APA Torture & Ethics Scandal Highlights Fact No Medical Professionals Have Been Held to Account for Torture

In her very interesting analysis of the American Psychological Association's new policy calling for withdrawal of psychologists from national security interrogations and sites identified with torture and abuse, such as Guantanamo, Deborah Popowski ("The APA’s Watershed Move to Ban Psychologists’ Complicity in Torture," August 11) writes:

I predict that ultimately, this resolution [Motion 23B passed by APA's Council of Representatives] will be more powerful than its AMA and American Psychiatric Association counterparts precisely because it took years of dogged advocacy to achieve. The APA’s bad behavior was a mobilizing force for psychologists of conscience. The organization now faces a savvy group of reformers that understand its playbook and will keep pressing for enforcement. I look forward to seeing how they ride this wave of momentum.

I think this is a good point, but it, like most of the analysis on the APA's new interrogations policy has a certain unreal character, as its analysis exists outside of the realities of the Department of Defense justifies its use of health professionals, including psychologists and psychiatrists, in interrogations.

DoD and the American Psychiatric Association "Ban" on Psychiatrists in Interrogations

Popowski mentions AMA and the American Psychiatric Association (APsyA) because both of these practitioner groups previously issued policies forbidding their members to participate in interrogations. Such participation is unethical, they said, although the psychiatrist's group did allow their members to "provide training to military or civilian investigative or law enforcement personnel... on the possible medical and psychological effects of particular techniques and conditions of interrogation..."

But what these powerful organizations condemn and how they enforce these policies are two different things. In addition, how the Pentagon chooses to interpret the policies of these organizations is yet another thing.

In a September 2008 letter to then-Secretary of Defense Robert Gates, the APsyA president, Dr. Nada Stotland, quoted an article by George Annas, who noted, "The DOD's new position that its physicians not follow nationally and internationally accepted medical ethics represents a major policy change." Stotland was complaining about how the Pentagon continued to train psychiatrists for interrogation despite the APsyA's opposition to the their participation. It is not known if or how Gates replied, but DoD's policy in the matter itself never changed.

But the psychiatrist association itself never put any teeth in their policy. It never moved to sanction any member for participation in interrogations, which is done under the auspices of the Pentagon's Behavioral Science Consultation (BSC) program. Later, then-APA president Gerald Koocher would use APsyA's stated preference not to bring any such charges as an example of the rightness of APA's own policy. (See "President's Column," APA Monitor, July/August 2006)

Indeed, no doctor, psychiatrist, psychologist, nurse, medical technician, or any medical professional involved in interrogations has ever been brought up on charges by any medical or professional association. Attempts to bring charges by state licensing agencies were undertaken by private individuals -- attempts with which Ms. Popowski has assisted -- and such attempts universally failed (thus far), though not for trying.

But as important as the attempts to get at the torturers via licensing board complaints are, is a strategy aimed at prosecution via state licensing agencies really going to be effective? As one state licensing agency official told me, "How do you expect us to prosecute these cases when the U.S. government will not do so?" It would indeed take a great deal of courage to buck the federal government. There is also the issue that legal actions against health professionals would be subject to "graymail" defenses, in that defendants will argue that (supposedly, or potentially) exonerating evidence is classified and highly unlikely to be made available from the government. What happens then?

Applicable DoD policy on BSCs goes back to the 2006 DoD Instruction 2310.08E, "Medical Program Support for Detainee Operations." This policy allows DoD to use psychiatrists or physicians with the approval of the Assistant Secretary of Defense for Health Affairs, despite the policy by the American Psychiatric and American Medical associations.

E2.2 As a matter of professional personnel management, physicians are not ordinarily assigned duties as BSCs, but may be so assigned, with the approval of ASD(HA), in circumstances when qualified psychologists are unable or unavailable to meet critical mission needs.

In case some might think this old Bush-era instruction is not in force, it is. The most current policy, DoD Directive 3115.09, "DoD Intelligence Interrogations, Detainee Debriefings, and Tactical Questioning" (in its most up-to-date version of 11/15/13) references the 2006 DoD 2310.08E instruction as "reference (r)", i.e., for policy on BSCs.

Manipulation of Phobias

It's worth noting, 3115.09 has also made allowance for the ongoing use of SERE techniques, as they are used in the Army Field Manual, which I pointed out some time back. The only recent change in 3115.09 has to do with BSC manipulation of detainee phobias, a change that has not been publicly noted before: "Behavioral science consultants may not be used to determine detainee phobias for the purpose of exploitation during the interrogation process." That appears to be the one concession made by the Obama administration to criticisms of its interrogation policy. The reference was to phobias as addressed in Army Field Manual 2-22.3 in its description of the "Fear Up" approach. Before this change was made in 2012, BSCs were allowed to manipulate or create phobias in prisoners in a style of coercive interrogation that an earlier version of the Field Manual noted some nations -- though not the United States -- would find illegal.

