Training

(based on an asylum evaluation conducted by Dr. Uwe Jacobs, Ph.D. on May 8 2001, San Francisco, CA, USA)

Conditions of Interview

Prior to this psychological evaluation, Mr. Doe and his client agreed to the condition that I approach the assessment with no particular result in mind and that I would exercise independent professional judgment on all aspects of this evaluation. Further, the payment of fees would not be connected to the contents of any report or consultation or any particular finding or recommendation on the matter in question.

Prior to commencing the interview, I informed Mr. __ that confidentiality is limited in a forensic psychological examination. I further informed him that I would discuss my findings with his attorney and write a report that his attorney could submit as evidence to the court if deemed helpful. He indicated that he understood my role to be that of an objective evaluator and that a forensic evaluation was not psychological treatment. I further informed Mr. __ that I had reviewed the asylum declaration prepared by his attorney and that I would be reviewing the entire history with him once more.

I interviewed Mr. __ on 4/27/01 for a total of about 5 hours face-to-face at the offices of Survivors International, San Francisco. In addition, I administered the Hopkins Checklist-25 (HCL-25), the Trauma Symptom Inventory (TSI), and the Harvard Trauma Questionnaire (HTQ). Present for the evaluation were Mr. __, myself, Ms. Erika Falk (Survivors International Intake Coordinator and Psy.D. candidate), and Mr. __, who functioned as interpreter and provided limited collateral information where indicated. Prior to the interview, I reviewed the following history and background information which was provided by Mr. __ during the face-to-face interview.

Relevant History

Mr. __ was born and raised in __, a little village near __ in Region ­__ of __. His date of birth on all records has been 5/6/71. However, he states that this date of birth was registered falsely and that he is approximately three years younger. He cannot state his exact and true date of birth and has always used the one given to him. His father registered his sons as older so that they would be done with the compulsory military service sooner and “begin life earlier”. He adds that this was common practice in his geographical area. Mr. __ is the youngest of six children and spent the later part of his childhood alone with his parents after his siblings had all moved away to __. He completed five years of compulsory formal education and was working on his father’s farm from a young age. He briefly stayed with a relative to start a secondary education about 100 km away from his village, but soon returned home to work on the farm.

Mr. __ describes his early family life as harmonious and states that his father was generally more lenient and loving than most fathers. His mother was a homemaker and took care of the household and family. He states that he does not have a very clear memory of his childhood overall, except that he was always working and that his only pastime was riding horses. When he was about 15, the family moved to __, near __. His father had a job as a night watchman and he worked as an apprentice in welding. The interpreter adds here that child labor is illegal in __ but rather commonly practiced.

When asked about the reason for the family’s move, __ states that most of the other 300 families of the village had already left because of the increased clashes between the army and the guerilla army __. He also states that he does not remember seeing any of this activity himself, and that the older people in the village discussed it. Mr. __ does not describe a strong identification with his ethnic __ background and states that he gradually lost a lot of the __ language he spoke as a young child. In addition, he says that he did not grow up with a sense of tension between the ethnic __s and other groups in his village and that some families spoke __ language, others spoke the language of the majority, and yet others spoke dialects he could not understand.

Mr. __ was drafted into the army approximately three years following the family’s move to __. He was sent for basic training to __, which lasted 3 months. Subsequently, he was sent to become a member of a commando unit that fought the guerilla army __ in the __ region. He states that this was the worst experience he had ever had. He was involved in an estimated 10-15 battles, at times being forced to shoot at targets he could not even see. He had to spend long periods of time in the mountains, in both summer and winter, and suffered from constant sleep deprivation and poor nutrition. He saw comrades wounded and killed. One friend who was from a village near his own was mortally wounded in one of the clashes. He helped dispose of his body when the fighting had ceased. When asked about having suffered any differential treatment because of his ethnic __ identity, he states that he often heard rumors about ill-treatment but did not experience it directly, except for the constant derogatory remarks that were made about the “illiterate” ethnic __s. He says that he felt hurt inside by this, but that in the army one has to do what one is told. When asked about his feelings regarding fighting people of his own ethnic group, he became very gloomy and refused to discuss this further. When asked why, he simply stated that there are things in life that are better not discussed.

Due to his active combat duty, Mr. __ was released after 15 months of service instead of the usual 18 months. After returning to __, he stayed at home for the first two months and felt like he literally could not move. He had difficulty breathing, experienced chest pains, thought he was dying, and never went out for fear of falling down and passing out and being publicly embarrassed. He went to see a physician, who gave him a prescription and advised him to go out and try to do things he finds enjoyable. He states that the pills did not make him feel any better, but rather made him feel even emptier inside, so he discontinued taking them. However, he did follow the doctor’s advice, started going out, began to feel better, and eventually met the woman who later became his wife.

Mr. __ explained that he was discovered as a musical talent by his teacher in elementary school and has always been a singer. He met his wife while singing at a wedding in 1994-1995. He began his singing career mostly by singing at weddings but increasingly got more work, gave some concerts, and made a couple of recordings as well. He states that he was doing well financially because he kept his welding job and made as much money from singing as he made at welding. During this time, he increased his repertoire of ethnic __ folksongs, which he learned from colleagues who were more familiar with the language and culture than he was.

