Gen. Stephen Xenakis (Ret.), psychiatrist, has written a new article on health providers and torture. He succinctly reminds us of the history of the dangers of blurred boundaries and the the reasons to keep health providers far away from participation in interrogations:
Healers, Torture and National Security
by Stephen N. Xenakis
In 2004, the news that Americans had committed abuse and mistreatment in Abu Ghraib and Guantanamo was shocking. Even more alarming, were the revelations that physicians, psychiatrists, and other mental health professionals had assisted with interrogations that bordered on torture.
In the span of just two generations, the United States had drifted from condemning Nazi physicians at the Nuremberg Trials for their collusion with torture, inhuman experimentation and cruel mistreatment to justifying waterboarding in the pursuit of better intelligence.
As a retired brigadier general and Army psychiatrist, committed to a strong military and national defense, I find these scandals to be most disturbing. The complicity of psychiatrists and other physicians clearly deviated from the fundamental ethical principles of the medical profession and military medicine. My generation of soldiers, who had served during the Vietnam War, vowed not to repeat the misdeeds of the My Lai massacres and rampant indiscipline we witnessed.
However, after the attack on the World Trade Towers, fear and anger dominated the country’s emotional climate and the principles of our profession were hijacked. The incessant drumbeat of political rhetoric that “the war on terror is a war like no other” and that “we must take all measures possible to stop the enemy” made it somehow easier for psychiatrists to apply their skills and training to exploit the vulnerabilities of prisoners. To this day, former government officials justify cruel and inhuman treatment of detainees at Bagram and Guantanamo with unsubstantiated assertions that their confessions led to the trail of Osama bin Laden. The public supported such conduct and the television show “24″ gained wide popularity as viewers were captivated by threats of violence and new gimmicks for bringing the bad guys down. Even the presidential candidates in 2008 were ambushed by questions that judged their fitness to be commander in chief by their willingness to torture a suspect who planted a “ticking bomb.”
But, there is no evidence to confirm the assertions that torture of prisoners has helped the war effort at all.
The plain fact is that nothing that has been claimed in the name of defending our country can justify cruel, inhuman and degrading treatment of another man or woman. Torture, in any form – light or heavy – is not a tool of interrogation or useful for gathering good intelligence. It is a propaganda tool and degrades the perpetrator as well as the victim. This is not just the rhetoric of bleeding heart progressives. It is the opinion of over fifty retired admirals, generals(1) and senior government officials convened by Human Rights First to discuss this issue, and our conclusions can be stated simply:
Torture Is Un-American. Gen. George Washington laid down the directive that American soldiers will treat the enemy humanely and conform to high moral & ethical principles on the battlefield.
Torture Is Ineffective. Experienced interrogators acknowledge that information extracted by the use of torture is unreliable.
Torture Is Unnecessary. Veteran FBI agents and military interrogators have spoken out publicly against the use of physical pressure in interrogation.
Torture has long been associated with political repression and with regimes without any semblance of an independent judiciary or media. The Soviet Union’s imprisonment of dissenters and forced use of psychotropic medication on them, the Khmer Rouge’s torture of thousands of people in Cambodia and the Augusto Pinochet regime’s brutality against prisoners in Chile all bear witness to the association between totalitarian or authoritarian regimes and their use of torture.
As the human rights lawyer Leonard Rubenstein and I wrote [4] in March 2010, “the medical staff at the C.I.A. and the Pentagon played a critical role in developing and carrying out torture procedures. Psychologists and at least one doctor designed or recommended coercive interrogation methods including sleep deprivation, stress positions, isolation and waterboarding. The military’s Behavioral Science Consultation Teams evaluated detainees, consulted their medical records to ascertain vulnerabilities and advised interrogators when to push harder for intelligence information. Psychologists designed a program for new arrivals at Guantánamo [5]that kept them in isolation to ‘enhance and exploit’ their ‘disorientation and disorganization.’ Medical officials monitored interrogations and ordered medical interventions so they could continue even when the detainee was in obvious distress. In one case, an interrogation log obtained by Time magazine shows [6] a medical corpsman ordered intravenous fluids to be administered to a dehydrated detainee even as loud music was played to deprive him of sleep.”
We cannot dismiss the psychiatrists and psychologists, who participated in interrogations in Guantanamo and helped devise the abusive practices, as mere rogues or outliers. They were actors on a much larger stage. They were swept up by a pervasive and persuasive attitude that subsumed the country and energized a military plan to “hunt down the criminals wherever they may be hiding.” The Department of Defense (DoD) issued policy accordingly and the Office of Assistant Secretary for Health Affairs contended that the legitimate objective of fighting terrorism trumps the ethical responsibility of the healing practitioner. In their eyes, “the ends justify the means” and a few brutalized prisoners were a small price to pay for protecting the citizens of the United States.
But, in truth, the use of torture and practices of cruel, inhuman and degrading treatment detracted from the military mission and compromised the international stature of our country, while also undermining the effectiveness, credibility and ethical foundations of the medical professionals. To a certain extent, the administration realizes this. Now, ten years into the wars in Iraq and Afghanistan, the White House has changed the national strategy and President Obama has insisted, “human rights is both fundamental to American leadership and a source of our strength in the world.” In his words, it “does not merely represent our better angels …” Standing up for human rights has come front and center both as a matter of national strategy and measure of human decency. Historically, the human rights stance against torture has been unequivocal, one of the few absolutes in human rights law: It is never permitted, never excused, never to be balanced against national needs or interests – even in cases of national emergency. Torture is also forbidden under the laws of war. It is considered a war crime under the Geneva Conventions [7].
