P165: A Pre-Review: The Psychodynamics of Torture under the Totalitarian Control

Torture is aimed to create a living dead. Pressing systematic control on individuals who are in opposition to the ruling authorities, persons’ sense of self would be damaged. Such an aversive situation is caused by intentional human action rather than natural causes. Torture occurs in more than 90 countries (Abu Ghraib prison is a prominent example) however, epidemiologic data are limited. The victim’s identity is attacked by some specific torture techniques such as the good guy/bad guy and impossible choice techniques. This review is aimed to offer a pre-review of some of the main articles related to this topic. Experiencing more severe symptoms in torture survivors rather than what patients with PTSD experience, it can be called complex PTSD or Disorder of extreme distress. Exposing to burdensome and unavoidable aversive torture under the totalitarian control elaborates more complex and stable symptoms in comparison to facing other traumatic events. Victims are likely to suffer mental death. This experience characterized by a loss of the identity one had before the interpersonal trauma. The main features of mental death are symptoms including guilt and shame, distrust and alienation from others, ineffectiveness and loss of autonomy, loss of core beliefs and values and a sense of being permanently damaged. Based on Kelly’s theory, engaging actively in building a structure to explain the routine life and its relationships, people have a framework to make the predictions and behave accordingly. Occurrence of a traumatic event may cause three core presuppositions be demolished: invulnerability of human, meaningfulness (i.e., orderly and comprehensible) of the world, and human’s autonomy. Furthermore, Silove suggests that torture impress constructs related to identity, safety, trust, attachments, justice, and existential issues. While the DSM4 defines PTSD criteria for syndrome occurs after a threat to the physical integrity of the self, other researchers discussed different symptoms containing changes in core beliefs and active coping, loss of predictability and control, mental defeat and alienation by experiencing totalitarian control.