On May 21, 1995, Mr. __ had been invited by a production company to perform in a concert for the traditional ethnic __ coming of spring celebration. This was an important event for him, as he expected more and better work as a result of this appearance. He was performing together with a female ethnic __ musician by the name of Ms. __. While performing ethnic __ songs they were interrupted by two policemen who jumped onto the stage, separated them, and pushed them into the background, saying things like “Don’t you know you’re not supposed to sing in ethnic __ language?” and “Why are you provoking this audience?” The crowd booed the officers. Mr. __ and Ms. __ were arrested and taken to the police station separately and kept separated upon arrival at the police station. Mr. __ was detained for about 12 hours. His possessions were taken from him and returned upon release. During this explanation, Mr. __ looked around the interview room and stated that his holding cell had been similar in size but the windows were smaller, the walls were white, and there was no clock that he could see.

Mr. __ was forced to sit in the same chair for 12 hours and was not allowed to use the restroom when he requested to use it. The officer let him use the restroom about 1-2 hours after he had asked. Mr. __ asked to make a phone call and was denied. He was denied water and cigarettes. He was constantly talked at for the entire time he was there, being told over and over that he was not supposed to sing in ethnic __ language. He was interrogated about who had organized the event. When asked about his feelings, he stated that he was feeling very irritated in recounting this event, that his visual recollection was vague but felt very real at the same time. When asked, Mr. __ stated that he still has a newspaper clipping in his possession from this event, the headline of which reads something like “Local Artist Arrested”.

Regarding his later arrests, Mr. __ states that he does not remember precise dates but only the seasons and years. It was difficult to ascertain these dates during the rest of the interview, as Mr. __ was not telling the story chronologically as he described events and there were a few misunderstandings. There might therefore be some discrepancies between the dates identified in this report and those specified other documentation.

In 1996 there was at least one incident of police harassment in connection with Mr. __’s involvement with a musician’s association that helped artists get engagements and allowed them to learn from each other. The organisation’s founder is named __. Policemen visited Mr. __ at home on one occasion while he was playing with his child. The doorbell rang and he asked his wife to open the door. Two policemen charged in, insulted him in front of his wife, a fact about which he is particularly bitter, and threatened to beat him up. He was interrogated about the purpose of the musicians’ organisation and a large record collection and scores of regional folk music were confiscated.

Another incident occurred in 1997 while Mr. __ was singing for a group of striking workers at the factory where he had once worked. The strike and the performace had been organized by a labor union. He was accompanied by drums and reed instruments. When he and his friend Mr. __, with whom he had worked at the factory for some time, left the factory, the police stopped them within a block, checked their ID’s, and took them to the police station. They were separated from each other and Mr. __ was interrogated. The police accused them of being members of the __ party, which is an underground organisation and apparently stands for __ __ __, an organisation Mr. __ had never heard of. The police told him they knew who they were and threatened that if he did not tell them about his friend Mr. __, they would electrocute his genitals and he would be impotent for the rest of his life. They also threatened that he might not ever see his wife and children again.

At this point in the interview, the interpreter adds that Mr. __ had instructed him not to translate the part about the electrocution of his genitals. I asked him to inform Mr. __ that he had done so, which resulted in an angry face and disgusted gesture on Mr. __’s part. I then reminded him that this was also detailed in his declaration and the interpreter stated that when he had helped prepare the declaration Mr. __ had also requested that it not be translated. However, the interpreter was advised by the attorney that these details were important.

Mr. __ went on to say he was not, in fact, electrocuted but that the officer repeatedly twisted his arm and frequently hit him on his chin with the palm of his hand, which may not seem very bad now but was very uncomfortable at the time (he gestured to demonstrate the way he was hit). He was so uncomfortable that he considered making up a story about his friend Mr. __ in order to get away but did not. He was also pushed around and detained for close to 24 hours. After his release, he never saw his friend Mr. __ again. Mr. __ says that he feels ashamed of this now, but he never inquired about his friend because he was scared by the threat of electrocution and feared for the future of his child and his wife, who was pregnant with their second child at the time.

In 1998 a similar incident occurred in which two officers reportedly came to his apartment and took him to the police station. On this occasion, Mr. __ was interrogated about an artist named __ and other members of the musician’s association. The officers harassed him by saying things like, “Don’t you know that the __ flag is only __ and __ colors?” Officers twisted his arm, pushed him around and told him to shut up. Mr. __ describes this as “sort of harmless”, i.e., it did not result in injury, but says that he felt very afraid at the time. Mr. __’s colleagues later told him that they were detained and interrogated about him in similar fashion.

