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Copyright © 1961 by John Wiley & Sons, Inc.

All rights reserved. This book or any part thereof must not be reproduced in any form without the written permission of the publisher, except for any purpose of the United States Government.

Library of Congress Catalog Card Number: 61-5669

Printed in the United States of America

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Contributors

ROBERT ROGERS BLAKE, Ph.D.

Professor of Psychology, University of Texas

R. C. DAVIS, Ph.D.

Professor of Psychology, Indiana University

LOUIS A. GOTTSCHALK, M.D.

Associate Professor of Psychiatry and Research Coordinator,
Department of Psychiatry, Cincinnati General Hospital

LAWRENCE E. HINKLE, Jr., M.D.

Associate Professor of Clinical Medicine in Psychiatry,
New York Hospital — Cornell Medical Center

PHILIP E. KUBZANSKY, Ph.D.

Chief Psychologist, Boston City Hospital

MALCOLM L. MELTZER, Ph.D.

Staff Psychologist, District of Columbia General Hospital

JANE S. MOUTON, Ph.D.

Social Science Research Associate, University of Texas

MARTIN T. ORNE, M.D., Ph.D.

Teaching Fellow, Department of Psychiatry,
Harvard University Medical School

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Acknowledgments

The editing of this book was carried out as a project of the Bureau of Social Science Research, Inc. Dr. Robert T. Bower, director of the Bureau, generously gave his time and talents to this project.

Valuable assistance in editing the contributors' manuscripts was given by Nadine Pitts, Frank G. Davis, Merle Goldberg, and Doris F. Julian.

The preparation of the chapters contained in this book was supported in part by the United States Air Force under Contract 18(600) 1797 monitored by the Rome Air Development Center of the Air Research and Development Command and under Contract AF 49 (638)-187 monitored by the Air Force Office of Scientific Research of the Air Research and Development Command.

The work of the editors was greatly facilitated by representatives of the Air Force, particularly Major Leo N. Brubaker and Lieutenant Colonel Robert E. Work.

The chapters by Dr. Martin T. Orne and by Dr. Lawrence E. Hinkle, Jr., draw upon work supported by the Society for the Investigation of Human Ecology, Inc.

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Contents

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fessions have received relatively more public and academic discussion than the attempts to elicit factual information through interrogation. Nonetheless, the editors believe that there are some major advantages to approaching the broader topic of the manipulation of human behavior by limiting attention initially to the latter type of situation. The background of recent concern with these problems may illuminate some of the considerations leading to the particular emphasis of this work.

Background

The notoriety that Communist exploitation of United Nations prisoners of war has received in the United States gave impetus to professional and lay concern with problems of the manipulation of behavior. Various writers have associated the compliance effected by Communist captors with phenomena observed in the laboratory; e.g., effects reported following experimental work in pharmacology, hypnosis, sleep deprivation, sensory deprivation, semi-starvation, electrical stimulation of the brain, as well as in social-psychological investigations of persuasion and group conformity pressures (3, 10, 13, 14, 16, 20, 23, 24, 28, 32, 39, 67).

The most radical expressions of concern have alleged that techniques for manipulating behavior are now capable, or are at least on the threshold of being capable, of eliminating the determination of the subject as a barrier to successful influence (21, 32, 33, 34, 35, 36, 37, 38, 39, 44, 52, 60). These claims have been challenged: other investigators have been impressed by the strength, stability, and resilience of long-established values and social controls, and by rational regard for self-interest, either as limiting the compliance of those subjected to coercive and persuasive influence attempts, or as enabling the subject to resist completely (2, 4, 7, 11, 15, 18, 50, 53, 54, 55, 65, 66, 68).

Certain other commentators have viewed the successful exploitation of captives in Korea and similar incidents as less indicative of increasing perfection in the arts of influence and coercion. They have attributed the successes of the captor to individual defects of background and stamina in the prisoners who collaborated, or to a general deterioration of the vitality of social values and controls in contemporary society (16, 25, 31, 61, 62, 63).

Scientific examination of the manipulation of behavior has been made difficult by the intensity of the recent controversy over national

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prisoner-of-war policy. Concepts such as determinism vs. moral responsibility are among the philosophical and value considerations implicit in this debate which have added considerably to the problems already posed by existing biases. There has been dispute regarding the extent to which individual repatriated prisoners of war are legally or morally responsible for deviations from ideal standards of military conduct, especially in the matter of yielding information or making "confessions" to the captor (9, 25, 31, 39, 41, 47, 49, 54, 64).

A central question of fact has stood out in this controversy, quite apart from the moral and philosophical issues raised: whether all individuals, regardless of how strongly motivated to resist, could be made to comply with demands for information, "confessions," or other collaboration by methods employed by the Communists, provided that the intensity, duration, and quality of the pressures were sufficiently great. Popularly, this proposition was phrased: "Every man has his breaking point." It gained acceptance as a premise in policy formulation, although the question remained regarding which, if any, of the situations encountered by United States prisoners of war in Korea approached those extremes of "stress" that no individual could be expected to lesist (40, 48, 64, 68).

Critics of the policy evolved after the Korean War — "The Code of Conduct" — argued that the failure of the policy makers to consider imminent developments in scientific methods of human manipulation has been a more serious error than a lack of understanding of the practices actually encountered by prisoners in Korea. One scientist (39, page 54) has written: ". . . one thing is certain — our national policy concerning the conduct of our prisoners of war has not yet fully faced up to psychological developments which are appearing over the horizon of the future." His own conclusion was that armed forces could protect information from an enemy only by denying it to persons subject to capture or, where this was not feasible, by giving such persons means for destroying either themselves or their memories.

In the study leading to the present book, the U. S. Air Force through their sponsorship has sought an authoritative examination of publicized speculations regarding the possible use of scientific developments in the manipulation of behavior against future prisoners of war. A specific objective has been to examine an enemy's possible use of scientific techniques to elicit guarded information from captives, which is the form of prisoner exploitation having the most immediate and and direct military significance.

It is axiomatic that interrogation has become a highly overdramatized subject. Aside from treatments of its more sensational aspects,

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very little information on the topic appears in open-source literature. The dearth of sober information on interrogation has had the unfortunate consequence of facilitating the exploitation of United States prisoners of war by Communist captors (64).

Our purpose here has been to bring together in one book authoritative information on methods of behavioral control that have been the subject of considerable speculation in discussions of interrogation. Scientists representing a variety of fields have examined a number of hypothetical means that might occur to an interrogator for eliciting information against the will of his subject. Their attention has been more on what could be done than on what actually may have been done.

All the questions that are frequently raised about these methods cannot be answered by such an approach, however, since many of them are not translatable into scientific terms.

Origin of Nonrational Concern

Many scholars have observed that science replaces magic and witchcraft as societies secularize. The problems of living in the present age remain much as they have always been, however. They generate many of the same wishes and terrors. The aspirations and anxieties that not so long ago were projected onto conceptions of the wizard and witch are now directed to the scientist.

Two of the most basic of life's problems are linked to the individual's power position vis-à-vis his fellow men: the inability to make others fulfill one's wishes; and the reverse, the fear of being controlled by others, with the consequent loss of the autonomy that is believed to be fundamental to the conception of the self. These opposites are incongruously exaggerated in paranoid thinking, one of the most prevalent mental symptoms of Western man. They doubtless exist in the fantasy of most persons, to extents that differ from paranoia in intensity and pervasiveness.

The profound fascination of the topic under consideration may stem from the primitive, unconscious, and extreme responses to these problems, which gain expression in myth, dreams, drama, and literature. On the one hand, there is the dream-wish for omnipotence; on the other, the wish and fear of the loss of self through its capture by another. The current interest in problems of manipulation of behavior involves basic ambivalences over omnipotence and dependency, which, if projected, find a ready target in the "omniscient" scientist (30).

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Myth and Reality

The "mad scientist" of the horror movie and novel has been with us for many years. More recent fiction has enlisted him in the service of the great nation-state. With the perfection of mass-destruction weapons and the elaboration of totalitarian efforts to control human behavior, the myth has begun to converge with aspects of reality.

Conjectures concerning the prospects of "total annihilation of the human will" appear almost as frequently as those regarding the threat of mankind's total destruction by thermonuclear or similar weapons. Regarding weapons of physical destruction, responsible scientific evidence is offered along with uninformed and ill-informed surmises, both in support of forecasts of doom and in rebuttal. In the case of the threats science poses to human autonomy, however, sensationally speculative expressions, like those of the Brave New World that Aldous Huxley (21) recently revisited, have enjoyed a near monopoly. In professional journals and publications, as well as in statements for popular consumption, scientists have sometimes contributed to uncritical thinking regarding the potential application of scientific developments to the control of human behavior. Some scientists have done so in their zeal to make the public aware of the dangerous tool which the techniques for manipulating behavior could become in the hands of totalitarian and other irresponsible practitioners. A common error has been to assume that some scientific development, or some explicit scientific theory, was being applied by Commanist "brainwashers" and other manipulators (2, 4, 5, 18). Other scientists, and interpreters of science, have also contributed to the identification of the behavioral scientist as a powerful and unscrupulous practitioner of the arts of influence, as in Vance Packard's Hidden Persuaders (45).

It has been pointed out that the ways in which the popular communication media define the problem are akin to those of prescientific times (56). Raymond Bauer (2) has noted the resemblance of the concept "brainwashing" to demonology: the idea of the "brainwashed" does not differ greatly from that of the "possessed" (6). "The battle for the mind" (52), sometimes fought against "the hidden persuader," has many elements of the occult.

Viewing the problem in magical or diabolical terms is not an altogetlier irrational analogy, given the existence of those who simultaneously practice and seek perfection of the means for controlling behavior and conceive of their efforts as directed toward "possessing the will" of their victims. As one of us has pointed out in discussing

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Communist interrogation and indoctrination practices (6), the Western conception of "brainwashing," in terms akin to "possession," is matched by the Communists' view of what they seek and how to achieve it as exorcism. Thus, the Chinese Communist leaders not only find nothing to resent in charges that they "brainwash" their opponents (cf. 1), but regard the term as a quite apt and honorable description of what they wish to achieve. To take another example, the symbolic imagery of the medieval Hexenhammer (22) is reflected in the designation of the Soviet World War II inquisitorial apparatus as SMERSH ("Death to Spies") (57).

