in 1992. The same search in 1994 produced 221 references and in 1996, 303 references. Furthermore, from their work with torture survivors, psychotherapists have reported on their experiences in their own practices (see review in Bustos 1992: 334, Mclvor & Turner 1995). Some of these reports have been given the status of textbooks, for example, Basoglu (1992),Danieli et al. (1996), Herman (1992), Hjern...

  7. 3 Psychotherapeutic Treatment: The Supportive Attitude and the Combination of Psychoanalytic and Cognitive Ways of Thinking
    (pp. 60-90)

    The psychotherapy of torture survivors can take various forms. In the literature, different working methods have been described, ranging from cognitive, behavioral techniques (Basoglu 1992) and the testimony method (Cienfuegos & Monelli 1983), to psychodynamic, psychoanalytic methods with different emphasis on supportive and explorative techniques (Herman 1992). In practice, the various treatment centers have developed combination therapies of cognitive and psychodynamic working methods, especially adapted to the survivors. Many take their inspiration from therapeutic methods developed to treat various forms of post-traumatic stress conditions such as assaults and natural disasters (Horowitz 1988, McCann & Pearlman 1990).

    The wide range of psychotherapeutic treatment...

  8. 4 The Cultural Psychology of the Torture Syndrome: A Distinction between What Is Universal and What Is Culture-Bound
    (pp. 91-112)

    Forced migration because of war and political persecution leads to a confrontation with cultures that are often quite different from the Western context, in which psychotherapy was created and developed. More than three-quarters of the world’s population live in non-Western cultures, and more than 90 percent are not familiar with our psychotherapeutic constructions.

    Torture survivors come mainly from non-Western cultures, and the problems that we have dealt with in the previous chapters may therefore be fictive. The demarcation of the torture syndrome from post-traumatic stress disorders, the special supportive method, and the treatment stages is based on a dubious assumption,...

  9. 5 Cultural-Psychological Treatment: Examples of Psychotherapy Showing Respect for Foreign Cultures
    (pp. 113-141)

    Meeting a foreigner gives rise to some fundamental considerations with respect to the effect mechanisms of psychotherapy. Change occurs, as Mead said, when two cultures intervene in each other, such as “another’s image of myself incorporated inside me and opposed to my own image of myself” (Mead 1932). Thus, the therapeutic session with a foreigner is not a collision between different explanatory models, but rather an interplay in which one sees oneself in the light of the other.

    But consideration should be given to whether psychotherapeutic assistance to torture survivors is a transference reaction due to our bad conscience, when...

  10. 6 Postscript: The Torture Survivor’s Perspective: A Follow-Up Examination Combining Supervision with Research
    (pp. 142-161)

    The torture survivor’s perspective may be distorted when it is processed and filtered by the professional. The considerations about the specific torture syndrome and supportive treatment have all been developed within a closed therapy room. The culture-psychologic approach certainly tries to put the psychodynamic working method into a larger perspective that respects the client’s cultural background and can recommend some culture-specific treatment methods. But all these reflections are those of the professional, and it cannot be taken for granted that they respect the clients’ interests. If one is unable to involve the torture survivors in the development of professional knowledge...

  11. Appendix
    (pp. 162-176)
  12. References
    (pp. 177-196)
  13. Subject Index
    (pp. 197-198)
  14. About the Author
    (pp. 199-200)
  15. Back Matter
    (pp. 201-201)