The fact is, the opponents of existing policy at APA, not to mention officers at AMA, APsyA, and a number of human rights watchdog groups are aware of current Pentagon policy on using physicians in interrogations in lieu of psychologists, and despite the opposition on paper of physicians organizations, but nothing is ever said about it. One has to ask why this is. Psychologists, who still have a fight on their hands in making the new APA policy enforceable within APA, have not mentioned DoD's policy on such use, about which nothing has changed since the days of the Bush administration.

The Enforcement Question

Except for an Aug. 8 article in Al Jazeera America, no news accounts have noted that when APA opponents of the old interrogation policy were putting forth their motion to ban members from participation in interrogations or at sites where human rights abuses take place, the first draft of that motion had a strong enforcement proviso, which stated, "Be it resolved that the APA will direct staff to contact the licensing boards of all states and territories informing them that it is the sense of the Council of Representatives that any complaint against a psychologist who refuses to comply with the call to leave Guantanamo be reviewed ‘with prejudice’."

The final version of the motion that passed, and is hailed as a victory, omitted that provision. Such a step back from enforcement does not bode well for the future effectiveness of the APA action.

Other arguments regarding the efficacy of enforcing the APA's new policy were raised by psychologist John Grohol at his blog PsychCentral last week. Grohol quoted an August 18, 2015 email from APA’s Associate General Counsel Jesse Raben to psychologist and ethics exert Ken Pope, who resigned from APA in 2008 over APA's slippery ethics policies.

With regards to 23B (and therefore with the 2008 [member-initiated] resolution [banning psychologists from interrogation at human rights violating sites]) while this new Council resolution invokes Ethical Principle A to “take care to do no harm,” it does not amend the Ethics Code and is not enforceable as a result [emphasis added]. However, Council’s implementation plan for the new policy requests that the Ethics Committee consider a course of action to render the prohibition against national security interrogations enforceable under the Ethics Code.

Grohol's article must have made some impact, because Nadine Kaslow and Susan McDaniel, both members of the Special Committee for the Independent Review by David Hoffman that excoriated APA's connivance with the Department of Defense on interrogation issues, responded to Grohol's charges in an email to APA's Division 48, The Society for the Study of Peace, Conflict, and Violence. (Kaslow is also an APA past president, while McDaniel is the organization's president-elect.)

APA Officials Respond

Kaslow and McDaniel's full reply is not online, but what follows is an edited version of the high points. The two APA officials sympathized with Grohol's skepticism, but felt "that this reaction is misplaced at this time in the history of APA."

The authority and processes regarding policy development and modifications to the APA Ethics Code are stipulated in APA’s Bylaws and Association Rules. The first very important step is for a policy, such as the national security interrogation prohibition, to be passed by Council. For those policies with ethical aspects such as this one, the next step is for it to be considered by the Ethics Committee. The independence of the Ethics Committee is important, as described in the Hoffman Report. According to our Bylaws and Association Rules, the Ethics Committee has authority for formulating the Ethics Code, overseeing the process for changing the Ethics Code (which involves governance review and public comment), and for enforcing it. The movers of New Business Item #23B -- Scott Churchill, Jean Maria Arrigo, and Frank Farley, supported by Steven Reisner and Dan Aalbers -- were well aware of the necessary process. They successfully achieved the policy change, the all-important first step to achieving their ultimate goal of an enforceable prohibition, in keeping with the American Medical Association. (The American Psychiatric Association's policy is not part of their Ethics Code.)

.... The movers also included a provision in the implementation section of the resolution for Council to request that the Ethics Committee "consider pursuing an appropriate course of action in as expeditious a manner as possible to incorporate into the Ethics Code the prohibitions surrounding psychologist participation in national security interrogations, as set forth in this policy." The next step is for the Ethics Committee to carry out this recommendation. An amendment to the Ethics Code will provide the necessary “teeth” for the policy to be enforced. In the interim, I would like to point out that the Ethics Committee considers APA policies, guidelines, and other documents when interpreting the Standards of the Ethics Code.

.... As noted above, although the 2013 policy is not enforceable under the Ethics Code, it provides valuable guidance to the Ethics Committee in this regard....

Changing policy, aspects of the Ethics Code, and creating a culture that is transparent and trustworthy in all parts of the organization will take time and considerable effort. But it is a commitment we feel deeply in support of our public, our discipline, and our members....

