If a person cannot sleep because of nightmares, it is cruel not to offer medication. He points out that it is hard to explain to a Cambodian Survivor that their present body pain is related to what happened to them 50 years ago. Survivors often do not see themselves as having been tortured. Martinez tells the story of a Survivor who did not consider himself as having been tortured though he was beaten, made to drink water contaminated with urine and feces, and suffocated. He thought that his cell mate was the one who was tortured as the latter lost an eye.
Pathology becomes normal.
There is denial of the magnitude and the experience is minimized. The most intrusive events are what happened to others, hearing the screaming or seeing the mutilation of others. The therapy needs to help overcome the guilt, emphasizing they could not do anything. Denial surfaces as a defense mechanism when the Survivor needs to fell less out of control and a sense of community. In a village of 200 where 10 families were tortured and killed, jokes were made to deal with the brutality.