Therapeutic Advocacy: Treating and Empowering the Politically Persecuted in Authoritarian 1973-1990

By Belinda Zhou

Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Bachelor of Arts In the Department of History at Brown University

Thesis Advisor: Jennifer Lambe

7 April 2017

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TABLE OF CONTENTS

Acknowledgements ...... 3

Introduction ...... 4

Chapter 1: The Political Identity and Goals of FASIC’s Medical-Psychiatric Team ...... 28

Chapter 2: Trauma: Individual and Collective, Direct and Indirect ...... 55

Chapter 3: Testimonio as Therapy and Archive ...... 85

Conclusion ...... 111

Bibliography ...... 122

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ACKNOWLEDGEMENTS

I am incredibly appreciative of Professor Jennifer Lambe’s guidance and time. Without her knowledge and encouragement, I would not have been able to complete this thesis. I also credit her with introducing me to the study of the history of psychiatry; had I not taken a course with her, I certainly would not have conceptualized such a thesis. I would like to express my gratitude to Professor Ethan Pollock for his constant positivity and support and to Professor

Daniel Rodriguez for introducing me to Steve J. Stern’s trilogy on Chilean memory studies, which became my entry point to exploring testimonio. My writing benefited greatly from the feedback of John Giambrone, Ryan Lee, Christopher Shum, and Daniel Ziring. Additionally, I’d like to thank my friends and family for their support throughout this process.

In Chile, I could not have accessed FASIC’s archives without the help of Angela Schaaf.

I am incredibly grateful to FASIC’s archive manager, María Graciela Acuña, for her assistance in locating Medical-Psychiatric Program’s documents. I also appreciated the opportunity to speak with Silvana Vetö and Nancy Nicholls, two knowledgeable scholars of Chilean psychoanalysis and human rights, respectively. Furthermore, I must thank Vetö for putting me in touch with Dr. Elena Castro, who graciously answered my questions about her time at FASIC.

Lastly, I am thankful to the Storm family for making a second home to me.

Here I must also acknowledge the bravery of both FASIC’s therapists and patients.

Despite the violent conditions in which they lived, they demonstrated an incredible openness to sharing their narratives of trauma and a remarkable dedication to human rights. Through the research process, I came to deeply admire the subjects of my thesis for their courage, intellect, and humanity. I sincerely hope I have avoided miscommunicating their sentiments and beliefs in my efforts to expose their remarkable work to English language audiences.

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INTRODUCTION

On November 9, 1983, a group of six mental health professionals stood before the

Chilean Association of Psychologists to accept the National Psychology Award. A week before the event, Alfonso Luco Rodriguez, the president of the association, wrote to the six therapists explaining that they were being honored for their “significant and valiant contribution” to the

“enhancement of our profession.”1 It is typical for a professional association to award those who have advanced their field of expertise in a “significant” way. However, what exactly made this group’s contribution “valiant”? Why did a psychological association’s members value their peers for their bravery?

Luco’s reference to their “valiant” efforts hinted at the nation’s tumultuous political situation. The ceremony took place in Santiago, Chile, more than ten years after Augusto

Pinochet’s coup d’état, which ended both the democratically elected and life of socialist president (1970-1973). By 1983 the military junta had begun institutionalizing its efforts under the guise of democratic norms in the hopes of raising its standing and legitimacy within the international community.2 The Chilean Association of

Psychologists recognized the work of Rosario Dominguez, Elizabeth Lira, Elisa Neumann,

Adrianna Maggi, Eugenia Weinstein, and David Becker, who were all members of the Medical-

Psychiatric Program at the Fundación de Ayuda Social de las Iglesias Cristianas (FASIC), or the

Social Aid Foundation of the Christian Churches.3 The organization provided support services

1 Letter, Alfonso Luco Rodriguez to Elizabeth Lira, “National Psychology Award 1983 to the Medical-Psychiatric Program of FASIC: Letters, Acceptance Speech,” November 1983. 2 Pablo Policzer, The Rise and Fall of Repression in Chile (Notre Dame: University of Notre Dame Press, 2009), 116-117. 3 Rosario Dominguez Vial, Elizabeth Lira Kornfeld, Elisa Neumann Garcia, Adriana Maggi Valenzuela, Eugenia Weinstein Levy, and David Becker Mathis, “Acceptance Speech for the Award ‘Association of Psychologists,’” FASIC (9 November 1983): 5.

5 for the victims of political persecution, including mental health treatment caused by the military junta’s repressive tactics, such as torture, execution, and disappearance. Chief among the association’s reasoning for honoring these therapists was their innovative therapeutic methods and their willingness to oppose the military junta by treating the politically persecuted.

In their acceptance speech, the FASIC team discussed their conviction in providing mental health services for those suffering from political repression, despite the sacrifices that they had to make in becoming affiliated with FASIC. “We were not prepared,” they said, and proceeded to list the situations of various patients they had encountered, such as “María who is already sixty-seven years old and does not have anyone…one day in November 1974, her husband was disappeared, later her son [was disappeared] and soon after her daughter left the country.”4 They shared patient profiles ranging from those experiencing economic hardship to children coping with living in exile, because, as they posited, societal “repair begins by naming things for what they are.”5 However, they also believed that the award had “put us in the difficult position of speaking about our work. Never before had we publicly [done so]...because we know, for example, that torture and disappearances are incidents that uncover wounds that divide us.”6

They concluded by expressing hope that their work would go beyond improving individual psychology by “bringing us closer...to the peace that we all yearn for.”7

The speech revealed the intimate knowledge that these therapists had of their patients and how deeply intertwined patients’ political, social, and psychological experiences were.

Additionally, the psychologists made it clear that their work went beyond the therapeutic realm.

The group aspired to effect change in the political sphere by criticizing the military regime in

4 Dominguez, et al., “Acceptance Speech for the Award ‘Association of Psychologists,’” 1. 5 Ibid., 5. 6 Ibid. 7 Ibid.

6 hopes that these efforts would help bring an end to authoritarianism. Yet they also recognized and hoped to prevent the divisive potential of state violence in a post-Pinochet Chile.

FASIC’s Medical-Psychiatric Team resisted the Pinochet regime in both practice and rhetoric. In the process, they brought progressive politics into the therapeutic space during an era in which individuals associated with the left were being aggressively persecuted by the military junta. This contrasted with the “neutral” stance adopted by many healthcare professionals, who wished to keep their work “objective” and completely apolitical. While FASIC’s therapists did not take a politically partisan stance, they combined their mental health expertise with the language of human rights to speak out against the Pinochet regime. This group of therapists focused on addressing the psychological trauma caused by political repression, which was broadly defined to include torture, exile, and economic hardship. These mental health professionals produced multiple pamphlets analyzing the impact of the political situation on mental health. They also developed new therapeutic tools, most prominently through incorporating testimonio into the treatment process, which both recorded denunciations of the military junta’s brutality and helped patients cope with their trauma. FASIC’s Medical-

Psychiatric Program presented an example of the politicization of mental health forged out of resistance rather than dominance. Furthermore, the team’s involvement in constructing national memory in the post-Pinochet era demonstrated the political influence that the mental health field could wield in the aftermath of collectively experienced trauma. Despite the rhetoric of national healing, present-day Chile continues to be deeply divided along political lines, raising questions about societal memory.

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From Democracy to Military Junta: Setting the Stage for the September 11 Coup

Before exploring FASIC’s therapeutic and political work, it is important to understand the historical conditions that brought Chile to a state of authoritarianism. The 1973 coup was partly the result of rising political tension in Chile between conservative portions of society and more center-left and leftist groups. Salvador Allende held a tenuous grip on the Chilean presidency—he had only won 36.2% of the vote in the 1970 elections, a plurality that required a congressional ratification in accordance with Chilean law due to the failure to win a simple majority of the vote.8 Even within his own coalition, (Unidad Popular, or UP), tensions existed between those who agreed with Allende’s pledge to work towards a “peaceful transition to socialism” and those who supported armed struggle as the method that the Chilean people should use to bring about a socialist nation.9

Allende’s desired plan focused on economic reform to diminish income inequality in

Chile with the ultimate goal of giving more political power to the popular classes. He invested more heavily in social programs started by President Eduardo Frei (1964-1970), providing additional health, educational, and housing facilities to low-income sections of Chilean society.10

Allende also nationalized the copper industry, prompting the ire of U.S. companies in the

Chilean mining industry. Despite this, the nationalization bill passed unanimously in Congress, showing broad support among politicians for the move.11 Although conservative and centrist politicians were willing to collaborate with the UP on these early pieces of legislation, their

8 Mark Ensalaco, Chile Under Pinochet: Recovering the Truth (Philadelphia: University of Pennsylvania Press, 1999), 5. 9 Ibid., 5-6. The Popular Unity coalition, formed in October 1969, included parties that identified as center-left or center: Socialist Party, Communist Party, Radical Party, and Popular Unitary Action Movement. The most influential of these were the Socialist Party and the Communist Party. The former had declared itself Marxist- Leninist in 1967. 10 Marcus Taylor, From Pinochet to the Third War: Neoliberalism and Social Transformation in Chile (London: Pluto Press, 2006), 24. 11 Ibid., 25.

8 passage eventually led to growing opposition from the middle and upper classes. The inflation rate and the nation’s deficit continued to grow, and there was a shortage of consumer goods, leading to long lines for basic commodities and an increasingly influential black market.12 Other political efforts caused discontent on both the left and the right. Allende continued the trend of land redistribution that had been enacted by his more conservative predecessors, Presidents Jorge

Alessandri (1958-1964) and Frei. The plan broke up large areas of farmland owned by individual families, to give property to lower income campesinos.13 Those who owned this land believed they were being economically threatened, while the campesinos, encouraged by more radical leftist parties, believed the process was going too slowly.

Even before the formation of the UP coalition, political polarization within the left was evident, especially in Allende’s own Socialist Party (Partido Socialista, or PS). Despite Allende’s moderate views, the militant faction of the party, led by Carlos Altamirano, successfully had the party declare itself Marxist-Leninist in 1967.14 Outside of the formal political system, militant activists created the Movement of the Revolutionary Left (Movimiento de Izquierda

Revolucionaria, or MIR). The MIR’s leaders emerged out of leftist student movements in the

1960s, and the group had wide support in labor unions and shantytown communities, called poblaciones.15 In the MIR’s view, Allende was not taking enough action to improve the economy in a way that would serve MIR’s more radical interests. His own nephew, Andrés Pascal

Allende, was a top leader in MIR and frequently criticized the president for his timidity.16 In contrast to Salvador Allende’s more moderate politics, MIR promoted industrial strikes and land

12 Taylor, From Pinochet to the Third War, 26; Paul E. Sigmund, The Overthrow of Allende and the , 1964-1978 (Pittsburgh: University of Pittsburgh Press, 1977), 282. 13 Ensalaco, 11. 14 Ibid. 15 John Dinges, The Condor Years: How Pinochet and His Allies Brought Terrorism to Three Continents (New York: The New Press, 2005), 43. 16 Ibid.

9 takeovers in the countryside, which contributed to economic stagnation and increased violence in rural areas.17

This violence, usually perpetrated against landowners, pushed those who identified as conservatives even further right on the political spectrum. Not only were they threatened by the government’s economic reforms, but they were also physically threatened by militant left-wing groups operating outside of the government’s purview. As a result, Allende increasingly lost the political cooperation of the Christian Democrats, who were progressively becoming more conservative. Although his 1970 opponent for the presidency, Radomiro Tomic of the Christian

Democrats, had supported the ’s validation of Allende’s election, three years later, the

Christian aligned with more conservative parties to call for Allende’s resignation.18 In fact, just prior to the coup, Congressional Christian Democrats had drafted a non-binding resolution enumerating the “government illegalities” that took place under

Allende.19 The military junta later used this resolution as part of their justification for the coup, which brought about over fifteen years of dictatorship.

Despite the growing political tensions, it is important to acknowledge that prior to the coup, Chile had a decades-long history of democratic government. From 1925 to 1973, with the exception of the months-long military regime in 1931, Chile had been governed by a democracy.20 Chilean society valued active democratic participation, exhibited by fervent popular demonstrations and debates leading up to elections. While many called for

Allende’s resignation, few had hoped for or anticipated a military coup. Prior to his death,

17 Ensalaco, Chile Under Pinochet, 11. 18 Ibid., 14. 19 Ibid., 15. 20 Inger Agger and Sören Buus Jensen, Trauma y cura en situaciones de terrorismo de estado: derechos humanos y salud mental en Chila bajo la dictadura militar (Santiago: Ediciones Chile América, 1996), 74-75. This is the Spanish version of Agger and Jensen’s book, which will be denoted from this point forward as “Agger & Jensen, Trauma y cura” followed by the page number.

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Allende recognized the growing discontent within the country and had planned on holding a plebiscite to have Chileans vote on whether he should stay in power.21

This respect for democracy extended to the military as well; the armed forces were expected to support the civilian government rather than oppose it. When a group of soldiers took control of a small number of tanks and shot at the presidential palace in June 1973, General

Carlos Prats successfully invoked his position as head of the Chilean military to defend the legitimacy of Allende’s presidency and call for the surrender of the soldiers involved.22 The incident and its resolution indicated that the military was divided in its allegiance to Allende.

Pinochet only consolidated support for the September 11, 1973 coup after he replaced Prats and purged pro-Allende officers.23

When the September coup occurred, it was an aberration in twentieth-century Chilean history rather than the norm. Many, regardless of political affiliation, expressed feelings of shock upon hearing about the bombing of the presidential palace and the successful military coup.24

Two months after establishing power, the military created the National Intelligence Directorate

(Dirección de Inteligencia Nacional, or DINA), which was responsible for much of the violence perpetrated under Pinochet, both domestically and abroad.25 Poblaciones were raided and destroyed to attack the left’s political base; the population of an entire neighborhood could be imprisoned or executed, even if they had no explicit political affiliations.26 A strictly enforced curfew was put in place on the day of the coup, and many people were suddenly without jobs if

21 Steve J. Stern, Remembering Pinochet’s Chile: On the Eve of London 1998 (Durham: Duke University Press, 2004), 43. 22 Ensalaco, Chile Under Pinochet, 2. 23 Dinges, The Condor Years, 43. 24 Agger & Jensen, Trauma and Healing, 39. 25 Ibid., 44. 26 Ensalaco, Chile Under Pinochet, 28.

11 they had appeared to be sympathetic to the UP.27 Highlighting Chileans’ faith in democracy, many had turned themselves into the police after their names appeared on lists identifying known

UP supporters.28 They assumed that they would be released as long as they had cooperated, only to find themselves faced with more violent fates.

The Seeds of Opposition: Human Rights and Religious Organizations

Groups across Chile responded immediately to Pinochet’s coup. Religious leaders were the first and most prominent group to establish human rights organizations that assisted politically persecuted Chileans. Their links to religious authorities allowed human rights organizations to continue operating during the dictatorship, although they were assisting those whom the military junta had deemed to be threats. Following the military junta’s rise to power, persecuted Chileans began turning to their churches for assistance, which motivated bishops from different Christian churches as well as a rabbi to work together to form the Committee of

Cooperation for Peace in Chile (Comité de Cooperación para la Paz en Chile, also known as

Ecumenical Committee for Peace in Chile, the Comité Pro Paz, and COPACHI).29 The organization’s primary concern was assisting those who had been detained or dismissed from their jobs for political reasons.30 In an effort to protect COPACHI, Santiago's Catholic

Archbishop, Raúl Silva Henríquez, with the encouragement of the Lutheran Church's German leader, Bishop Helmut Frenz, signed a decree to support the endeavor.31 Frenz had a connection

27 Agger & Jensen, Trauma and Healing, 44. 28 Stern, Remembering Pinochet’s Chile, 139; Ensalaco, Chile Under Pinochet, 28. 29 Mario Garcés and Nancy Nicholls, Para una Historia de los Derechos Humanos en Chile: Historia institucional de la Fundación de Ayuda Social de las Iglesias Cristianas FASIC 1975-1991 (Santiago: LOM Ediciones, 2005), 25. Approximate translation of the title: Towards a History of : Institutional History of the Foundation for the Social Assistance of Christian Churches FASIC 1975 – 1991. 30 Pamela Lowden, “The Ecumenical Committee for Peace in Chile (1973-1975): The Foundation of Moral Opposition to Authoritarian Rule in Chile,” Bulletin of Latin American Research 12 (May 1993): 194. 31 “Committee of Cooperation for Peace in Chile,” Archbishopric of Santiago Foundation of Documentation and Archives of the , accessed 30 March 2017,

12 to the World Council of Churches, which ultimately provided $1.8 million in funding for

COPACHI during its two years of operation.32 The hope was that being associated with the

Catholic Church would allow the organization to continue to provide legal and social services to victims of human rights violations.

However, the organization ran into problems because many of its leaders were foreigners associated with non-Catholic religious institutions. Unlike the , which was recognized as a public institution, the other churches were private ones that depended on the military junta’s recognition to continue to operate.33 Foreign religious leaders were also more easily deported from the country or prevented from returning after traveling, thereby interrupting their work.34 Furthermore, fractures began to emerge among some sects, particularly the

Lutheran Church, which had a significant faction that decided to support the military junta.35 The regime continued to pressure religious leaders to shut down COPACHI, and Pinochet suggested to the Catholic Archbishop that the military would close the organization down forcefully if it did not do so voluntarily.36 As a result, the organization ended its operations in 1975.

In order to prevent the regime from further obstructing human rights work, Cardinal

Archbishop Silva founded the Vicariate of Solidarity (la Vicaría de Solidaridad, or the Vicaría) in January 1976 as a ministry of the Archdiocese of Santiago.37 He specifically did this in order to attach human rights work directly to the Catholic Church. The military was opposed to the

http://www.vicariadelasolidaridad.cl/comite_cop_paz.php; Lowden, “The Ecumenical Committee for Peace in Chile (1973-1975),” 192. 32 Lowden, “The Ecumenical Committee for Peace in Chile (1973-1975),” 192. 33 “Committee of Cooperation for Peace in Chile.” 34 Ibid. 35 Garcés and Nicholls, Para una Historia de los Derechos Humanos en Chile, 34. 36 Thomas C. Wright, Impunity, Human Rights, and Democracy: Chile and , 1990-2005 (Austin: University of Texas Press, 2014), 44. 37 Wright, Impunity, Human Rights, and Democracy, 45; Lowden, “The Ecumenical Committee for Peace in Chile,” 190.

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Vicaría’s work and considered the organization a threat to its power. However, it was a political risk for them to attack the Vicaría because of the prestige of the Catholic Church—attacking the organization would be akin to attacking the Catholic Church itself. Chile was a Catholic majority country, with seventy-six percent of the population identifying as Catholic in 1970.38 Actions against the Church would only undermine the junta’s efforts to consolidate power, particularly in the later years of the regime as it attempted to institutionalize and present itself as a controlled democracy to the international community.39

The Social Aid Foundation of the Christian Churches (la Fundación de Ayuda Social de las Iglesias Cristianas, or FASIC) was founded in April 1975 by mostly non-Catholic church leaders; it functioned as a branch of the Methodist Church.40 Present-day, the organization continues to provide social services to vulnerable communities and maintains an archive on its work during the dictatorship. Like COPACHI, it was connected to the World Council of

Churches and received funding from it as well as other international sources.41 The organization initially concentrated their work on helping the politically persecuted leave the country, particularly those who had already been detained.42 It played a large role in helping exiled families reunite and transition abroad, especially after the military junta issued Supreme Decree

504 early in 1975, commuting many prison sentences into exile to expel left-wing political influences from the country.43 While FASIC was much more vulnerable than the Vicaría because it did not receive official recognition, part of the reason the military junta allowed FASIC and

38 “Religion in Latin America: Widespread Change in a Historically Catholic Region,” Pew Research Center, accessed 30 March 2017, http://www.pewforum.org/2014/11/13/religion-in-latin-america/. 39 Policzer, The Rise and Fall of Repression in Chile, 116-117. 40 Wright, Impunity, Human Rights, and Democracy, 46; Garcés and Nicholls, Para una Historia de los Derechos Humanos en Chile, 34. FASIC’s board had Bishop Jorge Hourton as its one Catholic representative. He eventually became the president of its board. 41 Wright, Impunity, Human Rights, and Democracy, 46. 42 Garcés and Nicholls, Para una Historia de los Derechos Humanos en Chile, 13. 43 Ibid., 32.

14 other human rights organizations to assist these individuals was because it also advanced their own objective of ridding Chile of threatening political forces. FASIC later expanded to provide additional social services for those who were being politically persecuted, such as health services and educational assistance for children of victims of repression.44

Chief among FASIC’s large portfolio of social services was their mental health practice.

Initially the Vicaría, as the largest human rights organization, was the main organized institution that provided therapy to victims of repression.45 Some psychiatrists and psychologists collaborated with the Vicaría to get involved in human rights work, while others consulted victims privately, particularly in the early and more brutal years of authoritarian rule.46 After returning from exile, psychiatrists Fanny Pollarolo and Paz Rojas decided to establish the

Medical-Psychiatric Program at FASIC in 1977, recruiting a number of other psychiatrists, psychologists, and clinical social workers to assist them.47

In addition to providing individual and group therapy, FASIC’s Medical-Psychiatric

Team produced numerous pamphlets that linked their therapeutic work to human rights advocacy, providing their analysis of the political situation and its impact on the communities the organization served. These documents were circulated clandestinely among domestic human rights groups and sent out to the international community through their foreign partners when possible.48 Additionally, the team helped document patient testimonios, or “testimonies,” of repressive experiences. Testimonios served as a way of denouncing the military regime and became important tools of healing and memory-making in the post-Pinochet era. These

44 Garcés and Nicholls, Para una Historia de los Derechos Humanos en Chile, 13. 45 Ibid., 67. 46 Ibid. 47 Ibid., 68-69. 48 Ibid., 69.

15 documents were intended to serve as an archive that contributed to collective memory formation.

The therapists consciously constructed testimonios as records that could participate in political and historical conversations. By centering my analysis of Chile around these documents, I hope to illuminate the connections between political conditions and mental health through the lens of human rights.

Historiography of Psychiatry, Trauma, and Memory

In developing this thesis, I drew from a wide range of literature about psychiatry, trauma, and memory in Latin America and other parts of the world. While the Pinochet dictatorship has been studied extensively by scholars, few works speak specifically to mental health treatment and its development in Chile. English-language information on this topic is particularly scarce.

As a result, this thesis and its analysis of the intersection between psychiatry and politics has been informed by similar research focusing on other authoritarian contexts, including Nazi- occupied Europe, the Soviet Union, revolutionary Cuba, and Argentina during the Condor

Years.49, 50 These texts have helped situate Chilean therapeutic work in a broader historical context by providing the lens through which to examine politics, psychiatry, and psychoanalysis on regional and international levels.

49 A prominent example of the intersection between psychiatry and politics has been the study of psychiatrists in Nazi Germany. While the initial narrative post-war had been that, like many other Germans, psychiatrists had been “innocent” and did not resist or collaborate, more recent research has shown that psychiatrists were actively involved in plans to execute and sterilize mental patients to advance the regime’s eugenic goals. Psychotherapists were also employed as an alternative to execution by providing rehabilitation in cases that seemed to indicate what was seen as a “curable illness,” such as homosexuality or a belief in communism. For more see: Geoffrey Cocks, “German Psychiatry, Psychotherapy, and Psychoanalysis during the Nazi Period: Historiographical Reflections,” in Discovering the History of Psychiatry, ed. Mark S. Micale and Roy Porter (New York and Oxford: Oxford UP, 1994), 282-297; and Ana Antic, “Therapeutic Fascism: Re-educating Communists in Nazi-occupied Serbia, 1942- 44,” History of Psychiatry 25 (2013): 35-56. 50 The “Condor Years” refers to a period in the 1970s when several countries in Latin America were ruled by dictatorships. The term comes from “Operation Condor,” a military during that period involving Argentina, , , Chile, , and with U.S. backing. The group shared intelligence in order to carry out political repression and state terror. For more see: John Dinges, The Condor Years: How Pinochet and His Allies Brought Terrorism to Three Continents (New York: The New Press, 2005).