This is important and good, but it is not enough. The political leadership of our nation does not have an appetite for investigating the misdeeds that were committed in the past ten years. A change for the better that is not informed by an honest assessment of the sins of the past is not likely to be either permanent or fully integrated into the power structure. Several human rights groups have called for a Commission of Truth and Reconciliation to spur corrective action. By this, they are referring to comprehensive programs that were undertaken in South Africa and in the former Soviet Union to bring to justice the perpetrators of misdeeds and examine the range of responsibility that society as a whole had for the injustices of the past. Mental health professionals understand the power of confession and repentance, for individuals, communities and institutions. Something is needed that goes beyond apology, regret or even a vow to do better. A Commission of Truth and Reconciliation is a step toward corrective action.
By reflecting on the ethical principles and traditions of the healing professions, a stronger case can be put forward against torture and mistreatment:
First, do no harm. The victims of torture and mistreatment breed political instability and discontent, weakening governments and societies.
Beneficence. Torture and mistreatment violate the intents and purposes of medical healers and participation in any way corrupts the ethical foundations of the practitioners and professions.
Professional role. Physicians are not interrogators, any more than they are fighter pilots or infantrymen. The military and other governmental agencies have other professionals to do those tasks and calling on physicians to fill such roles is irresponsible and ineffective.
Trust. Physicians enjoy special trust and confidence across almost all societies. That trust is undermined with participation in harmful, coercive and abusive conduct that is neither doctor-like nor appropriate.
In 1947, our nation and its allies tried and sentenced the Nazi physicians who violated basic principles of medical ethics. In 2003, the political dynamics and national sentiment induced physicians and psychiatrists and other health care professionals to commit actions that violated core ethics. The healing professions can lead corrective action, help the country recover the “high ground” and prevent future lapses in professional conduct and policies that violated human rights. Human rights are vital to national security in the 21st century.
Much has improved since the dark days of 9/11, but our nation has been damaged. Where once the symbol of our great democracy was the Statue of Liberty – it has now become the image of that poor hooded man in detention with wires strung from his hands and feet. Our men and women on the front lines are endangered because of the increased risk of retaliatory measures. We are not safer because of these misguided policies and how we have acted as a country.
1. I have recent experience that confirms my opinions on the ineffectiveness of harsh interrogation techniques, their unethical nature and harmful consequences. In the past five years, I have been asked to assess several detainees and review the medical records of many more on behalf of defense attorneys. Many detainees subjected to harsh interrogation, as designed and approved by clinicians working for the CIA and DoD, still suffer with the prolonged injuries and adverse psychological effects of their treatment. The evidence of negative effects of the harsh interrogations has been compelling. Moreover, the information gleaned in interrogations that involved harsh treatment has not been allowed in court proceedings.
A number of recent research studies have raised questions regarding the efficacy of many commonly prescribed psychotropic medications, including antidepressants. In some studies, these drugs do not perform better than placebo, when the placebo is selected to mimic the side effects that frequently allow participants in “double blind” randomized drug trials to tell whether or not they were given the active drug.
Now a new study adds to concerns by suggesting that antidepressant use may cause harm by significantly raising the likelihood of relapse upon cessation of medication in patients receiving them. In a meta-analysis quantitatively combing data from a number of published studies, Paul Andrews of McMaster University found that antidepressant use increased the risk of relapse from 25% among those not receiving drugs to 42% among those who received antidepressants, as described in a McMaster press release.
They [Andrews and colleagues] analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.
Andrews says anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.
Andrews, an evolutionary biologist, uses these results as the basis for speculation about the nature of depression and whether it should be conceptualized as a disease or “disorder”:
“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it’s an evolved adaptation that does something useful,” he says.
Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.
Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.
Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.
If these authors’ view that depression is, in most cases, a natural mechanism to deal with stress, then “treating” it with drugs that short circuit the healing process may be counterproductive in many ways.
As with all new research, we should be cautious about interpreting these results until they are critically examined by other researchers. Like with other research methods, there is often no consensus as to whether a meta-analysis has been properly conducted.
If this study holds up after critical examination, these new results should increase concerns that antidepressants are, at best, radically over-prescribed. Physicians, including primary care physicians who often know little about the subtleties of antidepressant use, often use these medicines as the first, and even only treatment for most depressions. Though knowledge about the danger of relapse when discontinuing these drugs has spread among thoughtful psychiatrists in recent years, this knowledge has often not spread to primary care physicians and others who do most of the prescribing of these medications.
Thus, extant evidence suggests that, these medications should be used carefully. This new study ads to evidence that these drugs should be used sparingly and that, once administered, antidepressants should not be discontinued quickly, but should be gradually tapered over a long time to give the brain’s neurotransmitter systems time to adjust.
Current patterns of antidepressant use may be causing serious harm to public health, this and other studies suggest. Thus, the mental health field should seriously reconsider whether antidepressant use should continue to be the first-line treatment for those suffering from depression. If these drugs increase relapse rates while having uncertain efficacy in many cases, they should be used sparingly and with caution.
Alternatively, first-line use of psychological treatment approaches that aid the body’s natural coping processes may avoid the problems with antidepressant use, including difficulty in withdrawing from the drugs and increased likelihood of relapse. Alas, the power of the pharmaceutical industry makes such reconsideration difficult. When there are billions of dollars at stake, science and public health often count for little.
