Waterboarding: A Mental and Physical Trauma

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A US soldier and a Vietnamese interpreter use the "waterboarding" technique on a Viet Cong suspect near Da Nang, South Vietnam, January 17, 1968.

In Chile, they called it submarino, a form of simulated drowning that has much the same effect as what we call waterboarding. During Augusto Pinochet's 17-year-long dictatorship, thousands of Chileans were detained by the military and subjected to torture. During the submarino, they were forcibly submerged in a tank of water, over and over again, until they were on the edge of drowning. (The Chilean military liked to foul the water with urine, feces or worse, something that—so far—hasn't been known to be a part of U.S. waterboarding of terrorism suspects.) Submarino became a popular tool for military interrogators, in part because it left relatively few permanent physical marks.

But the impact on the torture victim's mind was lasting. After Pinochet's fall in 1990, the new civilian government in Chile investigated incidents of alleged torture, and found deep scars. Years after they were tortured, submarino victims were still haunted. A 2007 study in the International Review of the Red Cross found that "the acute suffering produced during the immediate infliction of the submarino is superseded by the often unbearable fear of repeating the experience. In the aftermath, it may lead to horrific memories that persist in the form of recurrent 'drowning nightmares.'" As one Chilean who was tortured by submarino under Pinochet put it: "Even today I wake up because of having nightmares of dying from drowning." (Read "Obama: No Prosecution for Waterboarding.")

The news that the U.S. waterboarded one al-Qaeda prisoner, Abu Zubaydah, at least 83 times, and another, the confessed 9/11 mastermind Khalid Sheikh Mohammed, 183 times, has given new energy to the debate over whether U.S. interrogation methods amounted to torture. Defenders of waterboarding say that the procedure, while awful for the prisoner, is relatively safe and has few long-term effects. But doctors and psychologists who work with torture victims disagree strongly. They say that victims of American waterboarding—like the Chileans submitted to the submarino under Pinochet—are likely to be psychologically damaged for life.

"This is an utterly terrifying event," says Allen Keller, the director of the Bellevue/New York University School of Medicine Program for Survivors of Torture. "Psychologically this can result in significant long-term post traumatic stress, and produce anxiety and depression."

Defenders of the procedure have pointed to the fact that American soldiers are put through a form of waterboarding during the military's Survival, Evasion, Resistance and Escape program, as training for the possibility of capture. But Keller points out that being waterboarded during training, as scary as it might be, bears little resemblance to what a detainee would endure. "The trainees know that they are not going to be hurt," he says. "When someone's being tortured there are no such guarantees. There is no reason to believe they aren't going to be drowned."

If a prisoner is waterboarded repeatedly, as Zubaydah and Mohammed were, it's tempting to believe that the effect would lessen over time; that the victim would no longer fear drowning, knowing that his interrogator would stop the process in time. But waterboarding can be so intense—and the fear of drowning so primal—that each time would be a fresh trauma. Worse, being waterboarded repeatedly raises the possibility that something could go wrong and the detainee could, in fact, drown. (Read "Torture Memos Released.")

"Done 183 times on a single person, each flood of water, each subsequent near-death experience, increases the possibility of debilitating and irreparable harm," says Brad Olson, a research professor of psychology at Northwestern University. "The cumulative impact of this waterboarding is tremendous. It's going to produce permanent psychological damage even in the most resilient human."

Keller, who treats victims at Bellevue, agrees that psychological effects of asphyxiation torture like waterboarding can be insidiously long-lived. One patient whose head was repeatedly submerged during torture has constant flashbacks. "Every time he has a shower, he panics," says Keller. One victim panics every time he becomes the least bit short of breath, even during exercise. And in most cases, it is the helplessness the victims endured under torture that renders the experience ineradicable. "They fear that loss of control," says Keller. "That's what is so terrifying."

It can take years for psychological scars to show, and to truly gauge the long-term psychological impact of torture, psychologists need to follow up with victims well after they are released. That may never happen with detainees like Zubaydah and Mohammed—meaning we may never know the final wages of what CIA agents did in dark rooms under our name. But there should be no doubt now that we tortured. "That we would still be having a discussion about whether or not waterboarding is torture is so disingenuous," says Keller. "They should come out and say what it is."

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