Abstract
The medicolegal assessment of the mental sequelae of torture and incarceration is often difficult since the symptoms themselves can present an obstacle to adequate exploration and thus to a correct evaluation. This is illustrated by two case reports from the casebook of a psychiatric assessor at the Berlin Centre for the Treatment of Torture Victims.
The fact that assessment of the psychological sequelae of trauma can differ widely from one specialist to another would seem to result partly from the neglect of trauma and its mental sequelae in psychiatric training to date, as well as partially from the extreme countertransferential positions that assessors, just as psychotherapists, can experience when relating to their relationships with survivors of torture.
The tendency shown by survivors of torture to withdraw and isolate themselves, their mistrust of the world and their frequently passive and resigned basic attitude must be countered by assessors with an active willingness to engage with and show interest in their stories and fate, coupled with an understanding of the special significance of the trauma for their lives as a whole.
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Notes
- 1.
Federal compensation law for Jewish holocaust survivors.
- 2.
“How many murders of his own children does a man have to bear without showing any symptoms in order to have a normal mental constitution?”
- 3.
Reparation of SED Injustices Act.
- 4.
Splitting off of extremely traumatic experiences from the environment because they cannot be communicated; resistance to exploration.
- 5.
The abbreviations of names and places in this, as in the following case history, have been changed. When not affecting the political context, locations and time specifications have been left out completely.
- 6.
By the time of the examination, Mr. C’s application for asylum had already been rejected by the Administrative Court. The described diagnostic findings of the author were then declared as new findings and so far unconsidered evidence by another Administrative Court of Appeal that justifies a subsequent asylum procedure.
- 7.
Federal Office for the Recognition of Foreign Refugees.
- 8.
State Chamber of Physicians.
- 9.
Assessment of psychologically reactive sequelae of trauma in residence legal procedures.
References
APA/American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, fourth edition (DSM IV). American Psychiatric Press, Washington, DC
APA/American Psychiatric Association (2014) Diagnostic and statistical manual of mental disorders, fifth edition (DSM 5). American Psychiatric Press, Washington, DC
Birck A (2002) Traumatisierte Flüchtlinge. Asanger, Heidelberg
Bundesärztekammer Curriculum: Begutachtung psychisch reaktiver Traumafolgen in aufenthaltsrechtlichen Verfahren bei Erwachsenen. http://www.bundesaerztekammer.de/downloads/currbegutpsychotrauma.pdf. 2005
Bundesärztekammer Fortbildungscurriculum: Begutachtung psychisch reaktiver Traumafolgen im Sozialen Entschädigungsrecht. http://www.bundesaerztekammer.de/downloads/curriculum_gutachten_23062011.pdf. 2009
Denis D, Kummer P, Priebe S (2000) Entschädigung und Begutachtung psychischer Störungen nach politischer Haft in der SBZ/DDR. Med Sachverstand 96:77–83
Eissler K (1958) Die Ermordung wie viel seiner Kinder muß ein Mensch ertragen können, um eine normale psychische Konstitution zu haben. Psyche 5(63):241–291
Fischer-Homberger E (2004) Die Traumatische Neurose. Psychosozialverlag, Gießen
Flatten G, Gast U, Hofmann A, Liebermann P, Reddemann L, Wöller W, Siol T, Petzold ER (2004) Posttraumatische Belastungsstörung, Leitlinie und Quellentext. Schattauer, Stuttgart
General Foreign Office (1994, 1995) Lageberichte Türkei
Glaesmer H, Brähler E, Gündel H, Riedel-Heller S (2011) The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age, a German population-based study. Psychosom Med 73:401–406
Goltermann S (2009) Die Gesellschaft der Überlebenden. DVA, München
Haenel F (1997) Aspekte und Probleme in der Psychotherapie mit Folteropfern unter Beteiligung von Dolmetschern. Systhema 11:136–144
Haenel F (1998) Special problems in the assessment of the psychological sequelae of torture and incarceration. In: Oehmichen M (ed) Maltreatment and torture. Schmidt Roemhild Verlag, Lübeck
Haenel F (2000) Die Beziehung zwischen Gutachter und zu Untersuchenden und ihre Bedeutung bei der Begutachtung chronisch psychischer Traumafolgen. Med Sachverstand 96:84–87
Haenel F (2002) Zur Abgrenzung psychisch reaktiver Haft- und Folterfolgen von schädigungsunabhängigen neurotischen Störungen. Med Sachverstand 98:194–198
Haenel F (2006) Zu Problemen der Begutachtung psychischer Haft und Folterfolgen bei Personen mit Persönlichkeitsstörungen. Med Sach 102:S171–S174
Haenel F (2011) Die Posttraumatische Belastungsstörung – Psychiatrisch-psychotherapeutische Behandlung von Folter- und Bürgerkriegsüberlebenden. In: Machleidt W, Heinz A (eds) Praxis der Interkulturellen Psychiatrie und Psychotherapie. Urban & Fischer, München, pp 307–319
Henningsen F (2003) Traumatisierte Flüchtlinge und der Prozess der Begutachtung. Psyche 57:97–120
Herman JL (1994) Sequelae of prolonged and repeated trauma: evidence for a complex posttraumatic syndrome (DESNOS). In: Davidson JRT, Foa E (eds) Posttraumatic stress disorder: DSM-IV and beyond. American Psychiatric Press, Washington, DC
Hoppe K (1967) The emotional reactions of psychiatrists when confronting survivors of persecution. Psychoanalytic Forum 3:187–196
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry 52:1048–1060
Lansen J (1993) Vicarious traumatization in therapists treating victims of torture and persecution. Torture 3:138–140
Lansen J (1996) Was tut “es” mit uns? In: Graessner S, Gurris N, Pross C (eds) Folter – an der Seite der Überlebenden. Beck Verlag, München
Niederland W (1968) Studies of concentration-camp survivors. In: Kristal H (ed) Massive psychic trauma. International University Press, New York
Oppenheim H (1889) Die traumatischen Neurosen nach den in der Nervenklinik der Charitè in den 8 Jahren 1883–1891 gesammelten Beobachtungen. Hirschwald, Berlin
Pross C (1993) Wiedergutmachung – Kleinkrieg gegen die Opfer. Athenaeum Verlag, Frankfurt
Resnick PJ (1988) Malingering of posttraumatic disorders. In: Rogers R (ed) Clinical assessment of malingering and deception. Gilford Press, New York, pp 84–103
Skylv G (1993) Falanga – diagnosis and treatment of late sequela. Torture 3:11–15
Venzlaff U (1963) Erlebnishintergrund und Dynamik seelischer Verfolgungsschäden. In: Paul H, Herberg H-J (eds) Psychische Spätschäden nach politischer Verfolgung. Karcher Verlag, Basel
von Baeyer W, Häfner H, Kisker K (1964) Psychiatrie der Verfolgten. Springer, Berlin
Wenk-Ansohn M (2002) Folgen sexualisierter Folter – Therapeutische Arbeit mit kurdische Patientinnen. In: Birck A, Pross C, Lansen J (eds) Das Unsagbare. Springer, Berlin, pp 57–78
Wilson J, Lindy J (1994) Countertransference in the treatment of PTSD. Guilford Press, New York
World Health Organisation (1992) The ICD-10 Classification of mental and behavioral disorders and diagnostic guidelines. WHO, Geneva
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Haenel, F. (2015). Special Problems in the Assessment of Psychological Sequelae of Torture and Incarceration. In: Schouler-Ocak, M. (eds) Trauma and Migration. Springer, Cham. https://doi.org/10.1007/978-3-319-17335-1_8
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