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Module 1: Trauma, Recovery and Torture Survivors

What are some of the physical and psychological consequences of torture?

The impact of torture

The impact of torture and war trauma can be different for each individual survivor. Torture can
impact their physical health, relationships with family and friends, emotional health, ability to work
and more.

The impact can be related to many things, such as their age when harmed, the number of times
that they were imprisoned, or their belief that they were a target for harm because of their cause
(Başoğlu et al., 1994a). The degree of harm may vary, for example, between individuals who were
“caught up” in the situation versus those who were committed to a “cause” that they were fighting
for (Başoğlu et al., 1997).

The amount of support that they have from family and the community (Başoğlu et al., 1994b), and
their spiritual beliefs (Holtz, 1998) may also determine the way in which the individual experiences
the harm and the degree of impact on their life.

It is not unusual for survivors of torture and war trauma to have suffered physically. See Table 1 for
a summary of some of the common physical consequences of torture.

A physical examination can be difficult for both the survivor and the doctor. Patients may not inform
their doctors of their history of torture and war trauma (Crosby et al., 2006). When a survivor is
placed in a small examination room or surrounded by a curtain, when they are touched or looked at
by a doctor or when they see various medical instruments, it may cause them to recall their trauma
with vivid detail and may prevent a full examination from occurring.

It is important to remember that for survivors, pain and scars are ongoing reminders of horrific past
experiences. It is also important for providers to speak with their patients first about the examination
and what it may entail, give their patients choices and be prepared to allow more time for an
examination with a survivor.

As with other forms of trauma, survivors may feel great shame related to their experiences, which can
make it difficult to talk about them. Often, survivors fear that they may be rejected upon disclosure
of what happened to them or that they may be misunderstood or, even worse, not believed.

When the experience of torture involves intimate betrayals, in which survivors may personally know
their tormenters (such as their neighbors, their baker or butcher down the street, a former classmate
or someone from their religious congregation), the experience of betrayal raises the degree of trauma
to yet another level. Such betrayals may significantly erode one’s ability to trust others. For example,
being tortured by someone from their community greatly affects survivors’ integration into a new
country because it interferes with their ability to find or create a support network.

In addition, individuals may have difficulty learning how and where to get support because they
find it difficult to talk about what happened to them. It is common for survivors even after being in
a new country for a period of time to feel that they have made no friendships. Sometimes making
friends is difficult because they fear leaving their home and may find it difficult to trust others.

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