Matt Apuzzo, Sheri Fink and James Risen / The New York Times< - 2016-10-11 00:58:24 http://www.nytimes.com/2016/10/09/world/cia-torture-guantanamo-bay.html How US Torture Left a Legacy of Damaged Minds
Beatings, sleep deprivation, menacing and other brutal tactics have led to persistent mental health problems among detainees held in secret CIA prisons and at Guantanamo.
Matt Apuzzo, Sheri Fink and James Risen / The New York Times

“I have dreams of being at the bottom of a well and being suffocated.”
— Lutfi Bin Ali, released without charge after 12 years. Semey, Kazakhstan

(October 8, 2016) — Before the United States permitted a terrifying way of interrogating prisoners, government lawyers and intelligence officials assured themselves of one crucial outcome. They knew that the methods inflicted on terrorism suspects would be painful, shocking and far beyond what the country had ever accepted. But none of it, they concluded, would cause long lasting psychological harm.

Fifteen years later, it is clear they were wrong.

Today in Slovakia, Hussein al-Marfadi describes permanent headaches and disturbed sleep, plagued by memories of dogs inside a blackened jail. In Kazakhstan, Lutfi bin Ali is haunted by nightmares of suffocating at the bottom of a well. In Libya, the radio from a passing car spurs rage in Majid Mokhtar Sasy al-Maghrebi, reminding him of the CIA prison where earsplitting music was just one assault to his senses.

And then there is the despair of men who say they are no longer themselves. “I am living this kind of depression,” said Younous Chekkouri, a Moroccan, who fears going outside because he sees faces in crowds as Guantanamo Bay guards. “I’m not normal anymore.”

After enduring agonizing treatment in secret CIA prisons around the world or coercive practices at the military detention camp at Guantanamo Bay, Cuba, dozens of detainees developed persistent mental health problems, according to previously undisclosed medical records, government documents and interviews with former prisoners and military and civilian doctors. Some emerged with the same symptoms as American prisoners of war who were brutalized decades earlier by some of the world’s cruelest regimes.

Those subjected to the tactics included victims of mistaken identity or flimsy evidence that the United States later disavowed. Others were foot soldiers for the Taliban or Al Qaeda who were later deemed to pose little threat.

Some were hardened terrorists, including those accused of plotting the Sept. 11 attacks or the 2000 bombing of the American destroyer Cole. In several cases, their mental status has complicated the nation’s long effort to bring them to justice.

Americans have long debated the legacy of post-Sept. 11 interrogation methods, asking whether they amounted to torture or succeeded in extracting intelligence. But even as President Obama continues transferring people from Guantanamo and Donald J. Trump, the Republican presidential nominee, promises to bring back techniques, now banned, such as waterboarding, the human toll has gone largely uncalculated.

At least half of the 39 people who went through the CIA’s “enhanced interrogation” program, which included depriving them of sleep, dousing them with ice water, slamming them into walls and locking them in coffin-like boxes, have since shown psychiatric problems, The New York Times found. Some have been diagnosed with post-traumatic stress disorder, paranoia, depression or psychosis.

Hundreds more detainees moved through CIA “black sites” or Guantanamo, where the military inflicted sensory deprivation, isolation, menacing with dogs and other tactics on men who now show serious damage. Nearly all have been released.

CIA ‘Black Sites’ Where Prisoners Were Held in Secret

“There is no question that these tactics were entirely inconsistent with our values as Americans, and their consequences present lasting challenges for us as a country and for the individuals involved,” said Ben Rhodes, the deputy national security adviser.

The United States government has never studied the long-term psychological effects of the extraordinary interrogation practices it embraced. A Defense Department spokeswoman, asked about long-term mental harm, responded that prisoners were treated humanely and had access to excellent care. A CIA spokesman declined to comment.

This article is based on a broad sampling of cases and an examination of hundreds of documents, including court records, military commission transcripts and medical assessments. The Times interviewed more than 100 people, including former detainees in a dozen countries.

A full accounting is all but impossible because many former prisoners never had access to outside doctors or lawyers, and any records about their interrogation treatment and health status remain classified.

Researchers caution that it can be difficult to determine cause and effect with mental illness. Some prisoners of the CIA and the military had underlying psychological problems that may have made them more susceptible to long-term difficulties; others appeared to have been remarkably resilient.

Incarceration, particularly the indefinite detention without charges that the United States devised, is inherently stressful. Still, outside medical consultants and former government officials said they saw a pattern connecting the harsh practices to psychiatric issues.

Those treating prisoners at Guantanamo for mental health issues typically did not ask their patients what had happened during their questioning. Some physicians, though, saw evidence of mental harm almost immediately.

“My staff was dealing with the consequences of the interrogations without knowing what was going on,” said Albert J. Shimkus, a retired Navy captain who served as the commanding officer of the Guantanamo hospital in the prison’s early years. Back then, still reeling from the Sept. 11 attacks, the government was desperate to stave off more.

