Special Feature

 medium_SCRA_logomark_4col.jpg

The
Community
Psychologist

Volume 50 Number 1
Winter 2017

Special Feature

Clinical Psychologists Engaged in Torture and their Violation of their Field’s Ethos

Written by Valentina Rossi, National Louis University/University of Padua; Brad Olson, National Louis University; Marialuisa Menegatto, University of Padua; and Adriano Zamperini, University of Padua

The newly elected U.S. president, much of his cabinet, and the majority of the American public have made gestures of support for torture in national security investigations, despite prohibitions against such techniques. Previous support for involvement of psychologists in such interrogations came from the APA and its psychologists. Despite being censured for its complicity (Hoffman, 2015), many APA psychologists continue to deny there were widespread problems with APA and that the psychologists that participated were just a few bad apples. And yet there remains a powerful movement within psychology, insisting that the use of such adversarial approaches are antithetical to the ethos of the discipline (Arrigo, Eidelson, & Bennett, 2012; Soldz, Olson, & Arrigo, manuscript under review).

Community psychology, going beyond traditional psychology, can provide a systemic analysis that equally supports the value of individual narratives of the most vulnerable in any situation, perhaps providing deepened understandings of the field’s problems.

The New York Times recently provided narratives of survivors of U.S. Torture, and many of these survivors (Apuzzo, Fink, & Risen, 2016) were impacted directly by psychologists, and likely indirectly by APA (American Psychological Association) collusion (Hoffman, 2015).These narratives show the debilitating psychological consequences of torture and other cruel, inhuman, and degrading treatment (CIDT). For a systems-based understanding of past and present atrocities, narratives help to understand the long-term realities of survivors, and how they were impacted by manipulation and collusion of government policy and the field of psychology itself.

Narratives of torture survivors provide precious in-depth testimonies to the ethics affliction faced by U.S. psychology. Community psychology, while providing a multi-level system of torture, provides a more humanizing and liberating approach, particularly of the role of U.S. clinical psychologists in these instances. By focusing on the narratives of survivors of torture we may better safeguard against continued deteriorations of civil society's commitments to ethics, law and human rights, preventing associations and especially psychology, from becoming instruments of harm and oppression. 

Community Psychology, Clinical Psychology, and APA Collusion

It is well known that the Department of Defense (DoD) and Intelligence (e.g., CIA) favored clinical psychologists, specifically, for their work in enhanced interrogations (i.e., torture). Our sub-discipline of community psychology has, since its beginnings in the 1960s, a long, and not tension-free relationship with clinical psychology (Swampscott Report, 1965). At the same time, community psychology has done much, over the past decades, to salvage so much of the good within clinical psychology. We have also worked to correct the ethical path of psychology as a whole, toward greater empowerment and well-being for diverse members of global communities.

There is much community psychology can do to further study clinical psychology, and to understand the missteps around the interrogation/torture scandal. By studying the role of clinical psychology, a community psychology can go beyond the “bad apple” approach and provide a more systemic analysis, one that deepens understandings of psychologists, survivors, the broader field of psychology and civil society.

In APA’s years-long collusion with the CIA, DoD, and the White House, the Association strove actively to keep clinical psychologists participating in enhanced interrogations. The APA’s willingness to comply to government requests led it to promote acts that violated the ethos of the discipline itself (and clinical psychology). The individual CIA/DoD clinical psychologists, by violating the primary stakeholder of clinical psychology, the client, they also fundamentally violated the field’s ethos. That ethos, while different sub-disciplines of psychology use different names, and while is more of a constellation of factors than a single entity, we argue that the value involves an ethos of Beneficence.

Principle A of the APA ethics code is Beneficence and Non-maleficence, that: "Psychologists strive to benefit those with whom they work and take care to do no harm." We argue that beneficence—striving to benefit the client—is even more central than “do no harm”. This ethos, with torture as its antithesis, is the healing and humanizing approach to psychology, and to the people most directly impacted by our interventions.