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Psychoanalysis and other psychiatric practices have been accepted and criticized for being tools that serve both rightist and leftist political agendas. This raises questions about the ideological and partisan potentiality of these fields. However, does psychiatry only become political when the intent of those within the field is to adopt a political stance, or is it a field that is inherently political? Is it possible for psychiatry to be politically neutral and practiced in a way that is “objective”? Historical scholarship on other contexts suggests that psychiatry and psychoanalysis have had a political impact, even if it was unintentional. In some cases, the state explicitly politicized psychiatry and molded the field so that it supported the government’s non- medical political goals as well. Ari Kiev’s Psychiatry in the Communist World illuminates the connections between psychiatry and politics through case studies from the Soviet Union, Eastern

Europe, and China. Kiev argues that the trajectory of psychiatry’s development was closely tied to creating a strong, centralized state that had wide-reaching social influence.51 Kiev links the

Soviet Union’s adoption of Pavlovian theory as state orthodoxy in 1951 to the state’s political positioning. Pavlov’s research on dogs’ neural systems was applied to the human mind, forming psychiatry into a field that was seen as compatible with dialectical materialism. The government believed that Pavlovian psychiatry was important because it linked one’s mental health status to both internal biological processes and external social factors.52 The state and Pavlovian practitioners posited that this approach would improve individuals’ mental health and, by extension, their ability to contribute meaningfully to society.

Working in the post-Soviet era, Sarah Marks and Mat Savelli produced Psychiatry in

Communist Europe which focuses on how psychiatry’s trajectories have reflected and influenced political realities. The volume also challenges the idea that psychiatric ideology always aligned

51 Ari Kiev, Psychiatry in the Communist World (New York: Science House, 1968), 2. 52 Ibid., 11.

17 with practice. Consistent with the portrait painted by Kiev, Benjamin Zajicek shows that influential Soviet psychiatrists publicly argued that the Pavlovian approach was more “scientific” than “capitalist” psychiatry, which was criticized for not being based upon more rigorous research.53 “Capitalist” methods included practices that were popular or on the rise in the United

States and Western Europe, such as psychoanalysis, lobotomy, and electroshock therapy.54

However, additional articles also reveal that these official statements on psychiatry were at times in conflict with actual practice, which was influenced by Western psychiatry. For example, in

East Germany, psychoanalysis was publicly denounced but continued to be practiced through

“group therapies” that seemed more compatible with state ideology.55 The development of psychiatry, like other fields of medicine and science, publicly reflected political dynamics and ideologies. Specific presentations of and practices in psychiatry were meant to both legitimize the field and support the claim that a socialist society would promote health among the population, thereby strengthening support for the government. Yet the volume also shows that psychiatry in practice did not always reflect the officially projected image, raising questions about the degree to which ideology truly impacts practice.

Jennifer Lambe highlights the disconnect that could exist in psychiatry between professed ideology and actual practice in “Revolutionizing Cuban Psychiatry: The Freud Wars, 1955-

1970.” She argues that Cuban psychiatry officially moved toward Pavlovian theories in order to prove revolutionary potential politically as well as scientifically.56 While the move to adopt

53 Benjamin Zajicek, “Insulin Coma Therapy and the Construction of Therapeutic Effectiveness in Stalin’s Soviet Union, 1936-1953,” in Psychiatry in Communist Europe, ed. Sarah Marks and Mat Savelli (New York: Palgrave MacMillan, 2015), 65-66. 54 Ibid., 13, 66. 55 Sarah Marks and Mat Savelli, “Communist Europe and Transnational Psychiatry,” in Psychiatry in Communist Europe, ed. Sarah Marks and Mat Savelli (New York: Palgrave MacMillan, 2015, 9. 56 Jennifer Lynn Lambe, “Revolutionizing Cuban Psychiatry: The Freud Wars, 1955–1970,” Bulletin of the History of Medicine 91 (2017): 66.

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Pavlov as state orthodoxy was politically motivated, organicist psychiatrists themselves were often not politicized.57 However, the Cold War context required Cuban therapists to oppose

Freudian theory, in rhetoric if not in practice, as a rejection of the and capitalism.58

Although Freud’s influence faded in Cuba, many psychiatrists did not entirely reject

Freudianism.59 Ideological battles in psychiatry could reflect political ones, but these same political divides were not always as clear in practice.

In other countries in Latin America, psychoanalysis was claimed by those on both the right and the left, highlighting the political fluidity of the field. Marco Ramos examines both the expulsion of leftist psychoanalysts from Argentina’s hospital system and several military regimes’ appropriation of progressive psychoanalytic approaches to serve conservative political goals.60 The Argentine Federation of Psychiatrists (Federación Argentina de Psiquiatras, or FAP) attempted to be as politically neutral as possible in the 1960s, collaborating across political lines and working with the military to develop new community-based therapies.61 In the 1970s, therapists at FAP became more politically radical and proposed that mental illness was a

“manifestation of the norms and values of those in power,” indicating a political stance against the dictatorships that were in power during this volatile period.62 Conservative forces later applied this logic specifically to criticize leftist forces, implying that they were the root cause of mental illness in society.63 While leftist psychoanalysts were being persecuted and forced into exile, media sources also defended the field against claims that it was inherently linked to

57 Lambe, “Revolutionizing Cuban Psychiatry,” 80. 58 Ibid. 59 Ibid., 92-93. 60 Marco A. Ramos, “Psychiatry, Authoritarianism, and Revolution: The Politics of Mental Illness during Military Dictatorships in Argentina, 1966-1983” Bulletin of the History of Medicine 87 (2013): 253. 61 Ibid, 258. 62 Ibid., 260. 63 Ibid, 267.

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Marxism.64 Under situations of authoritarian rule such as in Argentina and Chile, leftist medical professionals were often political targets of the government. However, the fields in which they practiced as a whole were never entirely and uniformly politicized.

Although therapists at FAP and FASIC took an explicit stance against authoritarianism, other mental health professionals remained “neutral.” In Argentina, Brazil, and Chile during the right-wing dictatorships of the late twentieth century, the official psychoanalytic associations all took on an apolitical stance and refused to acknowledge the political circumstances.65 Although this caused more liberal practitioners to leave the associations and practice elsewhere, these associations adopted what Jane A. Russo described as “nonthreatening new language...to explain and make sense of those social and cultural changes” in order to continue to attract clientele of various backgrounds.66 Political neutrality was a tool of survival while living under military regimes.

In her examination of the position of neutrality adopted by the Chilean Psychoanalytic

Association (Asociación Psicoanalítica Chilena, or APCh), Chilean psychoanalyst and historian

Silvana Vetö harshly criticized the organization. She argues that the association’s stance reflected its adherence to a system of political repression, utilizing APCh’s “collective silence” to the disappearance of member Gabriel Castillo Cerna as a case study.67 Instead of discussing the potential link between Castillo’s left-leaning political views and his disappearance, the

64 Ramos, “Psychiatry, Authoritarianism, and Revolution,” 275. 65 Jane A. Russo, “The Social Diffusion of Psychoanalysis during the Brazilian Military Regime: Psychological Awareness in an Age of Political Repression,” in Psychoanalysis and Politics: Histories of Psychoanalysis under Conditions of Restricted Political Freedom, ed. Joy Damousi and Mariano Ben Plotkin (New York and Oxford: Oxford University Press, 2012), 175, 189. 66 Ibid., 189. 67 Silvana Vetö Honorato, Psicoanálisis en estado de sitio (Santiago: Facultad de Ciencias Sociales Universidad de Chile, 2013), 15. The title of the book translates to: Psychoanalysis in a State of Siege, referring to the state of siege that was declared by the military junta following the coup. This citation follows the convention in Latin America, which includes the paternal surname (Vetö) followed by the maternal one (Honorato). From this point forward, I will only use Vetö to refer to this author.

20 organization instead claimed that he was mistakenly arrested, because his mental illness caused him to appear to be sympathetic to the left.68 Vetö believes that the APCh’s rhetoric surrounding the incident and the de-politicization of Castillo himself contributed to an erasure of the political nature of the dictatorship’s actions.69 In this way, the organization did not acknowledge the political situation or the human rights abuses perpetrated by the regime. Vetö posits that ideologically, this was in part a result of the Chilean psychoanalytic community’s alignment with the work of Melanie Klein, who emphasized the internal causes of distress and conflict, rather than external factors (e.g. the political context).70 However, attributing the APCh’s “neutrality” to theoretical leanings does not take into full consideration the political context either. The fact that APCh’s members had to grapple with how to stay safe and employed under authoritarianism could also have contributed to taking on a neutral political position.

Additionally, as shown by other works in the history of psychiatry, theory can be politically flexible. Nancy Caro Hollander’s book, Love in a Time of Hate: Liberation

Psychology in Latin America, explores what she believes to be a parallel to “liberation theology” in the field of mental health. She interviewed Latin American psychoanalysts, most prominently

Marie Langer of FAP, who linked unconscious origins of mental illness to Marxist theory related to “the economic origins of social violence.”71 For them, Klein’s work complemented their leftist politics. Her book also discusses collective trauma, as many of her interview subjects defined the experience of as “social trauma.” Langer argued that an individual-focused

68 Vetö, Psicoanálisis, 70. 69 Ibid., 69, 148. 70 Ibid., 102. Kleinian psychoanalysis tended to evaluate the causes of distress and conflict as internal. External causes were emphasized mostly among those who adapted psychoanalysis to Marxist. For more on the connection between the theoretical affiliations within the psychoanalytic community and politics, see: Joy Damousi and Mariano Ben Plotkin, eds., Psychoanalysis and Politics: Histories of Psychoanalysis under Conditions of Restricted Political Freedom (New York & Oxford: Oxford University Press, 2012). 71 Nancy Caro Hollander, Love in a Time of Hate: Liberation Psychology in Latin America (New Brunswick: Rutgers University Press, 1997), 17.

21 definition of trauma failed to “capture the nature of group psychological reactions to violence produced by state terror.”72 The authoritarian of the changed the status quo when they came to power, which necessitated an adjustment in the behaviors and attitudes of the population. For many, the usage of state violence prompted fear; while each person may have only been concerned for specific individuals in their lives, large groups of people were having the same experience. Hollander’s book provides insight on the experience of being a mental health professional within the human rights movement, which involved addressing the trauma of others while also confronting one’s own trauma.

To gain further insight into Chilean therapists’ encounters with trauma, both personally and through their patients, psychologist Inger Agger and psychiatrist Søren Buus Jensen interviewed different Chilean mental health professionals during the early years of the post-

Pinochet government. The authors center their work on the psychological impact of torture on some of the therapists and the process through which these professionals navigated the treatment of their patients in unique political circumstances.73 Several interviewees argued that healthcare professionals were obligated to adopt “ethical non-neutrality” under conditions of state terrorism.

They contended that they were forced to confront politics due to the d intersection “between the private, the professional and the political dimensions” during authoritarian rule.74 Agger and

Jensen assume that all their interviewees related their clinical work to left-wing political beliefs.

This thesis aims to complicate that perception by exploring the extent to which mental health professionals considered human rights work to be politicized and partisan.

72 Hollander, Love in a Time of Hate, 17. 73 Inger Agger and Sören Buus Jensen, Trauma and Healing Under State Terrorism (London & New Jersey: Zed Books, 1996), 3. 74 Ibid., 5.

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The final portion of this thesis raises questions about trauma and memory. Discussions of trauma in this thesis include the therapeutic perspective as well as political and social analyses of trauma. In Cultural Trauma and Collective Identity, Jeffrey Alexander explores trauma that is experienced on the societal level. He lays out multiple characteristics of “cultural trauma,” defining it as an event or situation which is associated with negative emotions, not easily forgotten, and seen to be “threatening to a society’s existence. “75 Additionally, he argues that events are not inherently traumatic and that different societies have distinct ways of qualifying whether an event is traumatic or not.76 Alexander stresses the difference between “cultural trauma” and “mass mourning,” positing that the former undergoes a process of official and/or national acknowledgement whereas the latter is simply an experience of “negative affect” by a particular group.77 While Alexander’s analysis was useful for developing language and a framework from which to analyze trauma, it does not discuss the nuances of adopting collective trauma experienced by a specific population as the national narrative. In democratic Chile, recognizing the most marginalized people’s narratives as the national experience of trauma has masked the variety of experience and opinions about the Pinochet regime, thereby oversimplifying and homogenizing the image of Chile during that era.

Monica J. Casper and Eric Wertheimer’s multi-disciplinary volume Critical Trauma

Studies further analyzes how events are constructed as traumatic ones, as well as the ways in which trauma as a cultural object is addressed, reinterpreted, and contested.78 Maurice E.

Stevens’ essay claims that experiences are traumatic when they unsettle subjectivity and

75 Jeffrey Alexander, “Toward a Theory of Cultural Trauma,” in Cultural Trauma and Collective Identity, Jeffrey Alexander, et al. (Berkeley: University of California Press, 2004), 38. 76 Ibid., 34. 77 Ibid., 48. 78 Eric Wertheimer and Monica J. Caspter, “Within Trauma: An Introduction,” in Critical Trauma Studies: Understanding Violence, Conflict, and Memory in Everyday Life, ed. Monica J. Casper and Eric Wertheimer (New York: New York University Press, 2016), 3.

23 identity.79 He highlights the conflicts that arise between those who have personally experienced trauma and individuals, such as historians, psychologists, and politicians, who “manage” memory by deciding what should be recorded.80 In attempting to bring about healing and recuperation from traumatic events, Stevens posits that political forces can present emblematic traumatic remembrance that comes into conflict with individual narratives of trauma. Carmen

Goman and Douglas Kelley’s examine forgiveness in situations of historical trauma in this volume. They claim that in the context of trauma, there needs to be both interpersonal and intrapersonal forgiveness, the former being an individual process, and the latter being a dialogue between the victim and the transgressor.81 Framed on a collective level, they also discuss reconciliation, which they claim requires “a change in the offender’s behavior/attitude” beyond simply “overcoming resentment” on the part of the victims.82 Their arguments provide a framework from which to evaluate the Chilean post-dictatorship government’s efforts towards reconciliation and the ways in which its national memory-making process has failed to achieve this.

An influential entry point into the topic of memory and trauma in Chile is Steve J. Stern’s trilogy on memory studies, which provides a thorough examination of the discords among

Chileans regarding the Pinochet years. His first book, Remembering Pinochet’s Chile: On the

Eve of London 1998, provides a thought-provoking framework through which to view Chileans’ opinion of both Salvador Allende and the military junta. Stern conducted several interviews and

79 Maurice E. Stevens, “Trauma Is as Trauma Does: The Politics of Affect in Catastrophic Times,” in Critical Trauma Studies: Understanding Violence, Conflict, and Memory in Everyday Life, ed. Monica J. Casper and Eric Wertheimer (New York: New York University Press, 2016), 25. 80 Ibid., 33. 81 Carmen Goman and Douglas Kelley, “Conceptualizing Forgiveness in the Face of Historical Trauma,” in Critical Trauma Studies: Understanding Violence, Conflict, and Memory in Everyday Life, ed. Monica J. Casper and Eric Wertheimer (New York: New York University Press, 2016), 79. 82 Ibid., 80.

24 selected a few to represent “memory camps” that were meant to be emblematic of different experiences of the Pinochet years, showcasing the “memory struggles” among Chileans that persists today.83 Furthermore, he suggests there is residual trauma in those who experienced the military regime as a “rupture” from the Allende presidency.84 The book described the nuances of memory regarding the coup, complicating the national narrative promoted by the post- dictatorship government and revealing the underlying political and social tensions among

Chileans. The reinstated democratic government crafted the narrative of a traumatized nation in the process of collective healing, which was promoted through efforts like the National

Commission of Truth and Reconciliation in 1990. The commission, like a similar one established in Argentina in 1983, investigated the human rights violations during the military dictatorship. It was the first commission to utilize the name “Truth and Reconciliation,” which was later adopted by similar processes in , Liberia, and most famously, South Africa. However, Stern’s account shows how the emphasis on reconciliation has concealed the underlying political divides among Chileans, much like the official discourse in South Africa has masked present-day racial tensions.85

Overview of Chapters

This thesis is structured thematically rather than chronologically in order to better illuminate the goals, methods, and perspectives of FASIC’s Medical-Psychiatric Team. The regime changed through the fifteen years that it was in power, but the situations that the therapists confronted remained similar. In the later years of authoritarianism, there were periods

83 Steve J. Stern, Remembering Pinochet’s Chile: on the Eve of London 1988 (Durham: Duke University Press, 2004), xxii. 84 Ibid., 42. 85 Lyn S. Graybill, Truth and Reconciliation in South Africa: Miracle or Model? (Boulder: Lynne Rienner Publishers, Inc., 2002), 22.

25 in which political persecution was less intense. However, the FASIC team still encountered families with disappeared relatives or patients who had been tortured in detainment.

Furthermore, the military junta’s economic reforms led to decreased state funding in social services, and many who had been detained had difficulties finding work after their release.

Exiled families who returned to Chile faced difficulties integrating into their environments. The therapists’ texts on these experiences were not written to highlight changes over time. Rather, they emphasized the various ways the regime negatively impacted individuals, families, and communities. As a result, I have structured this thesis to explore major themes that were present in the texts that I analyzed.

The first chapter discusses the political decisions that mental health professionals faced following the coup. Like many Chileans, therapists were concerned about their ability to continue to live and practice in the country after the coup. Some healthcare workers and professional organizations aligned themselves with the Pinochet regime, while others deliberately chose not to address the political situation, operating as they did prior to the coup in order to avoid drawing attention to themselves. The practitioners at human rights organizations like FASIC and the Vicaría criticized the “neutrality” of some of their peers, believing that this made them complicit in upholding the authoritarian regime. Although they worked clandestinely, members of FASIC’s Medical-Psychiatric Team took a clear stance against the military junta and its actions, adopting the language and mission of human rights to both criticize the regime and remain non-partisan.

The chapter that follows analyzes the way in which therapists at FASIC defined

“trauma.” The patients that visited FASIC evidently had individual traumatic experiences that necessitated treatment. Some had been tortured during their detainment, and others were facing

26 social and financial difficulties after returning from exile. FASIC’s orientation towards social services influenced the mental health professionals who joined the organization to consider the familial and social impact of traumatic events in addition to the direct effect on individuals themselves. The team placed an emphasis on treating the trauma experienced by family members of the detained and disappeared. The group also authored many pamphlets that explored the trauma experienced by women and children who were relatives of those directly targeted by the junta, speaking to the communal and collective nature of the trauma experienced by Chilean society.

The final chapter looks at the implementation of testimonio as both a therapeutic and a political tool. The testimonios recorded patients’ oral accounts of their experiences under dictatorship. The Vicaría and FASIC played integral roles in collecting these narratives, and it was known in FASIC’s case that the Medical-Psychiatric Team played a significant role in gathering testimonios for the organization. FASIC’s therapists were also the ones who theorized that testimonios would allow their patients to confront and reflect upon their experiences in order to overcome the trauma that they were experiencing as a result of state repression. In addition to their therapeutic purpose, these documents provided evidence of the human rights violations that the regime perpetrated. The FASIC team often used excerpts of patient testimonios in their pamphlets to illustrate the conclusions they had reached about the regime and human rights.

However, the process of advocating for their patients through these pamphlets called into question the degree of agency the patients had in controlling how their accounts were utilized.

Victims’ ownership of their narratives became particularly important in the post-Pinochet era as the democratic government attempted to forge a collective national memory about Chile under the military junta.

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This thesis endeavors to understand the relationship between mental health and politics through the therapeutic work and advocacy performed at human rights organizations. Ultimately,

I argue that the framework of human rights allowed mental health professionals at FASIC to address the political situation and its impact on mental health without taking a partisan stance.

This orientation prompted them to examine and treat familial and collective trauma caused by political repression, as well as collect testimonios to serve a dual political and therapeutic purposes. In the post-Pinochet era, the human rights perspective lent itself to the democratic government’s desire to unite a previously politically polarized country, allowing FASIC and the

Vicaría to gain prestige for their work during the dictatorship. However, the primary focus on human rights in official national memory dangerously overshadows the multiple and distinct collective memories that exist among the Chilean population, thereby masking the political divides that had initially created the conditions for authoritarian rule.

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CHAPTER 1 The Political Identity and Goals of FASIC’s Medical-Psychiatric Team

Introduction

After the 1973 coup, there were portions of the medical community that wished to distance themselves from politics to maintain both their jobs and safety. Even if they were aware of the junta’s violent means of repression, criticizing it could bring about dire consequences. For example, immediately after the coup, employees at hospitals in Santiago were categorized into three groups: the “A-list” included “employees of the hospital who had the confidence of the new regime,” the “B-list” contained the names of employees “towards whom [the government was] doubtful,” and the “C-list” named employees who were considered “very dangerous” and

“terrorists.”86 A psychiatrist on the “C-list” immediately lost her job, and her husband had been in a similar position (although it was unclear what his profession was).87 Even before there was evidence of resistance from members of the medical community, those with certain political inclinations had already been singled out and punished by the junta. The new regime was more concerned about securing their political power than with improving public institutions. Given the highly polarized political climate and the fact that they took power by force, the military junta viewed left-leaning individuals and groups as threats to their authority, including those who may not have been directly involved in politics.

The junta may have viewed the field of healthcare as a potential threat because of the presence of socially-oriented medical practitioners, most prominently the late president himself,

86 Inger Agger and Sören Buus Jensen, Trauma and Healing Under State Terrorism (London & New Jersey: Zed Books, 1996), 44. These authors published both an English and Spanish version of their research; this is the English version of the book. Both editions were utilized in researching this paper, because I was in possession of these editions at different points in time. However, they both appear to present the same arguments and information. For clarity, this source will be denoted from this point forward as “Agger & Jensen, Trauma and Healing” followed by the page number. 87 Ibid.

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Salvador Allende. As Minister of Health in the late 1930s and early 1940s, Allende advocated for social and economic reform, such as increasing wages and providing affordable housing, in order to approve national health.88 As a senator in the 1950s, Allende introduced legislation that established the National Health System (Sistema Nacional de Salud, or SNS), which gave

Chileans access to a number of guaranteed health services.89 Additionally, he enhanced community participation in healthcare by creating Local Health Councils and Health Joint

Committees, comprised of representatives from the local community, labor unions, and health workers.90 Allende’s dedication to economic change and his insistence on its ties to national health made him a prominent figure in “social medicine,” which placed importance upon the conditions in which people worked and lived when evaluating health.91 He focused on the medical services that were being provided as well as the structural, social, and economic factors that impacted health. These considerations played into his broader agenda of achieving “the

Chilean Path to socialism,” since many of the problems he identified in health were linked to the position of the working class in the Chilean economy and the ways that economic systems functioned.

Pinochet also had strong conservative allies among the medical community, although they did not always agree with his team on healthcare reform. The Chilean Medical College

(Colegio Médico) was a professional association for physicians; doctors needed to be affiliated with the group in order to practice.92 They were known to be supportive of the coup and critical

88 Howard Waitzkin, “Commentary: Salvador Allende and the birth of Latin American social medicine,” International Journal of Epidemiology 34 (2005): 740. 89 Ibid.. 90 Esteban Hadjez-Berrios, “A socio-psychological perspective on community participation in health during the Unidad Popular government: Santiago de Chile from 1970 to 1973,” Journal of Health Psychology 19 (2014): 92. 91 Waitzkin, “Commentary: Salvador Allende,” 740. 92 Rossana Castiglioni, “The Politics of Retrenchment: The Quandaries of Social Protection Under Military Rule in Chile, 1973-1990,” Latin American Politics and Society 43 (2001): 59.

