The sequelae of torture are profound and can be disabling if the survivor does not have appropriate treatment. Severe sleep disturbances are common. Many survivors report being able to sleep only an hour every night. Nightmares and flashbacks make the torture a reality again, and always there are the memories, intruding when least expected. A torture survivor's sense of self-worth is deeply affected, his ability to trust is shattered, and his sense of a safe world is obliterated.
Many survivors report startling easily and being hypervigilant, constantly on the alert for danger.
One survivor nearly put his fist through my wall when a colleague slammed a file cabinet drawer in the next room. Torture can destroy a person's ability to feel joy. Anger can come quickly, at times with slight provocation, and friends, family members, and community professionals have difficulty understanding why the survivor cannot control these emotions. Profound guilt and shame often plague survivors. Many survivors are forced to do things that violate their values and beliefs about the sanctity of life, such as stab, rape, or torture other people or give false information that results in suffering for another.