Patients who use anti-depressants are more likely to suffer relapse, researcher finds
Patients who use anti-depressants are much more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster researcher.
In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used anti-depressant medications can be nearly twice as susceptible to future episodes of major depression.
Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour, is the lead author of a new paper in the journal Frontiers of Psychology.
The meta-analysis suggests that people who have not been taking any medication are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.
Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used anti-depressants compared to those who used placebos.
They analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.
Andrews says anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.
Though there are several forms of antidepressants, all of them disturb the brain’s natural regulatory mechanisms, which he compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, leaving the person at increased risk of depression when the brain’s regulating mechanism, like the compressed spring, overextends before retracting to its resting state.
“We found that the more these drugs affect serotonin and other neurotransmitters in your brain – and that’s what they’re supposed to do – the greater your risk of relapse once you stop taking them,” Andrews says. “All these drugs do reduce symptoms, probably to some degree, in the short-term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking anti-depressants to prevent a return of symptoms.”
Andrews believes depression may actually be a natural and beneficial – though painful – state in which the brain is working to cope with stress.
“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it’s an evolved adaptation that does something useful,” he says.
Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.
Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.
Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.
Not every case is the same, and severe cases can reach the point where they are clearly not beneficial, he emphasizes.
A bill in New York would ban health professionals involvement in torture. It is a sad comment that such a bill is needed. The state medical association is opposed. In contrast, the state psychological association supports it. We are pushing a similar bill in Massachusetts, as are psychologists in other states. Here is an article from the AMA newsletter:
Medical board could discipline physicians for torture under N.Y. bill The unique proposal would give the state board the authority to punish doctors and others who take part in, or conceal evidence of, torture
By Kevin O’Reilly
A New York bill that is the first of its kind in the nation would make participation in torture or interrogation of prisoners grounds for board discipline of physicians and other health professionals.
Dozens of medical students and other health professionals in training lobbied in favor of the legislation in late May, meeting with nearly 40 New York state legislators, said Allen Keller, MD. He helped organize the lobbying trip and directs the Bellevue Hospital Center/New York University Program for Survivors of Torture in New York City.
The bill, which was introduced in March by Democratic Assemblyman Richard N. Gottfried and has 39 co-sponsors, would give the state medical board and other health professional licensing boards the explicit authority to suspend or revoke practice rights based on evidence presented in accordance with the state’s usual due-process procedures (assembly.state.ny.us/leg/?default_fld=%0D%0At&bn=A05891&term=&Summary=Y).
Under the bill, physicians and other health professionals would be barred from directly participating in torture, treating patients with the intent of determining when torture could continue, concealing medical evidence of torture or taking part in individual interrogations. Health professionals could generally advise interrogators on rapport building or other nonabusive techniques.
The bill is needed to give medical licensing boards clear authority to discipline doctors and others for participating in torture, supporters say. In 2007, a complaint was brought against one psychologist alleged to have participated in abusive interrogations at Guantanamo Bay, but the New York state body that licenses psychologists said it did not have jurisdiction to investigate the matter.
“We want to clarify that this is, indeed, grounds for discipline and also to achieve a preventive effect,” said Dr. Keller, associate professor of medicine at NYU School of Medicine. “It’s easier for individuals to torture than we’d like to think, because of hierarchies and environments that allow it. We believe this legislation would help physicians who are put in an untenable position to say, ‘I can’t do this; I’d lose my license.’ ”
A state matter?
The American Medical Association and the Medical Society of the State of New York have policy opposing physician participation in torture or direct participation in interrogations. But the MSSNY said the matter is best handled at the federal level, noting that torture is already criminal under federal law. In a June 2 letter to the New York State Assembly, MSSNY Senior Vice President and Chief Legislative Counsel Gerard Conway noted other concerns.
“The bill provides no practical recourse for physicians who are intimidated by military superiors into withholding reports of torture,” Conway wrote. “There are inherent challenges and barriers to evidentiary discovery for accusations of torture in the military and prisons. Physicians may be poorly positioned to defend themselves since, ostensibly, many of these incidents would occur overseas. Physicians would have to overcome claims of national security and national defense and would have to operate in domains in which civil authority will be limited.”
In response, Dr. Keller said that, with regard to accessing classified documentary evidence, physicians would be on a level playing field with anyone bringing a complaint. If the evidence were classified, then neither the medical board nor the physician would have it to use in a proceeding. On the other hand, if national-security documents were brought into evidence, then both the physician and the board would have equal access to them.
And, he said, it is appropriate for state medical boards to act because they are the bodies charged with regulating physician practice.
“Health professionals — whether they practice in their state or in the Army or wherever — they do so because they have a license that is issued not by the federal government or the Army but by a state,” Dr. Keller said.
The New York legislative session is scheduled to end June 20. Advocates are pushing to have similar legislation proposed in other states.
Being around happy people can be dangerous to your health if you are not happy. Or so a new study concludes. Replicating cross-national studies they found that suicide rates are highest in US states where people are happier. [A prepublication draft of the paper can be downloaded here.]:
Happiest Places Have Highest Suicide Rates, New Research Finds
The happiest countries and happiest U.S. states tend to have the highest suicide rates, according to research from the UK’s University of Warwick, Hamilton College in New York and the Federal Reserve Bank of San Francisco.