30 of Allende’s policies, especially in regards to his support for public healthcare.93 The association was particularly concerned that his reforms would have a negative impact on private practices.94

In 1979, the association worked with Pinochet to decentralize healthcare by creating twenty-six regional health services.95 However, the Colegio Médico was strongly opposed to the economic team’s plans to further privatize the healthcare system.96 As a result, the proponents of privatization advanced their plan through the Ministry of Labor instead, and the association was prohibited from playing additional roles in policy-making.97

The Colegio Médico’s opinions in this debate revealed that even on the conservative end of the political spectrum, there was opposition to Pinochet’s healthcare reforms. While the

Colegio Médico was not as socially minded as Allende and his allies, they supported a more decentralized but government-run healthcare system and were concerned about the adverse impact of a parallel privatized healthcare system. The Colegio Médico’s conservatism and well its general support for the military junta prevented healthcare providers from being persecuted as a profession in the way that teachers were.98 This may have been part of the reason that psychiatrists associated with human rights organizations like FASIC and the Vicaría were not persecuted themselves. While some were sent into exile or detained by the police, the profession as a whole was not viewed as suspicious enough to warrant extensive monitoring.

The intense political polarization that occurred during Allende’s presidency and the military junta’s rule also caused divides within the fields of psychiatry and psychology.

However, prior to the coup, Chilean psychiatrists and psychologists were less politicized than

93 Castiglioni, “The Politics of Retrenchment,” 58. 94 Waitzkin, “Commentary: Salvador Allende,” 741. 95 Castiglioni, “The Politics of Retrenchment,” 58. 96 Ibid., 59. 97 Ibid., 59, 61. 98 Ibid., 60-61.

31 their counterparts in Argentina and Uruguay. Psychoanalysis had been introduced slightly earlier in the other two countries, and it became particularly popular in Argentina.99 Its earlier introduction gave the field greater opportunities to develop and cement its role in mental healthcare. The Argentine Federation of Psychiatrists (Federación Argentina de Psiquiatras, or

FAP) was established in 1959, and it initially was comprised of psychiatrists with diverse political backgrounds.100 There was a split based on professional differences; some felt more strongly about implementing psychoanalysis and community psychiatry, while others continued to believe that asylum psychiatry was the most effective framework for treatment.101 However, as political repression persisted under various different regimes, FAP decided in 1970 that psychiatrists should also be politically active and look beyond the clinical setting. Those who held these opinions began to merge Marxism with psychoanalysis.102 They were informed by

Melanie Klein, utilizing her theories to conclude that reforming societal structures was not enough to end oppression. Additionally, it was important to recognize the capacity for “hate, cruelty, and destructiveness” in the inner realm, confront it, and prompt people to act on a

“reparative impulse” and care for society more intuitively.103

In contrast, Chilean psychiatry was slower to incorporate psychoanalysis and reformist psychiatry, and divides within the field mostly began to appear as the country became more politically polarized. At universities in the late 1960s, psychiatrists continued to be trained traditionally, with a focus on behaviorism and the biological aspects of mental illness.104

99 Nancy Caro Hollander, Love in a Time of Hate: Liberation Psychology in Latin America (New Brunswick: Rutgers University Press, 1997), 59. 100 Marco Ramos, “Psychiatry, Authoritarianism, and Revolution: The Politics of Mental Illness during Military Dictatorships in Argentina, 1966-1983,” Bulletin of the History of Medicine 87, no. 2 (Summer 2013): 258. 101 Ibid. 102 Ibid., 259-260. 103 Hollander, Love in a Time of Hate, 73. 104 Ibid., 61.

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Mainstream psychiatric theory and practice generally disregarded social problems in low-income communities. However, some practitioners were beginning to attempt to reform psychiatry, such as a small group of psychiatrists at the University of Chile who proposed a shift towards

“intracommunity psychiatry” and established clinics geared towards addressing social issues, such as alcoholism.105 The Chilean Psychoanalytic Association (Associación Psychoanalítica

Chilena, or APCh) was also established in the late 1950s, but a number of its key figures left the country in the early 1960s, thereby hindering its development.106 Regardless, the association’s establishment was a sign that Chilean psychiatry was expanding to encompass a greater variation of subfields.

However, unlike the openly Marxist FAP, APCh officially adopted an apolitical stance under authoritarian rule. APCh, too, had been heavily influenced by the work of Melanie Klein; however, instead of reconciling it with Marxist thought, the APCh utilized her work to justify maintaining political “indifference” in therapeutic spaces.107 The leaders of the association acted along these lines and refrained from commenting on the coup and Pinochet’s rule; they emphasized that the APCh was a “scientific” community, not a political one.108 Yet during both

Eduardo Frei and Salvador Allende’s presidencies, members of the APCh had written about social and political elements in psychoanalysis.109 The coup led to a degree of self-censorship in the types of research projects and therapeutic initiatives launched by APCh’s members. Many of the articles in APCh’s journal, first published in 1979, were about “borderline personalities,”

105 Susana Mendive, “Interview With Dr. Juan Marconi, Intracommunity Psychiatry Program Creator. Reflections about his Legacy for Chilean Psychology Community,” Psykhe 13 (2004): 188. 106 Hollander, Love in a Time of Hate, 61. 107 Silvana Vetö, Psicoanálisis en estado de sitio (Santiago: Facultad de Ciencias Sociales Universidad de Chile, 2013), 121. 108 Ibid., 157. 109 Ibid., 145.

33 theories of psychoanalysis, and child development, drawing from Kleinian influence.110 Between

1989 and 1992, during the period of transition from the military junta to democratic rule, APCh did not publish a journal, and the 1992 edition included two articles about the “ethics of psychoanalysis.”111 However, neither of them drew direct connections between mental health and political repression.

However, there continued to be a number of mental health professionals who worked for human rights organizations like FASIC. This included individuals who were part of the APCh, despite the fact that the organization had officially declared itself “apolitical.”112 Similar to the progressive mental health professionals in Argentina that merged Marxism with Freudian psychoanalysis, FASIC’s Medical-Psychiatric Team brought politics into their clinical work. The group printed multiple pamphlets when it was active during the military junta, including descriptions of their patients’ experiences and their testimonios, to document the repressive tactics that the regime was using. Yet unlike the Argentine Marxist psychoanalysts, the FASIC team members did not communicate their political affiliations in explicit terms. Instead, its members attacked the junta’s actions from a human rights and health standpoint, largely avoiding the polarizing political language that reflected the tense and divided country.

FASIC’s Medical-Psychiatric Team was adamant about asserting its professional, scientific identity while also taking a more community-based approach to mental health. In texts presented at an international exposition for human rights in 1985, the team defined its work as

“scientific and professional” and stated that “the mental health problems caused by human rights

110 “Indices Acumulativos,” Asociación Psicoanalítica Chilena, accessed November 20, 2015, . 111 Ibid. 112 Vetö, Psicoanálisis en estado de sitio, 156.

34 violations” should be addressed therapeutically and “through the democratic process.”113 The therapists focused their mental health work on the political conditions and human rights violations. They also advocated for a political solution—democracy—alongside healthcare in order to improve the psychological situation of the population. To defend their orientation towards the social and political realms, their first words asserted the legitimacy of their work by highlighting the link between mental health and science. The members of the FASIC team constructed their therapeutic as human rights advocacy, thereby making their disapproval of the regime clear without stating an explicit politically partisan stance.

The Topic of “Neutrality”

After the coup, healthcare professionals reacted to and were treated by the military junta in a variety of different ways. As mentioned earlier, the Colegio Médico had always criticized

Allende and had shown great support for Pinochet after he took over, while others were forced to leave the country because of their political affiliations, real or perceived. Under these circumstances, there were healthcare providers who took a “neutral” political stance, who neither supported nor criticized the new political leaders. The FASIC team, and likely many other professionals who were involved in human rights work under the Pinochet regime, strongly believed that it was imperative that they take into account the political situation and its impact on their patients. If they had removed politics from their patients’ accounts and explanations, the full damage of detainment, torture, and disappearance would be trivialized or entirely discounted. A true solution could not be reached if the cause was not clarified.

113 Elizabeth Lira K., “Psychology and Human Rights in a Repressive Situation: FASIC’s Experience,” paper presented at the international seminar “The Defense and Promotion of Human Rights in a Democratization Process” for the Humanist Christian Academy (December 9-11, 1985): 1-2.

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In the field of mental health, the APCh was one of many psychoanalytic organizations that adopted official stance of “neutrality.” Psychoanalyst and historian Silvana Vetö argues that even after the military regime, there were only passing acknowledgements of the political situation in APCh’s newsletters and events.114 The APCh initially released a statement on

October 1973 stating that if they could “provide help in any way,” people should feel comfortable contacting them.115 However, leaders of the association adjusted this message shortly after, claiming that the political situation was “perfectly under control.”116 This signaled an important shift in the APCh’s stance towards official “neutrality.”

Additionally, the organization did not publish any articles that related to the suffering caused by the political circumstances.117 This was a stark contrast to the multiple articles that

FASIC’s Medical-Psychiatric Team authored and printed in relation to this topic.118 When

Gabriel Castillo, one of APCh’s members, was disappeared, the organization did not discuss what had happened to him until a “reflection” event in 1999, nine years after Pinochet stepped down from power.119 Furthermore, those that remembered his disappearance were adamant about depoliticizing the situation. Some APCh members said that he had likely been taken away because he was mentally ill, not because he was politically targeted.120 In some cases, his left-

114 Vetö, Psicoanálisis en estado de sitio, 77. 115 Ibid., 61. 116 Ibid. 117 “Indices Acumulativos,” Asociación Psicoanalítica Chilena. 118 Many of these articles had been printed and stored in the FASIC archives while Pinochet was in power. They were circulated clandestinely among domestic human rights organizations and sent through international donors and affiliates to the international human rights community. Some of them were later compiled and published as books, such as: FASIC, Trauma, duelo y reparación: Una experiencia de trabajo psicosocial (Santiago: Interamericana, 1987). The title translates to: Trauma, grief, and repair: An experience of psychosocial work. 119 Vetö, Psicoanálisis en estado de sitio, 67. 120 Ibid., 68-69.

36 leaning political views and his openness about them were characterized as symptoms of his deteriorating mental status.121

Vetö believes that APCh’s reaction, or non-reaction, to this disappearance highlighted its political “neutrality.” She ties this stance to the theoretical leanings of the Chilean psychoanalytic community, linking APCh’s development to the popularity of Melanie Klein in

Argentina. Kleinian theories came into play in Chile through psychiatrists who were highly influenced by Kleinians in Buenos Aires, Paris, and London, including two men who would become the presidents of APCh, Arturo Prat Echaurran and Carlos Whiting.122 Klein was known for focusing on how childhood and “inner” elements contributed to mental health issues.123 Vetö makes the argument that the Kleinian leanings of majority of APCh’s members led them to feel more comfortable ignoring the political situation, casting it as an “external” element that need not be focused on in the therapeutic space. She also posits that Castillo’s colleagues claimed that he was mentally ill so that they could avoid discussing his politics and pursuing the investigation of his disappearance further.124 Additionally, she believes that the APCh also wanted to distance itself from Castillo, someone who was politically persecuted, in order to avoid being labeled as a leftist institution.

While Kleinian psychoanalysis may have helped justify remaining neutral, this was likely not the primary motivating factor behind the “neutrality” maintained by those in the psychoanalytic community. In fact, the Argentine Federation of Psychiatrists (Federación

Argentina de Psiquiatras, or FAP) combined Kleinian psychoanalysis with Marxism to act in

121 Vetö, Psicoanálisis en estado de sitio, 68-69. 122 Ibid., 136. 123 Ibid., 102. 124 Ibid., 70.

37 opposition to the Argentine military regime of the 1970s.125 Additionally, mental health professionals were not immune to the impact of the coup and the resulting military junta, even if some members of the community supported Pinochet. The new regime was determined to solidify its authority and targeted those who they felt were threats to their power. As mentioned earlier in the chapter, the junta in some cases divided medical personnel based on their perceived loyalty. These individuals usually lost their jobs and were often driven into exile. As such, there were real risks and consequences to being perceived as leftist.

Thus, the hostile political and social environment may have been a stronger motivator for

APCh’s silence than the organization’s theoretical inclinations towards Klein. The military regime governed through force in order to instill a level of fear among the Chilean population.

FASIC’s Medical-Psychiatric Team wrote a piece that analyzed the “psychosocial mechanisms” the military junta used to keep the population subservient. The regime “torture[d] so that the masses learn[ed] what happen[ed] to those who opposed” the coup.126 The FASIC team added that in addition to targeting active political participants, the junta set out to harm in “an arbitrary manner” and on a “massive” scale to show that anybody could be a target.127 The therapists believed that torture had been used so routinely that it was “institutionalized,” so that many professionals, such as judges, lawyers, and physicians, felt compelled to remain silent or become active participants in the system of repression.128 These tactics, along with the closing Congress, limited public political discourse and contributed to the de-politicization of the country.129

125 Hollander, Love in a Time of Hate, 17. For additional discussion on this, see her book: Nancy Caro Hollander, Love in a Time of Hate: Liberation Psychology in Latin America (New Brunswick: Rutgers University Press, 1997). 126 Angélica Monréal U., Eliana Ortiz L., Fanny Pollarolo V., and Elisa Neumann, “Psychosocial Area: Medical- Psychiatric Program,” FASIC (August 1984): 2. 127 Ibid., 1. 128 “Torture: A Medical Problem,” FASIC (March 1983): 1. 129 Angélica Monréal U., Eliana Ortiz L., Fanny Pollarolo V., and Elisa Neumann, “Psychosocial Area: Medical- Psychiatric Program,” 2.

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Stripping power away from the Congress showed that citizens’ opinions had little influence over the new regime’s decisions. Additionally, the violence that the military and police carried out, particularly in the early years of the dictatorship, created a sense of widespread fear. Thus, many

APCh members likely felt it was dangerous to express disapproval of the military regime, and those who did risked uprooting both their personal and professional lives.

Indeed, one reason that some believed that Castillo had been mentally ill was because he had expressed his anti-Pinochet views publicly.130 His actions may have been considered

“insane” by his peers in part because they were living in circumstances that made speaking against those in power dangerous. In order to survive as an organization, APCh likely had to adopt a “neutral” stance. Even the pro-Pinochet Colegio Médico had been stripped of political influence for disagreeing with certain healthcare reforms. If the military junta was willing to punish a friendly professional association for their opposition, it was very likely that they would take action against other organizations that spoke out publicly against the regime. The anxiety about the APCh’s survival may have played a larger role than the organization’s theoretical leanings in its decision to remain “neutral.”

Even if APCh as a group was compelled to remain silent, there were some who opted to take the risk of challenging the junta in action. Despite the official stance of APCh, members of the organization worked for human rights organizations like the Vicaría and FASIC. Individuals who had private practices treated victims of repression in their offices covertly.131 Treating political targets of the dictatorship was a way for mental health practitioners to challenge the military junta’s actions and legitimacy. However, in order to continue doing so, they had to

130 Elena Castro (former psychiatrist at FASIC), interviewed by Belinda Zhou, Santiago, Chile, July 2016. 131 Mario Garcés and Nancy Nicholls, Para una Historia de los Derechos Humanos en Chile: Historia institucional de la Fundación de Ayuda Social de las Iglesias Cristianas FASIC 1975-1991 (Santiago: LOM Ediciones, 2005), 67.

39 remain publicly silent about their work. During an interview, Elena Castro, a child psychiatrist who worked at FASIC for several years, had a difficult time speaking about her own political beliefs at the time. She ultimately conceded that “political and sociopolitical” factors contributed to her participation in treating torture victims and their families, because it was impossible to ignore the “horrible thing that had happened,” referring in unspecific terms the coup.132

However, Castro did not mention explicit political affiliations or beliefs, and she defined her work as “humanist” rather than overtly political.133

Castro’s point of view was similar to that of the official stance of the Vicaría and FASIC.

It was possible for individual practitioners to take on a “non-neutral” stance by providing therapy for victims of repression, but the organizations and the individuals involved tended to take a human rights standpoint, rather than a politically partisan one. Pamela Lowden argues that defending human rights “does not amount to an alternative platform for rule, even though it implies a rejection of the essential basis of legitimation of an abusive regime.”134 Indeed, the

Vicaría, FASIC, and other Chilean human rights organizations did not express a clear vision for post-dictatorship Chile, other than the hope that democracy would return, and focused their advocacy on human rights. Furthermore, taking a more partisan stance would put them at risk of being persecuted by the Pinochet regime. In the case of the Vicaría and FASIC, emphasizing the

Christian values that guided their human rights work was essential to preventing the military junta from shutting down the organizations.135 While Castro may have been ambiguous about her

132 Elena Castro (former psychiatrist at FASIC), interviewed by Belinda Zhou, Santiago, Chile, July 2016. 133 Ibid. 134 Pamela Lowden, “The Ecumenical Committee for Peace in Chile (1973-1975): The Foundation of Moral Opposition to Authoritarian Rule in Chile,” Bulletin of Latin American Research 12 (1993): 190. 135 Steve J. Stern, Battling for Hearts and Minds: Memory Struggles in Pinochet’s Chile, 1973-1988 (Durham: Duke University Press, 2006), 115. The Vicaría’s survival in particular was also aided by the fact that it was founded by the Cardinal of the Chilean Catholic Church, Raúl Silva Henríquez, as an organization within the church’s structure. Pinochet could not directly attack the Vicaría due to its affiliation with the Catholic Church, which was an incredibly influential institution in the majority Catholic country.

40 political leanings because she personally felt that politics was not the main factor driving her to work at FASIC, giving a response that was not overtly political was also utilized as a tactic to avoid being persecuted by the regime.

Two FASIC psychologists wrote about their beliefs on political “neutrality” in the pamphlet “Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” published in 1985. They believed that striving for “neutrality” in psychotherapy could be dangerous and detrimental to the therapeutic process. For Lira and Weinstein, the authors of the text, “neutrality” was an “abstraction from reality” and an “absurd theory” that ignored “how reality permeates, colors and determines daily life, with its actions, experiences, and feelings.”136

In the case of Chile at this time, they also believed that “neutrality” in psychoanalysis would obscure “social violence in its most extreme forms.”137 Claiming “neutrality” meant a denial of the authoritarian measures that were taken to ensure political adherence to the regime, such as torture and execution.

Following this logic, if a therapist were to be entirely politically neutral, they would also be denying the experiences of their patients. The people who were going to FASIC and the

Vicaría at the time were doing so specifically because they had been targeted politically. By accepting their patients’ narratives as truth, these therapists were inherently also accepting the reality that the state had acted violently towards them. Lira and Weinstein claimed that unless this reality was recognized, a therapist would be unable to treat their patients’ pain and trauma.

Thus, mental health professionals in authoritarian Chile had to either compromise their political

“neutrality” or their ability to perform as effective therapists.

136 Elizabeth Lira K. and Eugenia Weinstein L., “Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” FASIC (1985): 11. 137 Ibid.

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Rather than showing support for certain political groups or policies, the psychologists highlighted how politics had impacted the patient-therapist relationship. They framed the therapeutic relationship as one that was based on a shared experience of the political situation:

“The ‘real’ can only be exposed within its political-social context and we are not indifferent to this...we share a clearly defined position with our patients about the historical events that we have not only lived through and endured, but also [the events] that we intend on transforming.”138 Lira and Weinstein argued that this goal could not be reached unless patient accounts were situated in the “political-social context.” If this context was denied or not taken into consideration, the legitimacy of their patients’ experiences would be called into question.

Additionally, even if they had hoped to embody the role of “neutral therapists,” they argued that they could not be “indifferent” to what was happening politically. While the therapists did not align themselves explicitly with any party, they clearly took the side of their patients—that is, they supported the side victimized by and in opposition to the state.

Lira and Weinstein also implied that some members of their team, if not all, had

“endured” political persecution like their patients. The team believed that sharing this positionality was an essential part of establishing a “therapeutic link” and allowed the patient to act more autonomously in therapy.139 By making a political statement about its work, the FASIC team accepted as fact each individual narrative it were told and acknowledged the political causes of their patients’ suffering. They did not view their patients’ experiences as isolated incidents, but as the consequence of the junta’s campaign of repression. Only by doing so would they be able to fully understand their patients’ worldview and help them reintegrate into their communities. Thus, the therapists were forthcoming about their bias and aligned themselves with

138 Lira and Weinstein, “Traumatic Experiences: Violence and Torture,” 11. 139 Ibid., 13.

42 their patients through shared experiences and a common vision for the future. While the practitioners’ statements demonstrated that they were biased against the regime, they did not take an explicit partisan stance and overtly link themselves to the left.

The absence of more specific references to political events, figures, and coalitions in this document could be seen as hypocritical. Despite their criticism of “neutrality,” they did not take a definitive political stance. Rather, they only alluded to politics by describing the connection they feel with their patients. However, FASIC’s therapists were purposefully vague so that their text could be applied to other contexts beyond the Chilean case. This was one way for the group to declare its solidarity with those suffering from human rights abuses in other contexts. The authors stated that they were fighting to “eliminate the injustice, exploitation and institutionalized violence that exist[ed] in our country,” but they also added that the “abuse of power and violation of human rights” stemmed from “ideologies of National Security that have contributed to strengthening the totalitarian character of regimes of force.”140 The organization responded directly to incidents in Chile, but it also supported a broader anti-authoritarian movement, considering that a number of Chile’s neighboring countries were being ruled by military juntas. Putting their arguments in broader terms would allow their statements to be applied to other settings, emphasizing the importance of human rights in general rather than only the importance of protecting human rights in Chile. In fact, the group sent copies of these pamphlets to international human rights organizations and the , hoping to simultaneously draw attention to the Chilean case and speak out against human violations in other countries.141

140 “General Basis for Social Work Projects in Fundamental Human Rights,” FASIC: 1. 141 Hollander, Love in a Time of Hate: Liberation Psychology in Latin America, 136.

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Furthermore, FASIC’s characterization of its opposition to the regime was not based on partisan politics, but on the violence military junta was committing to enforce its rule. This ambiguously described “non-neutrality” cast them more as therapists who were defenders of human rights, rather than anti-Pinochet leftists. The pamphlet claimed that FASIC’s therapists’ consideration of the political context was an approach that enhanced their ability to perform as professionals, because they were more able to understand their patients. In a way, they were portrayed as being more competent than therapists who subscribed to “neutrality” and ignored the political circumstances that brought about mental disturbances. Focusing the discussion on the topic of “neutrality,” rather than the political details, also allowed the pamphlets to remain rooted in how “neutrality” directly related to the therapeutic space rather than only the political one. Although FASIC’s mental health team elaborated more specifically on the political events in other pamphlets, these sections were usually utilized as introductions that were meant to contextualize the therapy that they were presenting. The political situation itself was an overarching consideration in all the pamphlets they produced, but to FASIC’s psychiatrists and psychologists, politics was not as central as the impact it had on people’s mental health.

Depictions of Authoritarian Chile

Majority of the FASIC Medical-Psychiatric Team’s writing focused on the impact of repression on the mental health of their patients. The group was adamant that they reject the notion of therapeutic “neutrality,” believing that it was essential to consider the political reality in order to treat their traumatized patients. In order to properly contextualize their work and their patients’ experiences, the FASIC team made references to political events and actors in its pamphlets. FASIC’s staff positioned themselves as defenders of human rights, rather than a group on the opposing side of the political spectrum. Their non-partisan and humanitarian

44 critique of the military junta was meant to unite Chileans of a variety of political beliefs against the regime’s violence.

This was reflected in the language the therapists used to describe the political situation.

At times, the authors of the reports wrote about specific groups of people who were going through traumatic experiences, such as the formerly detained and relatives of the disappeared.

However, in other situations, victims of repression were characterized as more general subjects.

In an article about the Social Services section of FASIC, the therapists described the threat the government posed to “the Chilean,” rather than describing groups that had been more directly impacted by the military regime’s policies.142 In a 1977 article about the impact on children, they wrote that the military coup “produced drastic changes in social life and in the valuation of people, and profoundly affected family life in general.”143 The professionals at FASIC expressed the opinion that the military government had a generally negative impact on the country, beyond those who were directly affected by torture, detainment, or disappearances. By writing about the impact the coup had on political and social life more broadly, the mental health professionals implicitly placed themselves within the same context as their patients, even if they experienced repression to a different degree or in another manner.

