WHEN James Risen, a New York Times reporter, published a book last autumn accusing the American Psychological Association (APA), the largest professional organisation of American psychologists, of working with the Bush administration on torture, the APA issueda swift rebuttal: “APA is committed to fostering the highest ethical standards for the profession… We will continue to proactively communicate our strict and explicit no torture under any circumstances policy to federal officials so they are fully aware of the appropriate restrictions on psychologists’ roles.” In a spirit of transparency, the APA commissioned an independent investigation to confirm that neither the association nor its members, who number around 122,500, endorsed the government’s use of enhanced interrogation tactics.
The investigation, led by David Hoffman of the law firm Sidley Austin, concluded this month with the publication of a 542-page report. Its findings diverge considerably from the APA’s expectations. Far from upholding their Hippocratic oath to “do no harm”, APA psychologists did indeed work with officials from the Defense Department and the CIA to facilitate the torture of detainees. This involved issuing loose ethical guidelines that endorsed existing DoD interrogation policies and permitted psychologists to participate at Guantanamo Bay and elsewhere—unlike their colleagues in the field of psychiatry, who refused to back the government’s evolving interrogation tactics. Though the APA’s policies adhered to US law, they violated medical ethics.
Stephen Behnke, ethics director of the APA, was at the heart of this effort. In a series of e-mail exchanges, he sought pre-clearance from leaders in the US Army Special Operations Command before determining what APA’s position should be. Perhaps the most disturbing discovery is the self-serving, amoral tenor of APA’s approach to this issue generally. The report notes:
"While we found many emails and discussions regarding how best to position APA to maximize its influence with and build its positive relationship with the Defense Department…we found little evidence of analyses or discussions about the best or right ethical position to take in light of the nature of the profession and the special skill that psychologists possess regarding how our minds and emotions work—a special skill that presumably allows psychologists to be especially good at both healing and harming."
It seems Mr Risen’s argument that a rising “homeland security-industrial complex” co-opted medical expertise for military ends holds up. But why did the Department of Defense seek the APA’s blessing in the first place? And what did the APA stand to gain from co-operating?
In 2002 the Office of Legal Counsel at the Justice Department issued memos defining torture, narrowly, as acts that intentionally cause physical or severe mental pain. It follows that actions could not be considered torture if interrogators could show that they did not intend to cause such pain. Seeking out the APA’s approval was a way for DoD officials to prove that they did not harbour this intent. This lent a veneer of professionalism and legitimacy to interrogators’ dubious practices.
It was a veneer the APA was happy to lend. This is in large part because the DoD is one of the largest employers of psychologists in the country. Today, 7% of APA members work with or for the department in a range of roles, including as clinicians and researchers. As of 2010, 3,400 psychologists were employed by the Veterans Administration alone. Since 2007, the DoD has also spent more than $730m to fund research on psychological health, post-traumatic stress disorder (PTSD) and traumatic brain injury, according to the Hoffman report. At least $120m in grants were awarded for research on behavioural, cognitive and psychological therapies between 2007 and 2011.
This partnership is mostly a good thing. Many psychologists are hired to help military personnel and veterans grapple with PTSD and other mental maladies. But this alliance also apparently encouraged the APA to accommodate less savoury practices. With evidence from correspondence, documents and interviews, Mr Hoffman and his associates concluded that the APA’s endorsement of torture was largely motivated by a desire to promote the profession and strengthen its relationship with the DoD. When the department was negotiating its torture guidelines, it was also figuring out how psychologists and psychiatrists might play a role in intelligence operations. E-mails show APA officials were eager to be involved and, especially, to not lose out to psychiatrists—an expression of thelong-standing rivalry between the professions. (As PhDs rather than MDs, psychologists are often defensive about their medical credibility.)
By 2006, the American Medical Association and the American Psychiatric Association had both issued decrees prohibiting their members from participating in interrogations. APA had not, and this support was duly rewarded. In 2006 William Winkenwerder, the Assistant Secretary of Defence for Health Affairs, issued a DoD instruction prioritising psychologists over psychiatrists as behavioural-science “consultants”. Mr Winkenwerder explained that the APA’s “clear support” for the role of psychologists in interrogations “influenced our thinking”.
The APA is now scrambling to distance itself from the military’s intelligence activities and to reaffirm its commitments to medical ethics. An initial set of policy and procedural changes includes a new prohibition on psychologists participating in interrogations by military or intelligence services. The proposals have been accompanied by an exodus of high-level APA officials. Mr Behnke was removed from his position at APA on July 8th. Norman Anderson, the chief executive, and Michael Honaker, his deputy, announced their retirement shortly thereafter. Rhea Farberman, director of communications, has resigned. The association is now left to answer some thorny questions about how a profession devoted to mental health could so easily be persuaded to pursue mental anguish instead.