The new research paper titled “Dark Contrasts: The Paradox of High Rates of Suicide in Happy Places” has been accepted for publication in the Journal of Economic Behavior & Organization. It uses U.S. and international data, which included first-time comparisons of a newly available random sample of 1.3 million Americans, and another on suicide decisions among an independent random sample of approximately 1 million Americans.
The research confirmed a little known and seemingly puzzling fact: many happy countries have unusually high rates of suicide. This observation has been made from time to time about individual nations, especially in the case of Denmark. This new research found that a range of nations — including: Canada, the United States, Iceland, Ireland and Switzerland, display relatively high happiness levels and yet also have high suicide rates. Nevertheless the researchers note that, because of variation in cultures and suicide-reporting conventions, such cross-country scatter plots are only suggestive. To confirm the relationship between levels of happiness and rates of suicide within a geographical area, the researchers turned to two very large data sets covering a single country, the United States.
The scientific advantage of comparing happiness and suicide rates across U.S. states is that cultural background, national institutions, language and religion are relatively constant across a single country. While still not absolutely perfect, as the States are not identical, comparing the different areas of the country gave a much more homogeneous population to examine rather than a global sample of nations.
Comparing U.S. states in this way produced the same result. States with people who are generally more satisfied with their lives tended to have higher suicide rates than those with lower average levels of life satisfaction. For example, the raw data showed that Utah is ranked first in life-satisfaction, but has the 9th highest suicide rate. Meanwhile, New York was ranked 45th in life satisfaction, yet had the lowest suicide rate in the country.
The researchers then also tried to make their comparison between States even fairer and yet more homogeneous by adjusting for clear population differences between the states including age, gender, race, education, income, marital status and employment status. Even with these adjustments. This still produced a very strong correlation between happiness levels and suicide rates although some states shifted their positions slightly. Hawaii then ranks second in adjusted average life satisfaction but has the fifth highest suicide rate in the country. At the other end of the spectrum, for example, New Jersey ranked near the bottom in adjusted life satisfaction (47th) and had one of the lowest adjusted suicide risks (coincidentally, also the 47th highest rate).
The researchers (Professor Andrew Oswald from the University of Warwick, Associate Professor of Economics Stephen Wu of Hamilton College and Mary C. Daly and Daniel Wilson both from the Federal Reserve Bank of San Francisco) believe the key explanation that may explain this counterintuitive link between happiness and suicide rates draws on ideas about the way that human beings rely on relative comparisons between each other.
University of Warwick researcher Professor Andrew Oswald said: “Discontented people in a happy place may feel particularly harshly treated by life. Those dark contrasts may in turn increase the risk of suicide. If humans are subject to mood swings, the lows of life may thus be most tolerable in an environment in which other humans are unhappy.”
Professor Stephen Wu of Hamilton College said: “This result is consistent with other research that shows that people judge their well-being in comparison to others around them. These types of comparison effects have also been shown with regards
Lloyd Sederer, Medical director, New York State Office of Mental Health, described his psychoanalysis in a re3cent Huffington Post article:
Instead of looking for a psychotherapist, I decided to go for the full Monty. I found a traditional Freudian psychoanalyst, a past president of Boston’s major analytic institute. Psychoanalysis, by the time I entered its pool, did not have the eminence it did in the good old 20th Century, having been eclipsed by the promise of neuroscience and an explosion of medications. But analysis was not dead — Woody Allen notwithstanding — nor were its conceptual roots in the power of the unconscious in driving how we feel and act and its methods of free association (‘say whatever comes to mind’) and dream interpretation.
I was on the couch, four times a week. After four years, I was convinced I was done. That led to another year of analysis after which I pronounced to my analyst that now I was surely done. A year later I was. I paid out of pocket for this treatment, which virtually no insurance covered then and I can’t think of one today that does. For me, analysis was exceptionally helpful where Freud said it counted the most, namely in love and work.
I wonder what helped? Was it the traditional technique of couch, dream interpretation, free association and analysis of the transference (how the demons of our past continue to impale us on the spikes of early, troubled relationships)? Or was it the relationship with my wise analyst who knew every psychological evasion in the book (and I had read the book), demanded that I take responsibility for how I felt and lived, and was deeply kind.
…
For me, analysis was a journey into the mind, into the primitive ways we can feel and judge and behave. It helped my ego take the reins of life away from my unconscious and its misguided ways. Psychoanalysis, notably, has evolved in recent decades and is now far more focused on relationships than instinctual sexual and aggressive drives.
Anti-war groups, a psychologist group as well as filmmaker Michael Moore and Pentagon Papers whistleblower Daniel Ellsberg have called for Bradley to be released from detention.
There are many new developments in the case of Bradley Manning, the alleged Wikileaks source. NBC News is reporting that the government has so far failed to find a direct connection between Manning and Wikileaks’ Julian Assange:
U.S. military officials tell NBC News that investigators have been unable to make any direct connection between a jailed army private suspected with leaking secret documents and Julian Assange, founder of the whistleblowing website WikiLeaks.
The officials say that while investigators have determined that Manning had allegedly unlawfully downloaded tens of thousands of documents onto his own computer and passed them to an unauthorized person, there is apparently no evidence he passed the files directly to Assange, or had any direct contact with the controversial WikiLeaks figure.