Scientific sobriety demands that the dry examination of experimental evidence replace the lively books on exorcism of ancient times. As in many contemporary works which are closer to the livelier lore of ancient times, however, the present review deals with human concerns antedating science that are at the root of the central question: "Can man really be made to behave contrary to his profoundest beliefs and his conscious self-interest?"

Symbols of science can be used in a magical way, as much of the "brainwashing" literature illustrates. Various writers have invested the techniques of interrogators with the magic of science by attaching technical labels to what actually have been traditional and pragmatic practices (2). In assuming the attitude of the "hard-headed" scientist toward the problem, there is a danger in falling into an equivalent misuse of science. This would be the case were one, in effect, to attempt to counter those who present a diabolical image of the "brainwasher" by invoking superior scientific deities to frighten this specter away. Thus, magical thinking and projections, as has been indicated, pervade prevalent judgments regarding the significance of the behavioral alterations that interrogators can effect. By substituting impassive scientific names for ordinary language with its intense connotations for human values, the impression may be given of eliminating not only these extravagant judgments but also almost all the human significance of these effects. In this way, for example, "treachery" can become mere "attitude change" or "a shift in the subject's frame of reference."

Is Control of Behavior Asymptotic?

Difficulties inhere in dealing scientifically with a problem that relates so immediately to basic human values. Assumptions in this work hold the person against whom the interrogation efforts are

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directed — who is designated following common intelligence usage as "the source" — to be highly motivated to safeguard the information; and that, at least initially, the source regards denying information to his interrogator as "more important than life itself." It apparently has not been a rarity for individuals undergoing interrogation to say "go ahead and shoot" in the face of a convincing threat of death, and yet to reveal the information thus guarded under seemingly mild pressure later (8). Similarly, Western jurisprudence recognizes that lengthy interrogation, even without physical coercion, can produce "unwilling" confessions, true or false, of capital crimes. Divergent interpretations have been placed on reported cases of individuals who have resisted very intensive interrogations without divulging information. Some use it to demonstrate the existence of an unconquerable, inextinguishable human will. Others regard the instances of successful resistance to interrogation as mere illustrations of remediable deficiencies in interrogation technique.

Neither this nor any other scientific volume, in the opinion of the editors, can resolve the differences implicit in these two orientations, or yet other interpretations. On the basis of scientific tests alone, they are difficult to resolve even with a completely deterministic set of assumptions. As the approach of this review illustrates, for any given set of motivations of the source, however powerful, one can at least speculate about possible manipulations to overcome them. On the other hand, it is possible to speculate about methods of heightening motivations and defenses against any conceivable manipulative assault. Exclusively scientific tests probably cannot foreclose either possibility at this time.

Another important qualification to conventional ideas about the ultimate limits of the control of human behavior will become apparent in some of the discussions that follow. The purposes that men have in seeking to control, or to influence, the behavior of others involve the distinctively human capabilities of men and their significance for one another. The major fallacy of the totalitarian interrogator grows out of a poor appreciation of this fact. Some of the chapters here indicate that there are limits to which the ability of a source to reveal information can be separated from his willingness to do so. The analytic divisions we make between such aspects of mental activity as the recall and transmittal of information on the one hand and motivations on the other do not correspond to behaviors that are totally independent of one another in the organism. Furthermore, much of the use one person can make of another resides in the latter's ability to function in a voluntary fashion: in his having

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initiative, making choices, preferring, and rejecting. The fallacy of belief in the possibility of total control for any purpose stands out as bizarre in the extreme when acted on by those whose purposes involve the control of self-initiated behavior. An example, simultaneously tragic and ridiculous, is the ideological interrogation.

A system in which mental conformity is sought through coercion and manipulation embodies an ever-present fear on the part of the controllers that conformity will be based on opportunism rather than conviction. In oppressive ideological systems, such as modern Communism, which demand "true sincerity" from their subjects rather than mere outward conformity, the inquisitorial process appears to be a natural development. It is a difficult matter to determine whether thoughts are indeed "true thoughts." The inquisitorial process, being itself highly coercive, reinforces the original suspicion regarding opportunistic conformity. In a vicious circle, coercion is used to produce conformity, generating fears that the conformity produced is insincere, generating in turn further coercion to make it "sincere." The abhorrence of these practices by those subjected to them makes the fears of the controllers well founded and further reinforces the vicious circle.

Under these circumstances, the ultimate test of the loyalty and sincere devotion of the individual to the system is his acceptance of the inquisitorial process itself: the purge, coercion, confession, and the entire paraphernalia of enforced conversion. Malleus Maleficarum (22, page 212) provides an illustration of the manner in which the victim is compelled to adopt the frame of reference of the inquisitor:

He [the suspected witch] must be asked if he believes that there are such things as witches, and that such things as were mentioned could be done, as that tempests could be raised or men and animals bewitched.

Note that for the most part witches deny this at first; and therefore this engenders a greater suspicion than if they were to answer that they left it to superior judgment to say. . . . So if they deny it, they must be questioned as follows: Then are they innocently condemned when they are burned? And he or she must answer. (Cf. Krivitzky, 26, page 141.)

One final test of loyalty demands that the prisoner act as though he hated himself with the intensity of the criminal definition which the system has placed upon him.

At the outset of the study the impression of the editors from their prior investigation of interrogation problems was that the effectiveness of scientific innovations for controlling human behavior may have been exaggerated in most public discussions. Before final evaluations, alarming or otherwise, were ventured from a human standpoint regarding the significance of the control over behavior

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which scientific developments will make possible, it was felt that a more sober, systematic, and accurate examination was required from a purely objective perspective. This evaluation relates to the applicability of such developments to a specified type of objective and to the nature and limits of the alterations of objective behavior that these developments will permit a would-be manipulator to induce in a resistant person. Although such an effort cannot settle the philosophical and emotional questions raised about the significance of the control which can be exerted, it can indicate that some are ill-founded and others premature. Yet others relate to very real matters.

This work does not represent an attempt to minimize the problem. The conclusions reached do in fact show that many developments can compound tremendously the already almost insuperable difficulties confronting the individual who seeks to resist an interrogator unrestrained by moral or legal scruples. On the other hand, it can be shown that many of the measures popularly supposed to render an interrogator omnipotent actually have no demonstrable applicability to his purposes. Other measures that appear to have high potential utility for the control or influence of behavior seem to owe their effectiveness to quite different kinds of processes than popularly supposed. Among the latter are "placebo" measures, the success of which depends largely upon the attribution to them of a nonexistent potency by the subject, and at times the manipulator. Knowledge, it appears, is a "two-edged sword" in interrogation.

The latter fact is a source of some comfort. Several scientists have reported on the possible applications of scientific knowledge that might be made by the most callous interrogator or power. The results of their thinking are available here for anyone to use, including the unscrupulous. The alternative is to confer on the would-be manipulator a monopoly of knowledge by default. His success, as the various chapters of this book illustrate, depends heavily on the ignorance of his victims. Skinner (58) has argued that those who are most concerned with restricting the vulnerability of men to control by others have the most to gain from a clear understanding of the techniques employed (pages 320-322). (See also Skinner, 59.)

Focus On Objective Behavior

The question of controlling fundamental attitudes and values may hold greater interest for many than our attention to the eliciting of guarded facts by interrogators. Much concern of recent years regard-

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ing behavior control, as has been discussed, has centered on connotations that have come to be conveyed by the term "brainwashing." The source of this concern is the belief that individuals can be "changed" in some fundamental way by devious and mysterious acts of influence. Certainly, Communist practitioners of "thought-reform" visualize the creation of a "new man" as their objective. People of Western nations, frightened and puzzled by these Communist practices, have also felt that the behavior displayed by many victims of such efforts could be explained only in terms of some very basic changes within the individual.

The difficulties confronting attempts to examine such complex issues scientifically argue in favor of dealing first with simpler and more objective forms of behavioral influence. In the "brainwashing" model, we have a basically nonrational attempt to effect nonrational changes of subjective states. Practitioners of "thought-reform" seek "real" changes in beliefs and values. They demand that the victim be "honest, sincere, and full" in his "self-examination, repentance, and change" (27). It is difficult to find objective indicators of the extent to which a "thought-reformer" has achieved "honesty and sincerity," and particularly difficult when given the special ideological meanings such terms have for the practitioners of "thought-reform." As for producing "real" and "fundamental" changes in the person, the superficial and stereotypical concepts about human personality on which Communist " thought-reform" efforts are predicated might lead one to expect that any fundamental changes they produce must be accidental rather than a realization of a deliberate objective.

There is no question that it is possible for men to alter, impair, or even to destroy the effective psychological functioning of others over whom they exercise power. The concepts influence, control, and manipulation denote a certain kind of alteration: the consummation of a purpose of the influencer in the behavior of the influenced. If we wish to examine scientifically questions denoted by the terms influence, control, or manipulation, we must be able to observe objectively and to define in precise terms both the effects sought and those obtained.

A focus on the elicitation of guarded factual information simplifies the analytical problem considerably by posing a model that involves such objectively specifiable purposes and effects. To achieve further simplicity for purposes of this review, the contributors were asked to consider as their primary model interrogations where the interrogator's objectives consisted of obtaining simple, objective information regarding the physical world.

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Interrogators in this age of "psychological warfare" increasingly seek "social and psychological intelligence" from their sources. As in most social science interviewing, the content of this type of reporting depends on such factors as the subjective state and the personal and cultural frames of reference of the reporter. Considerable simplification is achieved by avoiding the complex problems of interviewing, which involve influencing persons to report psychological and social information accurately, and the infinitely more complex question of what constitutes accurate information on such topics.

