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The Psychological and Physical Impact of CIA’s ‘Prolonged Diapering’

The CIA’s Office of Medical Services was very clear in its September 2003 guidelines about the objective of the “enhanced interrogation” techniques were. “In all instances,” reads the Sept. 4, 2003 memorandum, “the general goal of these techniques is a psychological impact, and not some physical effect, with a specific goal of ‘dislocat[ing] his expectations regarding the treatment he believes he will receive…’” The apparent 11th enhanced interrogation technique, prolonged diapering, was well-geared to serve that purpose, according to doctors who find the technique an appalling breach of medical ethics.

“Speaking as a psychoanalyst, the creation of a new torture technique reveals something about the mind of the torturer,” said Steven Reisner, Physicians for Human Rights’ adviser on psychological ethics.

Perhaps the most striking portion of the the OMS guidelines is that they make no evident attempt, despite the redactions, to argue the psychological case for diapering, despite listing it as an enhanced interrogation technique and providing explicit guidelines for the other techniques. In a strange way, that might be intellectually honest. “We have no idea whether diapering is as humiliating in the culture of the detainee as it seems to be for the torturer,” Reisner said. “Fortunately, anthropologists are prohibited by their ethics from researching such things. I wish psychologists were, but they are not.” Despite that lack of knowledge about the psychological impacts of leaving someone in his own waste, the CIA’s medical professionals embraced the technique.

Then there’s the medical impact and the physical pain — which exist even if they weren’t the point of the technique. “Leaving someone in their own wastes can be associated with urinary tract infections, skin breakdown and ulceration,” said Scott Allen, a physician at Brown University’s Alpert Medical School also affiliated with Physicians Against Human Rights. “Access to a toilet is a widely recognized minimum requirement for prisoners and detainees.”

Indeed, there’s an added element of pain added by the technique: the discomfort of avoiding soiling oneself. “A healthy subject with bowel and bladder control would likely try to resist” the humiliation of using the diaper, Allen added, “causing distress.”

But the physical pain is, as the OMS judgment says, incidental to the purpose of the technique: inducing a psychological state of learned helplessness in a detainee. Reisner’s bottom line: “There’s no question that psychologists who use psychological knowledge for the purposes of debilitation and abuse, even in the service of getting information, violate professional ethics, not to mention human rights law.”

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