Additionally, the FASIC team used language that characterized the military junta as illegitimate. The junta had utilized violence to gain power and continued to carry out political repression in order to maintain its authority. The dictatorship itself was aware of this image and determined to change it in the later years of its rule. By documenting the mental health status of their patients, the FASIC Medical-Psychiatric Team provided evidence and prevented the erasure

142 “Social Services,” FASIC (n.d.): 1. This document was not dated but referenced the of 1980, indicating that it was written after that year. The original Spanish is, “Atención de servicio social.” 143 “Damage to Youth and Children in Families Directly Affected by the Repression,” FASIC (1978): 2.

45 of the military junta’s repressive actions to the international community.144 In December 1977, the United Nations Human Rights Council formally condemned Chile for the human rights violations perpetrated by the military junta, and in July 1978 it sent a group to investigate the

Chilean situation.145 While there had been calls for this from the start of authoritarian rule, by

1980 even the United States, a major backer of the coup and Pinochet’s rise to power, began to encourage the military junta to change its strategies.146 As a result, the regime enacted a new constitution in 1980, incorporated civilians into the government, and diminished the number of executions and disappearances in order to begin institutionalizing the regime.147 The junta was moving towards the image of a more democratic state, but it was clear that Pinochet intended to continue as president until 1991 and that the military hoped to continue to have oversight over government operations.148 The National Intelligence Directorate (Dirección de Inteligencia

Nacional, or DINA) was replaced by the National Information Center (Centro Nacional de

Informaciones, or CNI), which disappeared fewer people and practiced more targeted torture.149

Although these were steps the military junta took toward appearing to be a more legitimate government, FASIC’s pamphlets continued to focus on the violence perpetuated by the CNI, the military, and the police. Thus, FASIC’s mental health professionals continued to characterize the military junta as an authoritarian force, rather than a transitioning government.

144 Hollander, Love in a Time of Hate, 136. 145 Garcés and Nicholls, Para una Historia de los Derechos Humanos en Chile, 80. 146 Pablo Policzer, The Rise and Fall of Repression in Chile (Notre Dame: University of Notre Dame Press, 2009), 105. Policzer believed the United States stance was primarily due to the 1976 assassination of Orlando Letelier, who served as ambassador to the United States under Allende, in Washington, D.C. Letelier had been living there in exile after the coup, and the assassination had been carried out by the Chilean National Intelligence Directorate (Dirección de Inteligencia Nacional, or DINA) agents. The United States was adamant about having Manuel Contreras, the head of DINA, extradited to be tried in court, but this request was rejected by the Chilean Supreme Court. 147 Ibid., 106-107. 148 Steve J. Stern, Battling for Hearts and Minds, 140. 149 Policzer, The Rise and Fall of Repression in Chile, 102.

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The FASIC team used precise language that condemned the military junta and its actions without discussing political parties. The mental health professionals were careful not to use vocabulary that would make the military junta out to be a legitimate government. For example, the team wrote that “the gravity of the medical problem” in Chile had a “direct relation to the brutality and sadism that has characterized the actions of the armed forces” and police.150 The group did not use the word “government” to describe the regime. Rather, the professionals portrayed Chile as a country that was run and threatened by the military and police. Those in power were part of institutions that were created specifically to exert force, rather than to govern.

Additionally, their pamphlets do not reference Pinochet in name, although he had been one of the principal leaders of the coup and the individual named president. By continually denying the political power of the junta and emphasizing the military’s use of force, the FASIC team did not grant the sense of legitimacy that the regime sought. Instead of ignoring the violence enacted by the military junta, FASIC highlighted political repression and its lasting impact on the population. This portrayal also sent the signal that the team did not disapprove of the coup and the dictatorship because of differences in political opinion, but because the authorities were acting violently towards the Chilean population.

The therapists’ frequent depiction of repression served the purpose of describing their patients’ experiences and better understanding the mental strain that many Chileans were experiencing. Additionally, these descriptions further delegitimized the military junta by emphasizing its reliance on violence to maintain power. Four therapists wrote that the

“institutional breakdown” caused by the coup ended “the process of democratization that existed

150 Professionals who Work in Human Rights Institutions, “Medical-Psychological Repercussions of Police Repression,” 1.

47 in the country.”151 The FASIC team cited the 1973 coup as the moment that Chilean democracy ended. What came after—the military junta—was not considered to be a legitimate continuation of the Chilean government. The therapists claimed that Pinochet’s regime had changed Chile from a democracy into a place where “conduct typical of actions of war” became the norm, thereby further disrupting society instead of improving it.152 In 1984, this was an implication that would have bothered Pinochet and his allies, who were attempting to appear more “democratic” and legitimate on the international stage. The FASIC group also wrote that the junta had established a “regressive economic model – sustained by terror and social discipline.”153 FASIC questioned the military junta’s ability to govern by disparaging the new economic policies that the regime was putting into place. The implication was that these economic reforms could only be generating more discontent among the Chilean population. According to the FASIC team,

Pinochet remained in power by employing the military and other agencies to use force against

Chileans. Furthermore, the military junta was doing harm to the nation by dissolving democratic systems and enacting neoliberal economic reforms.

FASIC’s Medical-Psychiatric Team also chose to describe the violence perpetrated by the regime as an affront to human rights, emphasizing both physical harm and the restriction of liberties. The team described the military junta’s repression as a “rupture of basic norms of human coexistence by universalizing the use of violence and torture for political dissidents.”154

The regime was unable and unwilling to protect the “basic” rights of its citizens, thereby failing to support and improve the lives of Chileans. The therapist implied that as a governing body, the

151 Angélica Monréal U., Eliana Ortiz L., Fanny Pollarolo V., and Elisa Neumann, “Psychosocial Area: Medical- Psychiatric Program,” 1. 152 Professionals who Work in Human Rights Institutions, “Medical-Psychological Repercussions of Police Repression,” 2. 153 Angélica Monréal U., Eliana Ortiz L., Fanny Pollarolo V., and Elisa Neumann, “Psychosocial Area: Medical- Psychiatric Program,” 1. 154 Ibid., 1.

48 junta should have taken on this baseline responsibility. Its failure to do so reflected poorly on its legitimacy and effectiveness as a government. Furthermore, this statement marked a contrast between human rights organizations and the military junta in terms of how they each viewed

Chilean society. FASIC wanted to promote peaceful “coexistence,” whereas the regime was focused on eliminating those that did not conform to their political ideas. The FASIC team characterized itself as a group that was advocating for the benefit of all Chileans, in contrast to the military junta, which was painted as violent and harmful towards threats to its power.

Mental Health Treatment as a Social Service

The Medical-Psychiatric Program was only one of the services provided by FASIC, which strove to help detained, tortured, and exiled individuals, as well as the families and relatives of the disappeared. The organization tackled their clients’ cases in a multidisciplinary way that addressed emerging social problems in the new political environment, speaking to the

“social aid” aspect of FASIC’s full name, the Social Aid Foundation of the Christian

Churches.155 The emphasis on social issues was what FASIC claimed to be the distinguishing factor between it and other human rights organizations.156 Most individuals came to FASIC through their Social Services Program, which helped prioritize clients’ needs and brought together “interdisciplinary resources” to assist them.157 This included a variety of professionals at the organization; FASIC had a team of lawyers, physicians, psychologists, social workers, and dentists who contributed to the effort. The organization also granted educational scholarships for students who had come to FASIC for aid.158

155 “Social Services,” 1. The constitution had been enacted by the military junta that year as part of a plan to institutionalize its power and legitimize it. FASIC stands for Fundación de Ayuda Social de las Iglesias Cristianas in Spanish. This is one of the possible translations of the group’s name. 156 Ibid. 157 Ibid., 4. 158 “General Basis for Social Work Projects in Fundamental Human Rights,” FASIC: 3-4.

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The Medical-Psychiatric Program was listed as the first “health” resource for those who had been detained.159 It became clear early on that victims of the junta’s repressive acts were plagued with psychological wounds, even more commonly than physical injuries. From 1973 to

1977, during the early and most brutal years of the military regime, most mental health professionals provided therapy in their own private practices, receiving referrals from the

Committee for the Cooperation for Peace (Comité de Cooperación para la Paz, or COPACHI) and, later, the Vicaría.160 The Medical-Psychiatric Team that was formed at FASIC in 1977 was unique because it was a more cohesive group that specialized in the “severe emotional alterations linked...to repression.”161 In addition to treating patients, the therapists utilized this more organized structure to further “develop more effective therapeutic methods.”162 Working alongside a group of other professionals gave the team members a chance to study and devise more innovative therapies, which had been difficult to do when they were previously treating patients in a decentralized manner.

In addition to treating ex-detainees, the team also worked with family members of the disappeared, tortured, and executed. Many of the families that they worked with were

“pobladores,” working-class people who lived in Chilean shantytowns called “poblaciones.”163

Certain neighborhoods were better known for their political activism and allegiance to the UP, which led them to become targets once Pinochet came to power. Additionally, many of these

159 “General Basis for Social Work Projects in Fundamental Human Rights,” 13. 160 “Medical-Psychological Attention of People Affected by Political Repression in Chile: The Medical-Psychiatric Program of FASIC,” FASIC (n.d.): 2. Although the date of print if not confirmed, details in the pamphlet itself indicate that it was likely written and printed in 1984 or 1985. COPACHI was a collaboration between leaders in both the Christian and Jewish communities. Its human rights work irked the military regime, and Pinochet warned Cardinal Silva to shut it down; otherwise, the junta would send people to do it. The Vicaría was founded after COPACHI was shut down, and it was created as a part of the Catholic Church to protect it from being closed. 161 Ibid. 162 Ibid., 3. 163 Professionals who Work in Human Rights Institutions, “Medical-Psychological Repercussions of Police Repression,” FASIC (August 1983): 2.

50 communities faced new hardships due to economic liberalization under Pinochet. Although the initial years of military rule were economically unsuccessful, the nation soon experienced an economic boom, with high annual growth rates between 7.8 percent and 9.9 percent between

1977 and 1980 and a large fall in inflation.164 This growth mainly served to create a middle-class consumer culture and made the elite wealthier.165 The regime orchestrated a number of transactions that transferred state assets to large conglomerates and transnational corporations, diverting money away from state-funded social services.166 As a result, the military junta cut funding from community resources in poblaciones, including health centers and hospitals, thereby bringing about greater economic inequality.167 Between 1976 and 1981, unemployment averaged eighteen percent, which was three times as much as the average throughout the 1960s; about two-fifths of the population was living in poverty, double the rate in 1970.168 Additionally,

FASIC argued that the regime’s political persecution exacerbated the economic situation for the working class.169 Having a family member detained meant that they would not be able to work to generate income; if they were released, these individuals often had trouble finding jobs and had to stay unemployed.

The mental health professionals extensive work with families in poblaciones drew attention to the political and economic ways that these communities had been targeted by the military junta. As a result, it worked in conjunction with the Social Services Program, which the therapists believed to be an “integral part to FASIC’s Medical-Psychiatric Program, focusing its

164 Steve J. Stern, Battling for Hearts and Minds, 168. 165 Ibid. 166 James M. Cypher, “Pinochet Meets Polanyi? The Curious Case of the Chilean Embrace of ‘Free’ Market Economics,” Journal of Economic Issues 38 (2004): 530; Stern, Battling for Hearts and Minds, 169. 167 Delia Ateaga Fuentes, “Work Experiences in Población Health,” FASIC Valparaíso (May 1982): 1. 168 Stern, Battling for Hearts and Minds, 169. 169 CENFA-FASIC, “Familial Therapy: Support and Application of Psychosocial and Mental Health Work by CENFA and FASIC,” FASIC (August 1983): 4.

51 professional duties on the areas of psychiatry and Fundamental Human Rights.”170 The text implied that the Medical-Psychiatric Ream could not fully achieve its goals, both in relation to addressing mental health and human rights, if the social services staff was not there to provide support. The mental health professionals took the lead with individual therapy sessions for each patient, which were “focused and psychodynamic.”171 The main activities that social workers addressed were related to economic hardships that FASIC’s patients were facing and group therapy sessions.172 This was all part of an integrated approach to improving patients’ mental health.

Additionally, group therapy sessions were important due to their efficiency and their community-building qualities. The Medical-Psychiatric team saw patients individually to understand their specific circumstances and mental health status, which they normally did over two or three therapy sessions.173 While the team regarded this as an essential step to “addressing

[the health] of emotionally damaged patients,” particularly for patients who had been tortured, it was not sustainable for them to provide individual long-term care to anyone. There were likely not enough therapists to meet the demand, especially when taking into consideration that they had to treat both direct victims of repression and their family members. Group therapy was an essential part of the treatment plan because it was not possible to provide consistent individual treatment for all their patients.

Social workers shared the responsibility of improving the mental health of the Medical-

Psychiatric Team’s patients, and they were also expected to assist patients in their social

170 “Social Services in the Medical-Psychiatric Program,” FASIC (n.d.): 1. This is different from the other pamphlet cited as “Social Services.” 171 Ibid., 2. 172 Ibid. 173 Ibid.

52 integration. Facilitating group therapy sessions helped patients reintegrate into their communities. In addition to providing additional therapy beyond individual sessions, group therapy sessions connected patients with others in similar situations and encouraged patients to start pursuing “collective goals.”174 By promoting and monitoring patient participation in group therapy sessions, FASIC’s social workers were improving each patient’s “individual development” while also “considering that collective conduct [was] necessary” in order to address the mental health issues the patients were facing.175 Each patient had different experiences and emotional issues that they had to address, but FASIC’s therapists also wanted to help them become accustomed to facing the political situation collectively.

The Medical-Psychiatric Team argued that the authorities targeted those who participated in unions, cultural groups, and religious groups, in addition to those who had openly opposed the regime.176 This was an indication that the Pinochet regime was trying to break apart the working- class base that had supported Allende so fervently and that, if organized, was likely to pose a major political threat. In addition to the therapy it provided, the Medical-Psychiatric Program adopted an “educative-preventative” mission that endeavored to help their patients understand the “psychosocial mechanisms” the regime utilized to discourage political participation.177 The military junta was creating a political and economic atmosphere based on fear and individualism in order to break apart groups that posed the greatest political threat. Group therapy sessions were a method of building community among victims and their families and creating social

174 “Social Services in the Medical-Psychiatric Program,” 2. 175 Ibid. 176 “Social Services,” 2. 177 “Medical-Psychological Attention of People Affected by Political Repression in Chile: The Medical-Psychiatric Program of FASIC,” 3.

53 bonds that improved individual mental health while combating the social isolation and de- politicization that the military junta imposed on pobladores.

Conclusion

The Medical-Psychiatric Team’s pamphlets provided important evidence of the human rights violations that were perpetrated under Pinochet’s regime. The group chose to take a non- neutral, but also non-partisan, stance. While the therapists heavily critiqued the military junta’s actions, they did not do so by allying with left-wing forces. Rather, adopting a similar tone to the religious founders of the Vicaría and FASIC, the therapists focused on the human rights aspect of authoritarian rule. The work that they performed as therapists was inherently political because they were treating the politically persecuted and their relatives. In order to address these patients’ mental health, the practitioners argued that they had to adopt the opinion that their patients’ accounts of their experiences were true and that the junta was harming their patients, mostly pobladores, in order to secure its political authority. The policies that brought about economic difficulties in low-income communities, as well as the impact that disappearances and detainments had on entire families, also led the team to be closely associated with the social services side of FASIC.

Additionally, this focus on the junta’s acts of violence denied it the legitimacy that it was attempting to gain through constitutional changes and institutionalization, which the regime was enacting to appease the international community and maintain power.178 FASIC’s documents spoke to the culture of fear and silence during the dictatorship that impacted large swaths of the

Chilean population. The therapists’ description of the Pinochet years helped characterize the context in which they were performing therapeutic work. Their concern about the violent and

178 Policzer, The Rise and Fall of Repression in Chile, 109.

54 repressive political and social situation of this country hinted at the approach they would take to evaluating trauma. Rather than solely considering the individual trauma caused by torture and detainment, FASIC’s Medical-Psychiatric Program extensively examined familial and collective trauma that resulted from authoritarianism more generally.

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CHAPTER 2 Trauma: Individual and Collective, Direct and Indirect

Introduction

“Trauma” and “traumatic experiences” were phrases that appeared in several of FASIC’s mental health pamphlets to characterize living under Pinochet’s rule. They were used to describe individual or collective experiences, and direct or indirect experiences. The September 1973 coup marked a moment when Chilean society had to adjust rapidly to an authoritarian government, regardless of political affiliation. This political, economic, and social disruption was a historical shift for Chileans. Who came to experience this period as “trauma”? Who was assigned the label of “traumatized”? What were methods of coping with trauma?

FASIC’s Medical-Psychiatric Team attempted to understand trauma from a variety of viewpoints, ranging from those who directly experienced torture to the families of the disappeared. The team’s printed pamphlets contained excerpts from patient interviews as well as analysis of the physical and psychological harm that patients experienced. Additionally, the authors often included introductory sections that described the Chilean political situation.

Inherent in their analyses of their patients’ health was the belief that there were political causes to their trauma, leading the team to characterize the negative impacts of the Pinochet regime as a medical issue. Their analyses of trauma were not only clinical notes of their patients’ experiences, but also explanations of the political context. The pamphlets presented the personal experiences of their patients while raising questions about the morality of the military. These were not merely documents on the trauma that individual patients faced; they were also texts that interweaved patients’ personal traumatic experiences with FASIC’s human rights convictions.

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This chapter weaves through various forms of trauma that the Medical-Psychiatric

Program treated and analyzed. The team considered individual instances of violence as well as political and economic factors that contributed to familial and collective trauma. Since its founding, FASIC recognized the important role that individuals played within the family. The main goal of their work was to provide “direct assistance to the affected and their relatives...under massive [and] sustained repression.”179 Like other human rights organizations,

FASIC’s staff recognized that they had to care for individuals directly impacted by political persecution as well as the communities that surrounded those individuals. To give voice to individual traumatic experiences, the therapists recorded and printed patient testimonios.

Additionally, they incorporated anonymous excerpts of patient interviews to evaluate the mental strain experienced by those directly affected by military action. The therapists characterized women and youth as “traumatized” if they directly experienced acts of repression, such as detainment and torture, but they also dedicated several pamphlets to describing the trauma women and children faced as family members of the detained and disappeared. The Medical-

Psychiatric Team recognized both individual and collective trauma, and this perspective was reflected in the way in which they provided therapy for patients through a combination of individual appointments and group therapy sessions.

The recognition of collective trauma also highlighted the importance of producing and archiving pamphlets. As mentioned previously, these mental health professionals were not only presenting medical findings; they were also writing about how politics intersected with their medical work and the lives of their patients. These pamphlets provided a way to protest the military regime’s oppressive behavior. By drawing patient experiences of trauma together, the

179 “Medical-Psychiatric Attention of People Affected by Political Repression in Chile,” FASIC (1984-1985): 2.

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FASIC team articulated the specific trends that impacted people. This approach held the military junta as a whole responsible for trauma, rather than just the individuals involved in each case of violence.

Definitions of Trauma: From Hysteria to Social Trauma

Explanations of trauma have changed across time and context, and debates about what constitutes trauma continue today among mental health professionals. Questions include whether trauma refers to a particular event or to the experience of processing the event thereafter. The proposed causes of trauma have also varied; while it was once primarily associated with hysteria, trauma also became a prominently used term to describe veterans’ combat experience. Other scholarly work has begun to analyze trauma as a collective cultural experience, rather than solely an individual one.

Sigmund Freud was one of the first figures to examine trauma as a mental phenomenon rather than a physical one. Originally, “trauma” was a term that described a surgical wound or areas where the skin had been breached.180 Freud and Jean-Martin Charcot, both neurologists by training, linked trauma to sexual experiences in their examinations of hysteria in late nineteenth and early twentieth century Europe. After World War I, Freud wrote more about “combat hysteria,” focusing on trauma in relation to the brutal combat that soldiers encountered.181

However, he did not believe that events were “intrinsically traumatic,” but rather that the experience of trauma was the “deferred act of understanding and interpretation.”182 Although the direct cause of trauma was internal processing, an experience could cause an individual to be

180 Ruth Leys, Trauma: A Genealogy (Chicago: University of Chicago Press, 2000), 19. 181 Ibid., 21. 182 Ibid., 20.

58 flooded by stimulus because of a “breach in the ego’s protective shield,” which would create internal conflict.183

To an extent, the mental health team at FASIC looked to Freud and psychoanalysis for guidance in treating their patients. Freud’s proposed treatment for trauma was to view a traumatized individual’s emotions as additional energy that needed to be expelled from the psyche. Trauma and the emotions associated with it had to be directly addressed or spoken about, that is “purged” through “catharsis.”184 Otherwise, the experience would remain in the patient’s mind, causing trauma by having them continually reprocess the event.185 FASIC and the Vicaría utilized strategies to prompt “catharsis,” which involved patients confronting their traumatic memories by vocalizing and recording them.186 The therapists commonly treated patients through creating testimonios, translated directly to “testimony,” of their experiences of detainment or torture. The process involved conducting and recording a therapy session in which patients retold their traumatic experiences, followed by a transcription of the patients’ words.187 They also utilized group therapy sessions in which patients discussed their different experiences of imprisonment.188 While the sessions helped patients “purge” their emotions, it also prompted them to make connections with others’ experiences and build community among ex-detainees.

The focus on treating trauma experienced by groups of people and caused by economic and political factors was a part of a movement in Latin America that psychoanalyst Nancy Caro

183 Ibid., 23. 184 Jill Littrell, “The Status of Freud’s Legacy on Emotional Processing: Contemporary Revisions,” Journal of Human Behavior in the Social Environment 18 (2008): 478. 185 Ibid. 186 Elizabeth Lira K. and Eugenia Weinstein L., “Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” FASIC (June 1985): 10. 187 Elizabeth Lira, “Testimony of Traumatic Political Experiences,” trans. Maxine Lowy, Psyke & Logos 30 (2009): 31. 188 Vicaría de la Solidaridad, File CD:001818, Archive and Documentation Center of the Vicaría de la Solidaridad, 1. No title, author, or date.

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Hollander coined as “liberation psychology,” drawing direct parallels to liberation theology. The psychologists in this movement linked Kleinian notions of the unconscious origins of mental illness to Marxist theory about “the economic origins of social violence.”189 The damage that the dictatorship committed not only impacted those who were imprisoned, tortured, or disappeared, it also damaged families and entire communities by causing economic instability. In Chile, this prompted FASIC’s mental health professionals to consider trauma caused by economic factors.

Many families lost their main source of income when heads of households were arrested or disappeared. Additionally, many ex-detainees were unable to obtain employment after their release, leading to additional tensions in economically struggling families due to the change in gender roles caused by women who became the primary breadwinners of their families.190

Economic neoliberalism worked in tandem with state violence to cause and amplify the trauma that poblaciones, or Chilean shantytowns, experienced. In addition to political persecution and state violence, the regime adversely affected the lives of many pobladores, residents of shantytowns, by decentralizing and diverting money from social services.191 The regime pushed for a “community-based approach,” especially in regards to healthcare, without providing the resources necessary to carry out these plans in poblaciones.192 As a result, pobladores likely sought mental health services at the Vicaría and FASIC during authoritarian rule for both political and economic reasons. Not only were they being politically persecuted, but they also lacked the resources they needed from official sources of healthcare.

189 Nancy Caro Hollander, Love in a Time of Hate: Liberation Psychology in Latin America (New Brunswick: Rutgers University Press, 1997), 17. 190 “Damage to Youth and Children in Families Directly Affected by the Repression,” FASIC (1978): 8. 191 Clara Han, Life in Debt: Times of Care and Violence in Neoliberal Chile (Berkeley: University of California Press, 2012), 68. 192 Ibid., 183.

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The experience of living under authoritarianism was also a form of “social trauma” because of the social and cultural shifts that it prompted. Julia Braun, an Argentine psychologist, argued that the individual perspective of trauma failed to “capture the nature of group psychological reactions to violence produced by state terror.”193 The authoritarian governments of the Southern Cone changed the status quo when they came to power, which necessitated an adjustment in the behaviors and attitudes of the population. For many, the usage of state violence prompted fear, and while each person may have only been concerned for people in their own lives, many Chileans were experiencing similar feelings of terror and uncertainty.