Reading Kaslow and McDaniel's email, I think Ms. Popowski may have a point about the sanguinary effect of the new APA policy. From my own standpoint, I believe it was a huge step forward for the new APA policy to bring the recondite and legal struggle against the U.S. Reservations to the UN Convention Against Torture treaty out into the open, and put the imprimatur of a huge medical and professional organization behind the goal of removing those reservations, which in action eviscerated enforcement of that treaty in the U.S., and which were used by John Yoo, Jay Bybee and Steven Bradbury to alibi torture in their infamous OLC memos on interrogation.

Loopholes on Unethical Research to Remain

But there are also giant holes in APA's new policy, particularly as it pertains to psychologist research for the military and intelligence agencies. Since that is really where the bulk of federal money to psychologists and psychology programs go, that means the haze of unreality around these issues is a veritable fog of obfuscation. APA ethics code 8.05 allows psychologists to suspend informed consent -- which is the bedrock of ethical research on human subjects -- "where otherwise permitted by law or federal or institutional regulations." In addition, ethics code 8.07 allows psychologists to use deception in research on "prospective participants," unless such deception would be "reasonably expected to cause physical pain or severe emotional distress." The emphasis on "severe" emotional distress is a weakening of earlier language, and allows great discretion for research using deception that would allow, say, "moderate" levels of emotional distress. Indeed, a section of the Hoffman report contains a section on the research issue, and I will examine it more fully in the near future.

Nevertheless, when it comes to interrogations or psychologists presence at national security detention sites, the APA policy is much more stringent that that passed by APsyA or AMA, and demands that psychologists not even involved in interrogations at sites such as Guantanamo be transferred out. But will DoD listen to that? And if psychologists continue to work in such secret circumstances, how will APA or anyone else know? And what if anything will happen about that? I don't imagine anyone in DoD is losing much sleep over this... yet.

There is also the force of moral suasion, which if not terribly powerful, does play some role in historical circumstances. The leaders of the fight against APA's previous torture policy, and against an APA leadership that worked with government forces to allow torture and abuse of prisoners during interrogation and detention, are to be congratulated. I know from private conversations they are aware that more battles lie ahead. I suggest those battles lie directly with the Obama administration itself, and the leadership of other medical professional and human rights organizations to hold the administration's metaphoric feet to the fire, and end the use of all medical professionals in interrogations and under cruel conditions of confinement at so-called national security detention sites that are known to abuse prisoners, like Guantanamo.

"Interrogation Psychologists" and the Allure of "National Security Psychology"

Martha Davis Ph.D., a Clinical Psychologist and a Visiting Scholar at John Jay College of Criminal Justice in New York City, has produced an important new documentary, Interrogation Psychologists: The Making of a Professional Crisis”. The film premiered at a conference entitled “The Interrogation and Torture Controversy: Crisis in Psychology,” held at the John Jay College of Criminal Justice, Center on Terrorism in New York City on September 12, 2008.

Dr. Davis describes the documentary:

"In 2005 the American Psychological Association endorsed the participation of military psychologists in detainee interrogations. This policy incited a firestorm of protest within the profession and around the world, but APA officials held fast, contending that the involvement of psychologists insured that interrogations were safe, ethical and effective. With interviews of experts and documentation of communications between APA and government officials, “Interrogation Psychologists” traces the origins of the policy and why the APA risked massive defections for it. The search leads to the emerging field of national security psychology, which has far-reaching implications for intelligence gathering operations and U.S. treatment of prisoners of war.”

The 46 minute long documentary is a fascinating examination of the issues and history involved in the psychologist-ethics-torture debate. The organizational turn of the APA, as exemplified by its policies around interrogations, towards "national security psychology" is what led me to resign from that organization earlier this year. At that time, I wrote:

Unlike some others who have left APA, my resignation is not based solely on the stance APA has taken regarding the participation of psychologists in national security interrogations. Rather, I view APA’s shifting position on interrogations to spring from a decades-long commitment to serve uncritically the national security apparatus of the United States. Recent publications and both public and closed professional events sponsored by APA have made it clear that this organization is dedicated to serving the national security interests of the American government and military, to the extent of ignoring basic human rights practice and law. The influence of the Pentagon and the CIA in APA activities is overt and pervasive, if often hidden....

