PTSD, Torture Specific Syndrome and the Varied Effects of Torture

In some of my readings, this week I was asked to look into the symptoms of psychological torture and how they differ from 'physical' torture. The psychological effects of torture are many, varied and while not as easily 'seen' by the naked eye as physical torture... as just as damaging to the victim's mental, physical and cultural health. However, unlike physical torture, psychological torture is harder to define, prove cause and effect, as well as determine whether it has occurred at all. (Maybe that is why more 'civilized nations' such as the United States will use it more than physical torture.... it gives the leaders plausible deniability. It also appears to give the perpetrators the 'idea' of being humanitarian but also getting the results that they are looking for.) So, whether torture was provided by physical means, psychological... or some of both, all have many of the same effects on the person affected. Isolation, for example, tends to produce changed brain function, disorientation, etc.... and has been described to have some of the same effects as a severe physical beating.

Other symptoms can be insomnia, PTSD and other mental health challenges, emotions such as guilt, pain, grief, anger, as well as problems that can bring back the images and feelings inappropriately. Many victims can feel pain in different areas of their bodies (constant or intermittent), migraines / headaches, troubles eating, social and relationship difficulties as well as severe problems with self identity. Delusions and other psychosis can be caused as well.

Unfortunately, it is also suggested by statistics and interviews that the people around the persona affected end up with many of the same symptoms, challenges and negative world views as the actual victim. So torture is not just the destruction and damage to one human life, but several... a bit like second hand smoke.... invisible but quietly making some internal changes that become difficulties and illnesses over time.

Torture Specific syndrome is usually described by four categories of symptoms:

1. impaired memory and concentration
2. sleep disturbances / nightmares
3. anxiousness, depression, physical symptoms that come without any findable cause, such as stomach complaints, breathing and heart problems,
4. other mental health problems such as depression or anxiety

These symptoms appear very similar to me as almost the same symptoms of post traumatic stress disorder and I suspect that these disorders are treated very similarly if not in the same ways. I'm actually a bit skeptical (and the textbook suggests many others are as well) that they are actually different disorders. It seems like they are just slightly different ways to describe the same problem. I wonder if people would feel more comfortable with one name over another.... like some parents did with the terms Asperger's over autism even though they are parts of the same thing. Not sure. Definitely some challenging reading this week. :)

What do you think? If you have been diagnosed with either disorder... which name 'feels' more comfortable to you? Any thoughts?

ABA and Difficult Situations

My husband had a disturbing experience the other day. He was shopping in a big box store with Bug and they were looking at a few toys while I got my glasses fixed. While they were doing so, a young man came into the aisle with an adult female. It became clear to my husband fairly quickly that the young man had autism and the female was not his mother, but probably his 'section 24' worker. The young man than asked to buy something and was promptly told no. This prompted him to go into a huge tantrum that seemed more of a statement and attention seeking and less of out of control behavior. The worker's reaction was extraordinary. She immediately became livid- absolutely unreasonably angry and it was clear very quickly that she was so angry that the situation would possibly go out of control for both of them. She was clearly so angry that she would be unable to help in any de-escalation of the situation. What was her next step? She looked at the young man and said “ Well, you just lost three stars, young man!”

I am so confused by ABA sometimes. In this situation, the worker allowing herself to get angry and then telling the child that due to his behavior he has lost a privilege, etc.. really seems to send the wrong message. For one thing, it feels pretty hypocritical to punish someone else for not controlling their behavior while you have lost control of your emotions/behavior. It was clear to my husband that the child's response was not “oh I should stop”. It resembled more of “Well, nothing left to lose now-already lost my privileges.” My husband quickly moved my son out of the aisle and they left as the situation did continue to rapidly spiral out of control. I was once told that anyone using behaviorism has to be very, very careful because often, the lesson that they are trying to teach is not the lesson that the other individual is picking up. And ABA is so rigid and doesn't take a lot of factors into account for the individuals involved. In some ways (and this worker expressed this) it is more about expressing and exerting control over someone else.

Now, it is possible that the worker was having a bad day and this wasn't her typical behavior. It is also possible that this is the worker's typical behavior and the child was having a bad day. Of course, we could have misunderstood the whole situation. And it is possible that the parents are either OK with this behavior or have no idea that the behavior by the worker is going on. It is also possible the the parent's know, but are so desperate for the break that they are willing to accept the worker's behavior. It is also possible that the worker is not really trained at all and is just struggling to figure out what she is supposed to do. There are probably several options that I haven't even thought of yet.

But that whole situation shouldn't have happened. In the end, it wasn't fair to the child. Sure his fake tantrum was silly, but he probably just learned to keep doing the tantrum by the worker's behavior. And the worker will probably get even more angry and quit, leaving the family in a bad spot, and leaving the child with more adverse behavior that the new worker will have to deal with. The whole situation just makes me sad.