Therapists, as individuals who lived under the military junta’s rule, were unable to escape this “social trauma.” Some members of the FASIC Medical-Psychiatric Program, such as Paz

Rojas, were themselves victims of political persecution and forced into exile before returning to

Chile. The dual role of the mental health professionals themselves, as care providers and traumatized individuals, reflected their extensive involvement in both the medical aspects and advocacy of FASIC and the Vicaría. In Critical Trauma Studies, Monica J. Casper and Eric

Wertheimer propose that trauma is a “cultural object” and “a product of history and politics, subject to reinterpretation, contestation, and intervention.”194 They recognize that those who experience trauma may also be trying to “fix” trauma in another capacity.195 In these situations, they posit that the question of what is normal and pathological arises, given both individuals’ shifting identities and changing political contexts.196 Members of the FASIC team were undergoing identity shifts as they treated their patients, who were undergoing a parallel process.

193 Han, Life in Debt, 110 194 Monica J. Casper and Eric Wertheimer, eds., Critical Trauma Studies: Understanding Violence, Conflict, and Memory in Everyday Life (New York: New York University Press, 2016), 3. 195 Ibid., 6. 196 Ibid., 7.

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However, the therapists’ personal experiences of trauma were largely absent from the documents they kept about authoritarianism and mental illness. While this may have allowed them to maintain professionalism by keeping their personal lives out of their work, it also denied the fact that their personal experiences informed their worldview, thereby impacting how they defined and addressed their patients’ trauma. Furthermore, the shifting boundary between normal and pathological brings forward the idea of national trauma. Although specific individuals and communities were more negatively impacted by the junta’s violent and economic means of repression, all Chileans experienced a period of radical change that contributed to the conceptualization of a “national trauma,” even if a substantial portion of Chileans was not adversely affected by the coup and its aftermath.

FASIC’s group therapy sessions were designed to address trauma collectively, acknowledging the bonds that were forged between Chileans who had experienced political repression directly or through family members. The therapists created a space where individuals would be able to express their pain and seek out ways to heal among those that understand the experiences themselves.197 In addition to providing a space for individuals to reflect on their detainment and torture, the therapists also recognized that their patients had developed strategies to cope with imprisonment that were “particularly effective in the emotional recovery of the detained.”198 They acknowledged that their patients already possessed mental resources that they could share with each other.

FASIC’s Medical-Psychiatric Team’s documents show that they considered mental health and trauma beyond individually experienced trauma. This chapter discusses how the

197 Irene Wirshing, Latin America: Interdisciplinary Studies: National Trauma in Postdictatorship Latin American Literature: Chile and Argentina (New York: Peter Lang, 2009), 3. 198 Vicaría de la Solidaridad, File CD:001818, 1.

62 therapists analyzed and characterized their patients’ trauma, as well as how patients described the trauma they experienced. FASIC’s mental health professionals frequently addressed the familial and social impact of trauma and connected the experiences of multiple patients when analyzing trauma. Additionally, the documents revealed their strong concern for individuals who were facing indirect trauma and had to grapple with the consequences of state violence inflicted upon loved ones. For example, the group observed how economic burdens compounded the trauma of physical violence. The junta’s economic policies and political persecution disrupted the structure of many families and highlighted the hypocrisy of the Pinochet regime, which presented itself as a defender of traditional family values. One of the ways in which state violence disrupted the family was by traumatizing its individual members, who often had difficulties reintegrating into familial structures after experiences of detainment and torture.

The Trauma of Torture

The words “trauma” and “traumatic” appear in the Medical-Psychiatric Program’s pamphlets, but the therapists do not explicitly define the terms. While the team did not have fixed definition of “trauma,” it used the term most frequently in relation to imprisonment and torture. For example, an article by Elena Gómez was titled “Torture: A Traumatic Experience,” although she did not expand on the meaning of “traumatic experience” in the pamphlet.

Additionally, a FASIC pamphlet titled “Trauma, Pain and Healing” dedicated most of its text to discussing torture. This did not mean that the only form of trauma the team recognized was torture; as previously discussed, these professionals were also very concerned with the trauma that impacted the family members of the detained, disappeared, and killed. In a 1985 pamphlet

“Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” the authors defined “torture” as “violence deliberately exercised against people for political reasons, which

63 would be considered a specific psychological trauma.”199 They also explained that they excluded discussions of the impact of disappearances and deaths due to “time and space.” This acknowledged that disappearance and death could be considered “traumatic” to the victims’ family members, but the topic required a separate discussion due to its equal “complexity.”200

The therapeutic efforts to address these situations focused on the trauma experienced by friends and family members. As a result, torture was the most direct and individualized form of trauma that these mental health professionals addressed in depth.

The reason the Medical-Psychiatric Team took on the labor of treating patients who had been tortured was partly because they viewed it as a “medical problem.”201 Ten years after the coup, the team stated that the regime continued to systematically apply both physical and psychological torture to those who were detained for political reasons.202 While at the time there were no concrete statistics about torture in Chile, the team believed there were “thousands of testimonios” collected by human rights organizations that described torture. 203 Additionally, the therapists cited a study presented at a conference on torture in 1978 that confirmed that victims of torture experienced long-term physical, mental, and social trauma.204 The mental health team justified its involvement in cases of torture by highlighting the medical aspect of the situation and emphasizing that they were performing “medical work.”205

Though their justification for getting involved was based on the health impact of torture, the team was also highly cognizant and critical of the political reasons behind torture. In a 1983 pamphlet, the author wrote, “Without room for doubt, the central objective of the torturers is to

199 Elizabeth Lira K. and Eugenia Weinstein L., “Traumatic Experiences: Violence and Torture,” 2. 200 Ibid. 201 “Torture: A Medical Problem,” FASIC (1983): 1. 202 Ibid. 203 Ibid., 2. 204 Ibid. 205 Ibid., 4.

64 break the detained person’s resistance.”206 “Resistance” could be interpreted psychologically and politically. Psychological resistance could mean a person’s emotional and mental barriers or their ability to withstand pain. Breaking psychological barriers would have helped the torturers obtain information about leftist groups from their victims, thereby making progress toward the larger goal of bringing down resistance to the military junta.207 The therapists did not focus on the politics of torture in their clinical work with patients. However, by writing and printing patient narratives that documented torture, the mental health professionals both examined medical work in its political context and produced articles that commented on politics.

There were some elements that were common to several of experiences of torture. Ex- detainees relayed personal accounts that often went into graphic detail about the physical trauma that they experienced, likely in order to provide evidence for denunciations against the military junta. Torture could include being forced to take cold showers while being beaten, followed by several sessions of electrocution of various parts of their body, such as their arms, legs, mouth, and genitalia, as they were being interrogated.208 These experiences had a long-term impact on the physical health of some of the detainees, such as problems with vision and fractures, and they also caused various psychological problems, including insomnia, depression, anxiety, and nightmares.209 The FASIC team also identified psychological symptoms, such as a “decrease in intellectual performance” and “loss of memory,” no doubt due to the physical trauma to the head that many detainees had endured.210 Evidently, the experience of physical torture caused both

206 “Torture: A Medical Problem,” 4. 207 Elena Gómez, “Torture as a Traumatic Experience: The Perspective of Pain,” FASIC (1985): 6. 208 “1. Application of Torture Methods to Youth,” FASIC (1984): 23.; “3. Application of Torture Methods to Women,” FASIC (1984): 54. 209 Elizabeth Lira K. and Eugenia Weinstein L., “Traumatic Experiences: Violence and Torture,” 10. 210 Ibid.

65 physical and psychological trauma that persisted after these individuals were released from detainment.

Additionally, several accounts mentioned methods of psychological torture that patients endured during their detainment. The physical aspects of torture were designed to cause and contribute to the psychological trauma, as the main objective of torture was to “exhaust

[detainees’] physical and emotional resistance.”211 An example of solely psychological torture included threats of detaining or killing family members.212 Several detainees also noticed that the interrogators would designate one individual as the “good” interrogator who appeared to be more humane.213 The “good” interrogator would never be present for physical torture and would claim that they disagreed with the “bad” interrogator’s methods.214 In some cases, the police and intelligence agents offered financial security in exchange for information, framing conversations with detainees as negotiations.215 Detainees also encountered psychologists and medical professionals who played a role in torture, most often because they were called upon to evaluate the physical and mental health status of the prisoners.216 In this context, procedures that were normally implemented in order to maintain and improve health were instead used to determine whether it was possible to continue torturing the subject.217

Furthermore, many of the ex-detainees, especially those who were university students, were taken from their homes early in the morning or late at night in front of their families. This was likely part of a strategy to instill fear in the families of detainees. Evidence that supported this was the account of one woman had been driven to her home during her detainment,

211 “Torture: A Medical Problem,” 3. 212 “1. Application of Torture Methods to Youth,” 27. 213 Ibid., 23. 214 “3. Application of Torture Methods to Women,” 55. 215 Ibid. 216 Ibid., 56. 217 “Torture: A Medical Problem,” 11.

66 seemingly so that the National Information Center (Central Nacional de Informaciones, or CNI) could show her family that she had been arrested and beaten.218 Furthermore, the agents often involved family members in attempts to get the persecuted to admit their affiliation with leftist groups or provide the names of other individuals associated with these groups. Family members were threatened when the authorities came to search for the targeted individuals, and interrogators would often tell the detainees that their family members had also been detained or had been killed because they had failed to provide information.219 One man was also forced to watch intelligence agents torture his teenage son during their joint interrogation.220

Patients’ testimonios often revealed more about the experience of detainment and torture itself, but these accounts also justified FASIC’s mental health professionals’ concern for how torture and detainment impacted the family. They believed that one of the reasons that torture could be so traumatic was the impact on the victim’s familial relationships. In her 1985 pamphlet

“Torture as a Traumatic Experience,” psychiatrist Elena Gómez stated, “In addition to the tortured person’s psychological symptoms, the impact on the family is always present in this dramatic experience.”221 She believed that torture was a specific kind of trauma that was individually experienced but that always ultimately impacted the family in an adverse way. Thus, looking at familial ties and relationships could assist in better understanding a patient’s trauma and their reflection on the experience after their release.

For those who had been tortured, the therapists prescribed treatment that involved articulating the experience to family members, which highlighted FASIC’s belief in the importance of maintaining familial relations was to addressing trauma. Gómez wrote that

218“3. Application of Torture Methods to Women,” 60. 219 Ibid., 66. 220 “2. Repression in Pudahuel,” FASIC (1984): 49. 221 Gómez, “Torture as a Traumatic Experience,” 1.

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“deprivatization” was key to maintaining these bonds.222 This term contrasted “privatization,” which Gómez used to describe keeping the experience of torture to oneself instead of sharing it.223 The pamphlet warned that if tortured individuals did not describe their experiences to family members, the trauma of torture eventually impact familial relations, instead of being isolated to the individuals themselves.224 While the active role that family members could play in the healing process was less clear, the mental health team believed that the tortured needed to re- establish familial bonds in a way that acknowledged their experiences without distancing themselves. The therapists did not believe the tortured would be able to heal or avoid disrupting family dynamics if the experience was only vocalized in the individualized clinical setting.

This family-centered perspective may have been expected from FASIC’s mental health professionals, who frequently analyzed the social and political climate and its impact on mental health. FASIC’s therapists believed that their patients had to be “active subjects” in their treatment in order for them to reintegrate into their families and communities.225 The goal was that their patients would be able to share and process their trauma openly in therapy sessions as well as with family.226 However, this model of treatment had the potential to disturb familial relationships. Patients may not have wanted to vocalize their experiences to their families, even if they had been comfortable doing so in individual therapy sessions. Gómez acknowledged that

“tensions” could exist between the parties and that knowing the “existing [familial] structure” was essential to understanding how to approach treating the tortured individual alongside the family.227 However, the inclusion of both the tortured individuals and their families in therapy

222 Gómez, “Torture as a Traumatic Experience,” 4. 223 Ibid., 5. 224 Ibid., 3. 225 Lira and Weinstein, “Traumatic Experiences: Violence and Torture,” 10. 226 Ibid. 227 Gómez, “Torture as a Traumatic Experience,” 4.

68 could have caused some patients to feel more resistant to sharing their experiences because they do not wish to tell their family.

In order to conduct useful familial therapy, therapists had to build trust with the patient and their family members, as well as forge an understanding between these two parties. Lira and

Weinstein, two of the FASIC’s psychologists, wrote that patients and their families had high expectations and believed that psychological treatment could make an ex-detainees “insomnia, nightmares, and symptoms disappear,” but they rarely came unless these symptoms became

“intolerable.”228 When it actually came to participating in therapy sessions, “the majority” of their patients became “progressive[ly]” more inhibited when they spoke about their experiences, and their families were usually wary and “terrified” of “‘knowing” what their relative endured.”229 Seeking professional services for mental health was not normalized among the population that FASIC served, as indicated by the late stage at which they approached FASIC and their reluctance to participate. Although it seemed like any preexisting stigma about seeing a mental health professional was outweighed by the degree to which detainment was traumatizing, patients and their families could clearly be uncomfortable with the process of sharing and listening to accounts of torture. The FASIC team had to find a way of ensuring that their patients cooperated in the therapeutic process. This was especially true because FASIC’s therapy was most effective when patients felt comfortable working with their therapists to analyze the experience and impact of detainment and torture.230 The mental health team also worked with family members separately from the tortured, allowing the therapists to explore the secondary impact of torture.

228 Lira and Weinstein, “Traumatic Experiences: Violence and Torture,” 8-9. 229 Ibid. 230 Ibid., 10.

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Trauma Experienced by Women

Chilean society was politically polarized just prior to the coup. Allende and the Popular

Unity’s supporters saw the Cuban Revolution and Fidel Castro’s government as a political inspiration and a potential model for reform.231 However, there were other sections of society who were intent on maintaining the status quo, particularly the elite, the middle class, and landowning families in rural areas.232 Although the UP’s base was typically working class, there were also people within these socioeconomic classes that supported right or center-right parties instead. This was the result of a variety of factors, including anxiety about social disorder due to political polarization and skepticism of the reform plans laid out by the Allende government.233

Interestingly, although their policies generally put women in subordinate positions,

Pinochet still had support from large portions of the female population. The right had women’s support even before the coup. For example, some women’s political groups organized and petitioned for Allende’s removal after his election.234 Camilla Townsend argues that many women leaned toward the right because it valued their roles as wives and mothers, whereas the left tended to promote the figure of the “virile male” and failed to find a unique and stable place for women within the movement.235 Many women, especially those of the upper and middle classes, preferred to be acknowledged as political actors instead of looked over, even if the role that was defined for them was to support male political leaders.

231 Steve J. Stern, Reckoning with Pinochet: The Memory Question in Democratic Chile, 1989-2006 (Durham: Duke University Press, 2010), xxiv. 232 Ibid. 233 Ibid., xxv. 234 Gwynn Thomas, Contesting Legitimacy in Chile: Familial Ideals, Citizenship, and Political Struggle, 1970-1990 (University Park: Penn State University Press, 2011), 142. 235 Camilla Townsend, “Refusing to Travel La Via Chilena: Working-Class Women in Allende’s Chile,” Journal of Women’s History 4 (1993): 58.

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The right was particularly attractive to women who saw their primary roles as wives and mothers because it emphasized the concerns that women had housewives while also giving them a chance to participate politically. The left tended to view issues in terms of class rather than gender, and it rarely discussed initiatives geared specifically towards enhancing the lives of women.236 However, the right acknowledged issues that concerned many women, specifically their traditional roles within the family. Conservative politicians honored women for the essential role that they played in raising the country’s children. In the 1970 election, conservative forces characterized Allende as a threat to Chilean children because of his socialist beliefs and urged women to vote in opposition to him.237 Additionally, the left’s efforts at promoting women’s rights highlighted their potential as career women or laborers.238 This message actually pushed some women away from the left, because it failed to affirm their domestic roles and had the potential to disrupt the traditional family structure. Some of women, primarily those of the upper class, formed Poder Femenino (Feminine Power), an anti-Allende group that staged the

March of Empty Pots to protest the president’s economic policies.239

Ultimately, these women, mostly of higher socioeconomic status, supported Pinochet because they believed he would restore societal order by supporting traditional gender roles and family structure. The Pinochet regime sought to reverse the course that Chilean society had taken

236 Townsend, “Refusing to Travel La Via Chilena,” 57-58. 237 Megan Allen Kareithi, “Women of Santiago: Gender Conceptions and Realities under Pinochet” (PhD diss., Tulane University, 2010), 6. 238 Margaret Power, “More than Mere Pawns: Right-Wing ,” Journal of Women’s History 16 (2004): 144. 239 Kareithi, “Women of Santiago,” 6. The march, held in December 1971, involved walking from Providencia, a wealthy neighborhood, to downtown Santiago where the seat of government was. They banged on empty pots and pans, which symbolized the food shortages that Chileans were suffering. While it was true that people had to wait in line to receive food and the circulation of certain goods was limited, the economy was not doing poorly in the first year of Allende’s presidency when this protest was happening. Furthermore, these women were of the elite and were, according to Marc Cooper, Allende’s translator, the “best-fed, best-clothed, fattest, and wealthiest people in Chile” who had access to private food distribution.

71 under Allende, not only politically and economically, but also socially. They were concerned with promoting conservative values in order to gain the support of the wealthier portions of society. For this reason, the junta utilized rhetoric that cast the coup as a political intervention for the sake of the Chilean family, both as an idea and in practice.240 The state cast itself as a protector of families that justified its violent actions by making it the government’s “fundamental duty” to promote “familial welfare.”241

The ideal family had a specific structure, especially in regards to gender roles. The regime emphasized the subservient role that women should play in society and within the family.

Pinochet believed that women should be entirely defined by their roles as wives and mothers.242

According to him, the “Chilean woman” was “beautiful, her home’s indomitable defender, a selfless mother and a loyal wife.”243 Women were supposed to be “selfless” and “loyal” to regime, to the extent that they withheld criticisms and personal desires.244 The military junta also put into place the previously abolished potestad marital, which gave men “legal control of their wives and their wives’ property.”245 There was also no means of getting a divorce, which prevented women who wished to separate from their husbands from having legal control over their lives.246 The military junta also dismantled many of Allende’s women’s health initiatives, including family planning programs and contraception, characterizing these initiatives as threats to the family.247

240 Gwynn Thomas, Contesting Legitimacy in Chile, 141. 241 Ibid., 142. 242 Power, “More than Mere Pawns,” 141. 243 Kareithi, “Women of Santiago,” 10. 244 Ibid. 245 Kareithi, “Women of Santiago, 9. 246 Ibid. 247 Ibid., 15.

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Despite this emphasis on family, Pinochet’s policies and his implementation of torture, exile, and disappearance disrupted many Chilean families and created atypical familial structures. Both men and women were adversely affected by military action. However, the trauma that they suffered differed because gender roles were very distinct in Chile, even under

Allende and among members of the working class. The disappearance or unemployment of fathers could prove to be traumatic for women because it altered the role that they had to play within the family. Additionally, men and women experienced sexual violence in torture that had an impact on their identities and ideas about gender roles. For men, it was an emasculating process, whereas women experienced harshly enforced subordination to male power.

The political situation disrupted rather than reinforced traditional family structures, causing “familial harm,” according to FASIC’s mental health team.248 At this time, regardless of class, many women were still influenced by traditional ideas of gender. Although being working class in some situations required women to work instead of caring for their children at home, many women were still taught to believe that there were defined and distinct roles for men and women within the family.249 Most families that FASIC served were of the “typical” structure, with a father who was “head of the household and played the role of the principal or only provider of the family, while the mother was responsible for domestic chores, caring for the children, distributing the family budget, and, in some cases, contributing economically.”250 The absence of a patriarch, either through disappearance, detainment, or exile, meant that the family did not have a male authority figure. Such a familial structure clearly did not adhere to the ideal

248 “Prolonged Psychological Harm of the Relatives of the Detained-Disappeared,” FASIC (1978): 3. FASIC’s medical-psychiatric team utilized the term “familial harm” (daño familiar) on multiple occasions, and it was not a term that was specific to this article. 249 Townsend, “Refusing to Travel La Via Chilena,” 55-6. 250 “Damage in Minors, Children of Families Directly Affected by the Repression,” FASIC (1978): 1.

73 nuclear family for which the regime advocated. This caused many women to take on duties that typically fell upon their husbands, which prevented them from adhering to conservative expectations of a wife and mother.

FASIC’s mental health team spoke with several patients to better understand the trauma of the relatives of the disappeared. In a pamphlet published in 1978, they quote a woman whose husband disappeared: “When they take your husband, the household is defenseless, and working by yourself is not like when you have your husband. You could say that you still have children, which is true, but you have to pay your water bills, electricity bills, and food by yourself.”251

This narrative revealed the emotional and economic burden of not having her husband with her.

Her family became “defenseless” because her husband was not there to fulfill the masculine role of protecting her family. His disappearance revealed his family’s political and economic vulnerability. The fact that the strong male figure in the family was harmed indicated that the military was capable of harming the rest of the family. Additionally, the woman’s identity as a wife was altered because her husband was no longer present. Without his physical presence, she appeared single, widowed, or separated to the public.

His disappearance also impacted her role as a mother. She acknowledged that she still had children, but her husband’s disappearance prevented her from properly fulfilling her maternal role. The fact that he was not there created the image that she was a single mother, which was stigmatized in Chilean society at the time, especially given the strict laws about divorce under Pinochet. It also impacted her function within the family. Her husband’s absence created an economic burden that made it difficult for her to provide for her children when it became harder to pay her bills and feed them properly. Additionally, while she indicated that she

251 “Damage in Minors,” 1.

74 was a working woman prior to her husband’s disappearance, she was by no means the sole breadwinner of the household. According to traditional values, while it would have been acceptable for the husband to be the only income generator within a family, it was not the norm for a woman to take on this role. In addition to disrupting gender norms, economically speaking, detainment and disappearance made it more difficult for the family to survive, creating a situation that could be traumatic due to economic hardships.

It was especially difficult for mothers to move on from the trauma of losing a spouse because their children would continue to remind them of the disappearance. Not only did mothers have to overcome the loss themselves, but they also had to help their children move past the absence of their fathers, particularly if they were disappeared and there was little possibility of return. One mother described confronting her children about her husband’s disappearance as

“horrifying” and that she had to wait five days before she “was more serene or more able” to tell them that “their father had been detained.”252 Whenever she arrived home, one of her sons would ask her what news she had of his father. The son began avoiding the topic once his mother cried in front of him.253 Another mother struggled to calm her thirteen-year-old daughter when it became apparent that she could not see her father: “she did not say anything but she cried, cried and cried and there was no way to console her.”254 These mothers were usually trying to make sense of the disappearance themselves and were personally suffering due to the situation. They had to manage the economic burden of taking care of the family without the support of their husbands, who, as mentioned previously, had made the majority of the income in most cases.

Additionally, as mothers, they had to be emotional support systems for their children who had

252 “Prolonged Psychological Harm of the Relatives of the Detained-Disappeared,” 4. 253 Ibid. 254 Ibid., 6.

75 been traumatized by the event. The first account was from a woman who was struggling to remain calm in front of her children and felt the obligation to appear “serene” when discussing the issue with them. Women could not to fully exhibit the emotional trauma they were experiencing due to their husbands’ disappearances because they were concerned about how it would emotionally impact their children. Furthermore, their children’s sorrow, crying, and questioning were reminders of the fact that their fathers were missing, only made it more difficult for women to direct their attention towards issues other than their husbands’ disappearance.

In cases where fathers and husbands returned home after detainment, the family often continued to suffer and remained in a traumatized state. Although the father was physically present, his could be unable to contribute economically which could cause tension within the family. Due to the stigma of being an ex-detainee, many men were unable to find a job after their release.255 The mental health team recorded wives’ opinions on their husbands’ situation: “[A wife] complains with feelings of ambivalence about her husband, ‘he got [me] into this

[situation]...’, she accuses him, she protects him: ‘he is so helpless...’ [She] needs to hide what the household needs from him, ‘I should look for...some income...’. Others will not give him work...‘It has to be me...’.”256 The wife’s “ambivalence” was characterized by conflicting feelings about her husband and an attempt at emotional detachment from the situation. She was frustrated because she was put in the position of ensuring her family’s survival alone, but she

255 “Damage in Minors,” 8. 256 Ibid. It is not clear whether this is a statement from one wife or a consolidation of multiple statements from different individuals. However, the mental health team utilized the quotes as if they spoke for the situation of having an unemployed husband in general, rather than ways that specific individuals experienced and managed the situation.

