How do you know when it is torture?
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Updated: May 4, 2026

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
Published on: April 14, 2016
1Harvard Medical School, USA. broth@bidmc.harvard.edu
Abstract:
The forensic psychiatric expert's assessment of torture survivors who manifest Post Traumatic Stress Disorder and apply for refugee asylum is a paradigmatic example of the interface of psychiatry and the law. While it is necessary to acknowledge the utility of current dominant and well-established protocols, it is also imperative to note and correct their failures and limitations. This paper illustrates a model which simultaneously comprehends and designates the negative dimensions of the humanitarian catastrophe of torture and brings forth monumental and profound positive strengths of character which sustain survivors. One case drawn from two decades of evaluations of torture demonstrates this innovative update of mainstream medical-scientific practice. A reproducible and easily communicated heuristic model respects clinical variables and reports the interactivity of individual psychological factors with the cultural/ political nexus. A consistent pattern emerged from review of country reports, survivors' affidavits, interviews, reports and testimonies to the court. Ordinary means led to extraordinary findings that were needed to incorporate and supersede the previous paradigms that have defined torture and designated capacities of psychological response. Torture is a crime of specific intent- to deconstruct and shatter the human connections of their subjects. Survivors had the force of human ties to sustain them. Necessary and legitimate methods achieve valid examination and forensic reporting. Professionals have the force to do right-verifiable objective means nurture justice and social progress.
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