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Implements of torture can be ordinary tools or utensils, or sophisticated techniques, including drugs, behavioral conditioning, and acupuncture. Electronic immobilization devices (stun guns), which emit high voltage shocks, are other implements of torture.

Most arguments justifying the use of torture tend to be pragmatic, such as the "ticking bomb" scenario proposed by legal expert Alan Dershowitz. However, modern interrogation techniques are far more effective than torture in extracting factual information. When laws prevent security agencies from using torture within their home countries, they sometimes resort to involuntary removal of prisoners to countries where torture is still practiced.

Little sets torturers apart from other people. Some become torturers out of political or social conviction or a religious belief. Child soldiers engage in torture because they are themselves terrorized by their commanders, or because they are trying to impress their fellow troopers with their "toughness." Some members of security forces regard it as routine job performance.

Some torturers may be sociopaths, but in other instances the government trains people to perform torture and commit atrocities. In societies where torture is traditionally used, no shame or guilt attaches to its performance, and therefore police, security, and military personnel will act as torturers without compunction, even though the practice may be unlawful. In many instances, torture techniques may be developed and practiced with the assistance of health care professionals, in violation of ethical standards.

The individual torture survivor suffers many consequences of the torture, some physical, some mental. These can be acute or chronic and come at great cost to the individual, the family, and society, with the possibility of long-term disabilities resulting from the torture and related maltreatment.

Psychological consequences of torture include posttraumatic stress disorder (PTSD), depression, anxiety, sleep disorders, phobic reactions, guilt feelings (especially survivor guilt), sexual dysfunction (especially in rape victims), and personality changes. Torture survivors often turn to substance abuse in an attempt to self-medicate their trauma. Family members may even develop PTSD vicariously or suffer ambiguous loss when individuals are abducted by security forces or militias.

Another consequence of torture to society is the loss of educated and skilled individuals. Wherever torture and atrocities were committed against the civilian population, the bulk of the middle class disappeared. These individuals were some of the first targets of rebel forces, and those not killed often fled the country entirely, their potential contribution to their nation lost forever.

Treatment of survivors of torture varies with the availability of facilities within the society, the willingness of victims to access treatment, and the training available to health care professionals. While the prevalent method of treatment worldwide has been psychodynamic, evidence shows that other methods are more effective and efficient. Cognitive-behavioral therapy, pharmacological treatment, eye movement desensitization and reprocessing (EMDR), and conjoint marital and family therapy have all successfully reduced symptoms and improved the long-term functioning of torture survivors. Especially needed is family therapy in cases where entire families were terrorized as a result of the torture or disappearance of a family member.

Several nongovernmental agencies attempt to combat torture worldwide through monitoring, publicity campaigns, public education, and humanitarian efforts. These include Amnesty International, the UN Office of the High Commissioner of Human Rights in Geneva, the International Red Cross, Physicians for Human Rights, and the International Rehabilitation Council for Torture Victims in Copenhagen, Denmark. These organizations also train professionals and paraprofessionals in how to deal with trauma and publicize the consequences of torture and trauma for society. Recently, commissions of truth and reconciliation served a role in raising public awareness of torture and its use in armed conflicts within some societies.

References:

1) American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association.

2) Boss, Pauline. 2000. Ambiguous Loss. Cambridge, MA: Harvard University Press.

3) Duner, Bertil, ed. 1999. An End to Torture: Strategies for Its Eradication. New York: Zed.

4) European Union. 2000. Charter of Fundamental Rights of the European Union. Brussels, Belgium: European Union.

5) Foa, Edna B., Terence M. Keane, and Matthew J. Friedman, eds. 2004. Effective Treatments for PTSD. New York: Guilford.

6) Forrest, Duncan, ed. 1996. A Glimpse of Hell: Reports on Torture Worldwide. New York: New York University Press.

7) Harbury, Jennifer K. 2005. Truth, Torture, and the American Way. Boston: Beacon Press.

8) Levinson, Sanford, ed. 2004. Torture: A Collection. New York: Oxford University Press.

9) Prip, Karen. 1994. "Physical Torture Methods and Their Sequelae." Torture (suppl. 1):9-13.

10) Timerman, Jacobo. 2002. Prisoner without a Name, Cell without a Number. Madison, WI: University of Wisconsin Press.

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