76 also viewed her husband as “helpless” because of the trauma he experienced in detainment. She vacillated between blaming her husband and wanting to attend to his emotional needs.

In order to distance herself from the emotional aspect of the situation, she focused on finding a job, declaring that “it [had] to be” her because of the stigma that made it difficult for her husband to find one as an ex-detainee. However, most Chilean women did not expect to play the role of the sole breadwinner if they were married, leading the mental health team to characterize some of their sentiments “accusations.” Thus, the direct trauma that men had experienced in detainment often had a negative impact on their wives even after their release. In addition to being responsible for a greater economic burden, these wives did not feel as if they could ask for more support from their husbands who were healing from physically and psychologically from torture—a more obvious experience of trauma than what the wives were experiencing.257

An unemployed, ex-detainee husband and father created a stigmatized situation for the entire family because the wife had to support the family in lieu of the husband. One wife admitted to hiding certain economic necessities from her husband after he returned from detainment, choosing instead to address economic issues alone.258 She did this in order to

“protect” him from the reality that he is “helpless” and can no longer provide for the family as he once could. However, men would not be fulfilling traditional gender norms if they were to stay at home without working. Ultimately, this meant that women were taking on more “masculine” roles, not necessarily in the absence of men in their lives, but because the men were not in the position to assist them economically. To the public, this familial situation would either signal

257 Adriana Maggi, “Torture and Children,” FASIC (1985): 4. Adapted from her presentation at the 20th Interamerican Congress of Psychology in June 1985. 258 Ibid.

77 that the husband was an ex-detainee or that the woman was more “masculine” than the man, both of which were stigmatized images. Furthermore, the situation could lead create more tension by leading men to feel as if their authority and role had been undermined within the household.

In addition to experiencing trauma as the wives, sisters, and mothers of men, many women were also politically persecuted and suffered at the hands of the CNI. The intelligence agents who detained, interrogated, and tortured individuals were often men, which meant that arrested women often experienced sexual assault. Both male and female detainees were often forced to strip naked in front of their interrogators and experience the electrocution of their genitalia.259 However, intelligence agents often touched women’s breasts and genitalia in addition to other forms of torture, whereas men who gave testimonios did not mention this sort of treatment.260 While none of the testimonios given by women explicitly discuss the experience of rape, one woman was convinced that she only avoided it because she had a contagious skin disease at the time of her detainment.261 This indicated that some officers would rape their female prisoners.

The sexual assault of women during detainment was a method that intelligence agents used to delegitimize women’s power and political participation. An intelligence agent could further assert his authority over a male detainee by challenging his heterosexuality; based on reports, this was usually done verbally, such as calling a man a “maricón,” a derogatory term to describe a homosexual male.262 However, violating another male sexually could raise questions about the torturer’s own sexuality. In this case, his own masculinity, along with the power that was tied to it, would be contested. The expected submission of women, in accordance with

259 1. Application of Torture Methods to Youth,” 23; “3. Application of Torture Methods to Women,” 54. 260 “3. Application of Torture Methods to Women,” 56, 59. 261 Ibid., 62. 262 Ibid., 54.

78 gender roles, enabled interrogators to take the step of physically asserting sexual dominance, because it could only reinforce their perceived masculinity and authority. Sexual assault also characterized women as sexual objects rather than political prisoners, ignoring the aspect of their identity that made them a political threat to the regime. In fact, the absence of sexual assault made one woman feel as if she had received “softer” and “equal” treatment when she was left alone with policemen who did not touch her, even though they tortured her in other ways and continuously said, “Let’s kill her right now.”263 While these men posed a threat to her life, they did not attempt to exert sexual authority over her. She believed that this was a sign that they treated her primarily as a suspected communist and as an enemy of the state, focusing on her politics rather than her gender. In this way, sexual assault was both an interrogation tactic and a way of delegitimizing women’s roles as political resistors.

These records revealed the ways in which women experienced and processed their trauma differently from men. The assertion of traditional gender roles during the Pinochet era and the forceful way in which the coup occurred bound gender and power tightly to each other in the new regime. In addition to the sexual forms of assault and torture women experienced, wives whose husbands were detained carried an additional economic burden. Their positions as the primary source of income for the household created tensions with their husbands, who would feel emasculated, and stigmatized their families for being associated with leftist, unemployed, emasculated men. Furthermore, women as mothers were responsible for explaining the political circumstances to their children and managing their reactions. Mothers’ accounts of these experiences hinted at the way in which children’s relationships with their parents changed and the nature of children’s traumatic experiences.

263 “3. Application of Torture Methods to Women,” 59.

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Trauma Experienced by Children

One of the most pressing issues for the families that came to the Vicaría and FASIC was the impact of authoritarianism on children. Both human rights organizations were initially concerned with the way that the military’s oppressive tactics were impacting both politically targeted individuals and their families. The psychiatric team at FASIC believed that the new regime caused “great anguish, disorientation...and...confusion” for families because it transformed the environment into a “fearful reality.”264 Disappearances, detainments, and murders of loved ones created a general sense of fear among certain parts of the population.

Among the people that came to the Vicaría and FASIC, there was growing concern for how children were impacted by the political situation. Due to the importance of this issue to families, the mental health teams at both institutions focused additional attention on the mental health of youth. Several of FASIC’s publications centered upon the way in which the political situation impacted children and adolescents, including articles ranging from the impact of having detained parents to the way that older youth were targeted and tortured by the military junta.

Interest in the mental health of children and adolescents was fueled by the concerns of various mothers and other family members who had come to the organizations for help. In a

FASIC pamphlet discussing the negative impact of political repression on children, the “chief complaints” were entirely defined by “the reasons given by mothers who agreed to have their children treated.”265 Additionally, psychologist Rosario Domínguez utilized a variety of parent testimonies in order to illustrate the trauma that children were experiencing when one or both of their parents was detained.266 Even in cases that involved teenagers, it was clear that parents

264 “Atención médico-psicológica de personas afectadas por la repression política en Chile,” FASIC (1985): 1. 265 “Daño en los menores, hijos de familias directamente afectados por la Represión,” FASIC (1978): 2. 266 Rosario Domínguez, “El efecto psicológico en los niños, hijos de detenidos politicos,” FASIC (1981): 2-9.

80 found their children’s mental health to be one of their most pressing concerns. However, it was less clear whether these children recognized that they could benefit from therapy. Due to the limited amount of autonomy that children generally have, mental health professionals’ decision to treat and analyze the mental health of children was highly dependent upon what their parents communicated and desired. In addition to grappling with their own emotional reaction to the situation, adult family members also sought to provide support for their children and vocalized these concerns to their mental health providers on behalf of their children

Although young children rarely experienced torture or detainment themselves, they were characterized as “indirect victims of the repression” because their parents or family members were politically persecuted and/or the children were witnesses to violence.267 Between August

1977 and February 1978, FASIC’s mental health team treated and analyzed data from 203 children between zero and twelve years old.268 These children all had a relative who had been disappeared. The team noted that 77.8% experienced “reactions of isolation,” which included silence and retreating from relationships with others, and 78.3% experienced “reactions of fear,” most frequently the fear that they would “suffer the same fate as their relative.”269 Although

“reactions of fear” were the most common concern, the team decided to list “reactions of isolation” as the symptom of primary importance. In doing so, the therapists linked children’s trauma most strongly to social isolation, thereby situating their experience primarily in the familial experience. Additionally, the team believed that “obviously, what is happening with children in some way also reflects the problems and necessities of familial groups.”270 Children had their own reactions to trauma, but these responses were treated as a reflection of the trauma

267 Maggi, “La tortura y los niños,” 7-8. 268 “Agrupación de Familiares de Detenidos Desaparecidos,” FASIC (1978): 1. 269 Ibid. 270 Ibid.

81 that impacted the family as a whole. FASIC’s mental health professionals treated children initially due to adults’ concerns about their behavior. Later, the therapists also came to examine children’s mental health in order to understand how to address familial trauma.

FASIC utilized the testimonio of Pedro, a thirteen-year-old boy whose father had been released from detainment, to highlight the ways in which children could internalize the trauma their parents faced directly. Adriana Maggi, a psychologist at FASIC, discussed how Pedro would constantly wonder what happened to his father during his detainment. He would eavesdrop on conversations his father had with other adults about memories of his imprisonment:

“He learned about [a form of] torture in which his father was forced to bury his head in human excrement...[and] eat it...[Pedro] started to experience...stomach pain, nausea... This is a typical case in which knowledge...of torture...invades the imagination of the child, who re-lives it.”271 In this case, Maggi emphasized the intergenerational and experiential nature of trauma. Although

Pedro was not the one who experienced torture directly, nor did he witness it, his psyche and his body carried the impact of it by reenacting the physical trauma his father experienced. Maggi’s emphasis on this aspect of his case implied that she believed it was important to look at the ways children experienced repression as if it were direct violence towards them, even if they were technically “indirect victims.” Maggi also broadened the way in which trauma could be passed intergenerationally. In addition to dealing with the psychological impact of witnessing trauma or living without a parent or family member, children in some cases physically re-lived their relatives’ trauma.

The treatment of children was framed as one of the Medical-Psychiatric Team’s central concerns as a way of showing their support for affected families. The team reinforced the idea

271 Maggi, “La tortura y los niños,” 12.

82 that it stood in solidarity with the adult family members of the disappeared, executed, and detained by caring for their children. Additionally, the therapists linked the treatment of children to a more positive future. The mental health team invited the families they worked with to a holiday party in December 1978 and highlighted children in the invitation: “On this day of celebration and family gatherings for many and of pain and uncertainty for us, we would like to open with what represents our most important effort in moving forward: working with our children. For the right to life, peace, liberty, and justice: we will meet!”272 The group considered healing children to be its “most important effort in moving forward,” highlighting the perceived importance of youth in the larger political movement. Even if most of them did not have the autonomy or awareness to make individual political decisions during this era, the implication was that in the future, these children would also contribute to the fight “for the right to life, peace, liberty, and justice.”273 Working with children was a way to address “pain and uncertainty” that impacted them by memorializing the trauma that the community faced and tying children to future political projects.274 Despite the fact that these children were traumatized, they would emerge as another source of hope in the creation of a more humane Chile.

Conclusion

The FASIC team had a broad and fluid definition of “trauma,” leading them to consider the impact of authoritarianism on both the individuals who were direct victims of violence and the families of the tortured and disappeared. The word’s ambiguity may have been purposeful, considering the widespread impact that the military junta’s policies had on Chilean society. The meaning of “trauma” could not be restricted because so many had suffered due to political

272 “Agrupación de Familiares de Detenidos Desaparecidos,” cover page. 273 Ibid. 274 Ibid.

83 persecution and economic violence. Those who had been tortured had clearly had a traumatic experience, but families and communities suffering from economic hardship also endured the psychological strain that came with it. This was especially true in the event of detainment or disappearance, which deprived families of loved ones and income earners. Despite Pinochet’s ostensible support for patriarchal familial structures and traditional gender roles, the military junta’s political persecution of its citizens disrupted both values. The detainment, disappearance, execution, and politically-associated unemployment of men disrupted familial dynamics by taking away most families’ primary source of income. Furthermore, it meant that women often had to take their husbands’ place as the heads of the household, which often meant that women had to work more outside of the home instead of caring for their children. The impact on children was one of the primary reasons that many families sought mental health services from FASIC, and children’s mental health status became a measure for how families were adjusting to the political climate.

This family- and community-based approach reflected these therapists’ worldview and their conviction that their medical work was tied to the political and social context. FASIC’s mental health professionals could only treat their patients by accepting that Pinochet’s intelligence and law enforcement agencies had harmed them, whether it was through torture, disappearance, or exile. Without acknowledging the political circumstances, therapists would be unable to work with patients to cope with the trauma they experienced. The team members believed that they, as well as other medical professionals, could not claim neutrality because their actions (or inaction) did not exist outside of a certain political reality.275 In order to advance both political and therapeutic goals, it became important for FASIC’s Medical-Psychiatric

275 “Traumatic Experiences: Violence and Torture,” 11.

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Program to develop therapy that tackled both issues at once. As a result, the team began to utilize the testimonio both as a way of achieving catharsis through confronting traumatic experiences and recording instances of political violence in order to denounce the Pinochet regime.

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CHAPTER 3 Testimonio as Therapy and Archive

Introduction

During the Pinochet years, FASIC’s Medical-Psychiatric Program produced a large and varied collection of written material, including bound records of testimonios, goals, and plans of action, and pamphlets analyzing the political situation’s impact on mental health. Although the pamphlets quoted their patients, they were not primarily utilized as clinical notes. Rather, they served as analyses of the team’s operations and condemnations of state violence. While most of this chapter focuses on the FASIC team’s documents and its usage and analysis of testimonio, I also draw from transcripts of group therapy sessions at the Vicaría de la Solidaridad (the

Vicariate of Solidarity, or the Vicaría). Although it had a less robust mental health team than

FASIC, the Vicaría was the largest human rights organization operating at the time and provided some mental health services to their clients. Its documents also provide insight into the ways in which patient narratives of traumatic experiences were collected and utilized for therapeutic and political purposes.

Prior to the establishment of mental health services at human rights organizations,

Chileans who were directly impacted by political repression were referred clandestinely to certain medical professionals, including psychiatrists and psychologists.276 They provided emergency care to patients in their private practices. Eventually the demand for mental health services grew to the extent that human rights groups began organizing in order to provide the

276 Mario Garcés and Nancy Nicholls, Para una Historia de los Derechos Humanos en Chile: Historia institucional de la Fundación de Ayuda Social de las Iglesias Cristianas FASIC 1975-1991 (Santiago: LOM Ediciones, 2005), 67.

86 resources to treat those in need.277 Both FASIC and the Vicaría founded their mental health programs towards the end of the 1970s, and staffed them with volunteer psychiatrists, psychologists, and social workers.278 At first, FASIC and the Vicaría provided psychiatric care through group therapy sessions for formerly imprisoned individuals and their families, many of whom were forced into exile.279

Joining FASIC or the Vicaría inherently involved taking a stance against the military junta. This is evident in the various pamphlets produced by therapists that link mental health disturbances to authoritarianism. By joining FASIC, the Vicaría, or any other human rights organization at the time, therapists put themselves at risk of being imprisoned, exiled, or killed.

The work that they performed could not be divorced from politics because the need for mental health services was exacerbated due to state violence. Their patients had been politically persecuted and lived in communities that were targeted for political reasons. Many were from poblaciones, low-income communities or shanty-towns, which were the communities that provided the largest political base for the left and President Allende’s Unidad Popular.280

Furthermore, the topic of the military junta would have been impossible to avoid when treating survivors of torture and family members of the disappeared.

277 Brandi Townsend, “La psique democrática: Género, salud mental y militancia bajo la dictadura de Pinochet,” Revista Internacional Interdisciplinar INTERthesis 10 (2013): 70. Elizabeth Lira, trans. Maxine Lowy, “Testimony of Traumatic Political Experiences: Therapy and Denunciation in Chile (1973-1985),” Psyke & Logos 30 (2009): 30. 278 Lira, “Testimony of Traumatic Political Experiences,” 30. 279 Ibid.; Vicaría de la Solidaridad, File CD:001818, Archive and Documentation Center of the Vicaría de la Solidaridad, 1. No title, author, or date. FASIC’s primary work at the beginning of the dictatorship was filing legal papers that commuted prison sentences into ones for exile. They processed the paperwork for about 5,000 political prisoners between 1975 and 1980. According to historian Nancy Nicholls, this contributed to the organization’s survival, as it was actually providing a service that the Pinochet government supported by sending political opponents out of the country, where they posed less of threat to the military’s power. FASIC was not doing this to assist the military government, but to prevent the continued detainment and probable torture or death of the imprisoned. 280 Mark Ensalaco, Chile Under Pinochet: Recovering the Truth (Philadelphia: University of Pennsylvania Press, 2000), 27.

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Mental health professionals introduced new therapies in order to address the trauma caused by the repressive political situation. Testimonio, which had origins in Latin American literary traditions, combined psychological therapy with political advocacy. This chapter endeavors to explore the adoption of testimonio as a therapeutic and political tool by FASIC’s therapists. FASIC’s mental health professionals utilized testimonios as both innovative therapies and an opportunity for them to become involved in human rights advocacy. Testimonio as a treatment tool was unique because it disrupted the traditional power dynamics between psychiatrist and patient by privileging the patient narrative. It also created a space in which the patients’ voices could be heard within an authoritarian situation, thereby challenging the culture of silence imposed upon the population by the political situation. However, in its design, the dual purpose of testimonio—as therapy and as archive—raised questions about its primary purpose.

While testimonio’s format challenged psychiatric and military authority, patients were not free of the influence of their therapists, who utilized patient narratives to advance political goals. These practitioners were usually advocating in the interest of their patients’ communities. However, the therapeutic arrangement deprived patients of the autonomy to decide the ways in which their narratives were utilized to challenge political authority. Ultimately, the FASIC’s Medical-

Psychiatric Team’s decision to deploy testimonio as both a therapeutic and political tool cemented the relevance of mental health professionals in present-day Chilean discourse on national trauma and memory.

Testimonio: Literary Voice of the Marginalized

The term testimonio refers to a category of literature that has its origins in Latin America.

The first person to utilize the term novela-testimonio and bring it to the literary world was

Miguel Barnet, who applied it to his 1966 work, The Autobiography of a Runaway Slave

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(Biografía de un cimarrón), an account of the life of a Cuban cimarrón, or escaped ex-slave,

Esteban Montejo.281 The Casa de las Américas, an organization created shortly after the Cuban

Revolution to promote cultural works and development in Latin America, established testimonio as an official literary genre by creating an award specific to testimonios in their annual literature competition.282 Testimonios are written in first-person in a style that speaks directly to the reader, which is a product of the relationship between the testigo (witness) and the editor (editor) or compilador (compiler).283 Normally the testigo tells their story orally to the editor, who is ultimately the person who records and transcribes the testimonio.284

Testimonio is not literature created for strictly artistic purposes; rather, the intention behind this genre is to communicate a political message through the stories of “repressed” voices.285 The word literally translates to “testimony,” as if “bearing witness in a legal or religious sense.”286 This analogy is meant to highlight the gravity of the text and the “sincerity” of the narrator, which the reader is meant to respect by believing the witness’ perspective to be true.287 Instead of narrating from the perspective of an academic or highly educated writer, the subject of the testimonio is usually an individual who is marginalized.288 The editor’s voice is absent from the text, which should be an accurate transcription of subject’s orally communicated narrative.289 The editor’s goal is usually to write testimonio in a colloquial tone that mimics and

281 George Yúdice, “Testimonio y concientización,” Revista de Crítica Literaria Latinoamericana 36 (1992): 211. According to Beverley (“Anatomía del testimonio”) there already existed a production of testimonios in Cuba at the time of Biografía de un cimarrón’s publication, including Ché Guevara’s memoirs and testimonios of military combatants. (9) 282 John Beverley, “Anatomía del testimonio,” Revista de Crítica Literaria Latinoamericana 25 (1987): 9. 283 Gustavo V. García, “Hacia una conceptualización de la escritura de Testimonio,” Revista Canadiense de Estudios Hispánicos 25 (2001): 426. 284 Ibid., 426. 285 Yúdice, “Testimonio y concientización,” 211. 286 John Beverley, Testimonio: On the Politics of Truth (Minneapolis: University of Minnesota Press, 2004), 32. 287 Beverley, Testimonio, 32. 288 García, “Hacia una conceptualización,” 426. 289 Yúdice, “Testimonio y concientización,” 211.

89 preserves the voice of the testigo. This is in order to focus on the message of the subject rather than that of the compiler, in order to allow the subject to define the political agenda of the piece.

The act of writing and publishing the narrative is meant to spread it to a larger audience that it otherwise would not have reached.

The testimonio is thus meant to empower the witness and give them authority in a political context where they may not normally possess it. The structure and style of the testimonio break away from the traditional norms of literature. Additionally, its content questions and critiques the political status quo. Testimonio is a vehicle through which the subject may

“communicate, a problem of repression, poverty, subalternity, imprisonment, struggle for survival” in order to challenge the social and political norms.290 These challenges are usually made implicitly through sharing the witness’ personal narratives, which are meant to cause discomfort that prompts readers to question the social order and act upon these feelings to change the norm.291 Therefore, the primary purpose of the testimonio is to promote solidarity with marginalized groups in order to promote social change.

The popularity of testimonio continued to expand in Latin America in the 1960s and the genre was generally utilized to communicate the political messages of the left. It embodied the revolutionary spirit the new Cuban government was trying to promote at home and abroad by giving voice to the marginalized and challenging more traditional literary forms.292 A subgenre of guerrillero (guerilla) testimonio became well known, largely due to the success of Ché

Guevara’s personal account of the Cuban Revolution.293 Additionally, testimonio was linked to

290 Beverley, “Anatomía del testimonio,” 9; Beverley, Testimonio, 32. 291 Kimberly Nance, “Disarming Testimony: Speakers’ Resistance to Readers’ Defenses in Latin American ‘Testimonio’,” Biography 24 (2001): 571. 292 Victoria García, “Testimonio literario latinoamericano: prefiguraciones históricas del género en el discurso revolucionario de los años sesenta,” Acta Poética 35 (2014): 68. 293 Beverley, “Anatomía del testimonio,” 10.

90 counterculture and viewed as a “form of catharsis or personal liberation.”294 The genre rejected the political, social, and literary convention, in both form and message. As intended, it would have an impact on fields beyond literature and be utilized to challenge repressive policies, governments, and social norms.

Testimonio as Therapy and Object of Political Analysis

Mental health professionals associated with human rights organizations were interested in exploring both the therapeutic applications of testimonio as well as the political ones, given that they were practicing in an authoritarian state. The goals of psychotherapy listed in a pamphlet about violence and torture were focused on psychological health and included “catharsis from the traumatic experience” and the “emotional elaboration of the meaning of the traumatic experience.”295 This presented the image that testimonio was utilized primarily to allow patients the opportunity to process their emotions in order to understand their personal trauma, rather than denounce the government. However, the Medical-Psychiatric Program was also founded under the Social Services Division of FASIC, and as such had to be dedicated to the “promotion and defense of Human Rights,” a central tenet of the division.296 Furthermore, by recording and printing the narratives of their patients, many of whom the state saw as political threats, mental health professionals at FASIC were performing political work that challenged the military government alongside their clinical duties. The therapeutic team was created under a department of FASIC that frequently collected data on and described the social impact of the coup.

Testimonios were a way for the FASIC team to help elevate their patients’ narratives and utilize them to represent the political reality.

294 Beverley, “Anatomía del testimonio,” 10. 295 Lira and Weinstein, “Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” 10. 296 “Social Services in the Medical-Psychiatric Program,” FASIC (n.d.): 1; “Frame of Reference: Professional Social Services,” FASIC (n.d.): 17.

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Initially, patients’ testimonios were recorded and filed as denunciations of the regime for individuals who had experienced especially brutal torture and harassment.297 Mental health professionals had been involved in this process and observed that denouncing the government seemed to assist in psychological recovery, leading them to consider ways of utilizing testimonio to continue to improve their patients’ mental health.298 Chile had a long history of democracy that was interrupted by the 1973 coup, and the military’s subsequent repressive actions caused trauma that many Chileans had never imagined nor faced before. In this sense, it was both a drastic political change and a new clinical challenge for the psychiatric and psychological community. Psychiatrist Elena Castro, who volunteered for several years at FASIC during the dictatorship, recalled that the Medical-Psychiatric Team had turned to testimonios because the existing tools were insufficient to address the trauma that Chileans were experiencing.299

The actual process of creating a testimonio involved recording the patient’s spoken narrative. For therapeutic purposes, the transcription of the recording would then be analyzed during therapy sessions in order to allow the patient to reflect on the details and emotions they presented in their testimonios.300 Through testimonio as therapy, patients could clarify their identity and challenge the label of “criminal” that the Pinochet regime had placed on them.301 As a literary genre, the testimonio gives representation to marginalized voices; in the context of therapy, it helped restore a sense of control in patients after it was taken from them through detainment, torture, or having a relative “disappeared.”