The NBC article also demonstrates that the military is feeling intense pressure over its brutal treatment of Manning through months of solitary confinement. They actually admit that Manning was put on “suicide watch,” over the opinions of three brig psychiatrists, by an official without authority to do so, as a punishment:
Military officials said Brig Commander James Averhart did not have the authority to place Manning on suicide watch for two days last week, and that only medical personnel are allowed to make that call.
The official said that after Manning had allegedly failed to follow orders from his Marine guards. Averhart declared Manning a “suicide risk.” Manning was then placed on suicide watch, which meant he was confined to his cell, stripped of most of his clothing and deprived of his reading glasses — anything that Manning could use to harm himself. At the urging of U.S. Army lawyers, Averhart lifted the suicide watch.
Anti-war groups, a psychologist group as well as filmmaker Michael Moore and Pentagon Papers whistleblower Daniel Ellsberg have called for Bradley to be released from detention.
Though, actually, we only called for him to be released from solitary confinement.
Meanwhile, the issue of Manning’s treatment by the military has reached the White House as ABC‘s Jake Trapper asked spokesman Robert Gibbs about it:
TAPPER: A quick question about Bradley Manning, the — suspected of leaking information. Is the administration satisfied that he’s being kept in conditions that are appropriate for his accused crime and that visitors to Bradley Manning are treated as any visitors to any prison are treated?
GIBBS: I haven’t — I — you know, truthfully, Jake, have not heard a lot of discussion on that inside of here. I’m happy to take a look at something. In terms of a specific question about that, I think that I would direct you to the authorities that are holding him.
Meanwhile, Juan Cole compares the US treatment of Manning to the protests of Mohamed Bouazizi, which began the end of the Tunisian dictatorship. Cole points out that, among the criticisms of the dictatorship Tunisians, and others around the world pointed to were cruel conditions of detention, including solitary confinement and sleep deprivation, that were imposed upon dissidents:
‘ Prison conditions: Many political prisoners reportedly suffered discrimination and harsh treatment. Some went on hunger strike to protest against ill-treatment by prison guards, denial of medical care, interruption of family visits and harsh conditions, including prolonged solitary confinement.’
And, yes, among the techniques used against prisoners was “sleep deprivation.”
Meanwhile, as Cole points lout, President Obama has hailed the brave Tunisians fighting for their freedom:
“The United States stands with the entire international community in bearing witness to this brave and determined struggle for the universal rights that we must all uphold, and we will long remember the images of the Tunisian people seeking to make their voices heard.”
So one of the universal human rights the Tunisians wanted was freedom from harsh conditions of detention when charged with thought crimes.
Perhaps now that the issue has reached the White House, President Obama will similarly recognize those who protest US government abuses.
Here are two videos. Manning’s friend David House discusses his psychological state:
And Firedoglake’s Jane Hamsher discusses how the military treated David during last weekend’s attempted visit:
Finally, Firedoglake has initiated a Bradley Manning Advocacy Fund.
The Bradley Manning Advocacy Fund is a new public advocacy effort for Bradley Manning that will organize events, issue press releases, recruit spokespeople to speak out on Bradley’s behalf, and assemble researchers and witnesses to help with Bradley’s case.
I was interviewed this week on Russia Today TV about the letterPsychologists for Social Responsibility wrote to Defense Secretary Gates regarding Bradley Manning’s solitary confinement:
The New York Times has an interesting article on the effects of Oxytocin. Evidently, it increases positive feelings, but only toward one’s in-group:
Depth of the Kindness Hormone Appears to Know Some Bounds
Oxytocin has been described as the hormone of love. This tiny chemical, released from the hypothalamus region of the brain, gives rat mothers the urge to nurse their pups, keeps male prairie voles monogamous and, even more remarkable, makes people trust each other more.
Yes, you knew there had to be a catch. As oxytocin comes into sharper focus, its social radius of action turns out to have definite limits. The love and trust it promotes are not toward the world in general, just toward a person’s in-group. Oxytocin turns out to be the hormone of the clan, not of universal brotherhood. Psychologists trying to specify its role have now concluded it is the agent of ethnocentrism.
A principal author of the new take on oxytocin is Carsten K. W. De Dreu, a psychologist at the University of Amsterdam. Reading the growing literature on the warm and cuddly effects of oxytocin, he decided on evolutionary principles that no one who placed unbounded trust in others could survive. Thus there must be limits on oxytocin’s ability to induce trust, he assumed, and he set out to define them.
In a report published last year in Science, based on experiments in which subjects distributed money, he and colleagues showed that doses of oxytocin made people more likely to favor the in-group at the expense of an out-group. With a new set of experiments in Tuesday’s issue of the Proceedings of the National Academy of Sciences, he has extended his study to ethnic attitudes, using Muslims and Germans as the out-groups for his subjects, Dutch college students.
These nationalities were chosen because of a 2005 poll that showed that 51 percent of Dutch citizens held unfavorable opinions about Muslims, and other surveys that Germans, although seen by the Dutch as less threatening, were nevertheless regarded as “aggressive, arrogant and cold.”
Well-socialized Dutch students might be unlikely to say anything derogatory about other groups. So one set of Dr. De Dreu’s experiments tapped into the unconscious mind by asking subjects simply to press a key when shown a pair of words. One word had either positive or negative connotations. The other was either a common Dutch first name like Peter, or an out-group name, like Markus or Helmut for the Germans, and Ahmad or Youssef for the Muslims.