There are various motivations or values which may underlie the resistance of a source to an interrogation attempt. The interest here is in any method through which these bases of resistance may be changed, outweighed, neutralized, or circumvented so that the person comes to behave in a manner he was originally strongly motivated to avoid. The particular form of behavior toward which attention is directed, the imparting of factual information, has various peculiarities. Some of these distinctive features are considered in the reviews. Few experiments, however, have dealt directly with attempts to elicit precisely this form of behavior. The attention of the contributors was broadened of necessity to exploit the relevance of experiments studying interpersonal influence on other forms of behavior.

This book does not pretend to examine the processes by which fundamental and lasting alterations of the value system of a subject come about. Nonetheless, in the review of experimentation on interpersonal influence (Chapter 6), it was imperative to consider knowledge developed through experiments that involved theoretical concepts such as "changes in attitude or belief." From the present perspective, the validity of such observations does not depend upon the degree to which observed changes truly reflect stable and lasting changes in the subject. When a determination is made that later behavior negates some value strongly affirmed earlier in the experiment, or the reverse, the experiment accords sufficiently with the questions being posed here.

Although the kind of influence attempt considered here represents a considerably simpler problem than the attitude changes or even attitude reporting used here for some inferences, it nonetheless involves the production and observation of complex, symbolic, learned human behavior. Thus, evidence regarding the manipulations that are possible of the salivary response or other simple responses of either animals or humans would not provide answers to the questions raised by this review.

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Scientific Purpose

We have attempted here to communicate scientific information to scientists, and the work originally undertaken for the U. S. Air Force has been revised and supplemented to this end. Emphasis has been placed on detailing the scientific implications of both the general and the specific subject matters, and their value for theory and research. The number of relevant questions left unanswered by the study points to the need for further investigation of the problem under consideration. The contributors represent a variety of scientific fields, and their material either separately or in the aggregate will undoubtedly hold interest for specialists in still other fields. The writing style here is akin to the broader style of papers designed for presentation at meetings of representatives from several different scientific disciplines.

This work might help the armed forces to offset the lack of knowledge that was in part held responsible for much of the success Communist captors achieved in interrogation of United States prisoners of war in Korea (64). Its value for this purpose is limited in that it assumes an interrogator who pursues his objective of developing information rationally. Past experience indicates that practices encountered by prisoners of war are not determined exclusively by considerations of logic (5). A rational examination of the problem cannot lead to predictions of a nonrational opponent's actions. Historically, there has been frequent resort to coercive practices for eliciting information, despite abundant evidence that such measures are relatively ineffective. Some estimates of what an opponent is likely to do, in addition to those based on considerations of what it will be feasible and advantageous for him to do, are required in devising measures for thwarting enemy exploitation attempts against prisoners of war.

If the present study also receives the attention of interrogators, it may offset their tendency to adopt the sensational stereotypes of interrogation on which many of them appear to have modeled their practice in the past.

Sources

This book is based exclusively on publicly available scientific material. Parallel, but secret, investigations can be presumed to have been undertaken by a number of police and intelligence systems.

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Although the generally available literature would probably reflect in an over-all way the achievements of secret research, it is conceivable that some unknown discoveries or applications may have been made. Our contributors have indicated gaps in specially relevant knowledge, many of which would not be pursued intensively in the ordinary course of scientific development. Largely, however, the unanswered questions that are central to the topic of this book also point to critical gaps in present scientific knowledge.

It should be noted that interrogations almost invariably proceed in private. The two major sources of information about them are: practitioners of the "art" and their victims. The former are generally required to guard the details of their craft as secrets; the latter may have a limited perception, understanding, and memory of what they have experienced. It is possible that practice in some respects has advanced beyond the level of the inferences and conjectures presented here. In other respects, experience has proven that some potentialities of interrogation have been overestimated. Free access to the guarded handbooks of interrogators everywhere probably would not lead to any substantial modification in the general conclusions of this review.

Scope

A thorough review has been attempted of the scientific areas that have figured most prominently in speculations concerning "scientific interrogation."

Because of its defensive application during interrogation, one aspect of the problem receiving special consideration in this book is the ability of the source to thwart his interrogator by feigning psychological disorder. Malingering is a time-honored tactic. Its discussion here illustrates some of the implications of personality evaluation for manipulative situations.

Personality evaluation historically has been considered a clinical adjunct to manipulation. Its application requires the manipulation to be "tailor-made" to the specific individual differences encountered in the intelligence source. No comprehensive discussion of this topic has been attempted here for several reasons: (a) most means of personality evaluation require the willing cooperation of the subject, which is not likely to be obtainable from reluctant sources; (b) assessments not requiring the cooperation of the source (e.g., observation, graphology, analysis of speech or gestures) yield notoriously poor agreement among independent judges or observers, unless the behavior

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is categorized into minutiae that are difficult to interpret meaningfully; (c) knowledge is lacking on how to effect maximal exploitation by differential treatment of sources on the basis of personality information, if it were available in reliable form; and finally (d) consensus on a theory of personality, which is critical to the integration and application of personality data, does not exist.

Published speculations that electrical stimulation of the brain might be employed for purposes of nefarious influence led the editors to believe initially that an examination of this area should also be included in this book. The notion that the action of the brain, and thereby the action of an individual, might be controlled directly is an ancient one. Electrical brain stimulation was one of the methods "Big Brother" used in Orwell's 1984 to control his subjects. Scientists, including Lilly (13, 29), Miller (39), Olds (42, 43) and Sargant (52), have indicated that recent experimental developments give some basis to the fiction-writers' conjectures. Observations, primarily from animal experimentation, led to the following surmises. First, and earliest, were possibilities suggested by observations of Penfield (46) that cortical stimulation might elicit "memory" and some spontaneous verbalization of information. Second, animal experiments raised the possibility that subjective experiences from subcortical stimulation might be so intense as to provide a basis for the administration of reinforcements of unprecedented strength. Also, the possibility was raised that organisms might be made more "teachable" by direct interventions of this kind.

The editors asked Sidney Marvin, M.D., Walter Reed Army Institute of Research, who has been working on subcortical stimulation for pain relief in human subjects, to review current knowledge and techniques in this area from the perspective of this book. Colonel Marvin found that experimentation had not progressed sufficiently to allow for other than conjectural statements regarding the questions raised. The editors believe it sufficient for the purposes of this volume to quote briefly the general conclusions of Colonel Marvin's report:

. . . In conclusion it should be said that in its current status: (1) subcortical electrostimulation is strictly in the research stage of development and that information is sketchy and variable, (2) precise implantation of electrodes into a given brain location is possible only within ±0.5 cm, a reasonable estimate of the present accuracy, (3) although damage to the central nervous system by such techniques is relatively minimal and usually reversible, still it is a major factor to be considered, (4) current knowledge and working concepts of neuroanatomy and other related disciplines are insufficient. . . .

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Unless knowledge and techniques exist far more advanced than those known to the Western scientific community, intracranial stimulation as presently known would not be employed in any rational attempt to elicit intelligence.

Also excluded from these pages is a consideration of the role of Pavlovian conditioned reflex theory in interrogation. The notoriety attained by this theory, as explaining the inspiration and effectiveness of Communist techniques of coercive interrogation (20, 32, 36, 52), has prompted studies by other investigators. A number of students of the subject (2, 4, 17, 18, 55, 56) have refuted the contention that Pavlovian theory influenced these practices, whereas Schein (56) and Farber, Harlow, and West (10) indicate the inadequacy of simple conditioning models to account for the kinds of complex behavior patterns produced in the course of interrogation.

Contributors have been free to choose eclectically whatever models and theories appeared most adequate to their respective topics. On the whole, matters of length, level of generality, and organization similarly have been left to the judgment of the individual contributors.

In those cases where the contributors to this book were not themselves highly conversant with interrogation practices, the editors have drawn on their own experience and on research that they have conducted on interrogation in advising the contributors and in editing the chapters. The editors thus actively sought to increase the relevance of the reviews to the realities of interrogation.

ALBERT D. BIDERMAN

HERBERT ZIMMER

Washington, D. C.

March 1960

References

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3. Bexton W. H. Some effects of perceptual isolation on human subjects. Unpublished doctoral dissertation, McGill Univer., 1953.

4. Biderman A. D. Communist techniques of coercive interrogation. Lackland Air Force Base, Texas: Air Force Personnel and Training Research Center, December 1956. AFPTRC Development Report TN-56-132.

5. Biderman A. D. "Communist attempts to elicit false confessions from Air Force prisoners of war". Bull. N. Y. Acad. Med., 1957, 33, 616-625.

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6. Intelligence Research, U. S. Dept. of State, October 7, 1957. External Research Paper No. 132.

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15. Hacker A. "Dostoevsky's disciples: Man and sheep in political theory". J. Politics, 1955, 18, 590-613.

16. Haring J. "Preface" (to special issue on "Brainwashing"). J. soc. Issues, 1957, 13(3), 1-2.

17. Hinkle L. E., Jr. "In Group for the Advancement of Psychiatry", Methods of forceful indoctrination: Observations and interviews. New York: GAP Publications Office, July 1957. GAP Symposium No. 4. Pp. 285-292.

18. Hinkle L. E., Jr., and Wolff H. G. Communist interrogation and indoctrination of "Enemies of the State. Analysis of methods used by the Communist state police. (Special Report), A.M.A. Arch. Neurol. Psychiat., 1956, 76, 115-174.

19. Hunter E. Brainwashing: The story of men who defied it. New York: Farrar, Straus and Cudahy, 1956.

20. Hunter E. Brainwashing in Red China. New York: Vanguard Press, 1953.

21. Huxley A. Brave new world revisited. New York: Harper Bros., 1958.

22. Institoris (H. Kraemer) and Sprenger J. Malleus Maleficarum. Translated by Montague Summers. London: J. Rodker, 1928.

23. Janis I. L. Are the Cominform countries using hypnotic techniques to elicit confessions in public trials? Santa Monica, Calif.: RAND Corp., April 25, 1949, RM 161.