The latest event that prompted Mr. __’s decision to leave the country is one that was not listed in the declaration that was made available to me and seemed to arise almost by accident. Mr. __ did not seem to want to discuss this event, even though it is a crucial piece of his persecution history. He added that he still sees this event vividly and that he felt very uncomfortable discussing it. One night after walking home from one of his wedding engagements, he was suddenly attacked, had a sack put over his head and upper body, and was beaten up and repeatedly kicked. He was carrying money but nothing was stolen from him. After he was left in the street, he found that his nose was bleeding. He sustained no lasting injuries but had aches and pains that lasted for days. He did not want to face his wife in this condition so he went to a public restroom in a religious compound and cleaned himself. He decided to return home much later, around 3-4 a.m., and he did not tell his wife the details of this event. He did tell his brother-in-law, however, who advised him to “leave now”, and suggested fleeing to either Germany or the United States. Mr. __ added that even Romania seemed an alternative, but the brother-in-law opined that the United States was good and that the people there appreciated music. Earlier, Mr. __ had stated that he never wanted to come to the United States in the first place but that his brother (by whom he meant his brother-in-law) had made him come.

Mr. __ states that he had no idea what political asylum meant when he arrived and that he learned of this only through his conversations with his translator, a man whom he had met at a local restaurant and to whom he had opened up about his experiences over time.

Medical History

Mr. __ denied any significant medical history apart from the psychiatric history following his combat experiences as described above and the presence of headaches in conjunction with his current psychological state. He uses over the counter medication for these headaches in low-moderate dosage and frequency. He described himself as generally healthy and denied any history of surgeries and accidents.

Psychological Assessment

The following conclusions are drawn from the individual interview of Mr. __ and psychological testing (HCL-25, TSI, HTQ).

Behavioural Observations/Mental Status Exam:

Mr. __ appeared on time for the interview and was appropriately dressed and groomed, looking his stated age. He was alert, fully oriented, pleasant and cooperative throughout the evaluation. There were no gross abnormalities in movement or posture on observation. Sensory functions and motor functions appeared to be intact. He appeared to possess high average intellectual ability, with good insight and judgment, although he was not well educated by Western standards. He became distressed when discussing particular events and admitted to feeling irritable while discussing sensitive details. Speech appeared clear and fluent, and there was no evidence of delusions, hallucinations or psychotic thought processes. Remote memory was intact. Attention appeared intact. Concentration and working memory could not be formally assessed but Mr. __ reported that they were impaired. Mood was depressed and affect was constricted. There was no evidence of suicidal or homicidal ideation.

Psychological Findings:

Mr. __ obtained a psychological profile on the TSI and HTQ that is highly suggestive of Posttraumatic Stress Disorder. Validity indicators suggest that he answered test items in a straightforward and internally consistent manner. There was no sign of dissimulation and results were valid for interpretation. Mr. __ reports the following psychiatric symptomatology:

1. Persistent Reexperiencing of Traumatic Events and Avoidance Behaviour: Mr. __ evinced intermittent distress while recounting traumatic events as well as profound discomfort while discussing relevant details, particularly in relation to experiences he considered embarrassing according to his cultural norms. His discomfort was also a reaction to the fact that he was experiencing an active, intrusive recall of events, especially in relation to the last assault he suffered before leaving the country. He reported nightmares from which he awakens in a sweat. The content of his dreams includes trauma-related material to varying degrees, but usually not precise repetitions of actual events.
2. Persistent Symptoms of Increased Arousal: Mr. __ suffers from poor sleep throughout the night and wakes up frequently. He states that this continues to be quite a problem, even though it has improved since he first arrived in the United States. He also startles easily, jumping in response to any kind of sudden noise. He feels that his concentration is impaired. He describes wandering through the city and not being able to find a major street, even though he has been there many times. He cannot concentrate on reading, even on familiar subjects in his national language. He has wanted to learn English but has had great trouble studying. Rather than studying from books, he has now begun to use tapes.
3. Dissociative Symptoms: Mr. __’s most frequently cited complaint is that his mind “goes blank” for minutes at a time. He finds it rather distressing to have this symptom; he feels that at times his mind is so empty that he feels he is going crazy. He then also has faint auditory illusions, for example the repeated experience of hearing a whistle when no one is whistling. He states that he hates that experience.
4. Somatic Complaints and Anxiety Symptoms: Mr. __ has a history of panic and anxiety symptoms dating back to his discharge from the military. The symptomatology described in terms of chest pains, shortness of breath, thoughts of death and dying and not leaving home for fear of fainting and embarrassing himself in public, constituted a diagnosis of Panic Disorder with Agoraphobia. This condition remitted without major treatment and on the advice of his physician to overcome his avoidance behaviour. Subsequent to the later events of persecution, these elements of panic disorder have reoccurred. Mr. __ frequently feels a lump in his throat, experiences shortness of breath and tingling and numbing sensations from his chest down through his extremities. He also suffers from frequent tension headaches that respond well to over-the-counter medicine.

Clinical Impression (Interpretation of Findings)

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Conclusion and Recommendations

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(based on an asylum evaluation conducted by Dr. Uwe Jacobs, Ph.D. on May 8 2001, San Francisco, CA, USA) Conditions of Interview Prior to this psychological evaluation, Mr. Doe and his client agreed to the condition that I approach the … Continue reading →