At around six-foot-eight and clad in combat fatigues, Kevin Kiley, the army surgeon general, cut an imposing figure. It was August 2006, and Kiley was in New Orleans to address the governing council of the American Psychological Association (APA) on the subject of psychology in the war on terror. For over a year, the organization had been under fire from human-rights groups and many of its own members, because psychologists had been tied to coercive interrogations and abuse at Guantanamo Bay and other places. Now, many APA members wanted the organization to draw up a firm policyone that mandated adherence to international standards barring abuseto prevent psychologists from participating in such practices again.
It was Kileys job to convince them not to bail out on interrogations. Its an open question how much psychologists have contributed to the art of interrogation in the war on terror, but the APA provides a seal of legitimacy that the government values. If it joined the American Medical Association (AMA) and the American Psychiatric Association by barring their members from joining the Guantanamo interrogations, it would further stigmatize the militarys practices. So, armed with PowerPoint slides, Kiley argued for keeping psychologists on the offensive against sworn enemies of the country. Psychology is an important weapons system, he explained. For the APA to draw up an explicit definition of abuse would be counterproductive. After all, is four hours of sleep deprivation? How loud does a scream have to be? How many angels can dance on the head of a pin?
Reisner made his pitch nonetheless. (The Hippocratic oath says do no harm. It does not say measure harm and see if it is the correct amount, he reminded the crowd.) But, having had almost no time to prepare, he was no match for Kileys slick presentation and call-to-arms rhetoric. Ultimately, APAs governing council passed a blandly worded resolution that, most critically, left the definition of the phrase cruel, inhumane, and degrading treatment up to current government interpretations.
This wasnt the first time the APA had declined to take a firm position against the administrations interrogation policies. After reports first surfaced in 2004 of psychologists participating in interrogation procedures, many of the APAs more progressive members demanded that the organization take a stand. In response, APA convened a task force to draw up guidelines for members but rejected efforts to ensure that they were specific and enforceable.
Why, then, was the leadership of the APA, an organization representing one of the most liberal professions imaginable, so willing to essentially acquiesce with a conservative administrations efforts to torture prisoners?The answer is that it fell intoa classic Washington trade-group dilemma: It became so enmeshed in the gears ofthe federal machine that it could be influenced by a determined administration and ended up supporting policies that many of its own members opposed.
SERE no evil
Psychology has long had ties to the military and the government. Indeed, the armed forces may have played a larger role than any other institution inestablishing psychology as a technical and scientific profession. During World War I, psychologists were placed in charge of aptitude tests given to soldiersa task they again carried out in World War II, by which time they had been thoroughly integrated into the military structure. By the 1950s, they were helping to conduct Cold War studies on interrogation that included experiments with sensory deprivation and hallucinogens meant to serve as truth serum (LSD, for example)and developed techniques used by the CIA to torture prisoners in Latin America in the 1980s.
It wasnt surprising, then, that psychologists and psychiatrists were on hand in early 2002, mostly in clinical roles, when detainees whod been captured in Afghanistan started arriving at Guantanamo. For most of that year, however, intelligence yields from the inmates were poor, and psychologists did not play a major role. That began to change later that year, with the arrival at Guantanamo of a new commander. Major General Geoffrey Miller believed strongly in breaking detainees down, and that psychologists were crucial to this effort. (Miller would later be dispatched to Abu Ghraib to Gitmo-ize the prison by giving advice on detainee treatment, where, according to one general, he told subordinates that detainees should be treated like dogs.)
Miller approved the creation of Behavioral Science Consultation Teams (BSCTs), which would include psychologists and other medical professionals. In theory, these biscuit teams would advise interrogators on how to develop a rapport with detainees, but in practice, things were less Dale Carnegie-esque. When one army psychologist and APA member helped interrogate Mohammed al-Khatani, the supposed 20th hijacker, some of the techniques used included stripping Khatani naked, giving him intravenous fluids to force him to urinate on himself, exercising him to exhaustion, and making him roll over and perform other dog tricks. The interrogation log includes such psychological observations as detainee seemed too comfortable.
There was another link to professional psychology. As first reported by The New Yorker, many of the techniques used to break down detainees at Guantanamo had been derived in late 2002 from a classified program known as Survival, Evasion, Resistance, Escape (SERE) at Fort Bragg, N.C. SERE was originally designed to train elite soldiers to resist torture such as forced nudity, Bible trashing, sleep deprivation, hooding, isolation, and water-boarding. But many of these practicesrather than training in how to resist themwere soon adopted at Guantanamo. According to The New Yorker, one of the primary conduits for passing on such techniques appeared to be the chief psychologist of the SERE program, Col. Morgan Banks. (Banks told the magazine he offered guidance to Guantanamos BSCT members but denied recommending that SERE techniques be used on detainees.)