24. Jordan H. "You too would confess". Argosy, February 1957, 15-17, 57-63.

25. Kinkead E. In every war but one. New York: Norton, 1959.

26. Krivitzky W. G. In Stalin's secret service. New York: Harper Bros., 1939.

27. Lifton J. "Thought reform of Western civilians in Chinese Communist prisons". Psychiatry, 1956, 19, 173-195.

28. Lilly J. C. "Mental effects of reduction of ordinary levels of physical stimuli on intact, healthy persons". Psychiat. res. Rep. Amer. Psychiat. Ass., 1956, 5, 1-28.

29. Lilly J. C., Hughes J. R., Alvord E. C., Jr., and Galkin T. W. "Brief, noninjurious electric waveform for stimulation of the brain". Science, 1955, 121, 468-469.

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30. Mausner B., and Mausner Judith. "The anti-scientific attitude". Scient. Amer., 1955, 192, 35-39.

31. Mayer W. E. "Why did so many GI captives cave in?" U. S. News and World Report, February 24, 1956, 56-62.

32. Mayo C. W. "Destroying American minds — Russians made it a science". U. S. News and World Report, November 6, 1953, 97-101.

33. Meerloo J. A. M. "The crime of menticide". Amer. J. Psychiat., 1951, 107, 594-598

34. Meerloo J. A. M. "Menticide". In Conversation and Communication, New York: Internat. Univer. Press, 1952. Pp. 149-157.

35. Meerloo. J. A. M. "Thought control and confession compulsion". In R. M. Lindner (Ed.), Explorations in Psychoanalysis, New York: Julian Press, 1953. Pp. 28-37.

36. Meerloo J. A. M. "Pavlovian strategy as a weapon of menticide". Amer. J. Psychiat., 1954, 110, 173-196.

37. Meerloo J. A. M. "Medication into submission; the danger of therapeutic coercion". J. nerv. ment. Dis., 1955, 122, 353-360.

38. Meerloo J. A. M. The rape of the mind. Cleveland: World Publ. Co., 1956.

39. Miller J. G. "Brainwashing: Present and future". J. soc. Issues, 1957, 13(3), 48-55.

40. "Misconduct in the prison camp: A survey of the law and an analysis of the Korean cases". A student note. Columbia law Rev., 1956, 56, 709-794.

41. Murray J. C. "Singing is for the birds". The Army Combat Forces J., 1955, 6(1), 15-21.

42. Olds J. "A physiological study of reward". In D. C. McClelland (Ed.), Studies in motivation. New York: Appleton-Century-Crofts, 1955, Pp. 134-143.

43. Olds J. "Self-stimulation of the brain: Its use to study local effects of hunger, sex, and drugs". Science, 1958, 127, 315-324.

44. Orwell G. Nineteen eighty four. New York: Harcourt Brace, 1949.

45. Packard V. The hidden persuaders. New York: McKay, 1957.

46. Penfield W., and Rasmussen T. The cerebral cortex of man: A clinical study of localization of function. New York: Macmillan, 1950.

47. Peterson D. B. Prisoners swayed didn't fall: Communists "sold" very few, says top Army psychiatrist. U. S. News and World Report, August 28, 1953, 35, 28.

48. Prugh G. S., Jr. "Justice for all RECAP-K's". The Army Combat Forces J., 1955, 6(4), 15-26.

49. Piagh G. S., Jr. "The code of conduct for the armed forces". Columbia law Rev., 1956, 56, 686-687.

50. Riesman D. "Some observations on the limits of totalitarian power". Antioch Rev., 1952, 12, 155-168.

51. Rolin J. Police drugs. Translated by L. J. Bendit. New York: Philosophical Library, 1956.

52. Sargant W. Battle for the mind. New York: Doubleday, 1957.

53. Schein E. H. "Reaction Patterns to severe, chronic stress in American Army prisoners of war of the Chinese". J. soc. Issues, 1957, 13(3), 21-30.

54. Schein E. H. "Epilogue: Something new in history?" J. soc. Issues, 1957, 13(3), 56-60.

55. Schein E. H. "Brainwashing". Encyclopedia Brittanica, in press.

56. Schein E. H. "Brainwashing and totalitarianism in modern society". World Politics, in press.

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57. Sinevirskii N. Smersh. Edited by K. Hill and M. Hill. Translated by C. W. Boldyreff. New York: Holt, 1950.

58. Skinner B. F. Science and human behavior. New York: Macmillan, 1956.

59. Skinner B. F. Walden II. New York: Macmillan, 1959.

60. Tennien M. No secret is safe behind the Bamboo Curtain. New York: Farrar, Straus and Young, 1952.

61. "U. S. Congress, Senate". Committee on Government Operations, Permanent Subcommittee on Investigations. Communist interrogation, indoctrination and exploitation of American military and civilian prisoners. 84th Congress, 2nd Session, Senate Report No. 2832, December 31, 1956. Washington, D. C.: U. S. Govt. Print. Off., 1957.

62. "U. S. Congress, Senate". "Committee on Government Operations, Permanent Subcommittee on Investigations". Hearings, June 26, 1956. Washington, D. C.: U. S. Govt. Print. Off., 1956.

63. "U. S. Dept. of the Army". Communist interrogation, indoctrination and exploitation of prisoners of war. Army pamphlet No. 30-101, May 1956. Washington, D. C.: U. S. Govt. Print. Off., 1956.

64. "U. S. Dept. of Defense". POW: The fight continues after the battle. The report of the Secretary of Defense's Advisory Committee on Prisoners of War, August 1955. Washington, D. C.: U. S. Govt. Print. Off., 1955.

65. West L. J. "United States Air Force prisoners of the Chinese Communists". In Group for the Advancement of Psychiatry, Methods of forceful indoctrination: Observations and interviews, New York: GAP Publications Office, July 1957. GAP Symposium No. 4, pp. 270-284.

66. West L. J. "Psychiatric aspects of training for honorable survival as a prisoner of war". Amer. J. Psychiat., 1958, 115, 329-336.

67. Winokur G. "The germ warfare statements: A synthesis of a method for the extortion of false confessions". J. nerv. ment. Dis., 1955, 122, 65-72.

68. Wolff H. G. Commitment and resistance. Washington, D. C.: Bureau of Soc. Sci. Res., Inc., January 1959. Study SR 177-D, Special Report No. 3.

69. Zimmer H., and Meltzer M. L. An annotated bibliography of literature relevant to the interrogation process. Washington, D. C.: Georgetown Univer Med. Center, 1957.

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The physiological state of the interrogation subject as it affects brain function

Introduction

When an interrogation is carried out for the purposes of intelligence, we may assume that it is intended to obtain information and not simply to produce compliant behavior on the part of the man being interrogated. One might describe an interrogator as a man who tries to obtain information from another man who may or may not possess it and who is not necessarily motivated to give the information if he does. The interrogator would like to have this man produce his information rapidly, accurately, completely, and without amendments or additions. In the words of the law, he wants "the truth, the whole truth, and nothing but the truth" — and often he wants this as soon as possible because the information that he seeks has perishable qualities. In the urgency of his need, he may interrogate a man who is injured, fatigued, or in pain. He may use various maneuvers such as prolonged or repetitive interrogation in order to overcome his informant's unwillingness to give information. In doing so he incurs the risk that his efforts may produce compliant behavior without eliciting accurate information.

The information that the interrogator seeks represents what his source still knows about various events, situations, organizations, devices, etc., to which he has been exposed in the past. The most complete and accurate information that he can hope to obtain can be only an approximation of the "true facts of the case" even "under

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the best circumstances." It is the purpose of this chapter to inquire into these "circumstances," to consider some of the situations where interrogation may be carried out, how these affect an informant's ability and willingness to give information, and what the ideal circumstances of interrogation may be. The term "circumstances" is taken to mean "the condition of the man being interrogated and the situation in which he finds himself at the time." We shall not consider methods of interrogation or the nature of the interrogation process, but rather the limitations placed upon these by the state of the man who is being interrogated.

The human brain, the repository of the information that the interrogator seeks, functions optimally within the same narrow range of physical and chemical conditions that limit the functions of human organs in general; and it has, in addition, certain special limitations of its own. Any circumstance that impairs the function of the brain potentially affects the ability to give information as well as the ability to withhold it.

Effects of Disturbed Bodily Functions Upon Brain Function

Some aspects of the physical and chemical conditions necessary for the normal function of the human brain are rather precisely known. The brain, like other organs of the human body, exists in an "internal milieu" which is maintained in a remarkably steady state by a great number of feedback mechanisms, some quite complex. Any disturbance in the constancy of this milieu brings into play homeostatic responses which may involve the great majority of bodily processes as well as the activities of the man as a whole. When environmental conditions pose a threat, these mechanisms are capable of creating major alterations in the internal economy and in many facets of behavior (59, 129, 130). It is largely in this manner that changes in the condition of the man being interrogated may affect his ability to give accurate information.

Some features of the internal milieu may be considered briefly in order to illustrate some of the vulnerabilities of the brain to external influences.

The temperature of the human internal environment is maintained very near 37.5° C. A rise in temperature above 44° C (112° F) (10, 33, 121), or a fall below 24° C (75° F) (73, 116) may damage the brain permanently or be fatal. An elevation of body temperature to 41° C (106° F) or above — which may occur during the fever accompanying

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ings of various sorts, vomiting or diarrhea from any cause, burns, shock caused by injuries, hemorrhage, and impairment of kidney function (14, 30, 42, 43, 100, 134). Even very rapid breathing, which sometimes occurs in people who are anxious or afraid, may lead to chemical changes in the blood that cause disturbances of brain function (17, 36, 77, 96).

Many of the crude procedures that interrogators have utilized from time to time to make informants "tractable" and to "make them talk" have an adverse effect upon the composition of body fluids: the "hot box" or "sweat box"; the deprivation of water; the salty diet; the "water treatment"; the use of emetics to produce vomiting; and the use of cathartics such as castor oil to produce diarrhea. These procedures have been used by both European and Oriental interrogators in the historical past. They were also in use quite recently in Communist countries, and perhaps still are. American prisoners of war encountered some of them during World War II and the Korean War, and it is likely they will encounter some of them again in the future.

