Often, unbeknownst to police who are interrogating suspects and extracting confessions, and to judges who are ruling on cases, the condition known as PTSD, Post-Traumatic Stress Disorder, may actually be present in many suspects, thereby wreaking havoc with the justice system and leading to the incarceration of innocent people.
PTSD develops in response to exposure to trauma, defined as, for example, “a threatening or horrific event” or “actual or threatened death, serious injury, or sexual violence.” PTSD can occur even following a single traumatic event such as a car accident or an assault.
A more severe disorder, known as Complex-PTSD (c-PTSD) can result from prolonged exposure to trauma or a situation in which escape is difficult and one’s fate is in the hands of another. Examples may be kidnapping, prisoners of war, or hostages, and was seen in many of the sex-slave victims of ISIS.
As a method of self-preservation, sufferers of c-PTSD will often show dissociative symptoms as a means of severing themselves from the trauma and thereby sparing themselves the pain of the trauma. In so doing, a person who is truly in pain and who is suffering and agitated may simply “turn off” from the surroundings and appear totally calm and at peace, concealing their pained and stormy true inner feelings.
WHAT DOES this have to do with criminal justice? A great deal! For example, a child victim of long-term sexual abuse, a type of trauma that puts someone at significant risk for c-PTSD, may be in horrific pain and yet, when the police interrogate them, may appear so calm as to cause the interrogator to question whether the seemingly calm person in front of them really experienced the trauma they claim.
Another scenario relevant to the criminal justice system is “kidnapping” by the authorities for interrogation. From the perspective of the traumatized individual, it matters little if the “captors” were from an enemy country or the local police doing these harmful actions and threatening him.
As a country, we were recently given a shocking window into the interrogation methods used against a well-connected individual in a white-color crime investigation when Nir Hefetz described his ordeal as a witness in the Netanyahu trial.
He was held for 15 days during which he suffered sleep deprivation, lack of food, unsanitary conditions, and failure to receive medical treatment, as well as untold psychological pressure, such as explicit threats (see articles in The Jerusalem Post and elsewhere). Captivity under such conditions can unquestionably cause c-PTSD.
Studies have shown that the prevalence of c-PTSD after prolonged trauma where one’s destiny is completely under another’s control is over 50%, while the prevalence of only-PTSD is another 23%. Meaning, nearly three-quarters of such people will develop a psychiatric post-traumatic condition.
The prevalence of PTSD in various forms and its dissociative symptom is very relevant regarding interrogated suspects and their confessions. For decades, Israeli courts have treated confessions as the “queen of evidence.” But the law requires that for a confession to be acceptable in court, it must have been given by the defendant’s free will.
How do the courts ascertain such a thing? It would make sense to consult with a mental health professional who is an expert in traumatology to help determine if the confession was in fact given out of free will. Sadly, that does not seem to be the practice.
IT IS instructive to look at an extreme case currently in front of the Supreme Court, the Ben Uliel appeal in the matter of the deadly Duma arson attack in July 2015.
Amiram Ben Uliel was held in severe conditions for 17 days and then tortured to finally extract his confession, which was then repeated the following day. The court determined that his confessions given during the torture were coerced and thus inadmissible, but that those given the next day were given freely. This was despite the fact that they were made in the presence of the torturer, whose mere presence is a “trauma reminder.”
How did the justices arrive at that troubling conclusion? They claimed that by observing the “calm demeanor” of the defendant in the videotaped confession, they could ascertain that he was not stressed, and ergo the confession was given freely.
These judges essentially decided that he was not suffering from c-PTSD, was not in a dissociative state, and that the presence of the torturer did not produce any stress. It may be that they did not even realize that those were the implications of their decision, but that shocking decision is the kind that is eroding public trust in the judicial system.
That a person might appear outwardly relaxed and yet actually be feeling threatened and under great stress is well known in the psychology world. Yet the court displayed hubris in its utter indifference to the basic science. The court seemed to understand nothing about stress, PTSD, dissociation and other factors at play at the time of those confessions, and yet the justices felt so emboldened by their “robes” that they did not seek a professional consult.
The naive layman, and that may include the typical judge, might assume that the mental state of the suspect and the degree of his free will can be reliably assessed by watching the confession video.
In the Ben Uliel case, the accused suddenly went from a free man to a prisoner with prolonged absence of contact with the outside world, sleep deprivation, fatigue, threats, physical torture/abuse, solitary confinement, etc., all of which qualify as trauma exposure. In such a case, the traumatic symptoms, including dissociation, could be reactivated every time the prisoner would be exposed to a “trauma reminder” – e.g., an interrogator associated with the trauma.
Of note, traumatic symptoms can be activated even by weak triggers. For example, the scientific literature reports a case of a woman who was raped by a “tall and bald man” and who years later saw someone “tall and bald in a restaurant” and displayed activated symptoms.
In the Ben Uliel case, the lead Shin Bet (Israel Security Agency) interrogator was present for the videotaped confession. There can hardly be a stronger trauma reminder for someone who spent 17 days in “regular” Shin Bet interrogation, and several more with “enhanced” interrogation. What’s more, both PTSD levels and dissociative state levels have been found to be elevated under conditions where the perpetrator is in an authoritarian relationship with the victim, as in this case.
It is not unlikely that a traumatized victim in the presence of the trauma reminder will be in a disconnected, dissociative state, in which they appear calm and compliant and do not outwardly exhibit excitatory emotional states. Both complex-PTSD and PTSD are characterized by dissociative states.
Although the non-psychologist may be bothered by the counterintuitive reality that a trauma/torture survivor would display outward serenity or calmness, this is the reality, especially in the presence of a strong trauma reminder.
This is because dissociations, a trauma symptom itself, can mask very intense emotions, such that the presenting person comes across as compliant, not-difficult, and even agreeable, self-confident, cooperative, unafraid, and free from emotional constraints. Persons in a dissociative state may even perform actions and/or agree to things to which they are fundamentally opposed, all the while appearing calm.
Thus, in the Ben Uliel case, the prolonged interrogation accompanied by extreme measures most likely traumatized the individual and led to trauma symptoms, including dissociative states.
Because of this, there is no way that anyone, judges included, can determine, by simply watching the video of the confession, that his confession given after torture was given by free will.
There is a high likelihood that his confession (particularly since it was given in the presence of his torturer) was actually driven by a dissociative-based trauma state and should not be admissible in any court.
The writer is a professor of neuroscience at Bar-Ilan University.