What is measured is the length of time a subject takes to press a key. If both words have the same emotional value, the subject will press the key more quickly than if the emotional overtones conflict and the mind takes longer to reach a decision. Subjects who had sniffed a dose of oxytocin 40 minutes earlier were significantly more likely to favor the in-group, Dr. De Dreu reported.
In another set of experiments the Dutch students were given standard moral dilemmas in which a choice must be made about whether to help a person onto an overloaded lifeboat, thereby drowning the five already there, or saving five people in the path of a train by throwing a bystander onto the tracks.
In Dr. De Dreu’s experiments, the five people who might be saved were nameless, but the sacrificial victim had either a Dutch or a Muslim name. Subjects who had taken oxytocin were far more likely to sacrifice the Muhammads than the Maartens.
Despite the limitation on oxytocin’s social reach, its effect seems to be achieved more through inducing feelings of loyalty to the in-group than by fomenting hatred of the out-group. The Dutch researchers found some evidence that it enhances negative feelings, but this was not conclusive. “Oxytocin creates intergroup bias primarily because it motivates in-group favoritism and because it motivates out-group derogation,” they write.
Dr. De Dreu plans to investigate whether oxytocin mediates other social behaviors that evolutionary psychologists think evolved in early human groups. Besides loyalty to one’s own group, there would also have been survival advantages in rewarding cooperation and punishing deviants. Oxytocin, if it underlies these behaviors too, would perhaps have helped ancient populations set norms of behavior.
Early religions were also involved in establishing group cohesion and penalizing offenders. Could oxytocin be involved in the social aspects of the religious experience? Dr. De Dreu sees oxytocin’s effects as being very general, and no more likely to be associated with the religious experience than with soccer hooliganism. “When people get together with others who share their values, that drives up the level of oxytocin,” he said.
For military commanders, nothing is more important than the group cohesion of their soldiers, for which oxytocin might now seem the ideal prescription. But this assumption is a bridge too far, Dr. De Dreu said, given that his findings are based only on lab experiments.
What does it mean that a chemical basis for ethnocentrism is embedded in the human brain? “In the ancestral environment it was very important for people to detect in others whether they had a long-term commitment to the group,” Dr. De Dreu said. “Ethnocentrism is a very basic part of humans, and it’s not something we can change by education. That doesn’t mean that the negative aspects of it should be taken for granted.”
Bruno B. Averbeck, an expert on the brain’s emotional processes at the National Institute of Mental Health, said that the effects of oxytocin described in Dr. De Dreu’s report were interesting but not necessarily dominant. The brain weighs emotional attitudes like those prompted by oxytocin against information available to the conscious mind. If there is no cognitive information in a situation in which a decision has to be made, like whether to trust a stranger about whom nothing is known, the brain will go with the emotional advice from its oxytocin system, but otherwise rational data will be weighed against the influence from oxytocin and may well override it, Dr. Averbeck said.
Dr. Averbeck said he was amazed that a substance like oxytocin can affect such a high-level human behavior. “It’s really surprising to me that this neurotransmitter can so specifically affect these social behaviors,” he said.
Psychologists for Social Responsibility (PsySR) has just issued the following Open Letter regarding the conditions of detention in which alleged Wikileaks source PFC Bradley Manning is being held:
PsySR Open Letter on PFC Bradley Manning’s Solitary Confinement
January 3, 2011
The Honorable Robert M. Gates
Secretary
100 Defense Pentagon
Washington, DC 20301
Dear Mr. Secretary:
Psychologists for Social Responsibility (PsySR) is deeply concerned about the conditions under which PFC Bradley Manning is being held at the Quantico Marine Corps Base in Virginia. It has beenreported and verified by his attorney that PFC Manning has been held in solitary confinement since July of 2010. He reportedly is held in his cell for approximately 23 hours a day, a cell approximately six feet wide and twelve feet in length, with a bed, a drinking fountain, and a toilet. For no discernable reason other than punishment, he is forbidden from exercising in his cell and is provided minimal access to exercise outside his cell. Further, despite having virtually nothing to do, he is forbidden to sleep during the day and often has his sleep at night disrupted.
As an organization of psychologists and other mental health professionals, PsySR is aware that solitary confinement can have severely deleterious effects on the psychological well-being of those subjected to it. We therefore call for a revision in the conditions of PFC Manning’s incarceration while he awaits trial, based on the exhaustive documentation and research that have determined that solitary confinement is, at the very least, a form of cruel, unusual and inhumane treatment in violation of U.S. law.
In the majority opinion of the U.S. Supreme Court case Medley, Petitioner, 134 U.S. 1690 (1890), U.S. Supreme Court Justice Samuel Freeman Miller wrote, “A considerable number of the prisoners fell, after even a short confinement, into a semi-fatuous condition, from which it was next to impossible to arouse them, and others became violently insane; others still, committed suicide; while those who stood the ordeal better were not generally reformed, and in most cases did not recover sufficient mental activity to be of any subsequent service to the community.” Scientific investigations since 1890 have confirmed in troubling detail the irreversible physiological changes in brain functioning from the trauma of solitary confinement.