But Captain Shimkus now regrets not making more inquiries. “There was a conflict,” he said, “between our medical duty to our patients and our duty to the mission, as soldiers.”

After prisoners were released from American custody, some found neither help nor relief. Mohammed Abdullah Saleh al-Asad, a businessman in Tanzania, and others were snatched, interrogated and imprisoned, then sent home without explanation. They returned to their families deeply scarred from interrogations, isolation and the shame of sexual taunts, forced nudity, aggressive body cavity searches and being kept in diapers.

Mr. Asad, who died in May, was held for more than a year in several secret CIA prisons. “Sometimes, between husband and wife, he would admit to how awful he felt,” his widow, Zahra Mohamed, wrote in a statement prepared for the African Commission on Human and Peoples’ Rights. “He was humiliated, and that feeling never went away.”

Lutfi bin Ali, a former detainee now living in Kazakhstan, has chronic health problems and undergoes physical therapy for injuries he sustained in custody. Credit: Bryan Denton for The New York Times

‘A Human Mop’
In a cold room once used for interrogations at Guantanamo, Stephen N. Xenakis, a former military psychiatrist, faced a onetime Qaeda child soldier, Omar Khadr. It was December 2008, and this evaluation had been two years in the making.

The doctor, a retired brigadier general who had overseen several military hospitals, had not sought the assignment. The son of an Air Force combat veteran, he debated even accepting it. “I’m still a soldier,” General Xenakis recalls thinking. Was this good for the country? When he finally agreed, he told Mr. Khadr’s lawyers that they were paying for an independent medical opinion, not a hired gun.

Mr. Khadr, a Canadian citizen, had been wounded and captured in a firefight at age 15 at a suspected terrorist compound in Afghanistan, where he said he had been sent to translate for foreign fighters by his father, a Qaeda member. Years later, he would plead guilty to war crimes, including throwing a grenade that killed an Army medic. At the time, though, he was the youngest prisoner at Guantanamo.

He told his lawyers that the American soldiers had kept him from sleeping, spit in his face and threatened him with rape. In one meeting with the psychiatrist, Mr. Khadr, then 22, began to sweat and fan himself, despite the air-conditioned chill. He tugged his shirt off, and General Xenakis realized that he was witnessing an anxiety attack.

When it happened again, Mr. Khadr explained that he had once urinated during an interrogation and soldiers had dragged him through the mess. “This is the room where they used me as a human mop,” he said.

General Xenakis had seen such anxiety before, decades earlier, as a young psychiatrist at Letterman Army Medical Center in California. It was often the first stop for American prisoners of war after they left Vietnam. The doctor recalled the men, who had endured horrific abuses, suffering panic attacks, headaches and psychotic episodes.

That session with Mr. Khadr was the beginning of General Xenakis’s immersion into the treatment of detainees. He has reviewed medical and interrogation records of about 50 current and former prisoners and examined about 15 of the detainees, more than any other outside psychiatrist, colleagues say.

General Xenakis found that Mr. Khadr had post-traumatic stress disorder, a conclusion the military contested. Many of General Xenakis’s diagnoses in other cases remain classified or sealed by court order, but he said he consistently found links between harsh American interrogation methods and psychiatric disorders.

Back home in Virginia, General Xenakis delved into research on the effects of abusive practices. He found decades of papers on the issue — science that had not been considered when the government began crafting new interrogation policies after Sept. 11.

At the end of the Vietnam War, military doctors noticed that former prisoners of war developed psychiatric disorders far more often than other soldiers, an observation also made of former P.O.W.s from World War II and the Korean War. The data could not be explained by imprisonment alone, researchers found. Former soldiers who suffered torture or mistreatment were more likely than others to develop long-term problems.

By the mid-1980s, the Veterans Administration had linked such treatment to memory loss, an exaggerated startle reflex, horrific nightmares, headaches and an inability to concentrate. Studies noted similar symptoms among torture survivors in South Africa, Turkey and Chile. Such research helped lay the groundwork for how American doctors now treat combat veterans.

“In hindsight, that should have come to the fore” in the post-Sept. 11 interrogation debate, said John Rizzo, the CIA’s top lawyer at the time. “I don’t think the long-term effects were ever explored in any real depth.”

Instead, the government relied on data from a training program to resist enemy interrogators, called SERE, for Survival, Evasion, Resistance and Escape. The military concluded there was little evidence that disrupted sleep, near-starvation, nudity and extreme temperatures harmed military trainees in controlled scenarios.

Two veteran SERE psychologists, James Mitchell and Bruce Jessen, worked with the CIA and the Pentagon to help develop interrogation tactics. They based their strategies in part on the theory of “learned helplessness,” a phrase coined by the American psychologist Martin E. P. Seligman in the late 1960s.