By 2005, media reports about coercive treatment of detainees were becoming increasingly frequent and alarming. Since APA members faced being drawn into the BSCT teams, the group felt compelled to develop a set of guidelines. That task would fall in part to Gerald P. Koocher, an influential member of the board of directors, who would take over the APA presidency the following year. A short, pale, youthful-looking man in his late fifties, Koocher wears large glasses and bright bowties. He is dean of the School of Health Studies at Simmons College in Boston, and editor of the journal Behavior and Ethics. Hes also a child psychology expert, and a scan of regional newspapers over the years reveals occasional quotes from Koocher about matters such as how to keep your kid from getting frightened on Halloween. By any standard, Koocher was an unlikely ally in the Bush administrations bid for expanded interrogation authority.
In fact, though, there were plenty of reasons why Koocher was unwilling for his organization to take a strong stand against administration policyoutside of its occasional criticisms of the White Houses most extreme pro-torture positions. Psychologists have long had to face skepticism about the efficacy of their profession, and often feel that associations with the military enhance their credibility. As Reisner puts it: The military put psychologists on the map. Jeopardizing relations with the armed forces could well lead to a loss of status and influence for the organization. In addition, former APA president Philip Zimbardowho designed the famous Stanford Experiments in which students acted as prison guards and abused fellow students playing prisonersnotes that the military employs hundreds of psychologists, and that academic psychologists also depend greatly on military-related research funding.
Beyond strictly military issues, the APA, like any other trade group, frequently seeks to influence government policy, and is therefore unwilling to alienate key decision-makers. Recently, for instance, the group has been pushing to amend state laws to allow psychologists to write prescriptions for medication, and their leaders had supported a now-defunct military pilot project allowing such prescription privileges. (Generally, in every state except New Mexico and Louisiana, only psychiatristsin addition to other medical doctorscan prescribe.) The APA has a vested interested in maintaining good relations with the Bush administration, says Zimbardo.
Koocher challenges that assertion, pointing to APAs stance in favor of the McCain anti-torture resolution. The measure passed by 90 votes, but Koocher, in an email, claims it took great courage for his group to back it: Supporting an amendment in direct contradiction to the Administrations wishes was decidedly not the politically expedient thing to do in order to advance APAs financial interests. It was, however, the right thing to do, and APA did it, despite that doing so placed significant funding for psychology in jeopardy.
In truth, there was a more urgent concern driving the organizations approach to interrogations: the possibility that APA members who worked on the biscuit teams, by following military orders, had already become embroiled in interrogation methods that were ethicallyand even legallyquestionable. Retroactively disowning such methods might leave those members vulnerable to prosecution.
The ideal stand for the APA to take, then, would be no stand at allor at least one that wouldnt inconvenience the Pentagon. And so, in February 2005, Koocher and APA president Ronald Levant led the creation of the blue-ribbon, 10-member Psychological Ethics and National Security (PENS) task force to study the problem. But they stacked the deck by ensuring that six of the 10 members were from the military. One was Capt. Bryce Lefever, a trainer at the Navys SERE School and author of the lecture Brainwashing: The Method of Forceful Interrogation.
Another was R. Scott Shumate, director of behavioral science for the Pentagons Counterintelligence Field Activity division, who, according to his own bio, had engaged in risk assessments of the Guantanamo Bay detainees. There were also Michael Gelles, chief psychologist of the Navys Criminal Investigative Service; Col. Larry James, chief psychologist for the intelligence group at Guantnamo in 2003; and Robert Fein, whose biographical blurb describes him as a consultant to the Directorate for Behavioral Sciences of the Department of Defense Counterintelligence Field Activity.
The boldest choice of all was Col. Morgan Banks, the very man accused of helping to introduce SERE techniques to Guantanamo. It was like a Monty Python spoof, says Dr. Steven Miles, a professor of bioethics at the University of Minnesota medical school who followed the process for his book, Oath Betrayed. At a certain level, you had to laugh. Asked about charges that the APA stacked the deck, Koocher responded in an email that the task force worked by consensus.