APA decisions were not steered by the well-being of the client. APA, with a willingness to comply to government requests, lost its ethical axis and consequently promoted decisions that overshadowed the client. The same was true of the clinicians, focused not on the client and ameliorating, but in their employment to their government who, in their eyes, was their real client. We do recognize that not every DoD/Intelligence adversarial clinical psychologist is the same. Some, like James Mitchell, greedily engaged in their passion for torture. Other clinical psychologists severely conformed, engaged, and may have experienced cognitive dissonance, but completely perpetuated the system of CIDT. They all violated the key forms of the good in clinical psychology, exploiting theories and tools of psychology to bring harm.

We focus on three violations to clinical psychology. Clinical psychologists: 1) using their tools to create long-term psychological disorder; 2) being used by the government to make torture look like non-torture, and; 3) breaking the trust of all therapist-clients around therapeutic alliance.

1. Clinical Psychologists Using Clinical Tools to Create Psychological Disorder

NY Times survivor narratives reveal just how psychologists used their clinical skills to produce lifetime-long clinical disorders: PTSD, anxiety, major depression. The narratives reveal much evidence of paranoia, psychosis, inability to sleep, long-term memory loss, and many other symptoms that would be of no surprise to clinical psychologists who have focused exclusively on beneficence with survivors of torture. The narratives show the debilitating psychological consequences of harm-focused psychologists. For the worst of these psychologists the goal was to psychologically dislocate the detainee and exploit this psychological suffering. The survivors report their experiences as: “Make him as uncomfortable as possible”, “Work him as hard as possible”, and “[Keep] him away from anyone who spoke his language”. The totality was the worst part: “They tortured us in jails, gave us severe physical and mental pain, bombarded our villages, cities, mosques, schools.” And, “Of course we have flashbacks, panic attacks and nightmares”.

Community psychologists, in our work, make the appreciation of diversity and vulnerable populations explicit. There is little more shocking than the case of Mohammed Jawad, brought in at the vulnerable age of 14 years, whose capture and detention involved a psychologist. Today he suffers from PTSD. The psychologist involved in his capture and detention said then, about the teenager: “The detainee comes across as a very immature, dependent individual…his demeanor looks like it is a resistance technique”. Rather than show any semblance of cultural competence of recognition of a youth as a vulnerable person, fundamental to all psychological ethics and good sense, the experience was a process of exploitation.

From a more sociopathic-orientation, there are the torturing “clinical psychologists”, like James Mitchell, CIA contractor, whore boasted, publicly, about his use of waterboarding. Mitchell received knowledge directly from psychologist Martin Seligman, about Seligman’s long-time work on learned helplessness. Much like Seligman’s early work in his experiments with dogs, Mitchell’s only intent was to fully break down the psychological resources of his morally excluded “subjects”, the detainees.

2. Clinical Psychologists used to Legitimize Torture

Psychologists like Mitchell were set only on harm and other psychologists used their psychological “skills” to exploit detainees. This latter group were also used by the government to pretend torture fell short of “torture” in a process of manipulating well-established legal definitions of psychological torture. The White House goal was to undercut the internationally agreed upon definition “severe pain or suffering, whether physical or mental” from the Convention Against Torture (CAT, 1987), which covers the psychological impact of techniques such as waterboarding, stress positions, beating, temperature manipulation, threats of harm to person, family or friend, sleep deprivation, sensory bombardment, violent shaking, sexual humiliation, prolonged isolation and sensory deprivation (Physicians for Human Rights, 2007). The White House was setting a higher bar for such harm to constitute torture. Under the new White House such techniques only constituted torture if they gave proof of “several mental pain or suffering” associated with torture required proof of “prolonged mental harm” (Bybee, 2002). One could say then that psychological pain and suffering that did not develop new disorders was not “torture”.  Who better then to monitor these enhanced interrogations then clinical psychologist who could say “stop here or long-term damage will occur”. Clinical psychologists on the health side at places like Guantanamo rarely diagnosed detainee symptoms as PTSD, symptoms which no doubt are attributable to torture. In other words, clinical psychologists played key roles in rationalizing that torture was something less than torture. What the NY Times survivor narratives, and the “legacy of damaged minds” show, is that despite the clinical psychologists, and despite the White House’s draconian definitions, torture is torture.