He gave electric shocks to dogs and discovered that they stopped resisting once they learned they could not stop the shocks. If the United States could make men helpless, the thinking went, they would give up their secrets.

In the end, Justice Department lawyers concluded that the methods did not constitute torture, which is illegal under American and international law. In a series of memos, they wrote that no evidence existed that “significant psychological harm of significant duration, e.g., lasting for months or even years” would result.

With fear of another terrorist attack, there was little incentive or time to find contrary evidence, Mr. Rizzo said. “The government wanted a solution,” he recalled. “It wanted a path to get these guys to talk.”

The question of what ultimately happened to Dr. Seligman’s dogs never arose in the legal debate. They were strays, and once the studies were over, they were euthanized.

Mohamed Ben Soud drew pictures depicting his treatment in a CIA prison, which included being forced to stand naked, shackled to a bar on the ceiling, and deprived of sleep. It also included being placed in a wooden box and poked through its holes.Credit: Holly Pickett/American Civil Liberties Union

A Sense of Drowning
Mohamed Ben Soud cannot say for certain when the Americans began using ice water to torment him. The CIA prison in Afghanistan, known as the Salt Pit, was perpetually dark, so the days passed imperceptibly.

The United States called the treatment “water dousing,” but the term belies the grisly details. Mr. Ben Soud, in court documents and interviews, described being forced onto a plastic tarp while naked, his hands shackled above his head.

Sometimes he was hooded. One CIA official poured buckets of ice water on him as others lifted the tarp’s corners, sending water splashing over him and causing a choking or drowning sensation. He said he endured the treatment multiple times.

Mr. Ben Soud was among the early captives in the CIA’s network of prisons in Afghanistan, Thailand, Poland, Romania and Lithuania. Again and again, he said, he told the American interrogators that he was not their enemy. A Libyan, he said he had fled to Pakistan in 1991 and joined an armed Islamist movement aimed at toppling Col. Muammar el-Qaddafi’s dictatorship.

Pakistani and United States officials stormed his home and arrested him in 2003. Under interrogation, he said, he denied knowing or fighting with Osama bin Laden or two senior Qaeda operatives.

In 2004, the CIA turned Mr. Ben Soud over to Libya, which imprisoned him until the United States helped topple the Qaddafi government seven years later. In interviews, he and other Libyans said they were treated better by Colonel Qaddafi’s jailers than by the CIA

Today, Mr. Ben Soud, 47, is a free man, but said he is in constant fear of tomorrow. He is racked with self-doubt and struggles to make simple decisions. His moods swing dramatically.

“‘Dad, why did you suddenly get angry?’ ‘Why did you suddenly snap?'” Mr. Ben Soud said his children ask. “‘Did we do anything that made you angry?'”

Explaining would mean saying that the Americans kept him shackled in painful contortions, or that they locked him in boxes — one the size of a coffin, the other even smaller, he said in a phone interview from his home in Misurata, Libya. They slammed him against the wall and chained him from the ceiling as the prison echoed with the sounds of rock music.

“How can you explain such things to children?” he asked.

Mr. Ben Soud, along with a second former CIA prisoner and the estate of a third, is suing Dr. Mitchell and Dr. Jessen in federal court, accusing them of violating his rights by torturing him. In court documents, Dr. Mitchell and Dr. Jessen argue, among other things, that they played no role in the interrogations.

Mr. Ben Soud was one of the men identified in a 2014 Senate Intelligence Committee report as having been subjected to the CIA’s “enhanced interrogation techniques.”

Condemning the methods as brutal and ineffective in extracting intelligence, the report noted that interrogators also used unapproved tactics such as mock executions, threats to harm prisoners’ children or rape their family members, and “rectal feeding,” which involved inserting liquid food supplements or purées into the rectum.

Senate investigators did not set out to study the psychological consequences of the harsh treatment, but their unclassified summary revealed several cases of men suffering hallucinations, depression, paranoia and other symptoms. The full 6,000-page classified report offers many more examples, said Daniel Jones, a former FBI analyst who led the Senate investigation.

“The records we reviewed clearly indicate a connection between their treatment in CIA custody and their mental state,” Mr. Jones said in an interview.

Reporting was contributed by Jawad Sukhanyar from Kabul, Afghanistan; Rami Nazzal from Jerusalem; Nour Youssef from Cairo; Hwaida Saad from Beirut, Lebanon; Maher Samaan from Paris; Suliman Ali Zway from Berlin; and Karam Shoumali from Istanbul. Kitty Bennett and Alain Delaquérière contributed research.

A version of this article appears in print on October 9, 2016, on page A1 of the New York edition with the headline: US Torture Leaves a Legacy of Detainees With Damaged Minds.

Read the entire excellent report online at:
http://www.nytimes.com/2016/10/09/world/cia-torture-guantanamo-bay.html

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