Author(s): J. Carey Jackson, MD

Date Authored: March 12, 2014

There are several reasons to be very clear about the relationship between symptoms experienced in the present like tooth pain, itchy eyes, headaches, ringing in the ears to the mechanisms that produced them. For forensic work it is important to be able to link the mechanism of torture to the injury it produced in order to establish a credible history of torture for the asylum proceedings.

For clinical care it is important to be able to understand that “tooth pain” or “itchy eyes” have an historical and emotional significance, a kind of symptomatic “iceberg” where what lies beneath the present symptoms and their connections have so much more weight than one could anticipate without a clear story.

This is also where the detailed enumeration of common acts of torture help prompt the person to recall what was done and might elicit more symptoms and connections. This is particularly true of sexual torture where the individual may not want to retrieve or expose certain important history but with a matter of fact systematic inventory is given permission to relate sensitive, personal, but important details.