297 Ana Julia Cienfuegos and Cristina Monelli, “The Testimony of Political Repression as a Therapeutic Instrument,” American Journal of Orthopsychiatry 53 (1983): 44. 298 Lira, “Testimony of Traumatic Political Experiences,” 31. 299 Interview with Elena Castro, July 6, 2016. 300 Ibid. 301 Ibid.; Cienfuegos and Monelli, “The Testimony of Political Repression,” 44.

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Part of the clinical rationale behind employing testimonio drew from Freud’s ideas on catharsis through verbal communication.302 Freud believed that an individual would have to reproduce the experienced trauma in order to reach a state in which they could helpfully “talk out” and analyze the traumatic event.303 The testimonio process was helpful through the initial, cathartic articulation of the traumatic experience, and the transcription of the oral narrative allowed the patient to reread and continue to reflect upon the experience.304 An evaluation in

1983 by two Chilean psychologists determined that testimonio as therapy could not entirely stop

“acute symptoms, such as anxiety or acute depression,” but the process helped diminish their severity.305 Elizabeth Lira, one of the most prominent psychologists at FASIC, claimed that the testimonio was helpful because it restored both a sense of purpose and the ability to trust in the lives of the detained and tortured.306

Additionally, testimonio was meant to be applied to political critique. The Medical-

Psychiatric Team produced reports on the mental health of specific groups and topics, such as the psychological harm done to relatives of the disappeared, experiences of the detained, and children impacted by the coup. In several of these documents, they utilized excerpts from testimonios in a manner that is more politicized than using it as qualitative data to prove a psychological theory. The interview transcriptions provided a record of therapeutic interactions in addition to criticizing the dictatorship. The team hoped to study the political and social changes as well as the psychological issues of their patients. Furthermore, one of the goals of the

Medical-Psychiatric Program was to collect information for “denunciations” of the military

302 Lira, “Testimony of Traumatic Political Experiences,” 33. 303 Cienfuegos and Monelli, “The Testimony of Political Repression,” 45. 304 Ibid., 45. 305 Cienfuegos and Monelli, “The Testimony of Political Repression,” 48. 306 Lira, “Testimony of Traumatic Political Experiences,” 43.

93 government in order to speak out against the regime on both domestic and international platforms.307 As a result, each testimonio served the political purpose of communicating the state of repression and fear that many Chileans experienced.

This consideration of the social and political impact of the dictatorship was clearly demonstrated in various publications authored by members of the mental health team. For example, a 1981 report by Elena Gómez and Angelica Monreal, two psychiatrists at FASIC, was titled, “The Unresolved Death, the Disappearance.”308 The title itself was a critique of the military junta. Those who supported the military regime were unlikely to know about or publically acknowledge “disappearances,” as the term suggested that people were going missing after being detained by the authorities. To write about “disappearance” as a shared experience validated the suspicions, anger, and grief of the psychiatrists’ patients. Through producing and archiving testimonios, FASIC’s mental health professionals demonstrated their solidarity with the repressed and took a stance against authoritarianism, rather than maintaining a clinically detached outlook.

Testimonios recorded and printed in their complete form promoted patient agency by highlighting patients’ political views without additional commentary. For example, Gustavo

Zepeda Camillieri praised two of his colleagues for their “rigid and firm attitude” in the face of torture.309 He went on to say, “My will—and that of theirs—is to continue fighting tirelessly for the rights of the majority for work, for justice, for liberty, for democracy, and for socialism.”310

Although the authorities tried to cast him as a militant “extremist” that was a threat to the country, Zepeda was able to utilize the testimonio to assert his identity and clarify his political

307 “Frame of Reference: Professional Social Services,” FASIC (n.d.): 17. 308 Elena Gómez and Angélica Monreal, “The Unresolved Death, The Disappearance,” FASIC (June 1981): 1. 309 “The Practice of Torture in Chile During 1983,” 24. 310 “The Practice of Torture in Chile During 1983,” 24.

94 views, to himself and to those who would later read the document. In this process, he also affirmed his relationship to two of his fellow detainees and the left-leaning political goals they shared. As such, his therapist helped him create a testimonio that made a more nuanced statement about his political beliefs compared to the junta’s label of “extremist.” This contextualized his individual experience and created a narrative that went against the one being promoted by the

Pinochet regime. These testimonios were records of their suffering that gave the patients the ability to communicate their political experience to others and undermine the authoritarian government.

In other cases, the therapists extracted excerpts from patient testimonios to advance their advocacy for human rights. “Torture, a Medical Problem,” a booklet published in 1983, contained several testimonios of torture experiences and strongly linked the patients’ accounts to both political and medical goals. On one hand, the information was gathered and recorded to

“expand on and understand the neurophysiological alterations...triggered by the massive attack that torture represents,” which would imply that the documentation served primarily clinical purposes.311 However, the article also highlighted the political importance of testimonio in denouncing the military regime, because it made it “impossible to not acknowledge that physical and psychological torture constitute[d] a habitual and massive practice in our country.”312

Documentation of a similar nature that challenged Nazism was described as having

“extraordinary testimonial value, that also constituted relevant medical-scientific reports.”313 In a similar manner to testimonial collection in Europe in the aftermath of World War II, professionals at FASIC expressed their interest in both the clinical perspective and the important

311 “Torture: A Medical Problem,” FASIC (March 1983): 3. 312 Ibid., 1. 313 Ibid.

95 political and legal role that the testimonios could play in denouncing the military government’s actions. As such, these medical professionals also acknowledged the potential that their written material would be used for political, and not strictly scientific, purposes.

Psychiatrists Gómez and Monreal utilized patient narratives to understand the political situation from the point of view of the relatives of the disappeared. In treating these individuals, they authored a document expanded more thoroughly on the political and social situation rather than clinical notes they had on their patients. In the introduction, they wrote that the political situation caused “incalculable psychological harm to the individual [that] continues to increase the repercussions in the familial, labor, and social realms.”314 Despite their specialization in mental health, the psychiatrists did not restrict themselves to the psychological aspects of the issue and instead emphasized the connection between the societal, familial, and psychological.

Additionally, their analysis in this booklet tended to be in reference to the social impact of the coup more than clinical analyses of their patients. While the psychiatrists mentioned emotional patterns and similar thoughts among their patients, such as “feelings of frustration and hopelessness” and imagining the “torture [and] harassment” their detained relatives faced, they utilized the voices of their patients in excerpts of testimonios to elaborate on the psychological and social impact of “disappearances.” Patients had the opportunity articulate and process their emotions about the disappearance of their relatives to aid them psychologically, but they were also given a critical political role in constructing evidence of the military government’s transgressions.

For example, Gómez and Monreal chose to quote several patients when explaining the experience of coming to think of an “absent relative as ‘disappeared.’”315 The psychiatrists

314 “Torture: A Medical Problem,” i. This is the introductory page. 315 Gómez and Monreal, “The Unresolved Death, The Disappearance,” 3.

96 purposefully decided not to summarize their patients’ thought process. One woman spoke to others who told her “that they did not know anything of their husband for five or six months, the only thing I thought is that the same thing did not happen to me, that is, I recognize that is enormous arrogance, but [that situation] was so brutal.”316 Another had believed that the family of the detained still received “news” of their relative and that she only really used the term

“disappeared” once she “lived the situation” of “knowing absolutely nothing of your relative.”317

In the first account, the retention of “that is” (o sea) was representative of that individual’s way of speaking, helping to retain the “sincerity” of their statement that is important to testimonios.318

This format also allowed the women to define “disappeared,” rather than having the psychiatrist define their reality. In both cases, the lack of analysis of the statements after they were placed in the text implied that the reader should acknowledge the value of these women’s experiences, rather than rely on a “professional” interpretation. This reflected the testimonio’s intention of affirming the voice of “the excluded or the marginal.”319

While the focus of the testimonios was the narratives of the patients themselves, the

Medical-Psychiatric Team utilized these accounts to represent collective trauma. Testimonios were useful for human rights advocacy as standalone texts as well as objects of analysis.

Although the way in which they experienced repression may have been different, a large portion of the Chilean population’s freedom was limited by the new regime. As such, by helping their patients construct their narratives of suffering, the therapists were contributing to the process of creating testimonios of trauma that denounced the military junta and came to represent the suffering of Chilean society at large.

316 Gómez and Monreal, “The Unresolved Death, The Disappearance,” 4. 317 Ibid. 318 Beverley, Testimonio, 32. 319 Ibid., 34.

97

Addressing Cultural Silence through Testimonio

At FASIC, testimonio was implemented to help individuals heal from their traumatic experiences and denounce the authoritarian regime’s repressive actions. However, reaching the point at which patients felt ready to speak and record their testimonio could be difficult, as discussing their trauma could reproduce the negative emotions and pain that were associated with the original experience.320 In many cases, torture caused formerly detained individuals to experience “a high level of anxiety;...loss of self-esteem; [and] social withdrawal.”321 This was the result of the military government’s tactics to break down the “identit[ies], bonds, loyalties, and beliefs” of “political threats.”322 Given this situation, revisiting one’s experience in prison could be an incredibly trying and painful process. For this reason, while some were enthusiastic to record a testimonio as part of their mental health treatment plan, others had not spoken about their experience for over five years.323 The nature of the society that these individuals were returning to also must be taken into account when considering the process of giving testimonio.

Pinochet utilized repressive tactics to secure his power through de-politicizing the population and challenging the stability of popular organizing. Like other Latin American military juntas of the period, his regime was known for torturing, executing, and disappearing people who threatened the stability of the new military junta. The primary targets of the initial round of crackdowns were the armed leftist groups, such as the Revolutionary Left Movement

(Movimiento de Izquierda Revolucionaria, or MIR), followed by known but more moderate

Allende supporters, such as politicians within the UP.324 However, the military junta also began

320 Lira, “Testimony of Traumatic Political Experiences,” 52. 321 Cienfuegos and Monelli, “The Testimony of Political Repression,” 45. 322 Elisa Neumann and Consuelo Macchiavello, “Prolonged Solitary Confinement: Another Form of Torture. Psychological Repercussions in the Individual,” FASIC (August 1988): 1. 323 Cienfuegos and Monelli, “The Testimony of Political Repression,” 47. 324 Ensalaco, Chile Under Pinochet, 27.

98 to target leaders of non-militant labor movements, student movements, and poblaciones, among other groups.325 The targets were evidently leaders with working-class support. This indicated the junta’s interest in fracturing social support networks forged within working class communities The loss of leadership as a result of widespread repression and violence made it more difficult for working class resistance groups to organize in opposition to Pinochet's regime.

These organizational barriers made it difficult for groups to form cohesive and substantial opposition to Pinochet.

In this way, under Pinochet’s rule, the Chilean population became more concerned with individual self-preservation, rather than collective action against oppression. There was an ever- present threat that military authority would dictate “if you should abandon your country, if you will have a job...what you can read, what you can say.”326 In such an environment, there were people who felt uncomfortable remembering or speaking openly about their experiences of torture, detainment, or disappearances. They performed an “unthinking habit” or “conscious burial of the dangerous,” given that anything one said against the military regime could lead to threats to themselves or their families.327 Dr. Elena Castro, a psychiatrist at FASIC, shared a similar sentiment during the period; although she did not let the “constant fear” she felt prevent her from providing services at FASIC, she felt compelled to maintain her silence and avoid political subjects in public.328 As such, ex-detainees and other victims of repression that returned to their families still faced the obstacle of overcoming a societal silence caused by fear. For example, a man name Jose C. had survived a firing squad and remained in hiding for five years;

325 Garcés and Nicholls, Para una Historia de los DD.HH. en Chile, 21. 326 “Some Mental Health Problems Detected by the Psychological-Psychiatric Team,” Vicaría de la Solidaridad (n.d.): 10. 327 Steve Stern, Remembering Pinochet’s Chile (Durham: Duke University Press, 2004), 89; FASIC, 335. 328 Interview with Elena Castro, July 6, 2016.

99 he only gave a testimonio of the experience six years after due to the fear he felt about telling his story.329 This environment likely made it even more challenging for patients to feel comfortable articulating their experiences and begin reintegrating into the community around them.

Producing a testimonio was thus also important because it challenged the silence imposed upon Chilean society. The therapists at FASIC considered silence as being “complicit not only in the application of torture, but also in the destruction of the dignity of the homeland.”330 They posited that victims’ silence could lead to isolation and a failure to reintegrate into society, and they believed that participating in group therapy sessions and seeing other patients’ similar testimonios validated patients’ personal experiences and created connections with others.331

Making a testimonio, provided a way to reassert one’s identity after being officially labeled as a criminal or “dangerous” to the country. Additionally, challenging the public norm of silence and denouncing the dictatorship in the form of a testimonio contributed to the collection of evidence against the policies enacted by the regime. Testimonios were especially useful when informing international human rights organizations about the Chilean situation.

In addition to testimonios, FASIC’s therapists conducted group therapy sessions because they gave participants the opportunity to reflect upon their own experiences and create relationships with those who had lived through similar events. They involved patients recounting their own narratives as victims of torture or family members of the disappeared and listening to the experiences of others. This tied personal experiences into collective opposition to authoritarianism. In one report, FASIC’s therapists emphasized that it was a space for participants to “express themselves in their own language,” highlighting the importance of the

329 Cienfuegos and Monelli, “The Testimony of Political Repression,” 47. 330 “The Practice of Torture in Chile During 1983,” FASIC (June 1984): 1. 331 Lira, “Testimony of Traumatic Political Experiences,” 52.

100 patients having autonomy over self-expression and representation after being detained, tortured, or otherwise limited by the dictatorship.332 Although there was an emphasis on processing what they had lived through, mental health professionals also utilized group therapy sessions to connect their patients to each other and create a community. In the absence of a safe and free public life, the group therapy sessions allowed for “collective development” and “joint learning” that was utilized as social support.333 For example, the pamphlet “The Unresolved Death, the

Disappearance” (1981) included the testimonios of various individuals that were searching for their disappeared relatives.334

Mental health professionals could also actively prompt group identity formation through the questions they asked. At one session at the Vicaría, the psychiatrist asked, “You are also a campesino. What do you say to this?” and “What do you think, ladies?”335 These questions highlighted the identities each individual held and formed sub-groups by drawing attention to other people who related to that identity. The usage of multiple types of groups, including occupation and gender, promoted connections to different sets of people. This allowed participants to discuss their experiences and the political situation through a variety of lenses, rather than just one. Furthermore, the structure of group therapy in itself promoted collectivism through physical space and association with a particular organization. By providing a forum for each individual in the group to talk about their own experience, therapists gave their patients an opportunity to construct a collective identity together.

332 “A Work Experience in Poblacional Mental Health,” FASIC (August 1985): 19. The word “poblacional” is the adjective form of población, which were Chilean shantytowns. 333 Ibid.; Sergio Lucero Conus, “Mental Health and Human Rights Violations,” Vicaría de la Solidaridad (June 1989), 3-4. 334 Gómez and Monreal, “The Unresolved Death, The Disappearance,” 2-13. 335 Vicaría, “Detention and Reclusion,” 34.

101

This method received positive feedback from patients, who felt empowered to improve their social and psychological situation. Furthermore, the patients were grateful for the opportunity to forge bonds with other patients. Rosario Domínguez and David Becker facilitated a group therapy session in 1986 specifically geared towards youth. Based on their patients’ evaluations, Domínguez and Becker challenged the traditional therapeutic power dynamics by giving group members enough agency to feel that they could have an impact on the mental health of others. At the end of the semester’s therapy sessions, patients credited the therapists, the group’s format, and other patients for their improvement. One participant characterized

Domínguez and Becker as “excellent professionals,” because they “did not filter the information said by each one of us.”336 Another patient said the best thing about the sessions was “the dialogue that was established between the youth and the psychologists,” and the patient felt “able to and tried to help one of [the patient’s] peers.”337 There was open dialogue established between the two parties that allowed patients to better understand their psychological state and the therapies they could employ to address them. Furthermore, the therapists were able to create an environment in which the youth felt empowered to help themselves and others, thereby promoting patients’ active participation in the therapeutic process.

Both during Pinochet’s government and post-dictatorship, the testimonio has served as a way for those impacted by repression to have their narratives legitimized and to combat the culture of silence imposed by the military regime. They have also served as a way the compilers of testimonios to further particular political messages. In the case of mental health care practitioners, especially at FASIC, testimonios would be utilized to produce pamphlets about the negative impact that the military regime’s repressive tactics had on mental health. They were

336 Rosario Domínguez and David Becker, “Youth Group: Second Semester 1986,” FASIC (1986): 13. 337 Ibid.

102 also used as ways of articulating a collective identity centered on shared trauma. While testimonio is a literary genre through which the oppressed are empowered, the Medical-

Psychiatric Team’s pamphlets usually did not make clear the psychiatrists intervention in the therapy sessions, nor did they always consider and analyze their patients’ points in their full context. Although the process of creating and sharing testimonios empowered and forged bonds between patients, it also subjected them to another form of authority.

Psychiatric Authority and Patient Autonomy

Although testimonio disrupted the traditional power dynamics between the psychiatrist and patient, the FASIC therapists’ continued to control the ways in which patient narratives were deployed as political tools. The mental health professionals that modified their therapies to incorporate testimonio were responding to the repressive conditions in Chile. Their work also fit into a broader international trend of challenging psychiatric power, exemplified by the anti- psychiatry movement that was concurrently gaining influence. The Medical-Psychiatric Team worked with patients to construct narratives of their social, political, and psychological experiences under authoritarianism. However, the therapists’ usage of testimonio re-inscribed psychiatric power by advancing their own political views through patient voices. Centering patient voices in testimonios and other pamphlets made patient perspectives more visible, but it also masked the role of mental health professionals in constructing those accounts.

Anti-psychiatry was a movement of individuals who began to question and criticize the role of psychiatry in society. In the United States, anti-psychiatry gained momentum in the late

1960s and 1970s, coinciding with and influenced by the rise of counterculture.338 The movement was a reaction to the perceived “exploitation of objectification of the mentally ill” in the

338 Heather Murray, “‘My Place Was Set At the Terrible Feast’: The Meanings of the ‘Anti-Psychiatry’ Movement and Responses in the United States, 1970s-1990s,” The Journal of American Culture 37 (2014): 45.

103 preceding decades.339 Anti-psychiatrists suggested that through over-medicalizing unconventional behaviors, psychiatrists were limiting people from exploring their individuality and restricting them to particular social norms.340 Two names often associated with the movement are Thomas Szasz and R. D. Laing, although neither individual ever self-identified as an anti-psychiatrist. Szasz, a psychiatrist himself, famously challenged the notion that “mental illness” was based in biology, positing that mental illnesses should actually be considered

“problems in living” that are primarily “social and ethical.”341 He believed that experiences labeled as “mental illnesses” were primarily caused by conflicts between personal values or needs and societal norms.342 Laing, who was also trained as a psychiatrist, believed that madness was defined against “‘sane’ society,” but he did not view “insanity” as a negative state.343 Rather, he felt that madness could be “a journey of self discovery,” leading him to found Kingsley Hall in London, where those with mental illness could live without being hospitalized or forced to take medication.344 Not all parties in the anti-psychiatry movement supported the exact ideas that

Szasz and Laing put forward, but they were unified in their critique of psychiatry and its role in imposing social norms upon patients.

The rise of the movement overlapped in part with the dates of the military dictatorship in

Chile. Considering both the progressive actions of the therapists at FASIC, as well as the fact that a few of them had gone into exile in the early years of the dictatorship, it was possible that anti-psychiatry impacted their practice.345 In one article, FASIC psychologist Elizabeth Lira indicated that while Laing contributed greatly to understanding the psychological impact of

339 Ibid., 37-38. 340 Murray, “My Place Was Set At the Terrible Feast,’” 37-38. 341 Thomas S. Szasz, “The Myth of Mental Illness,” The American Psychologist 15 (1960): 113-114. 342 Szasz, “The Myth of Mental Illness,” 15. 343 Allan Beveridge, “R. D. Laing revisited,” Psychiatric Bulletin 22 (1998): 452. 344 Ibid. 345 Garcés and Nicholls, Para una Historia de los DD.HH. en Chile, 67.

104 repression, she did not believe he advanced therapeutic interventions to address it.346 However, the FASIC therapists’ usage of testimonio as therapy and their extensive implementation of group therapy suggested that they were also interested in dismantling the power that psychiatrists traditionally had over the mentally ill. Their treatments sought to disrupt the conventional power dynamic between psychiatrist and patient, in ways that would give more agency to those that they were treating. This was especially important given the context of authoritarianism. The homes of those seeking help from FASIC and the Vicaría were not safe, due to the extensive monitoring and policing by the government, especially in poblaciones, where a large number of them resided.347 In this way, FASIC and the Vicaría were sites of refuge for their patients, not only because the organizations provided safer physical spaces, but also because they were places where patients could process, as openly as possible, their suffering and loss with others who had similar experiences.

Regardless of the motives that non-patient parties, such as the therapists and other staff of human rights organizations, had to encourage testimonio production, the usage of testimonio could also be seen as a way that patients were empowered to guide their own treatment.

Normally, the mental health care provider drew from institutional biomedical knowledge to diagnose the patients and treat their symptoms. However, the FASIC team based their analysis of mental health under authoritarianism on their patients’ testimonios. Additionally, the treatment method itself was a collaborative process that prompted active patient participation. The final work that was produced would be attributed to the patient and legitimized by the institution

346 Elizabeth Lira K. and Eugenia Weinstein L., “Traumatic Experiences: Violence and Torture, A Psychotherapeutic Approach,” FASIC (1985): 7. 347 Ensalaco, Chile Under Pinochet, 27.

105 through designating it as a therapeutic document and a document worthy of preserving in an archive.

The psychiatric care team also incorporated the language of their patients in advancing political arguments about human rights, rather than only documenting cases in psychiatric language. They utilized patients’ analysis of their experiences to describe the coup’s impact on collective mental health in society at large. For example, in a document about disappearances published in 1981, psychiatrists Gómez and Monreal argued that relatives of the disappeared experienced psychological damage akin to “torture” that is “chronically” lived, with

“repercussions that transcend beyond the individual.”348 The psychiatrists were trying to understand and mend societal mental health because the potential mental impact went beyond individual patients. Furthermore, they related these relatives’ trauma to “torture,” thereby comparing the experience of having a loved one disappeared to a direct form of political violence. The objective of writing such a document was to shed light on the political situation and criticize the military, rather than treat their patients as distinct medical cases.

FASIC’s mental health professionals implemented testimonios as therapy to provide a way for their patients’ to be heard and to advance arguments about the collective experience of authoritarianism. Testimonio was adapted for therapeutic use to promote the idea that within

FASIC’s clinical setting, patient opinions were valued and authoritative power was minimized.

However, through utilizing quotes from therapeutic interviews in this way, mental health professionals still controlled the usage and framing of their patients’ narratives. Gómez and

Monreal quoted a patient directly in their article on disappearance, attempting to demonstrate the collective political trauma that patients were experiencing: “...‘disappearance is worse than

348 Gómez and Monreal, “The Unresolved Death, The Disappearance,” 9.

106 death’...the uncertainty...is much worse...we [the family members of the disappeared] have suffered the most difficult part of the whole repressive process.”349 The patient herself highlights how disappearance went beyond the individual that had been targeted, and she pinpointed a collective discomfort with the experience of being a relative of a disappeared person. In the quote, she conceptualized this identity was a collective one, as highlighted by her usage of “we.”

