Psychological Preparation of Torture Victims as Witnesses toward ...

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TORTURE IN WAR: CONSEQUENCES AND REHABILITATION OF VICTIMS VICTIM-WITNESS PSYCHOLOGICAL PREPARATION While the victim’s needs received little attention in the past, interest in legal and psychosocial assistance to witnesses in criminal procedures has grown all over the world. There have been a large number of centres and services for support to witnesses opened aimed at the provision of information and assistance to witnesses. The basic objective of the psychological preparation of the witness is the prevention of retraumatisation and revictimatisation. The best preparation of the witness for testimony delivery in court is a usual therapeutic procedure applied in the every day psychological-psychiatric practice which must be commenced as early as possible regardless of the fact whether the torture victim is to testify or not. Therefore an approach to the traumatised person does not differ much dependent on the fact whether the person has already received a treatment or he/she, having already decided to testify, is coming for the first time, asking for psychological assistance on that occasion. Here, in order to determine an appropriate type of intervention, an important role also plays the factor of time remaining up to the court process. At all events, every psychological-psychiatric intervention must be modulated in such a way which ensures that any disruption of the statement authenticity is avoided and no distortion of facts throughout court process is caused or no impact on the witness and his/her testimony in court is made in any other way. It is groundless to believe that psychological and psychiatric interventions, regardless of the type of psychiatric method used, may to a varying extent impair memory. We share Alexander’s opinion that »A person is not restored to health remembering but starts to remember restoring health«. Psychotherapy in work with the traumatised is aimed to reduce the level of overwhelming emotions jeopardising the process of thinking thus alleviating potential effects of retraumatisation. The psychiatrist’s role is not without an impact on the patient’s decision and will to participate in the court proceeding as a witness. A successful psychiatric therapy is supposed to ensure a patient’s better insight into a situation and easier decision-making due to the reduction of symptoms and restoration of self-esteem. Thus empowered, the torture victim with less difficulty accepts the court process and determines to testify. Beside the fact that a therapist does not try to persuade or convince the patient to make his decision to testify, he/she should assume an unambiguous and clear attitude that offenders must be identified and punished, since therapeutic neutrality may be understood as forgiving the perpetrator of the crime. This also enables basic patient’s confidence in his/her therapist to be established. Balanced provision of necessary information on the court process and possible sources of fear likely to occur throughout the court trial may reduce irrational fears. Balance is indispensable to avoid an increase in fear and anxiety. Besides, all the time a therapist should also be aware and certain of the fact that the benefits from the intervention far outweigh possible adverse effects. 382
PART VII LEGAL AND PSYCHIATRIC ASPECTS Concurrently, a therapist must be aware of the needs of the victim, which directs and determines the further approach. These needs entail the respect of their (victims’) boundaries, the need to feel acknowledged, not assessed, to talk and be listened to, to pay attention to their feelings and to recognise their individual time lines of recovery. Therefore, the therapist’s approach should allow presence, care, listening and empathy, with the optimum measure of neutrality retained. Special care should be taken that the setting provides an intimate and comfortable atmosphere and that all objects are visible (the absence of screen) always bearing in mind that tension may provoke the presence of things which we pay no attention to. Any possibility of surprise should be carefully eliminated to ensure the patient’s sense of control. The objectives of psychological preparation are: the diagnostics of current psychiatric disorders and their healing as well as the reduction of anticipatory anxiety related to the litigation process. It is necessary to establish a diagnosis in order to determine a strategy of further therapeutic treatment as well as predict possible reactions throughout the court process. Diagnostic documents may also have forensic significance in the event of forensic expertise or compensation proceedings. Components of CISD (Critical Incidence Stress Debriefing; Busuttil et al., 1995), crisis interventions, cognitive behavioural methods which also encompass EMDR (Eye Movement Desensitisation and Reprocessing) are used for therapeutic purposes, but brief focused analytically oriented methods and supportive psychotherapy are also applied. The reduction of anxiety is achieved by means of relaxation techniques. Frequently it is necessary to administer psychotropic drugs in the course of a certain period prior to and immediately before the court trial. Besides anxiolytics and hypnotics, beta blockers may also be administered while the administration of antidepressants should be introduced at least a month prior to the court process. In many courts throughout the world there are services providing support to victims whose staff also include psychologists and social workers. Such a profile of experts is especially required in courts where war crimes are processed (e.g. the International Criminal Tribunal for the Former Yugoslavia in The Hague) and their role is clear in the period prior to, during and after the testimony. Prior to the testimony the victim is confronted with an unpredictable period of waiting, closed or isolated environment, expectation of the unknown, cultural and language barriers, and so forth. The psychological preparation in this phase is aimed at helping the person to relax, which is achieved by constant informing, paying attention to practical needs and relief from anxiety. During the court proceedings, which represents the mo st stress-inducing part, the best prevention of retraumatisation is achieved by means of technical measures for the witness protection such as: testimony delivery in writing or behind the screen or via direct television transmission, by which the direct confrontation with the accused is avoided unless the witness himself/herself insists on the direct confrontation. The psychological support throughout the litigation is limited to the provision of surroundings which allows release, rest and self-possession. Here attention should be also paid to the practical needs, 383
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