3. Clinical Psychologists Destroying Therapeutic Alliance for All Psychologists

An additional key violation of clinical psychology was the radiating negative impact these clinical psychologists had on therapeutic alliance, not only within their own setting but everywhere else. Therapeutic alliance, within clinical psychology, best represents beneficence. Therapeutic alliance is the “quintessential integrative variable” of therapy (Wolfe & Goldfried, 1988). It is the crux of the clinical art where trust, respect, and acceptance are promoted and put into practice, first by therapist, ultimately in collaboration with the client. The quality of the alliance significantly contributes to positive clinical outcomes independent of the approach used. For benefits to occur, regardless of difficulty in the process, the client must know the therapist’s intent to help. Trust is essential. The therapist must respect the client’s culture, religion, worldview. Regardless of difficulty in the process, the ultimate goal must be to help the individual and primary stakeholder, the client. And if the therapist is unable to fulfill that contract, for whatever reason, the alliance is contaminated.

In many ways, adversarial clinical psychologists and the APA all contributed to the creation of survivors’ long-term symptoms, to the legitimization of torture denial, and to the radiating breakdown of the therapeutic alliance. In many ways, the lack of appreciation of, and empathy to, survivors of torture is, we believe, a primary cause so many APA psychologists of all types still engage in denial, historical revisionism, and political amnesia.

Guantanamo psychologists, it is given, contaminated the therapeutic alliance within their own setting, but they, we argue, damaged it in all settings. Nowhere did they contaminate the future universe of therapeutic alliance more than for clinicians who work with torture survivors. Clinicians in the U.S. who work with survivors of torture must now have a very difficult time obtaining trust from their clients.

For these reasons, in our research, we are currently interviewing these clinicians. Survivor narratives acquire a deeper meaning when they are considered jointly with testimonies from clinicians. Through these interviews we hope to learn much, but we are particularly interested in understanding how the discipline of psychology can begin to re-establish a therapeutic alliance in clinician-survivor relationships, and trust from society in general. Through these narratives we hope to better understand the ethos of an ethical clinical psychology and the resulting systemic problems connected to the torture scandal. As community psychologists, we hope to help retrace the steps that led clinicians to do harm. With such new understanding we can all work to help re-focus psychology toward its fundamental ethical values and ensure psychologist's decisions and actions adhere to those values.

By recognizing the survivors of torture and the clinicians who have dedicated their lives to helping survivors of torture, we can better safeguard the field of psychology. We can also help prevent other areas of civil society from violating ethics, law, and human rights, preventing the protectors of mental health from becoming instruments of harm and oppression. 

References

Apuzzo, M., Fink, S., & Risen, J. (2016). How U.S. torture left a legacy of damaged minds. New York Times. Retrieved from http://www.nytimes.com/2016/10/09/world/cia-torture-guantanamo-bay.html.

Arrigo, J. M., Eidelson, R., & Bennett, R. (2012). Psychology under Fire: Adversarial Operational Psychology and Psychological Ethics. Journal of Peace and Conflict.

Convention Against Torture and other Cruel, Inhuman, or Degrading Treatment or Punishment. (1987, 26 June). Retrieved from http://www.ohchr.org/Documents/ProfessionalInterest/cat.pdf.

Hoffman, D. H., Carter, D. J., Vigucci, C. R., Benzmiller, H. M., Guo, A. X., Latifi, S. Y., Craig, D. C., (2015). Report to the Special Committee of the Board of Directors of American Psychological Association. Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, And Torture.

International Committee of the Red Cross (2007, 14 February). ICRC Report on the Treatment of Fourteen “High Values Detainees” in CIA’s Custody.

Memo for Alberto R. Gonzales Counsel to the President (2002, 1 August). New York Times

Physicians for Human Rights. (2007). Leave No Marks. Enhanced Interrogation Techniques and The Risk of Criminality.

Swampscott, Massachusetts, (1965, 31 December). One Hundred and Fourteenth Annual Report of the Town Officers.

Wolfe, B. E., & Goldfried, M. R. (1988). Research on psychotherapy integration: recommendations and conclusion from an NIMH workshop. Journal of Consulting and Clinical Psychology, Vol. 56, N.3, 448-45.