The psychiatric voice did not comment directly on the quote, thereby giving it the appearance of being an opinion that emerged from the patient. However, it should be considered that a mental health care provider still had to be present to solicit and record the answer. There was no context given for the opinion the patient expressed, so readers of the pamphlet would know nothing about her disappeared family member or the questions the psychiatrists asked her in order to solicit such a response.

In other cases, FASIC’s mental health professionals employed psychiatric authority to only extract clauses from patient narratives that that advanced their version of the political reality, rather than faithfully produce a full account of their patients’ lived experiences. For example, in a text titled “Torture: A Medical Problem,” several excerpts of different testimonios were incorporated to further the therapists’ claims about torture. Using the patients’ words, the pamphlet described a “craziness in observing how all this violence is carried out by other men, their compatriots” and utilized the following quotes to support that point: “‘In torture everything is so absurd, so animal…’ (U.V.1980). ‘The place, the environment...it is something sordid, sinister, inhumane...’ (E.X.1980). ‘It is to suddenly be in hell’. (C.L.1975).”350 When written the way it appears in the pamphlet, the quotes communicated the claim that the violence in this context was particularly striking because it was being carried out by a Chilean “compatriot.” The

349 Ibid. 350 “Torture: A Medical Problem,” 7-8.

107 format of the text allowed the therapists to highlight the phrases and adjectives most important to their interpretation of violence, such as “craziness,” “absurd,” and “inhumane.” However, the individual narratives of the patients are lost, as well as the original message that each of the patients had hoped to communicate. As such, the reality the patients wanted to express were filtered and morphed into conveying the therapists’ interpretation of the political situation.

Erasing themselves from conversations with their patients was another way of masking their involvement in crafting testimonios while imposing a certain framework through which readers should interpret their patients’ quotes.

Mental health providers also limited their voices in transcripts of group therapy sessions and rarely interfered in the conversation. Psychiatrists were only identified as “psiquiatra” in these records, whereas many of the patients who spoke in the sessions said their name and talked extensively about themselves, including where they were from, how they came to be imprisoned, and their family backgrounds.351 While this may have been done to center the discussion upon the patients, it also granted the psychiatrist a certain level of authority. Unlike their patients, they were not placed in the vulnerable position of sharing their own traumatic experiences.

Additionally, if the documents had been found by those supporting the regime, it would have been possible to identify the ex-prisoners based on their names and detailed narratives; however, psychiatrists were at lower risk of this because they only employed their professional title. In this sense, they were more protected from political persecution than their patients due to their anonymity, whereas their patients were highly identifiable in these records based on what they said in these sessions.

351 Vicaría, “Detention and Reclusion,” 3-15. These pages were dedicated to a section titled, “The experience of being politically detained,” and mainly consisted of people explaining their family background, their political views, and the actual experience of being caught by the authorities. In these narratives, patients utilized their first names, although a few chose to only use their initials.

108

Conclusion

Testimonio aims to give voice to the narratives of marginalized groups and has been linked to “struggles for human rights and re-democratization.”352 FASIC’s Medical-Psychiatric

Program designed a way for testimonio to be used dually as a therapeutic tool and as a form of advocacy. The process of creating testimonios allowed their patients to confront trauma through narrating and reflecting upon their experience, creating a space for emotional “catharsis” in the

Freudian sense.353 Additionally, the documents provided evidence of the military regime’s human rights abuses, thereby mobilizing patients’ narratives as a form of advocacy. This literary form adopted as therapy involved patients in crafting their own tools of healing and archived their experiences so that they could be used to denounce the government. However, patients did not necessarily have complete authority over what happened to these records. As testigos, the patients ceded a degree of control over their narratives to their editores, the FASIC therapists.

The testimonios that were examined were dictated and recorded by FASIC’s mental health professionals. While this imbued the narratives with a therapeutic purpose, the genre of testimonio also implied that the stories that were produced had a political function. The mental health practitioners utilized the narratives they collected through patient interviews and group therapy sessions in articles written about specific topics, such as the experience of torture and of children with detained parents. Although the documents may have circulated among FASIC and to other human rights organizations, such as the Vicaría de la Solidaridad, they were not narratives that could be shown publicly in Chile at the time of production. The hope was that the collected testimonios could still serve as modes of resistance by condemning authoritarianism

352 Beverley, Testimonio, 61. 353 Jill Littrell, “The Status of Freud’s Legacy on Emotional Processing: Contemporary Revisions,” Journal of Human Behavior in the Social Environment 18 (2008): 478.

109 and producing material that could be presented as evidence of the regime’s crimes, both domestically and internationally through human rights organizations.

Additionally, although testimonio allowed for more patient participation in the therapeutic process, it was unclear whether patients believed that the testimonio process improved their mental health status. Most documents and excerpts of their narratives told more about their experiences and feelings due to trauma caused by torture, unemployment, and/or the disappearance of a family member. Patients’ reflections on the therapeutic efficacy of testimonio were absent from FASIC’s pamphlets. Additionally, while patients were given space in the therapeutic context to craft their own narratives of traumatic experiences, they did not have complete control over the political uses of their voice. When their testimonios were published in full, readers would read and process the situation through the patients’ lens. However, FASIC’s therapists frequently lifted quotes from these accounts and utilized them in their own analyses of trauma and authoritarianism. Although mental health care professionals tried to advance goals that would benefit their patients by denouncing the repressive actions of the military, patients were not active participants in this form of political advocacy.

FASIC’s collection of testimonios foreshadowed the process of defining and overcoming national trauma in the post-Pinochet period. This official process raised questions about who controlled the voices of the marginalized. The dictatorship came to an end in 1990, and in the same year, President Patricio Aylwin created the National Commission of Truth and

Reconciliation, also known as the Rettig Commission.354 It was appointed to investigate human rights violations and was part of the recently restored democratic government’s attempt to

354 Thomas C. Wright, State Terrorism in Latin America: Chile, Argentina, and International Human Rights (Lanham: Rowman & Littlefield Publishers, Inc., 2007), 179.

110 promote national healing after Pinochet’s repressive regime.355 The commission had an official process of collection and evaluation of these testimonios in order to determine the legitimacy of the claims of human rights violations. The purpose of testimonio in this context was to provide a version of the past from the viewpoint of the victim that would encourage “healing, forgiveness, and national unity,” as evidenced by the inclusion of “reconciliation” in the official title of the report.356 Through this particular process, narratives of torture, imprisonment, disappearance, and violence were legitimized by the government and incorporated into national memory. However, in adopting the trauma of the politically persecuted as the national experience of authoritarianism, the post-Pinochet government has only concealed lasting political and social divides among the Chileans, rather than promote genuine societal reconciliation.

355 Macarena Gómez-Barris, Where Memory Dwells: Culture and State Violence in Chile (Berkeley: University of California Press, 2009), 4. 356 Lynn Stephen, “Testimony in Truth Commissions and Social Movements in Latin America,” in Pushing the Boundaries of Latin American Testimony: Meta-morphoses and Migrations, ed. Louise Detwiler and Janis Breckenridge (New York: Palgrave Macmillan, 2012), 110.

111

CONCLUSION

The work of FASIC’s Medical-Psychiatric Team was at once political and therapeutic.

The individuals who came together to form the team began treating victims of human rights violations for disparate reasons. Not all the therapists who joined the team were looking to become involved in a political project, but they believed that their medical or psychological training would assist those who were suffering the most under the new regime. Ultimately the team would collectively produce hundreds of pages of pamphlets that critiqued state repression in addition to documenting their patients’ trauma. The team rejected the “neutrality” adopted by other medical and psychological associations that ignored the impact of repression in their research during the Pinochet era.

The therapists’ thorough consideration of the political climate and its psychic impact prompted them to address collective mental health in addition to the individual trauma that people faced. Those who had been tortured had evidently undergone excruciating experiences that left them traumatized after they were released from detainment. The FASIC team understood that in addition to treating these individuals, it was important to consider the communities to which these patients would be returning. As such, the group also took on the task of providing therapy for the families of the disappeared, detained, and tortured, who were experiencing a different form of trauma that was not as obvious. Additionally, the therapists worked extensively with social workers in order to address the economic variables that impacted their patients’ mental wellbeing. The mental health professionals’ utilization of group therapy sessions forged bonds between their patients and encouraged collective action during a period when the state was attempting to divide working class communities. In the process of addressing collective trauma,

112 the therapists highlighted the political and economic causes of mental health disturbances, thereby politicizing their work.

The development of testimonios as a therapeutic tool highlighted the combination of the therapeutic with the political. The testimonio allowed patients to address the trauma they had experienced while also providing them with a political tool to denounce the regime.

Additionally, the FASIC team utilized these accounts in its human rights advocacy, quoting patients in pamphlets and circulating patient narratives throughout the human rights community.

Their implementation of testimonio in this form was an innovative therapy, but testimonio would emerge as even more prominently as a key element of national memory formation in the aftermath of the dictatorship.

The Fall of Authoritarianism

In order to maintain power, Pinochet and his allies attempted to institutionalize the regime and make it appear more democratic in the 1980s. This served two purposes. The first was to appease the international community, which urged the Pinochet regime to stop perpetuating human rights violations and transition into a more democratic system. By the 1980s, the opposition included the United States, which had supported the coup against socialist president Salvador Allende and provided financial support to Pinochet.357 The second was to ensure that the military would continue to play a significant role in governing the country, even if more civilians were brought into the administration. Chile would appear to be a more democratic country without the military having to relinquish the political power it had gained through the coup.

357 Mark Ensalaco, Chile Under Pinochet: Recovering the Truth (Philadelphia: University of Pennsylvania Press, 2010), 174.

113

The military junta drafted a constitution and held a national plebiscite, or referendum, to vote on the document and the regime’s fate in 1980. Over two-thirds of the population voted

“yes,” thereby approving the 1980 constitution and agreeing to let Pinochet serve as president for eight more years.358 While there were discussions of fraud in this particular election, the results showed that sixty-seven percent of the population believed the military junta had improved the country, despite the suffering that other sectors of the population had experienced.359 The military junta called a new plebiscite in 1988, in which voting “yes” allowed the regime to stay in power for another term and voting “no” would force the military to step down by 1990. The military junta was worried that Pinochet would not be a strong contender in this election if he remained a general, believing that a conservative civilian representing their interests would perform better in the polls.360 Pinochet ultimately ran without relinquishing his military title, believing that his victory was assured.361 This election, unlike previous plebiscites, had electoral safeguards, such as voter registration and observers from all registered political parties at each polling station.362 The day of the election, the “yes” and “no” campaigns released opposing results information, each in favor of its own side. Late in the evening, the military regime stopped releasing results; only after midnight did the junta publicly concede defeat.363 54.7% of voters voted against Pinochet, compared to the 43% that supported him.364 This election did not experience significant voter fraud, and the “no” camp ran an effective, optimistic campaign that

358 Steve J. Stern, Battling for Hearts and Minds: Memory Struggles in Pinochet’s Chile, 1973-1988 (Durham: Duke University Press, 2006), 173. 359 Ibid. Stern estimates about forty-five to fifty percent of the country still supported the military regime and genuinely voted to approve the Constitution of 1980. 360 Mary Helen Spooner, The General’s Slow Retreat: Chile after Pinochet (Berkeley: University of California Press, 2011), 14. 361 Ibid. 362 Ibid., 16. 363 Ensalaco, Chile Under Pinochet, 179. 364 Stern, Battling for Hearts and Minds, 372.

114 changed the political discourse from “Pinochet versus socialism” to “dictatorship versus democracy.”365

This was certainly a triumph for the Coalition of Parties for Democracy (Concertación de

Partidos por la Democracia, or Concertación), a wide range of political parties who came together against the regime, and the thousands of Chileans who experienced violence, exile, and loss.366 The military men who had taken control of the country by bombarding Chile’s presidential palace were now bound by a democratic vote to leave behind the building’s offices and the power they represented. However, the political atmosphere in the country continued to be uncertain and tense. Those who supported the “no” campaign feared that the military would refuse to recognize results, with some believing that the military junta would begin another round of harsh political repression.367 Furthermore, the results highlighted the deep divisions that would continue to pervade Chilean society from the transition to democracy to the present day. A significant minority voted in favor of Pinochet, and many had done so with the hope that maintaining the status quo would allow for continued economic growth, without taking into consideration the political persecution the regime had carried out over the years.368 Some

Chileans remembered the Pinochet years as the most prosperous years of their life, while others experienced it as the era in which they experienced the most suffering.

FASIC’s Medical-Psychiatric Team and other human rights organizations expressed the latter point of view, standing in solidarity with the many individuals and families that had sought aid through their agencies during the dictatorship. The group accepted their patients’ testimonios

365 Stern, Battling for Hearts and Minds, 368. 366 Ibid., 16. 367 Hernán Vidal, Cultural Politics of Historical Memory: Human Rights and Cultural Discourses in Chile (Santiago: Mosquito Editores, 1997), 247. 368 Spooner, The General’s Slow Retreat, 23.

115 of violence, detainment, and death caused by the military regime sas truth, and they worked hard to help their patients address individual trauma, reintegrate into their communities, and record accounts that could later be utilized as political denunciations. The numerous documents the team produced were helpful during the dictatorship as evidence to the international community that the regime was perpetrating human rights violations. The therapeutic care that FASIC provided also motivated patients to provide testimonios to the Vicaría and government officials who were gathering accounts of the dictatorship in the transition to democracy.369 In the post-

Pinochet era, these documents and other testimonios would play an important role in crafting national memory about fifteen years of military rule.

Memory, Mental Health, and Testimonio in the Concertación Era

Patricio Aylwin, the leader of the center-left Christian Democrats, was the

Concertación’s presidential candidate in 1990, and he prevailed over the conservative candidate that represented the “yes” block’s interests.370 The government was determined to bring justice to the many who suffered under the military junta’s repressive actions, and its efforts came to focus on investigating and validating the claims of the victims. Aylwin and his administration were working within the constraints of the 1980 constitution penned by the military junta, and, due to an amnesty law, they were not allowed to prosecute anyone associated with the junta who had committed a human rights violation prior to March 1978.371 They were unable to change the law because the military still posed a threat to the civilian government’s stability.372 As a result,

Aylwin turned towards methods of memorializing those who suffered under authoritarianism,

369 Vidal, Cultural Politics of Historical Memory, 265. 370 Thomas C. Wright, State Terrorism in Latin America: Chile, Argentina, and International Human Rights (Lanham: Rowman & Littlefield Publishers, Inc., 2007), 179. 371 Ibid., 185. 372 Ibid., 186.

116 hoping to bring peace to the victims and their families, as well as publicly recognize and apologize for the actions of the Pinochet regime.

To promote national healing, the government established memorial sites and appointed committees to investigate the human rights violations of the military junta.373 President Aylwin also created the National Commission of Truth and Reconciliation in 1990, also known as the

Rettig Commission. The name of the commission indicated the Concertación government’s concern with validating the testimonios of people whose relatives had died or disappeared and understanding the circumstances that caused repression to continue for over sixteen years. The government also called for the “reconciliation” of a deeply divided nation, requesting that all

Chileans come together in order to promote collective healing. Aylwin concluded after receiving the Rettig Commission’s report that “the State and the whole society are responsible, whether by action or by omission” for the human rights violations perpetrated during the authoritarian regime.374 He added, “I venture, in my condition as President of the , to assume representation of the entire nation in order, in its name, to apologize [pedir perdón] to the relatives of the victims.”375 Aylwin concluded that those who did not protest the military’s actions had been complicit in the system that had caused harm to so many Chileans, much like human rights organizations’ arguments of “ethical non-neutrality.” His apology also placed the responsibility of addressing the impact of violence on the entire citizenry, rather than simply the perpetrators, in an attempt to promote unity and collective healing despite political divides. By asking for forgiveness, pedir perdón, Aylwin was also trying to prompt the victims and their

373 Macarena Gómez-Barris, Where Memory Dwells: Culture and State Violence in Chile (Berkeley: University of California Press, 2009), 4. 374 Steve J. Stern, Reckoning with Pinochet: The Memory Question in Democratic Chile, 1989-2006 (Durham: Duke University Press, 2010), 87. 375 Ibid. Translation of “apologize” added by Stern.

117 families to cooperate in national healing by accepting the apology. The president’s focus on human rights violations allowed him to guide the political discourse about the violence that was universally recognized as the regime’s major transgression.

The Rettig Commission accepted 3,550 testimonios related to deaths or disappearances due to political repression, and it published a report in 1991 that recognized 2,296 cases as direct victims of human rights violations.376 They were collected by a group of social workers and lawyers who worked together to standardize the process of family hearings.377 In 2003, determining that it was important to expand on the cases that had already been officially examined, President requested the formation of the National Commission on

Political Imprisonment and Torture, also known as the Valech Commission.378 The report it published in 2004 accepted additional cases of disappearances, as well as testimonios about torture under the dictatorship.379 The Valech Commission received 36,035 testimonios, of which

28,459 people were recognized as direct “victims of political prison and torture during the military dictatorship.”380 When the Valech Commission was reopened under President Michelle

376 Presidential Advisory Commission for Qualification of Disappeared Detainees, Executed Politicians and Victims of Political Imprisonment and Torture, Report of the Presidential Advisory Commission for Qualification of Disappeared Detainees (2011), accessed December 1, 2015, http://www.indh.cl/wp- content/uploads/2011/10/Informe2011.pdf, 1. This is referred to as the second Valech Commission, when it was reopened by President This version of the document is hosted by the National Institute for Human Rights. 377 Stern, Reckoning with Pinochet, 80. 378 National Institute for Human Rights, “Información Comisión Valech,” accessed December 1, 2015, http://www.indh.cl/informacion-comision-valech. 379 Presidential Advisory Commission for Qualification of Disappeared Detainees, Executed Politicians and Victims of Political Imprisonment and Torture, Report of the Commission, 1. 380 “...víctimas de prisión política y tortura durante la dictadura militar.” Ibid., 6. In the initial examination of these testimonies, the commission had recognized 27,255 of these cases. However, during a period of reconsideration between November 2004 and May 2005, they recognized an additional 1,204 cases. The version of the report that is being used is an updated form of it that was published in 2011.

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Bachelet in 2010, it published a report in 2011 that classified an additional thirty cases as detained-disappeared and 9,795 additional victims of political prison and torture.381

The number produced by these reports are startling, but it is even more unsettling to consider that there were likely many more cases that were not submitted or officially recognized.

The commissions had the daunting task of going through thousands of cases during a one-year period, making it difficult to hear the circumstances of all Chileans who had been directly impacted by the junta’s repressive acts. The process also involved officially legitimizing certain accounts of human rights abuses, while denying this classification to other reports. This contrasted FASIC’s approach to testimonio collection, which accepted the traumatic experiences of all their patients as true. The commissions also utilized testimonios in order to construct an analysis of human rights in Chile during the Pinochet era. While those who reported their cases knew that they had the potential to contribute to the construction of an official government report, they also lost a degree of control over their personal narratives once they completed their hearing. Their stories were now in the government’s hands to mold into whatever collective narrative they deemed to be most reflective of the victims’ and their families’ experiences.

While each commission’s report focused on those who had been the direct victims of the military junta’s actions, it was evident that large portions of Chilean society would have been directly or indirectly affected by political violence between 1973 and 1990. The statistics themselves did not speak to the suffering of relatives and community members. However, individuals targeted by the junta lived in communities that were undoubtedly impacted by the dictatorship, through economic changes if not through physical violence. FASIC’s extensive work with the families of the detained, tortured, and executed was a testament to the way in

381 Presidential Advisory Commission for Qualification of Disappeared Detainees, Executed Politicians and Victims of Political Imprisonment and Torture, Report of the Commission, 52.

119 which relatives and communities could be impacted by the authoritarian regime’s violence, even if they were not specifically targeted. While the number affected in this way was not quantified by the report, the government recognized that this population required psychological therapy as well and created the Program of Reparations through Comprehensive Health Care (Programa de

Reparación en Atención Integral en Salud, or PRAIS) after the release of the Rettig Report. The program provided health services, including mental health treatment, for victims of human rights violations recognized by one of the commissions, their family members, and individuals who worked to protect their human rights.382 The treatment that would be available to human rights advocates such as those at the Vicaría and FASIC were reflective of the Concertación government’s focus on human rights as well as their recognition of the important role these organizations played during the Pinochet years. With the return to democracy, the Vicaría has become an archival center that is open to the public. FASIC, on the other hand, continues to provide social services for those in need, in addition to maintaining an archive of documents produced during the dictatorship.

Final Thoughts: Political Polarization and The Reality of “Reconciliation”

The government’s adoption of the human rights lens to construct national memory of the

Pinochet years was part of a strategy to hone in on collective trauma and healing, rather than politicize the period. FASIC’s Medical-Psychiatric Team employed this tactic in its own documents—the main problem was not the political allegiances of the military junta, but the violence they were directing towards their fellow Chileans. This approach was highlighted by the

Concertación government’s focus on analyzing testimonios about human rights violations in order to ascertain the issues the nation would have to address moving forward. It allowed people

382 “Program for the Healthcare of People Affected by Political Repression Exercised by the State in the Period 1973-1990,” Ministry of Health (January 2007): 17.

120 who had been deprived the right to publicly express their suffering the opportunity to utilize their narratives to impact the government’s direction.

While the national process of Truth and Reconciliation helped legitimize the suffering of the victims of authoritarian repression, it failed to heal the political divides that continue pervade the country. The focus on human rights, by FASIC and the Concertación government, was a way of drawing attention to the faults of the authoritarian regime without taking an explicitly partisan stance. The approach was meant to appeal to Chileans’ humanity, rather than their political beliefs. This has given a voice to the oppressed, thereby revealing the brutality of the military junta and providing an additional method through which the victims have been able to heal.

However, the Truth and Reconciliation Commission endeavored to go beyond acknowledging the trauma experienced by thousands of Chileans. The term “reconciliation” implies forgiveness on the part of the victims and genuine remorse on the part of the transgressor. Without both of these factors, true reconciliation cannot be achieved.383 In Chile’s

Truth and Reconciliation process, there was no expression of remorse from the main oppressors or Pinochet’s support base, leading to continued political tensions. Although President Aylwin publically asked for forgiveness from the victims of political repression, he was not directly involved in the military junta and its perpetration of human rights violations. For this reason, he was not the individual from whom victims were seeking an apology, but the military junta’s members had no practical reason to apologize, as they had been granted amnesty under the

Constitution of 1980. A parallel case that reflects similar circumstances is that of South Africa, in which the majority of the white population has not shown remorse for the institutionalized

383 Carmen Goman and Douglas Kelley, “Conceptualizing Forgiveness in the Face of Historical Trauma,” in Critical Trauma Studies: Understanding Violence, Conflict, and Memory in Everyday Life, ed. Monica J. Casper and Eric Wertheimer (New York: New York University Press, 2016), 79.

121 racial discrimination of apartheid rule. Again, due to the amnesty laws, there was no reason for white applicants of amnesty to express remorse, as that was not a factor the commission was considering when granting amnesty.384 As a result, the South African population remains fractured along racial lines and structural racism continues to be entrenched in the nation’s institutions.385

Adopting a human rights framework to construct collective memory has glossed over the political polarization that led to the coup and the tensions that continue to exist in Chilean political discourse. The national narrative has ignored the perspectives of the forty-three percent of Chileans that voted in favor of Pinochet in 1988, and there is without a doubt still a large segment of the population who believes that the “trauma” of the Pinochet years is a myth. The present-day government’s image of Chile as a nation that has uniformly condemned the military junta is idealistic: it fails to fully acknowledge the conflicting opinions of those who supported the Pinochet regime. FASIC’s emphasis on human rights rather than partisan politics was an important strategy for the organization’s survival, therapeutic development, and advocacy, but this approach has worked less effectively in bringing about true reconciliation in post-Pinochet

Chile. The government should shift away from the narrative of a homogenously traumatized nation and acknowledge the deep political and social tensions that continue to divide Chileans.

Otherwise, it is taking a risk that could lead to further political polarization and the reemergence of the threat of authoritarianism.

384 Lyn S. Graybill, Truth and Reconciliation in South Africa: Miracle or Model? (Boulder: Lynne Rienner Publishers, 2002), 43. 385 Ibid., 22.

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