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This comprehensive report has been written by Gretchen Borchelt, JD & Christian Pross, MD and with research assistance by others Systematic use of psychological by US Forces*

Physicians for Human Rights**

Abstract sufficient evidence available now to show a This report is the first to comprehensively exam- consistent pattern of the use of psychological ine the use of psychological torture by US person- torture as a key element in the interrogation nel in the so-called “war on terror.”1 It reviews the of detainees by US personnel. Various tech- techniques used on detainees, what clinical experi- niques were often applied in combination, in ence and studies reveal about the long-lasting and order to amplify and heighten their effect. extremely devastating health consequences of psy- chological torture, how a regime of psychological torture came about and was perpetuated, and Prolonged isolation what the current status of psychological torture is The use of prolonged isolation took place in in US policy. Although the evidence is far from all three theaters of operation throughout complete, what is known warrants the inference the “war on terror” and most likely is con- that psychological torture was central to the inter- tinuing today. There are reports from the rogation process and reinforced through condi- US-run Bagram Air Force Base in Afghan- tions of confinement. Evidence exists of its contin- istan that forces used at ued use in 2004 and some practices likely remain the base in 2002 and that the harshest treat- in place to this day. (...) ment was directed at detainees held in isola- tion.7 US personnel also used isolation as an A regime of psychological torture interrogation tactic in Iraq. Based on visits Much of what took place in the closed facil- to detention facilities throughout Iraq in ities where detainees were kept and interro- 2003, the ICRC (International Committee gated remains secret. In particular, the pol- of the Red Cross) found that detainees held icies and practices of the Central Intelli- at Baghdad International Airport were “held gence Agency (CIA) are almost completely for nearly 23 hours a day in strict solitary shielded from public scrutiny.Yet there is confinement in small concrete cells devoid of daylight”.8 *) The following is an extract from the report An even more restrictive use of isolation was in place at Abu Ghraib prison in Iraq. **) Physicians for Human Rights (PHR) worked to stop tor- ture, disappearances, and political killings by govern- Sleep deprivation

Volume 15, Number 1, 2005 Volume ments and opposition groups and to investigate and ex- The use of sleep deprivation appears to have pose violations, including: deaths, injuries, and trauma been a common interrogation tactic in inflicted on civilians as well as harsh methods of incarcer- ORTURE

T ation in prisons and detention centers. Afghanistan, Iraq, and Guantánamo. 67

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Detainees held at various locations in the source, in 2003 female interrogators Afghanistan in 2002 and 2003 describe be- used sexually provocative acts as part of in- ing routinely deprived of sleep.18 The terrogation. For example, female interroga- spokesman for the American-led force in tors sat on detainees’ laps and fondled them- Afghanistan admitted in 2003 that sleep selves or detainees, opened their blouses deprivation was “probably within the lexi- and pushed their breasts in the faces of de- con”19 and that a “common technique” for tainees, opened their skirts, kissed detainees keeping detainees awake was to keep bright and if rejected, accused them of liking men, lights on at all times or to wake detainees and forced detainees to look at pornographic every fifteen minutes.20 At Guantánamo, pictures or videos.35 Although the use of fe- sleep deprivation also was regularly em- male interrogators appeared to decline in ployed. Personnel familiar with conditions 2004, a source told PHR that humiliation there described how sleep deprivation was and violation of cultural and religious implemented at the naval base in 2003: taboos, including forced shaving, persisted.36 (...) An inmate was awakened, subjected to an interrogation in a facility known as the Gold Use of threats and dogs Building, then returned to a different cell. to induce fear of death or injury As soon as the guards determined the in- Interrogators in Afghanistan, Iraq, and mate had fallen into a deep sleep, he was Guantánamo cultivated the fear of injury awakened again for interrogation after which and death through the use of military work- he would be returned to yet a different cell. ing dogs, the threat of beatings or electrocu- This could happen five or six times during a tions, and mock executions. night.21 There is evidence that the use of dogs to instill fear and threaten detainees was used Its use continued in 2004, according to de- as an interrogation technique in all three tainees held there during that time.22 theaters of operation, from the beginning of Sleep deprivation occurred in detention the “war on terror.” (...) facilities throughout Iraq as well. (...) Aside from the use of dogs, mock execu- (...) At Guantánamo, detainees’ accounts tions and death threats were prevalent in of forced and sexual humiliation were Afghanistan and Iraq. A detainee in Kanda- confirmed by FBI reports. An FBI letter to har, Afghanistan says that in 2002, a 9 mm an Army official states that during late 2002 pistol was held to his temple.47 A Criminal

an agent witnessed a female interrogator at Investigation Command report describes a T ORTURE Guantánamo rubbing lotion on a detainee’s compact disc that contains digital images of arms during Ramadan, when “physical con- American soldiers conducting mock execu- Volume 15, Number 1, 2005 tact with a woman would have been particu- tions on Afghan detainees beginning in early larly offensive to a Moslem male.”33 News December 2003 at Fire Base Tycze, Dah reports confirmed that the use of female in- Rah Wood, Afghanistan.48 terrogators violating Muslim taboos regard- ing sex and contact with women occurred at Combination of techniques Guantánamo in 2003 as well.34 These ac- The evidence points to a widespread and counts were confirmed to PHR by a source systematic application of these techniques, familiar with conditions there. According to often in combination. (...) 68

