Public Employee Press

Local 1189 Psychologists make a difference

At Bellevue Hospital, torture survivors find refuge, treatment and compassion

The Bush administration has all but openly embraced torture as an instrument of national policy in its war against terrorism. Meanwhile, in New York, Psychologists in Local 1189 work with a world-renowned team that helps patients overcome the horror of torture and seek political asylum.

By GREGORY N. HEIRES

Late one night, Nazareth Oliveira and her daughter Cristina were awakened by the noise of their apartment door being broken down.

Seconds later, they found themselves surrounded by men in military uniforms with machine guns.

Nazareth was one of thousands of citizens who were detained, tortured or murdered from 1964 to 1985 during the brutal military dictatorship in Brazil. Like so many survivors of those years of political repression, she has spent the rest of her life struggling to deal with the permanent scars from her experience.

“They closed the courts, Parliament and the Senate, and cut off all human rights,” Nazareth said. “It was all around us. Demonstrations and military police. The news censored. Students being arrested.”

Tortured with husband
The military had raided the apartment in search of Nazareth’s husband, a lawyer, who wasn’t there at the time. To protect her, Nazareth’s husband hadn’t told her that he worked underground as a political activist, fighting the repressive military regime.

Both were reunited in prison, where they were tortured.

The military released Nazareth, who returned to the apartment, where she found her 9-year-old daughter unharmed. Nazareth visited her husband in prison over the next two years, but one day he disappeared without any explanation from the authorities. Soon, Nazareth took her daughter and left the country for Europe; they eventually settled in the United States.

Living in Westchester County near New York City, Nazareth supported herself and Cristina by teaching Portuguese and working as a health aide in private homes. But she could never overcome the loss of her husband and the torture.

She suffered from attacks of high blood pressure caused by her anxiety. Her bouts of anxiety were followed by shortness of breath and chest pain.

Union Psychologists help
One day, Nazareth watched a television documentary about the treatment of torture victims at New York City’s Bellevue Hospital, where DC37 psycholo­gists and other health care professionals help patients put their lives back together. She then sought help at the Bellevue/NYU Program for Survivors of Torture, which has treated 2,000 people from 80 countries since it was founded in 1995.

Bellevue offered Nazareth comprehensive treatment. She received psychiatric medication for her anxiety. She was treated in the medical clinic for her high blood pressure. And she regularly visited a psychologist for help with her depression.

Today, Nazareth feels stronger and has a renewed sense of self-confidence. Her anxiety and depression are under control, and she doesn’t break down and cry as often. She attributes most of her recovery to the help she received at Bellevue.

“This program is like a refuge for people,” said Local 1189 member Dr. Lucia Kellar, a Senior Psychologist, who has been part of the program since its inception. “The program has provided help for people from all over the world. They often come here with no home, having left their families behind. They may be seeking asylum in the United States.”

“Our civil service Psychologists are highly trained and experts in their specialties. We are proud that our members at Bellevue make an impact on torture survivors that is recognized globally,” said Dr. Leonard Davidman, president of the Psychologists Local 1189.

Human rights groups have documented torture in 130 countries. An estimated 400,000 torture survivors live in the United States, with the highest concentration residing in New York City.

Virtually all the patients at Bellevue are seeking a new life in the United States after living through the horror of a civil war, ethnic cleansing or social dislocation in their own country. Some are political activists targeted by repressive governments. Others come from refugee camps. Besides psychological torture, they have been victims of sexual abuse, threats, beatings and mutilation, as well as discrimination for sexual orientation, race and gender.

Post-traumatic stress disorder
Typically, survivors suffer from post-traumatic stress disorder (most commonly associated with war veterans and child abuse victims), said Senior Psychologist Dr. Carol Pepper, a Local 1189 member. She counseled Spanish-speaking survivors of torture and arrest when she started out at Bellevue in 1998. Pepper now works with doctoral students from New York University in the program.

The victims have constant attacks of anxiety and difficulty in concentrating. Reminders of their experience trigger flashbacks.

Because of restlessness and nightmares, survivors of torture have trouble sleeping. They often have feelings of detachment, an inability to love or feel loved, which make it very difficult to establish a new intimate relationship and strain existing relationships.

The survivors’ immigrant status may compound their trauma, Pepper said. “They may face enormous stresses because they are undocumented and live in fear of being discovered,” she said. “They could be suffering from the stress of acculturation. This may be their first time in the United States, and they may not speak English.”

Torture is a process that aims to dehumanize victims and make them feel defenseless. So, their post-traumatic stress may also be aggravated by feelings of powerlessness and betrayal (which may be a product of being reported to the authorities by a friend, neighbor or other political activist). War, exile and loss of family all produce pain that should be addressed.

Severe head injuries
Frequent memory loss is another common problem faced by survivors. It typically is caused by severe head injuries that occurred when they were beaten during interrogation, according to Kellar.

“The people we treat may simply be having difficulty handling the day-to-day activities of their lives,” Kellar said. “We want to help make their life more manageable.”

Bellevue, the nation’s oldest public hospital, runs one of 37 treatment programs for torture survivors in the country. “We are unique insofar as we offer one-stop shopping,” said Dr. Hawthorne E. Smith, co-director of clinical services and psychology supervisor. Besides counseling, for instance, Bellevue provided the surgery that saved the mutilated hands of a tortured Tibetan man.

David Gangsei, clinical director of Survivors of Torture International, a treatment center in San Diego, described Bellevue as one of the leading such institutions in the country. “Their multi-service model is the recognized standard for meeting the needs of torture survivors and helping them with recovery.”

Besides psychological counseling and psychiatric care, the program provides patients with comprehensive medical care, English-language instruction, family and group therapy, physical and occupational therapy and social services, including assistance with housing, education and employment.

Help with political asylum
Most of the patients are seeking political asylum. Bellevue staff work closely with their patients’ attorneys to help build their cases. To gain asylum, applicants must show a well-founded fear of persecution because of race, religion, nationality, political opinion or membership in a particular social group. Nationally, perhaps 30 percent of asylum applications are accepted. Nearly all of Bellevue’s patients are granted asylum, which Smith attributed partly to the credibility that the program has built up over the years through its dealings with judges and court officers.

Restoring lives
Treatment typically lasts from six to 18 months. But some survivors who are already coping well when they come to Bellevue may only need two or three counseling sessions for closure. Others may remain in counseling for years.

Patients get a tremendous relief from simply recounting their experience in individual therapy. Sharing their traumas and the difficulties they face in their daily lives at group therapy sessions provides another outlet to get rid of stress.

Therapists help patients redirect their post-traumatic stress disorder symptoms, Pepper said. Coping skills help reduce their flashbacks and nightmares. Their sleep improves. And they have fewer feelings of detachment.

“These people are truly all survivors,” Smith said. “Despite all the efforts to destroy their humanity, they have moved forward to save their own lives and get healed.”

“Our goal is to address the health consequences of the trauma and to restore an individual’s sense of physical and mental health,” said Dr. Allen S. Keller, director of the program. “There is nothing we can do to undo what has happened to them, but there is a lot we can do to help people get on with their lives.”