The Pain Stops Here

On a given Wednesday morning, if you saw 55-year-old Karen Hanscom, PhD, leave the Baltimore Museum of Art in her silver Audi TT sports car after attending an art history class, you might imagine that she's simply out for a morning's entertainment. But this is one of the few restorative measures Hanscom can squeeze in while doing her job as a psychologist at the cutting edge of the relatively new field of counseling torture survivors. So after class, she drives north (fast), pulls over, and parks in front of a tidy row house. The small sign on the door reads ASTT: ADVOCATES FOR SURVIVORS OF TORTURE AND TRAUMA, the organization she runs that counsels survivors of state-sponsored abuse who come to the United States seeking asylum.

"The problem of torture is horrifyingly global," says Stevan Weine, MD, a psychiatrist at the University of Illinois at Chicago who works with survivors of political violence. "But not a lot of us do this work. There are not many books and papers describing what we do." In fact, treatment programs in this country began only in the 1980s.

"The hardest thing," Hanscom says, as we sit in her small office waiting for a young woman from Cameroon to arrive for a session, "is that there are an estimated 400,000 torture survivors in the country, 40,000 survivors in this area alone, and we can afford to see only 200 of them a year."

Hanscom's office door opens and in comes Meh Vivien*, a 30-year-old woman with deep dimples and curly hair. Wearing blue jeans and a matching jacket, she sits down in the wicker chair opposite Hanscom. She looks extremely thin.

"Have you been eating?" Hanscom asks her gently.

The young woman smiles and looks at her hands. "No, not really, but I'm okay," she says. For torture victims, not eating can indicate many things: that they can't afford to buy food given that they're not allowed to work, for example, or that they're exhibiting a form of control over their bodies, because the first thing a torturer does is to take that control away.

Meh Vivien has been in the United States only a few months. As a member of the political opposition fighting for the rights of English-speaking citizens in predominately French-speaking Cameroon, she'd been arrested three times and tortured in prison. Convinced that she was going to be killed if she stayed in the country, Meh Vivien fled, carrying only the phone number of a family in Washington, D.C., whom she'd never met. Fortunately, they took her in, but now the family is struggling to afford to keep sheltering her.

"I don't have a bed; I sleep on the floor," Meh Vivien says. "But who cares? It's a house!"

*Name has been changed for client's protection.