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(...) Detainees reported that at Guantá- search are consistent with the earlier find- namo in late 2002, they observed techniques ings of solitary confinement’s harmful conse- such as short-shackling, loud music playing quences. Effects include depression, anxiety, in interrogation, forced shaving of beards difficulty with concentration and memory, and hair, putting people in cells naked, tak- hypersensitivity to external stimuli, halluci- ing away people’s comfort items, sleep depri- nations and perceptual distortions, paranoia, vation, and the use of cold air.54 (...) and problems with impulse control.67 People who are exposed to isolation for the first Health consequences time develop “a predictable group of symp- Psychological torture and cruel, inhuman, toms, which might almost be called a ‘dis- and degrading treatment can have extremely ease syndrome.’”68 The symptoms include destructive health consequences for individ- “bewilderment, anxiety, frustration, dejec- uals. Short- and long-term effects can in- tion, boredom, obsessive thoughts or rumi- clude memory impairment, reduced capacity nations, depression, and, in some cases, hal- to concentrate, somatic complaints such as lucination.”69 headache and back pain, hyperarousal, avoidance, irritability, severe depression with Sleep deprivation vegetative symptoms, nightmares, feelings of The most pronounced impact of total sleep shame and humiliation, and post-traumatic deprivation is cognitive impairment74,which stress disorder.63 Sources with knowledge of can include “impairments in memory, learn- interrogation at Guantánamo told PHR that ing, logical reasoning, arithmetic skills, com- some detainees there suffer from incoherent plex verbal processing, and decision mak- speech, disorientation, hallucination, irrit- ing.”75 Sleep-deprived individuals take ability, anger, delusions, and sometimes longer to respond to stimuli, and sleep loss paranoia.64 Some detainees who have been causes “attention deficits, decreases in short- released from US run detention facilities af- term memory, speech impairments, perse- ter being subjected to a combination of psy- veration, and inflexible thinking.”76 These chologically abusive interrogation techniques symptoms may appear after one night of to- report that they suffer from depression, tal sleep deprivation, after only a few nights thoughts of suicide and nightmares, memory of sleep restriction (five hours of sleep per loss, emotional problems, and are quick to night)77. (...) anger and have difficulties maintaining rela- tionships and employment.65 Based on past Sexual humiliation experience, post-traumatic stress disorder is According to clinicians at the Minnesota- likely to be common. based Center for Victims of Torture (CVT), forced nakedness is intended to create a Prolonged isolation power differential between detainees and in- In the 1950s and 1960s, studies demon- terrogators by stripping the victim of his/her strated that short-term isolation caused an identity, inducing immediate shame, and es- inability to think or concentrate, anxiety, so- tablishing an environment where the threat matic complaints, temporal and spatial dis- of sexual and physical assault is always pres-

Volume 15, Number 1, 2005 Volume orientation, deficiencies in task performance, ent. By denying the victim the most basic hallucinations, and loss of motor coordina- forms of decency and privacy, forced nudity