As expressed by Dr. Craig Haney, a psychologist and expert in the assessment of institutional environments, “Empirical research on solitary and supermax-like confinement has consistently and unequivocally documented the harmful consequences of living in these kinds of environments . . . Evidence of these negative psychological effects comes from personal accounts, descriptive studies, and systematic research on solitary and supermax-type confinement, conducted over a period of four decades, by researchers from several different continents who had diverse backgrounds and a wide range of professional expertise… [D]irect studies of prison isolation have documented an extremely broad range of harmful psychological reactions. These effects include increases in the following potentially damaging symptoms and problematic behaviors: negative attitudes and affect, insomnia, anxiety, panic, withdrawal, hypersensitivity, ruminations, cognitive dysfunction, hallucinations, loss of control, irritability, aggression, and rage, paranoia, hopelessness, lethargy, depression, a sense of impending emotional breakdown, self-mutilation, and suicidal ideation and behavior” (pp. 130-131, references removed).
Dr. Haney concludes, “To summarize, there is not a single published study of solitary or supermax-like confinement in which non-voluntary confinement lasting for longer than 10 days where participants were unable to terminate their isolation at will that failed to result in negative psychological effects” (p. 132).
We are aware that prison spokesperson First Lieutenant Brian Villiard has told AFP that Manning is considered a “maximum confinement detainee,” as he is considered a national security risk. But no such putative risk can justify keeping someone not convicted of a crime in conditions likely to cause serious harm to his mental health. Further, history suggests that solitary confinement, rather than being a rational response to a risk, is more often used as a punishment for someone who is considered to be a member of a despised or “dangerous” group. In any case, PFC Manning has not been convicted of a crime and, under our system of justice, is at this point presumed to be innocent.
The conditions of isolation to which PFC Manning, as well as many other U.S. prisoners are subjected, are sufficiently harsh as to have aroused international concern. The most recent report of the UN Committee against Torture included in its Conclusions and Recommendations for the United States the following article 36:
“The Committee remains concerned about the extremely harsh regime imposed on detainees in “supermaximum prisons”. The Committee is concerned about the prolonged isolation periods detainees are subjected to, the effect such treatment has on their mental health, and that its purpose may be retribution, in which case it would constitute cruel, inhuman or degrading treatment or punishment (art. 16).
The State party should review the regime imposed on detainees in “supermaximum prisons”, in particular the practice of prolonged isolation.” (Emphasis in original.)
In addition to the needless brutality of the conditions to which PFC Manning is being subjected, PsySR is concerned that the coercive nature of these conditions — along with their serious psychological effects such as depression, paranoia, or hopelessness — may undermine his ability to meaningfully cooperate with his defense, undermining his right to a fair trial. Coercive conditions of detention also increase the likelihood of the prisoner “cooperating” in order to improve those circumstances, even to the extent of giving false testimony. Thus, such harsh conditions are counter to the interests of justice.
Given the nature and effects of the solitary confinement to which PFC Manning is being subjected, Mr. Secretary, Psychologists for Social Responsibility calls upon you to rectify the inhumane, harmful, and counterproductive treatment of PFC Bradley Manning immediately.
Sincerely,
Trudy Bond, Ph.D.
Psychologists for Social Responsibility Steering Committee
Stephen Soldz, Ph.D.
President, Psychologists for Social Responsibility
For the Psychologists for Social Responsibility Steering Committee
Psychologist Jeff Kaye discusses the soul-crushing effects of isolation and solitary confinement that are being meted out to alleged Wikileaks leaker Bradley Manning even before conviction. To get a sense of what Kaye is referring to, watch this interview with David House, one of a few people who have met with Manning in detention [h/t Firedoglake.]:
Bradley Manning and the Torture That Is Solitary Confinement
By Jeff Kaye
Solitary confinement will slowly wear down the mental and physical condition of Bradley Manning, held in 23-hour isolation in the brig at Marine Corps Base Quantico, in Quantico, Virginia, the same facility that held John Hinckley, Jr. That is my assessment after talking to David House last weekend. House is the only person, besides Manning’s attorney, David Coombs, who sees the prisoner regularly since he was locked up at the Quanitco brig in what the Department of Defense calls “maximum custody” conditions.
Manning was arrested last May for his alleged role in downloading videos and documentary files for transfer to the muckraking Internet site, Wikileaks. The “maximum custody” conditions include a Prevention of Injury (POI) order which, according to House, “limits his social contact, news consumption, ability to exercise, and places restrictions on his ability to sleep.” As Glenn Greenwald noted last week, the brig regimen is essentially that of a Supermax prison. They are also similar to the “Special Administrative Measures” or SAMs imposed on Syed Fahad Hashmi the Bush administration, renewed by Attorney General Holder under President Obama, which kept Hashmi is kept in 23-hour lockdown and isolation before trial for three years.
Indeed, the conditions of solitary confinement are so onerous it led the International Committee of the Red Cross in a 2004 report to state, in regards to the CIA’s detention of so-called high-value detainees, that “strict solitary confinement in cells devoid of sunlight for nearly 23 hours a day constituted a serious violation of the Third and Fourth Geneva Conventions.” While Bradley Manning is not being held as an “enemy combatant,” the conditions under which he is being held are redolent of the torture inflicted upon U.S. “war on terror” detainees, or suffered under the terms of the military’s Army Field Manual Appendix M, where such detainees are held in conditions of isolation, including significant limitations on sleep and certain forms of overt sensory deprivation.
The deleterious effects of solitary confinement have been copiously documented. A literature review on the subject, and an excellent discussion of the effects of isolation can be found in a 2003 article by psychology expert Craig Haney.