The brain, like other organs, maintains its functions by constant metabolic activity. The basis for this activity is energy obtained by the oxidation of the organic chemicals available from food. Thus, a constant supply of oxygen must be brought to the brain by the blood in the amount of approximately 50 cc per minute (40, 66, 102). The most common way by which the brain becomes deprived of oxygen is by failure of the circulation (65), which may be brought about by loss of blood from hemorrhage, by shock resulting from injury (which has an effect on the circulation quite similar to that of hemorrhage), or by illness. Such failure of the circulation may occur also when a man is forced to stand still in a fixed position for a long time. It is responsible for the common phenomenon of the soldier who faints while standing at attention (20, 22, 89, 90, 107). Transient circulatory failure is also involved in "emotional fainting," which occurs as a result of an acute fall in blood pressure produced by an "emotional" stimulus. Failure of the circulation has other adverse effects on cerebral metabolism in addition to the effects produced by relative anoxia.

Unlike other organs, the brain cannot use proteins and fats as sources of energy, and thus must rely on carbohydrates (65). It is, therefore, peculiarly sensitive to deficiencies in its supply of sugar, a substance normally present in blood. Small increases in sugar concentration, which usually occur after meals, have no discernible effect on brain function, but relatively small decreases in concentration

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may have a distinct effect on mood and behavior. Small decreases set in motion homeostatic processes that lead to feelings of nervousness, restlessness, sweating, and inability to concentrate (27, 36, 92). A fall in blood sugar occasionally occurs in people who are anxious or fearful, and seems to contribute to their symptoms. A serious deficiency of blood sugar profoundly impairs brain function (65). This is one of the terminal events of starvation, and it contributes to the final stupor of the starved man (54, 67).

The brain is not dependent on the immediate level in the blood of any foodstuff other than sugar, but it does ultimately suffer if it is deprived of other foods over a long period of time. The prolonged deficiency of protein and fat, which is usual in general starvation, very probably contributes to changes in brain function occurring under these circumstances (1, 18, 54, 67, 82). More immediate and readily recognizable changes in brain function occur when the diet is relatively deficient in one of the accessory foodstuffs, or vitamins, which the body cannot produce itself, but which it requires in minute but definite amounts. Among these the "B" group of vitamins are the most immediately relevant to the brain, probably because they take part in various processes of carbohydrate metabolism. A relative deficiency of thiamin (vitamin B1) causes beriberi; a deficiency of niacin causes pellagra; a deficiency of vitamin B12 causes pernicious anemia; and a deficiency of pyridoxine (vitamin B6) causes nervousness, insomnia, weakness, abdominal pain, and difficulty in walking. All these diseases may be associated with pronounced changes in brain function (95, 99, 120). Beriberi and pellagra have been endemic among prisoners of war from time immemorial (54).

The normal function of the brain is also dependent upon the removal of metabolic end-products from the fluid that surrounds it. Especially when there is impairment of the lungs, liver, or kidneys (the organs primarily involved in maintaining the normal composition of the blood and in clearing it of toxic substances), the internal milieu becomes deranged and impairment of brain function follows. The kidney is the organ most often implicated in this phenomenon because it is highly vulnerable to many common disturbances. Dehydration, surgical shock, hemorrhage (14, 38, 43), or the circulatory impairment produced by very long standing (20, 22, 89, 90, 107), all may impair kidney function to such an extent that the internal milieu may be seriously disturbed.

In summary, brain function is readily impaired by disturbances in homeostasis. It is easily disordered by physical abnormalities that affect the body as a whole, including such common conditions as

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ably lost. Their deranged condition is easily recognized, and the information that they give can be evaluated with this in mind. However, under less drastic conditions the syndrome may develop slowly and be difficult to recognize, and its existence may elude an interrogator.

In the earliest stages of the "brain syndrome," the subject experiences the various uncomfortable symptoms associated with his physical state: pain, fatigue, thirst, hunger, drowsiness, or the like. He loses some of his capacity to carry out complex responsibilities accurately, speedily, effectively, and to plan and delay his activities. This is especially noticeable in his impaired ability to meet new situations and his occasional lapses in dealing with familiar situations (24, 25). His interpersonal relations may deteriorate; conflicts arise which he might have avoided under other circumstances. He is likely to become emotionally labile, irritable, depressed, jumpy, and tense, and at other times to be unexpectedly blunted or apathetic in his reaction. His concern for the finer aspects of human behavior-for neatness, accuracy, honesty, veracity, and kindness, as well as patriotism and honor — may fall off to varying degrees, whereas at the same time he shows an increased and at times frantic concern for his more immediate bodily needs such as food, water, sleep, rest, and the alleviation of pain.

In this early stage of the syndrome, the only outward manifestations of disturbed behavior, other than those directly associated with illness, injury, or depletion, are likely to be a slight deterioration of dress, speech, and personal appearance. The subject's performance on short-term tasks, including psychological tests of moderate complexity, may not be outside the normal range (24, 25), especially if he is highly motivated at the time. Yet, despite his ability to rise to a short-term challenge, his performance on tasks generally will be slowed, less accurate, and less effective. If his premorbid level is unknown, a moderate deficit may be undetected. Frank disorientation may be absent. He is more likely to be vague and forgetful about time, place, and person, to have to be reminded, or to make a conscious effort to remember.

People who are injured, ill, or depleted by combat or exposure are often interrogated if they seem to be in good condition and capable of pulling themselves together. Under these circumstances they may be subject to disturbed brain function in this earlier and subtler form. The presence of this condition may not be recognized by either the interrogator or the man being interrogated, even though the source may wish to cooperate with his interrogator and may appear

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to be mentally "normal." However, the subject's memory may be especially deceptive. There may be a distinct hiatus in his memory, without its being noticed either by the source or by one who examines him. More often he is vague, uncertain about details, and has temporary blocks of memory, especially for the nuances, or the finer (and sometimes the most important) details.

In this state, the subject may have no frank illusions, hallucinations, or delusions, but he overvalues small events, misinterprets, blames others, and accepts explanations and formulations which he might reject as patently absurd under different circumstances. He does not confabulate, but he may be willing to state that a report is "clearly true," or that an event "actually occurred," when in fact the report merely could be true, or the event might have occurred. His intellectual functions, his judgment, and his insight decline to a similar degree.

As the "brain syndrome" develops, the subject's dress, behavior, and speech deteriorate further. His orientation for time, place, and person becomes increasingly deficient. Initially he may have been quite aware of the impairment of his mental faculties, and his awareness potentiates the apprehension that he may experience. The subject is especially prone to become fearful if his illness is precipitated rather suddenly by acute infection, injury, poisoning, or dehydration. When it comes on more slowly or is due to starvation, his mood may be one of apathy or depression.

The subject is quite likely to have thinking difficulties and sensory experiences, illusions, delusions, hallucinations, and projective or paranoid thinking. Frequently these contain naively transparent elements of wishful thinking. If starved, he may believe that he is about to receive a large meal or he may see it before him. Such experiences may be frightening. If the syndrome develops gradually, he may perseverate, or pointlessly repeat a fragment of thinking, speech, or behavior; or he may confabulate and create figmentary "memories" to cover up actual defects in his memory. Such confabulation may occur even if the subject has a reputation for the utmost adherence to veracity. Since he may be more than usually suggestible (131), the combination of confabulation and suggestibility may make it possible to elicit from him a plausible story that is largely figmentary.

Other mental activities deteriorate also. His intellectual functions fall off. His capacity to calculate, to abstract, to estimate time, to recall items, digits, or stories is impaired. General information that one might expect him to know is not available to him. His judg-

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ment is faulty. Although he may at first have had some insight into the fact that he has lost his faculties, later he may have none at all. His memory becomes defective, at first for recent or special events, and later for all sorts of events and topics. The subject's awareness is increasingly clouded, and he becomes more and more drowsy as the process advances to the borderline of the pathological.

The state just described is not uncommon among men who have been through prolonged combat (114) or through prolonged and depleting activities of any sort (4, 39, 83, 124, 135), in men who are injured, who are ill, who have undergone serious exposure to the elements, and who are malnourished or deprived of water. It can be assumed that the U. S. Armed Forces would not deliberately create such a state in prisoners of war, but it is quite likely to occur among them naturally, simply because men often become prisoners of war after strenuous combat, and may be ill or wounded. It can be assumed that future enemies probably will create such a state in American prisoners of war, although they may not do so with any sophisticated intent. Historically, it has been the common practice of captors, police, and inquisitors to isolate their prisoners in places that are cold, damp, hot, unventilated, unsanitary, and uncomfortable, to deprive them of food, fluids, sleep, and rest and medical care, and to beat, torture, harry, overwork and threaten them, as well as to question them interminably with leading questions. Such procedures have been used partly because they make prisoners more "pliable," more "ready to talk," and more "cooperative." They are very likely also to make the information obtained from the prisoner increasingly unreliable.

Some Circumstances under Which Brain Function May Be Disturbed without Demonstrable Disturbance of Other Bodily Functions

The phenomena just considered relate to men who have suffered some disturbance of their homeostasis — some measurable change in the internal environment affecting the body as a whole, other organs as well as the brain. People who experience the effects of isolation, fatigue, or sleep loss may show no measurable disturbance of their general homeostasis. They may nonetheless exhibit impaired brain function, for the brain has special vulnerabilities over and above those that it shares with other organs. It is possible to have disturbed brain function in the absence of any other significant alteration in homeostasis.

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The brain of man is an organ that deals with "information," using this term in the technical sense as it is used in communications theory (135). The accumulation and transmission of information in this sense is a characteristic of all living organisms. The nervous system of the higher animals is a specialized apparatus capable of dealing with information in complex ways and thereby greatly increasing the general adaptive capacities of the animal. The exceedingly complex nervous system of man has this fundamental function. It takes in information from the organs of special sense, and from the sensory nerve endings within the body and its surfaces, and transmits this information to the brain. There it is analyzed, organized, evaluated, stored, and used as a basis for organizing the activities of the man as a whole. We might say that "information" arising from the configurations of minute amounts of energy is the substrate for the activities of the brain, in somewhat the same sense that "food" is the substrate for the activities of the gastrointestinal tract.