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absolute control over the detainees’ bodies vere sexual humiliation, and disoriented by and can do as they please. Implied in the – are indeed forms of torture. What context of forced nudity is the threat of the images do not show, but what this report other, more abusive violations, whether sex- reveals, is that psychological torture, even if ual or physical.81 not as graphic as the images, was at the cen- There is evidence that US personnel dir- ter of the treatment and interrogation of de- ected sexual humiliation toward detainees tainees in US custody in Afghanistan, Guan- because they knew that Arabs are particu- tánamo and Iraq since 2002. larly vulnerable to sexual humiliation and Since the Abu Ghraib scandal broke a sought to exploit that vulnerability.82 Clin- year ago, the physical abuse of detainees icians at the Center for the Treatment of through beatings, use of stress positions, Torture Victims in Berlin, Germany (Berlin deprivation of food, and infliction of severely Center), who treat a large population of cold and hot temperatures, has understand- Muslims, have found that Muslim victims of ably gained the most attention, and the sexual torture forever carry a stigma and will Army has itself labeled the often be ostracized by the community. They deaths of 26 detainees as homicides. The have found that male victims often feel de- evidence now available from witness ac- graded in their manhood, especially if the counts, documents released under the Free- perpetrator was a woman. (...) dom of Information Act, official investiga- tions, leaked reports from the International Psychological torture Committee of the Red Cross (ICRC), media The use of psychological torture followed reports, and inquiries by Physicians for Hu- directly from decisions by the civilian leader- man Rights, shows that physical forms of ship as well as high ranking military officers, torture and cruel, inhuman and degrading including those in the executive branch, and treatment served only to punctuate the per- their support of decisions to “take the gloves vasive use of psychological torture by US off” in interrogations and “break” prisoners personnel against detainees. by employing techniques of psychological The use of the psychologically abusive torture including sensory deprivation, isola- interrogation methods is immoral and is il- tion, sleep deprivation, forced nudity, the legal under the Geneva Conventions and use of military working dogs to instill fear, other sources of international law to which cultural and sexual humiliation, mock execu- the United States is a party, civil domestic tions, and the threat of violence or death to- law and the Uniform Code of Military Jus-

ward detainees or their loved ones. These tice. US courts, international treaty bodies, T ORTURE kinds of techniques have extremely devastat- UN special rapporteurs on torture, and the ing consequences for individuals subjected US State Department have all identified Volume 15, Number 1, 2005 to them and can be just as harmful and are these techniques as a form of torture or often more long-lasting than physical tor- cruel, inhuman, or degrading treatment. In- ture. deed, when Congress enacted a law to im- The infamous pictures from Abu Ghraib plement the requirement of the Convention prison in Iraq indelibly brought home how against Torture to criminalize torture, it de- severe forms of psychological coercion – de- fined precisely what it meant by the criminal tainees terrorized by snarling dogs and wires act of mental or psychological torture. The dangling from their wrists, subjected to se- US Congress defined the severe mental pain 70

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or suffering that constitutes an element of person being interrogated or to any third the crime of torture as including threats of party, or imposing severe physical condi- death or injury and the administration or tions.”5 This reiteration of policy came on application or threatened administration or the heels of a number of complaints from application of “procedures calculated to dis- the FBI to the Department of Defense re- rupt profoundly the senses or the person- garding their use of unacceptably aggressive ality.”2 This definition encompasses exactly interrogation tactics.6 the procedures that were used. Psychological torture also violates long- Closing remarks standing instructions for military interroga- Based on a review of disclosed documents, tions. Army Field Manual 34-52, the Army’s comprising administration memorandums, guide on interrogations, currently being re- government documents released pursuant to vised, allows psychological methods of inter- a Freedom of Information Act request, and rogation, but draws a very sharp line at psy- leaked International Committee of the Red chological coercion and efforts to break Cross reports, as well as PHR’s own inter- down detainees, which it considered both views, it is clear that US personnel have unlawful and ineffective: used these techniques systematically at de- tention facilities in Afghanistan, Guantá- [The] use of force, mental torture, threats, namo, and Iraq, from the beginning of the insults, or exposure to unpleasant or inhu- “war on terror” through 2004. Some tech- mane treatment of any kind is prohibited by niques, like sleep deprivation and nakedness, law and is neither authorized nor condoned were designed to part of interrogation plans by the US Government. Experience dictates and strategies for particular detainees; that the use of force is not necessary to gain others, like long-term isolation, were part the cooperation of sources for interrogation. and parcel of the conditions of confinement Therefore, the use of force is a poor tech- for many detainees. Because of the close re- nique, as it yields unreliable results, may lationship between conditions of confine- damage subsequent collection efforts, and ment and interrogation techniques, the vic- can induce the source to say whatever he tims could well number in the thousands. thinks the interrogator wants to hear.3 The evidence points to a system of consis- tent psychological torture and ill-treatment, The Federal Bureau of Investigation agrees. accompanied by physical abuse that was After the Abu Ghraib scandal, it issued an central to the interrogation of detainees. electronic communication that said that FBI There has been no accountability for the policy “has consistently provided that FBI practice of psychological torture among offi- personnel may not obtain statements during cials responsible for putting the practices interrogations by the use of force, threats, into place. physical abuse, threats of such abuse or se- vere physical conditions.”4 It reiterated, “It is References the policy of the FBI that no interrogation of The numbers of references refer to their original placement in the PHR report. detainees, regardless of status, shall be con- The report called “Break Them Down” and its refer- Volume 15, Number 1, 2005 Volume ducted using methods which could be inter- ences can in full extension be accessed at preted as inherently coercive, such as physi- www.phrusa.org/research/torture/news_2005-05-

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