Solitary confinement is an assault on the body and psyche of an individual. It deprives him of species-specific forms of physical, sensory and social interaction with the environment and other human beings. Manning reported last weekend he had not seen sunlight in four weeks, nor does he interact with other people but a few hours on the weekend. The human nervous system needs a certain amount of sensory and social stimulation to retain normal brain functioning. The effects of this deprivation on individuals varies, and some people are affected more severely or quickly, while others hold out longer against the boredom and daily grind of dullness that never seems to end.
Over time, isolation produces a particular well-known syndrome which is akin to that of an organic brain disorder, or delirium. The list of possible effects upon a person is quite long, and can include an inability to tolerate ordinary stimuli, sleep and appetite disturbances, primitive forms of thinking and aggressive ruminations, perceptual distortions and hallucinations, agitation, panic attacks, claustrophobia, feelings of loss of control, rage, paranoia, memory loss, lack of concentration, generalized body pain, EEG abnormalities, depression, suicidal ideation and random, self-destructive behavior.
In fact, while the Defense Department claims that “maximum custody” and POI are meant to protectBradley Manning from harm, or mitigate possible agitated or aggressive behavior by the prisoner, the very conditions they have placed him under are known to break down individuals and bring about the very kinds of aggressive behavior the POI orders are supposed to prevent. Indeed, it appears the government wants to impress upon Manning its immense power, and induce in the prisoner a feelings of utter futility and helpless dependence.
A number of courts have found solitary confinement to be unconstitutional under the Eighth Amendment. According to a report by Physicians for Human Rights (PDF, bold emphasis added):
The United States District Court for the Southern District of Texas… found solitary confinement to be a violation of the Eighth Amendment and even called it tantamount to torture. In a case concerning the prison system in Texas, the court found that inmates in administrative segregation “suffer actual psychological harm from their almost total deprivation of human contact, mental stimulus, personal property and human dignity…. The wounds and resulting scars, while less tangible, are no less painful and permanent when they are inflicted on the human psyche.” (Ruiz v. Johnson. 37 F. Supp. 2d 855, 913. S.D. Tex. 1999)
What are the effects of isolation on Bradley Manning?
Having experience with assessing the response of individuals held in abusive conditions, or even torture, in my capacity of having conducted forensic psychological evaluations for ten years on asylum applicants, and having spoken to David House, I have been considering Manning’s situation and the effects upon his likely mental and emotional status. While an accurate assessment of a person would mean direct access to them, and the application of psychometrically valid psychological instruments, experience allows me to make some general statements.
From what can be ascertained, the effects of solitary confinement are having some effects already on Bradley Manning. His concentration and thinking processes appear somewhat slowed. He avoids certain topics. He has little access to humor. His color is pale, and his musculature is starting to look soft and flabby. It is unknown what stress Manning had prior to his arrest, but if one can believe the published logs between Manning and Adrian Lamo, he suffered from some amounts of stress in the military.
From a number of accounts, Manning appears to be trying to adapt as well as he can. Those people do best in isolation who are able to draw upon deep reservoirs of inner meaning and commitment, and Bradley Manning seems to be that kind of individual. But no human being is impervious to the degradations of isolation.
Manning is not suicidal, though it appears he has trouble sleeping due to various mild to moderate impediments (no pillow, uncomfortable “suicide” blanket, low-level light in the room during sleep hours, being woken up if he sleeps in certain positions that impede the guard’s observation). This is not traditional sleep deprivation, but seems meant to make him uncomfortable and keep him from getting a restful sleep. However, he has asked for and received sleep medications. He has not been forced, either, to take any medication against his will. He has not been subjected to overt sensory deprivation techniques, although isolation itself is a form of sensory and social deprivation.
The brig officials do not appear to be practicing environmental manipulations of temperature, or diet, though Manning felt the cell was a little too cold at times when he first arrived. He may have suffered more traumatic conditions of confinement or abuse while held in Kuwait. I don’t have enough information to determine that, except Manning appears reluctant to talk about it much.
Even if Bradley Manning is not being held in conditions as horrific as those CIA black site prisoners suffered in the early days of the Bush administration, his situation, like those of thousands of Supermax prisoners in the United States, are onerous and destructive enough. We must ask that the unnecessary POI orders be lifted, and Manning allowed social time with other prisoners, according to normal prison rules and safeguards. He should have full access to mail and the ability to write to others, and to exercise unrestricted by shackles and chains. He should be allowed normal bedding, and greater rights of privacy.
Isolation is a technique well-known to break down individuals. Why does the U.S. government wish to break down Bradley Manning? Is it to get him to confess, to force a plea bargain, to implicate Julian Assange or other people, or to make an example of him to those who would choose a higher good over the machinations of the U.S. government in a senseless and criminal war?
Manning’s case should also be a wake-up call to Americans as regards the on-going practice of soul-crushing solitary confinement in America’s prisons. It is unlikely that the government could get away with the kinds of cruel and unusual punishment meted out to prisoners like Manning or Hashmi or Jose Padilla, or to the “war on terror” detainees at Guantanamo and elsewhere, if isolation hadn’t been allowed to flourish in the prisons of this country, despite the occasional judicial rebuff.
Such treatment has also gained traction through the policies of the current administration which has turned a blind eye to prisoner maltreatment and even torture by agencies of the U.S. government, policies and actions which organizations like Wikileaks have tried to expose. And so the circle comes round and we have the case of a man who tried to expose such policies, whistleblower Bradley Manning, a man held in chains and what the English poet Lord Bryon called “the damp vault’s dayless gloom.” It is our obligation to demand humane treatment for him, and by extension, all prisoners held in U.S. custody.