Deprived of information, the brain does not function "normally." It must have a certain quantity of patterned, meaningful, sensory input from the external environment, and some opportunity to organize its output as behavior (31, 60, 74, 86, 87, 91, 136). Nor can the brain perform one sort of activity continuously and maintain its efficiency. Even though the task undertaken is entirely "mental" (or, as one might say, involves only the carrying out of activity within the brain), and no significant changes in the general physical state of the individual occur as a result of it, the phenomenon of "fatigue" eventually supervenes, and brain function deteriorates (4, 32, 41). In addition to this, the brain requires "sleep" from time to time — a cessation of its "conscious" pattern of activities; otherwise its functions suffer (35, 64, 84, 98, 118). Thus the brain has special vulnerabilities of its own; it cannot function "normally" unless it receives a certain amount of information upon which to operate, and it cannot carry out a single pattern of activities unremittingly and indefinitely.

These points are considered briefly.

Isolation

The experiments of Hebb and others (11, 44, 45, 53, 55, 56, 80, 109, 126), who have concerned themselves with "sensory deprivation," have consisted of putting men into situations where they received no patterned input from their eyes and ears, and as little patterned input as possible from their skin receptors. In some cases there was a

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diminution in sensory input itself; but it appears to have been the lack of patterning, the paucity of information, that was important. The subjects were deprived of opportunity for purposeful activity. All of their other bodily needs were taken care of-food, fluids, rest, etc. Yet after a few hours the mental activities of the participants began to go awry. Their capacity to carry out complex tasks and to perform well on psychological tests fell away. They developed illusions, delusions, and hallucinations, a mood of fearfulness, and many of them discontinued the experiment.

Such experimentally contrived situations are by no means the same as those of persons in prolonged prison isolation, yet undoubtedly some aspects of these observations on sensory deprivation are applicable to our understanding of the reaction of the individual to prolonged isolation. It is well known that prisoners, especially if they have not been isolated before, may develop a syndrome similar in most of its features to the "brain syndrome" (57, 58, 91). They cease to care about their utterances, dress, and cleanliness. They become dulled, apathetic, and depressed. In due time they become disoriented and confused; their memories become defective and they experience hallucinations and delusions. In these circumstances their capacity for judgment and discrimination is much impaired, and they readily succumb to their need for talk and companionship; but their ability to impart accurate information may be as much impaired as their capacity to resist an interrogator.

Classically, isolation has been used as a means of "making a man talk," simply because it is so often associated with a deterioration of thinking and behavior and is accompanied by an intense need for companionship and for talk. From the interrogator's viewpoint it has seemed to be the ideal way of "breaking down" a prisoner, because, to the unsophisticated, it seems to create precisely the state that the interrogator desires: malleability and the desire to talk, with the added advantage that one can delude himself that he is using no force or coercion. The prisoner himself may be taken in by this and later stoutly maintain that the interrogator "never laid a hand on me." However, the effect of isolation upon the brain function of the prisoner is much like that which occurs if he is beaten, starved, or deprived of sleep.

The fact that some people, who have been through prison isolation before, or who can create for themselves an active and purposeful inner life of fantasy, can endure isolation for a long time (5, 15, 75) does not vitiate the fact that total isolation effectively disorganizes

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many people who are initially obliged to undergo it, even when it is not carried out under circumstances of uncertainty and threat, as it usually is. There appears to be a wider range of variability in the capacity of men to withstand isolation, sleep deprivation, and fatigue than in their ability to withstand dehydration or fever, for example, even though ultimately brain function may be deranged by all these conditions. We shall consider the basis for this.

Sleep Deprivation

For reasons not yet known, a brain cannot continue to function without occasional periods of sleep. The amount of sleep men require is quite variable. Some can function effectively for fairly long periods with relatively few hours of sleep obtained at irregular intervals (64, 68). Under experimental conditions men have been known to endure for more than a hundred hours without sleep at all (16, 35, 46, 72, 98, 118, 123), and for more than two hundred hours with only a few brief naps (64). Yet most people deteriorate markedly after about seventy-two hours without sleep, and all deteriorate sooner or later (35, 46, 64, 118, 122). The highest functions suffer first; the capacity to cope with complex and changing situations without making mistakes or errors in judgment is often the first to go. This is followed by a deterioration of dress, speech, and behavior; dullness; emotional lability; defects of recent memory; disorientation; hallucinations, delusions, thinking disturbances; and impaired judgment and intellectual functions, all increasing in severity with the passage of time (35, 46, 64, 72, 98, 118, 122). Even at a fairly late stage of this deterioration, people faced with an acute challenge and highly motivated to meet it may briefly perform complex tasks quite adequately; but ultimately even this capacity is lost (4).

Sleep deprivation affects brain function directly, while producing little or no change in the general internal milieu. Efforts to demonstrate a disturbance of the general homeostasis consistently associated with lack of sleep have been largely futile (84, 118). The constituents of the blood and the function of organs other than the brain may show little or no abnormality in those who have been without sleep for many hours. People whose thinking and behavior are seriously deranged may show "nothing wrong with them" on physical examination or various chemical tests. Their demonstrable defect is a disturbance of brain function.

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Fatigue

“Fatigue” is a term which has more than one scientific meaning, as well as more than one popular meaning. We shall use it to denote a group of somewhat similar phenomena which occur in muscles, in reflex arcs, and in the brain. “Muscle fatigue” is precisely defined and denotes the deterioration in the function of a muscle produced by its steady or repeated activity. The phenomenon is readily measured and reproduced. It is associated with measurable changes within the muscular system, and it has its counterpart in the “muscle fatigue” that occurs in the intact man after muscular activity. The fatigue of neural arcs is similarly definable and reproducible. On the other hand, “fatigue” of the man as a whole has been given various definitions (4, 32, 88). It is often seen in people who are depleted or ill, but no measurable bodily change is necessary to it or consistently associated with it. The “fatigue syndrome” may be produced in a man if he is put to performing a given task over and over, without rest and without change. After a while he performs this task less rapidly, less efficiently, less effectively, and with more mistakes. This falling off in his performance on the specific task is usually accompanied by a feeling of “weariness,” or “fatigue.” His impaired performance on this task is not necessarily associated with any other changes in his bodily functions, and his performance on any other task may be unimpaired; indeed, if he is suitably motivated, he may perform even the task that fatigued him quite adequately for a short period of time (4, 32). In addition, the rapidity with which the fatigue syndrome develops is influenced by the attitude of the man to the task that he must perform (4, 32, 81).

“Fatigue” and impaired performance of the degree just described, or of even greater degree, is readily produced by purely “mental” tasks; and if such tasks are continued long enough, performance deteriorates to the extent that the task can scarcely be carried on (4). However, the most extreme degrees of fatigue that have been studied have been associated with combat or with other extremely trying military operations where muscular activity, lack of sleep, and sometimes injury played a part in their production (4, 8, 13, 32, 41, 49, 50, 81, 83, 88, 111, 114, 115, 135). Bodily changes were therefore present. The fatigue that occurs in combat or other military operations is like that occurring during the prolonged and unremitting interrogation carried out by state police in various countries (57). The observed mental phenomena are quite similar in both cases. The profoundly

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fatigued man, after combat or military operations, or after prolonged interrogation, shows a deterioration of his speech, dress, and general behavior, emotional lability and blunting, confusion, disorientation, defects of memory, hallucinations, delusions, illusions, paranoid thinking, impairment of intellectual functions, loss of judgment, and very little insight (4, 57, 114). Perseveration and confabulation may occur under these circumstances, as they also may after sleep loss (114). In addition, profound anxiety is often exhibited by those who have been in prolonged combat and who have undergone terrifying experiences (114).

THE MANIFESTATIONS OF DISORDERED BRAIN FUNCTION PRODUCED BY ISOLATION, SLEEP DEPRIVATION, AND FATIGUE

The symptoms of disordered brain function that occur under these conditions differ little, except in detail, from those of the "brain syndrome," as this is produced by disturbances of homeostasis. It is easy to differentiate a man who has been long isolated or who is profoundly sleepy or tired from one who is suffering the effects of pneumonia, gunshot wounds, or starvation; but this differentiation is made upon the basis of symptoms and signs other than manifestations of disturbed brain function. It is not profitable to argue whether or not the symptoms produced by isolation, fatigue, and sleep deprivation should properly be classified under the "brain syndrome." However, if one assumes that the effective performance of complex tasks, alertness, orientation, memory, discrimination, and judgment are dependent upon the function of the brain, then there can be no doubt that isolation, fatigue, and sleep deprivation produce disturbances of brain function. If one accepts that the function of the brain is always associated with electrochemical events occurring within it, then these changes in brain function are, in fact, "organic," as are all brain functions. So far as "organicity" is concerned, the effects of isolation, fatigue, and sleep deprivation upon the brain are different from those produced by pneumonia, starvation, or gunshot wounds primarily in the rapidity of their occurrence and the extent to which they can be reversed. Not all of the phenomena that may occur as a part of the "brain syndrome" have yet been described as occurring during isolation, fatigue, or sleep loss, but this seems to be a function of the limited number of observations that have been made on people who are subject to these conditions in extreme degree.

On the other hand, there is a difference in the predictability of the point at which disturbed brain function will be produced by these various circumstances. One can state within rather narrow limits the

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levels of body temperature, blood glucose, or oxygen saturation, beyond which a severe disturbance of brain function can be expected. Isolation, sleep loss, and fatigue, however, present no such narrow limits. It is probably correct to say that if any of these are carried on long enough they will disorganize the brain function of anyone; but the differences in the ability of man to withstand these conditions are very wide. Under experimental conditions, some people have succumbed to sensory deprivation within one-and-a-half hours, whereas others have maintained adequate function for thirty-six hours or more (126). Under prison isolation, as this has been carried out by Russian and Eastern European state police, most prisoners developed symptoms of disorganization within three to six weeks (57); but some have been known to endure this for many months (15, 75), and some have succumbed within days. After forty-eight hours without sleep, some people become disorganized and ineffective, whereas others have been known to go as long as a hundred hours with their functions largely intact (35, 64). A task that will fatigue some men within a short while can be carried on by others for many hours with no evidence of fatigue (4, 32).