In the recently APA published book, Psychology in the Service of National Security (APA Press, 2006), the book’s editor, A. David Mangelsdorff, wrote, “As the military adjusts to its changing roles in the new national security environment, psychologists have much to offer” (p. 237). He notes the recent forward military deployment of psychologists, their use in so-called anti-terrorism research, and assistance in influencing public opinion about “national security problems facing the nation.” L. Morgan Banks, himself Chief of the Psychological Applications Directorate of the U.S. Army Special Operations Command, [a former SERE psychologist, and a member of the controversial APA Psychological Ethics and National Security or] PENS panel [in 2005], wrote elsewhere in the same book about the “bright future” (p. 95) for psychologists working with Special Operations Forces.

"Befehl ist Befehl"

The Davis film takes the viewer through the post 9/11 story of the APA, from the introduction of psychologists to the Behavioral Science Consultation Teams (BSCTs) in Afghanistan and Guantanamo and Iraq, to the changes in the organization's ethical code which made adherence to military orders a valid option for psychologists, even if such orders went against a professional's ethical code or guidelines.

The primary culprit in this last case was the rewriting of APA's Ethics Code 1.02 back in 2002. It now infamously allows psychologists to obey commands and "governing legal authority," even when an action is at variance with professional ethics, remains a virtual get-out-of-jail card for military psychologists engaged in abusive interrogations. The code, rewritten after 9/11, places into APA's ethics code the Nazis' Nuremberg defense: "I was only following orders" ("Befehl ist Befehl"). The APA promised to insert a qualifying phrase about human rights into 1.02 back in 2006. No action has been taken to date.

Interrogation Psychologists takes the viewer on a guided tour of the political manipulations that guided APA's bureaucracy in the post-9/11 era, through the creation of a mysterious National Security Caucus within APA, and the stacking of the PENS panel that would assess ethical questions in this new national security environment with military and intelligence figures involved in the various dubious ethical misdeeds -- such as directing abusive interrogations at Guantanamo -- taking place under U.S. military and CIA command. Also covered by the documentary is the rise of a critical opposition within APA that would bring about numerous fights over anti-torture resolutions, and ultimately, a successful petition campaign to change APA official policy and pull the psychologists out of national security sites that violated international and domestic human rights laws.

The documentary appears to be a fusillade of sorts against the project of establishing a National Security Psychology (NSP) within the field of psychology proper. Dr. Davis describes NSP as providing jobs and funding for interrogation psychologists, intelligence research, and security screening and assessment. There are millions of dollars to be doled out in coming years, and already plenty of psychologists and psychology schools have lined up to suck up the funds. The greed has already spread down to the layers of the professional school movement, where schools like Pacific Graduate School in Palo Alto, have pitched in with military and CIA researchers to study the psychology of deception for homeland security purposes.

The Rise and Fall of CIFA

Until recently (and possibly still in some kind of existence), there was the Center for National Security Psychology (CNSP), as part of the Behavioral Sciences Directorate at the Department of Defense's agency for Counterintelligence Field Activity (CIFA). Established under Rumsfeld's Pentagon in 2002, CIFA was formally shut down last August, after being associated with scandals over infiltration of U.S. domestic peace groups and charges of domestic spying.

CNSP's chief was CIFA psychologist Kirk Kennedy, who, according to Linkedin, now works for the Defense Intelligence Agency. (I guess if you are a "national security psychologist," there's always some agency that will hire you.) The contributions of "national security psychologists" are not always nefarious. Take this snippet from a review of a talk by Dr. Kennedy at a Special Libraries Association meeting in 2006:

But the similarities between a psychopathic murder, or a suicidal person, to a terrorist are few. Kennedy and other terrorism psychologists believe that terrorism is complex, driven from many factors. One of these factors, though, is not abnormal or psychopathological (that is, the terrorists are NOT crazy)....

Kennedy wants us to understand these cultures and religions rather than declaring the perpetrators as criminals. We have to accept the fact that the actions of terrorists may be explainable but not always understandable.

According to Gulf Times:

The Defence Department said it had “disestablished” the Counterintelligence Field Activity office, or CIFA, created in February 2002 by former defence secretary Donald Rumsfeld to manage defence and armed service efforts against intelligence threats from foreign powers and groups such as Al Qaeda.

Those responsibilities will now be carried out by a new organisation called the Defence Counterintelligence and Human Intelligence Center, overseen by the Pentagon’s Defence Intelligence Agency.

CIFA’s operations stirred concern among members of Congress and civil liberties advocates. A CIFA database known as Talon, set up to monitor threats against US military installations, was found to have retained information on US antiwar protesters including Quakers after they had been found to pose no security danger, officials said.

As Interrogation Psychologists points out, one of the main members of the initial APA policy units looking at national security and interrogations (PENS) was R. Scott Shumate, then director of the psychology unit for CIFA. I don't know if the CNSP still exists, or has migrated over to the new Defense Counterintelligence and Human Intelligence Center of the Pentagon (DCHIC).

