The mark of torture and the therapeutic relationship

Abstract

The title of this paper, 'the mark of torture,’ comes from the clinical insight that in the intersubjective field of therapy with torture survivors a set of motives tends to repeat itself. These motives are here conceptualized as 'perversion-like states,' since they present features and dynamics that can also be found in the so-called 'perversions'. However, the limits and the sense of the use of this term will be discussed and clarified. It is argued that such states are the result of the perverse traumatic experiences of torture in which trauma represents only the pars destruens of the process, the disrupting device that disintegrates the previous psychological organisation and leaves posttraumatic symptoms as traces of the impact of this experience; while the 'perversion' constructs and converts the functioning of mind - pars construens - through its characteristic use of body and pain. It is assumed that this happens through an implicit registration of the experience, that may or may not reach the point of changing the characteristics of the person's object relations.A clinical vignette outlining the development of a therapy with a torture survivor will illustrate some of these peculiar aspects. This paper implies that a well-founded understanding of these aspects in the interpersonal dynamics of therapy may help the therapeutic dyad to unpack crucial themes impressed by torture, accelerating the patient's progress towards recovery.

Keywords

• trauma, body, torture, perversion-like states, implicit relational knowing