It must be conceded that these differences in the ability of men to withstand isolation, fatigue, and sleep deprivation may be based on subtle differences in their genetically inherited characteristics; but if this be true, no evidence has yet been brought forward to substantiate it. On the other hand, there is abundant evidence to indicate that the personality of a man and his attitude toward the experience that he is undergoing affect his ability to withstand it. People who enter prison with attitudes of foreboding, apprehension, and helplessness generally do less well than those who enter with assurance and a conviction that they can deal with anything that they may encounter. Those who readily withdraw into a life of meaningful fantasy and intellectual activity seem to do better than those who are dependent upon activity and interaction with other people. Some people who are afraid of losing sleep, or who do not wish to lose sleep, soon succumb to sleep loss; others, convinced that they can stay awake indefinitely, have done so for well over a hundred hours (64). A great number of reports from industry, and from experimental observations, indicate that the attitude of workers and experimental subjects is as important in determining the rate at which they fatigue as are the tasks they undertake (4, 81). Troops, carried without sleep or rest to the limit of endurance, have been able to straighten up and present a smart appearance for a short time when an appeal was made to their pride (118). In short, the brain, the organ that deals with infor-

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mation, also organizes its responses on the basis of information previously fed into it. This information, in the form of a personality developed through the experiences of a lifetime, as well as immediate attitudes and the awareness of the immediate situation, conditions the way that the brain will react to a given situation. There can be no doubt that personality, attitudes, and the perception of the immediate situation seriously influence the ability of a brain to endure the effects of isolation, fatiguing tasks, and loss of sleep.

Some Conditions under Which the Function of the Brain May Be Disturbed by Factors Not Intrinsically Harmful

In a certain sense one might regard isolation, sleep loss, and fatigue as direct assaults upon the brain; for the first can be regarded as depriving the brain of the substrate of its operations, and the last two can be regarded as leading to the depletion of processes in the nervous system which can only be repaired with a period of rest. However, hypotheses such as these cannot easily be applied to the explanation of the human reactions to pain, hunger, and situations interpreted as dangerous or threatening. Here one is dealing with a form of sensory input that may be of great intensity, but which is not in itself disorganizing to brain function even if continued indefinitely. Pain of fairly high intensity may be borne by individuals over a long period of time without necessarily producing impairment of their highest integrative functions (8, 50). In the heat of combat or of physical contests intensely painful conditions may pass quite unnoticed and may not impair performance. When the attention is focused elsewhere by various means, such as hypnosis, the pain of childbirth or of surgical operations may be withstood and not be remarked upon (103, 125). The reaction to pain is therefore quite variable (3, 6, 7, 28, 48, 50, 63, 69, 78, 93, 94, 112, 132, 133). So likewise is the reaction to hunger (21, 34). Hungry men have produced intellectual and artistic output of a high order, and have been responsible for extraordinary military feats. Men have undergone prolonged fasts without significant impairment of their highest faculties. And, so far as dangerous situations are concerned, there are some who are stimulated or even exhilarated by them, and many others who act as if they do not regard them as dangerous at all.

Thus, hunger, pain, signals of danger, and similar forms of sensory input cannot be shown to be necessarily toxic to the human brain, for, under the right circumstances, any individual apparently can

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tolerate them indefinitely. The weight of evidence is that it is not the sensory input itself, but the reaction of the individual to this input which may adversely affect his brain function. This is not so with isolation, sleep deprivation, and fatigue, where the effects are intrinsically adverse, and the reaction of the individual is a factor only in determining how long these effects can be withstood. With hunger, pain, and signals of danger, the adverse effects on brain function may be entirely the result of the reaction of the individual. Activities of the brain, initiated in response to incoming information, lead to an impairment of brain function. This special vulnerability of the brain to its own activities, long suggested by clinical observation, has recently received experimental support (24, 25).

Hunger

The syndrome commonly associated with the reaction to hunger is slow in developing, but it can be expected to occur in the majority of those who are exposed to prolonged hunger from any cause (18, 67). It has been seen among starved populations (1), among inmates of concentration camps (54, 70), and among prisoners of war (47, 61, 67, 104), and has been reproduced experimentally (18, 67, 82). This and other rigors of the prison camp experience were probably responsible for a good deal of the symptomatology that occurred among American prisoners in Korea (79, 105, 113). People deprived of food very soon develop a persistent hunger, which does not leave them until death approaches or nutrition is restored (18, 21, 54, 67). Accompanying this hunger there is a constant preoccupation with food, which may encompass the greater part of waking thoughts and activity (18, 54, 67). As starvation progresses, the niceties of dress and behavior are neglected, and if the lack of food carries with it a threat of death, behavior may cease to be governed by the restraints of "honesty," "unselfishness," "pride," and "honor," which are active under normal circumstances; in short, the very highest integrative functions drop away (18, 54, 67). During the earlier stages of hunger, irritability and emotional lability are the rule, but later profound and continuing apathy occurs (18, 19, 54, 61, 67, 104). In the most advanced stages of inanition, defects of memory, confusion, hallucinations, delusions, and intellectual deficits become evident (1, 54, 67). Advanced inanition is associated with major changes in the physical state of the individual. Although it is quite possible that this state is directly responsible for the derangement in brain function which takes place, the disturbances of behavior and of mood which occur during the

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early part of starvation are present long before any significant derangement of the internal milieu can be demonstrated (18, 19, 67).

It is not to be taken that the reaction to hunger is always the same. In starved communities, in concentration camps, and in experimental situations, some people endure hunger for a long time, and maintain their highest level functions with very little evidence of disorganization until the effects of illness or lack of food supervene (1, 18, 19, 54, 67, 70). Such people, although they do feel hunger and are aware of it, are able to engage in thought and behavior other than that centering around a preoccupation with food; their symptoms are less outstanding and their behavior is more "normal." So far as is known, this greater ability to withstand hunger has no constitutional or genetic basis; on the other hand, the attitude of the man to the experience that he is undergoing appears to be of great importance in determining his capacity to endure hunger.

Pain

The investigation of pain has been especially enlightening in this regard, because many careful laboratory studies have defined the difference between the "sensation of pain" and the "reaction to pain" (3, 50, 52, 110, 132, 133). The sensation of pain seems to be roughly equal in all men, that is to say, all people have approximately the same threshold at which they begin to feel pain, and when carefully graded stimuli are applied to them, their estimates of severity are approximately the same (6, 28, 48, 50, 51, 71, 85). In general, the reaction to pain is in proportion to its severity, and the most intense pains incapacitate men for any sort of complex function during the period of their duration. Yet exception must be taken even to this statement, for when men are very highly motivated, as they may be when their own lives or the lives of others are at stake, they have been known to carry out rather complex tasks while enduring the most intense pain. The variability of human reactions to the moderately severe grades of pain, such as those found in various diseases, is notorious. Some people perform quite effectively over many years while experiencing the pains of chronic headache, peptic ulcer, arthritis, or similar conditions; others with like amounts of pain are severely incapacitated (3, 6, 7, 8, 28, 48, 50, 63, 69, 78, 93, 94, 103, 112, 125, 132, 133).

The adverse reaction to chronic pain of moderate severity is clinically familiar. It is characterized by withdrawal from the more complex and responsible functions of life, a certain amount of irritability

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and emotional lability, and concentration upon personal comfort and survival at the expense of the needs of others and of the society. Under experimental circumstances, those who try to "carry on" while experiencing moderate pain show impairment of their performance on complex tasks, impairment of decision making, loss of efficiency, and difficulty in estimating time (8) — symptoms which would be expected to occur in the early stages of the “brain syndrome” and much like those of people who have suffered the destruction of a small segment of their cerebral hemispheres (24, 25).

It is possible that the differences in the way that various people react to pain may be partly determined by their constitutions, for it sometimes appears to the clinical observer that people of “mesomorphic” build, the heavily muscled and big-boned individuals, are those who react to pain with stoicism or with anger and a mobilization for action that temporarily enhances their performance; whereas the lighter and asthenic “ectomorph” often reacts to pain with withdrawal, incapacitation, self-concern, and anxiety. Yet the exceptions to this are many, and the variations in the reaction of the same person from time to time are great. In general, it appears that whatever may be the role of the constitutional endowment in determining the reaction to pain, it is a much less important determinant than is the attitude of the man who experiences the pain (3, 6, 7, 48, 50, 52, 69, 94, 110, 112, 125, 132, 133).

Threat

Threats of any sort, direct, implied, or symbolic, are not necessarily derived from sensory input which is intrinsically “unpleasant.” The question of the intrinsically noxious nature of a threat does not even arise. Complex situations, symbols, and small cues arouse potent reactions entirely because of the interpretation put upon them. In different men similar situations produce different reactions. Some men react to ostensibly dangerous situations with continued effective performance. When men react to such situations as threatening, and when their reactions are characterized by anxiety or other intense emotions, these reactions may disorganize their brain function. Intense anxiety, for example, is sometimes associated with defects in every area of performance that is impaired in the “brain syndrome.” Threat is not usually thought of as a “physical” stimulus and the syndrome of anxiety is quite distinct from “brain syndrome.” However, the defect in function that occurs in the anxious man is quite real.

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DISTURBANCES OF BRAIN FUNCTION PRODUCED BY PAIN, HUNGER, AND THREATS

Pain, hunger, and threats are usually thought of as psychological stimuli because the conditions that produce them may not be noxious unless perceived to be so. The features that determine whether or not a man will perceive a given situation as noxious — his personality, his past experiences, his immediate mental set, and the characteristics of the situation — are outside of the scope of this chapter, but we must take due note of their importance.