Will Psychologists Really Stop Assisting National Security Interrogations?

The world of national security intelligence is a shadowy one. The spooks who run it never give up, and it is unlikely that the new policy of APA which aims at pulling psychologists from national security interrogation centers in places like Guantanamo will quietly be implemented. What's more likely is that we will see obfuscation, lying, more cover-up, and covert, classified actions that are aimed at keeping counterinsurgency-based torture policies active. Already there are plenty of reports that doctors and psychiatrists have not absented themselves from DoD interrogations, despite the official policies of the American Medical Association and the American Psychiatric Association against just such activity.

This is what Jonathan Marks and M. Gregg Bloche had to say in a recent issue of The New England Journal of Medicine:

... documents recently provided to us by the U.S. Army in response to requests under the Freedom of Information Act (FOIA) make clear that the Department of Defense still wants doctors to be involved and continues to resist the positions taken by medicine's professional associations. An October 2006 memo entitled "Behavioral Science Consultation Policy" ... fails to mention the APA statement and provides a permissive gloss on the AMA's policy, at some points contradicting it outright. The memo appears to claim that psychiatrists should be able to provide advice regarding the interrogation of individual detainees if they are not providing medical care to detainees, their advice is not based on medical information they originally obtained for medical purposes, and their input is "warranted by compelling national security interests." The advice envisaged by the memo includes "evaluat[ing] the psychological strengths and vulnerabilities of detainees" and "assist[ing] in integrating these factors into a successful interrogation"....

The policy memo also states that a "behavioral science consultant" may not be a "medical monitor during interrogation" and suggests that this is a "healthcare function." However, it appears to authorize monitoring as part of consultants' intelligence functions, since "physicians may protect interrogatees if, by monitoring, they prevent coercive interrogations." It asserts, more specifically, that "the presence of a physician at an interrogation, particularly an appropriately trained psychiatrist, may benefit the interrogatees because of the belief held by many psychiatrists that kind and compassionate treatment of detainees can establish rapport that may result in eliciting more useful information."

The government's position that physicians or psychiatrists can "protect interrogatees" is, of course, the same position taken by the American Psychological Association regarding the use of psychologists in interrogations. Or it was the position until a referendum by APA membership tossed out the old policy and instituted a new policy denying use of psychologists at governmental sites that deny basic human rights and engage in torture or other abusive treatment. How enforceable this policy will be, in the light of government inaction or obstruction, remains an open question. It is particularly unclear what goes on when psychologists work for the CIA, whose very prisons and even prisoners are mostly unknown and secret.

The Case of MKULTRA

It's important to remember, too, that this is not the first spate of scandals regarding the nefarious use of psychological knowledge. In the 1970s and 1980s, there were numerous revelations about CIA's recruitment of psychologists and other human behavior and medical specialists in government mind control programs, e.g. MKULTRA, and research into sensory deprivation and the "breaking" of prisoners. If I had any criticism of Davis's documentary, it was the failure to place the current controversy in the context of the decades-long history of the problem. One place the reader can start is with Patricia Greenfield's article in the APA Monitor (of all places) back in December 1977, CIA's Behavior Caper.

One major component of the CIA's program, dubbed ARTICHOKE, was described in a CIA memo of January 25, 1952, as "the evaluation and development of any method by which we can get information from a person against his will and without his knowledge." An internal review of the terminated ARTICHOKE program, dated January 31, 1975, lists ARTICHOKE methods has having included "the use of drugs and chemicals, hypnosis, and 'total isolation,' a form of psychological harassment." Another major component of the CIA's program, called MKULTRA, explored, according to a memo of August 14, 1963, "avenues to the control of human behavior," including "chemical and biological materials capable of producing human behavioral and physiological changes," "radiology, electro-shock, various fields of psychology, psychiatry, sociology and anthropology, graphology, harassment substances, and paramilitary devices and materials"....

While news of blatant attempts at behavioral control have had immediate shock value, the CIA's support of basic research has had the more lingering effect of posing many difficult and complex questions and issues for psychologists. How were psychologists and other social scientists enlisted by the CIA? What did they do? What, if any, is the scientist's responsibility for the applications of research? How are social scientists affected by social and political forces? What are the implications of covert funding?

Greenfield's questions are still pertinent today. We can add to them now the query as to how long psychologists will play operational roles in abusive interrogations and torture.

Documentaries like Martha Davis's Interrogation Psychologists help to bring the truth about how this process takes place out of the shadows of academia and government agencies into the full light of public exposure. Now it's up to us, the people, to demand an end to this barbarity.