Any countervailing influence, then, would have to come from the four civilian members. But when the task forces discussions began, it soon became clear that the APA leadership was determined to resist their proposals. When Jean Maria Arrigo, an independent scholar on the ethics of military intelligence, and Michael Wessells, a professor of psychology at Randolph-Macon College, and a specialist in how children are affected by armed conflict, argued that international law such as the Geneva Conventions should be the gold standard in the APAs ethics code, Koocher, serving as a liaison from the APA board, was dismissive. Were not going to go there, he announced. International law doesnt have any standing in U.S. courts. (According to Arrigo, one of the military psychologists was even blunter, declaring: Weve taken an oath to our commander-in-chief.) Then, when Arrigo argued for an appendix of case histories that would clearly illustrate some examples of banned behavior, such as water-boarding, an APA lawyer who was advising the panel rejected the idea, warning that such examples could be used in court against psychologists. Wessells, still dissatisfied by the lack of specificity, cited the use of techniques like sleep deprivation as clearly out of bounds. To which one of the military panelists responded: Maybe its useful to an interrogation to wake someone up early.
Drafting the task-force report fell primarily to Stephen Behnke, a lawyer and psychologist who heads the APAs Office of Ethics. Behnke produced a rough draft on day one, a model of ambiguous wording that effectively determined the scope of the discussions. Ultimately, the final report did assert that psychologists are alert to acts of torture and other cruel, inhuman, or degrading treatment and have an ethical responsibility to report these acts to the appropriate authorities. But, crucially, it did not offer specific guidance on what did and did not constitute torture. And it noted pointedly that over the course of the recent United States military presence in locations such as Afghanistan, Iraq, and Cuba, rules and regulations have been significantly developed and refined. In other words: Things are changing. Good luck feeling your way about.
It was immediately clear to the civilian members that the report didnt go nearly far enough. Wessells warned that if it were allowed to stand as the APAs primary public communication on the issue, the group will be body-slammed, and damage done to the association. Ultimately, though, they went along, after being assured by Koocher and other APA officials that examples of specific instances of impermissible interrogation would soon be addressed in a casebook to be produced by the APAs permanent ethics committee. Today, nearly a year and a half later, no such casebook has been released. Things in an association will not always happen as quickly as some would like, says Behnke, who promises the casebook will be forthcoming in early 2007.
Wessellss warning proved prescient. The APAs report, released in July 2005, met with widespread condemnation from human rights groups and many in the media. The New York Times and other news outlets noted Bankss role on the task force, and the prestigious Lancet medical journal called the report a disgrace. The episode also helped open a breach between the APA and the rest of the medical community. After seeing APA raked over the coals for the timidity of its report, the American Psychiatric Association and the AMA released much stronger statements this year that flatly bar their members from participating in interrogation of enemy detainees. They also got specific: The American Psychiatric Association, for instance, prohibits its members from exposing any subject to degradation, threats, isolation, imposition of fear, humiliation, sensory deprivation or excessive stimulation, sleep deprivation, exploitation of phobias, or intentional infliction of physical pain such as use of prolonged stress positions.
These divisions were dramatized in October of 2005, when APA president Levant and American Psychiatric Association president Dr. Steven Sharfstein traveled together to Guantanamo as guests of the Pentagon. On a day-long tour of the facility, the men glimpsed white-jump-suited Muslim detaineesbut werent allowed to talk to them.
Sharfstein, alarmed by published reports about the BSCT teams and their potential to engage in torture, wasnt reassured by his visit and urged military officials to exclude psychiatrists from involvement in interrogations. Levant, by contrast, eagerly offered his organizations support to the military, announcing in a press release, I saw the invitation as an important opportunity to continue to provide our expertise and guidance for how psychologists can play an appropriate and ethical role in national security investigations.
In the wake of the split, APA has taken some small steps to repair its image. In September, Koocher joined with leading health professionals and Physicians for Human Rights in publicly opposing the administration-backed bill that essentially allows it to disregard the Geneva Conventions, and explicitly condemning techniques such as water-boarding and stress positions. But APA has not relented on the most crucial issue that it faces: preserving the right of psychologists to participate in coercive interrogations. And, thanks to an earlier loophole in the APAs still-vague ethics code, psychologists are allowed to obey so-called lawful military orders instead of the APAs own ethical guidelines, even as the APA offers lip-service to opposing any involvement in torture. As Stephen Soldz, a Boston-based psychoanalyst and APA critic observes: What sort of experts on ethics write the Nuremberg defense into their professional ethics code?
This is by no means the first time that the leadership of a traditionally liberal Washington interest group has courted controversy by essentially siding with the Bush administration on a major policy issue over the objections of many of its members. In 2003, AARP provided crucial support for the corporate-backed Medicare prescription-drug billand lost thousands of members as a result. Three years later, that legislation has proved so costly and cumbersome that Republican lawmakers seldom talked about it on the campaign trailand AARP now supports changing the legislation to allow the government to negotiate drug prices. But theres little evidence that APA is similarly reconsidering its position on interrogations. As Koocher approvingly noted in a paper on 21st Century ethics that he presented at the APAs New Orleans conference: The dictum of do no harm has evolved to do as little harm as possible.