On the other hand, the psychological reactions to pain, hunger, and threats will be discussed. These reactions are not called "organic reactions," and they are not considered to be part of the "brain syndrome," but this is a sterile distinction.

The same considerations that were applied to the reactions to isolation, fatigue, and sleep loss apply also to those of pain, hunger, and threats. Insofar as mood, thought, and behavior are functions of the brain, the disturbances of mood, thought, and behavior that occur in reaction to pain, hunger, or threat are disturbances of brain function. Insofar as all brain functions are concomitants of electrochemical events in the brain, these disturbances are "organic." Yet the impaired function associated with anxiety is distinguished from the "brain syndrome" because of its reversibility, and because of the relatively greater disturbance of mood and behavior than of intellectual functions, memory, or orientation that usually occur with anxiety. Yet impaired brain function, not entirely distinguishable from the organic reaction pattern, and in effect "permanent," may in some cases be produced by anxiety alone (24, 25).

Quite aside from the question of whether or not the reaction to threats, hunger, and pain may be directly associated with changes in brain function, there is no doubt that it may be associated with notable changes in the function of other organs. When environmental conditions pose a threat, adaptive mechanisms are capable of creating important changes in the internal economy (59, 129, 130). Manifestations of disturbed function of the gastrointestinal and cardiovascular systems are most frequently reported by prisoners (57), but disturbance of any organ system may occur. In the absence of other causes of disease, dysfunctions produced in this manner are not usually fatal, although they may be. When combined with the effects of isolation, loss of sleep, or starvation, they lead to rapid deterioration and sometimes to death. Even if one were to overlook entirely the

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direct effect upon the brain of reactions associated with anxiety, fear, or depression, the indirect effect of the homeostatic derangements that often occur at the same time would ultimately be deleterious to brain function.

Some Implications of This Information

We have drawn a distinction between the "willingness" of a man to give information and his "ability" to do so. The implications of this may now be considered.

As the master organ of human adaptation, the brain functions as a whole in enabling man to carry out the exceedingly complex activities of life in the societies that he has erected. Even impairment of the lower level functions of the nervous system, for example, of sight, hearing, or motor function, to some extent impairs his performance of these activities. Yet many of the highest level activities of man remain possible despite such impairment. Milton was blind, Beethoven was deaf, and Winston Churchill was not the last statesman to carry on after he had suffered a cerebro-vascular accident. The part of the brain essential to these highest level activities, without which they cannot be carried on, is the most recent evolutionary development and the part particularly well-developed in man: the cerebral hemispheres, the neopallium. It is this that must be intact for the performance of the creative and responsible tasks that confront a mature man and, in fact, for all those "conscious" activities that are part of being an alert, sentient, and civilized human being.

Within the cerebral hemispheres are many discrete pathways which have to do with lower level functions, including those of sight, hearing, and the motor functions that have been mentioned. These lower level functions are relatively localized. Damage to their pathways can impair them temporarily. But the highest level functions, those necessary for the adequate expression of human needs, appetites, and drives, those which provide the mechanisms for symbolic activity ("memory," "abstraction," "cognition," "integration," "reason," and so on), and those which enable men to tolerate frustration, to deal effectively with threats, and to maintain effective and well-modulated defense reactions, do not appear to be localized within the hemispheres (24, 25).

In carrying out these highest integrative functions, the cerebral hemispheres behave somewhat in the manner of a data-processing machine that has "digital" (or "counting") and "analogue" (or "meas-

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uring") characteristics, as well as many other characteristics not yet duplicated by man-made apparatus (26). The cerebral hemispheres have no specific pathways associated with "abstraction," "cognition," "integration," "reason," or similar mental activities. Rather, they include a maze of potential pathways, over any of which the complex patterns of activity associated with the highest integrative functions may be set up. Thus, when any part of the hemispheres is damaged, none of the highest integrative activities are entirely lost, but the capacity to perform all is impaired to some extent. It is for this reason, undoubtedly, that anything that impairs the function of the cerebral hemispheres-direct injury, drugs, toxins, diseases, homeostatic disturbance of all sorts, isolation, sleep loss, fatigue, and some reactions to pain, hunger, and threats — ultimately produces a global impairment of the highest integrative activities.

Yet it is also true that some high level functions of the brain are more vulnerable than others. It seems to be a characteristic of the central nervous system that those functions that are "newest" and most complex, those which have appeared most recently in evolutionary development, are most vulnerable and drop out first when the function of the brain is impaired. The cerebral hemispheres provide no exception to this general rule. When they are impaired, the first functions lost are those that are thought to be the most complex and to have been acquired most recently by civilized man: the capacity to carry out the highest creative activities, to meet new, challenging, and complex situations, to deal with trying interpersonal relations, and to cope with repeated frustration (24, 25). Relatively small degrees of homeostatic derangement, fatigue, pain, sleep loss, or anxiety may impair these functions.

As impairment of brain function continues, somewhat less complex activities deteriorate. There is a lessening of the speed and efficiency with which the ordinary tasks of daily life are carried out. Concern about "accuracy," "propriety," "moral rectitude," "honor," and "feelings of other people," and similar "socially oriented" behavior falls away, and an increased concern about sleep, rest, comfort, food, and other bodily needs becomes apparent (24, 25, 54, 67). There is less adherence to niceties in speech, behavior, and dress. Emotional displays lose some of their social orientation. Judgment and insight are less acute. These complex aspects of brain function may be distinctly impaired, whereas orientation, memory, recall, and the capacity to perform well on psychomotor tests are still intact.

Symptoms of impaired orientation appear as impairment proceeds. Memory becomes faulty, the capacity to recall remote events being re-

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tained after memory for recent events is lost. Difficulty in simple computations becomes evident, and impairment of performance on tests becomes quite noticeable.

With still further impairment awareness becomes clouded. It is at this point that misinterpretations, illusions, delusions, and hallucinations may appear, and "delirium" may occur. Large defects in memory and profound impairment of discrimination and judgment are evident. As they develop, confabulation may take place and perseveration is likely.

With further deterioration of brain function, loss of contact with reality and finally loss of consciousness occur.

It is notorious that threats, pressures, and deprivations, skillfully manipulated by police and interrogators with long practice in their use, will "break" almost any man, "soften him up," "make him cooperate," and "make him talk." They succeed because the most complex, the most "civilized," and the most "socially determined" aspects of human behavior are most affected by these procedures. The "less civilized" behavior patterns, directed at comfort and survival, are brought to the fore in a man whose capacity for judgment and discrimination is diminished. "Honor," "bravery," "security," "loyalty," and "patriotism" then have less weight in determining his behavior; pain, fear, and confusion have more. Rationalizations come easier to him, and points that once seemed important are now unimportant. He becomes more "willing to give information."

"Willingness to give information" is an "attitude," a "mental set," an "increased propensity of the individual to react in a given manner." It is not, in itself, a discrete function of the brain; it is a statement about the likelihood that a given pattern of reaction will occur, provided this reaction pattern can occur. Various degrees of "willingness" exist so long as the brain has any "ability" whatsoever to give information. The "ability to give information" is a statement about the capacity of the brain to furnish information: the possibility that it can do so under any circumstances. "Willingness" and "ability" are not necessarily parallel.

It is easy to see why various police procedures often increase the willingness of men to give information. So far as one can tell, the willingness to give information is not determined by any constitutional factor or by the direct action of any agent from the outside, but by information already within the brain, what might be called its "directions for action." Most of the "directions" which call for a prisoner to withhold information were implanted there by his society. They are the sum total of those learned reactions that have

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to do with "loyalty," "honor," "propriety," "security," and so on. As brain function is impaired, information derived from past experience generally becomes less potent as a guide for action, whereas information derived from the immediate experience, pain, thirst, discomfort, and threats to life, becomes more potent. The "attitude" is likely to change, and the man becomes more "willing" to do whatever is necessary to secure his comfort and survival.

The new "attitude," the newly increased propensity, is directed toward doing whatever is necessary to secure comfort and survival. It is directed toward "compliance," toward doing what the situation seems to demand. This new state of the informant may be a trap to an interrogator, especially if he is a vigorous and persistent man with a good hypothesis as to what he might uncover. He is now dealing with a man who is likely to have lost some of his finer capacity for discrimination and judgment, whose insistent physiologic needs impel him toward ready solutions that may serve to relieve him of his discomfort, whose memory for details may be fuzzy and confused, and who is more than usually ready to accept a plausible suggestion. The source is, indeed, more prepared to talk, but he is also more likely to be inaccurate and to give false, misleading, incomplete, or inexact information, of a type like that which his interrogator happens to be seeking. The fact that the giving of this information does not redound to his credit or to his long-term self-interest and the fact that he is prepared to state that it is true, and later to defend his statements, should not be taken as evidence of its accuracy.

Note that these are statements of probability; they are not absolute. "Willingness" is not necessarily enhanced as "ability" deteriorates. Our simple hierarchical outline of the way that brain function falls off is generally true. All the disturbing influences that we have mentioned can be accompanied by the "brain syndrome," and can ultimately cause disorganization and unconsciousness. However, one cannot make a more exact statement, because the precise nature of the symptoms and the facility with which they are produced are dependent upon the personality of the prisoner, what has happened to him before, and how he views the circumstances in which he finds himself at the time (24, 25, 131). These factors have a great deal to do with the form of the "brain syndrome" produced by disturbances in homeostasis. They determine whether a man becomes garrulous or withdrawn, anxious or angry, paranoid or trusting. They likewise determine the form of the "brain syndrome" produced by isolation, sleep loss, and fatigue, and they further have an important influence upon his ability to withstand pain and hunger, and they

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approach being an absolute determinant of whether or not a "threat" will produce a disorganizing reaction.

Unwillingness to give information is a mental set. If it is strongly imbedded in a man before his capture, it may continue to govern one aspect of his behavior right up to the point of delirium or unconsciousness, no matter what symptoms he may develop. Some people -criminals adhering to the "code of the underworld" (127) as well as prisoners of war adhering to the "finest military traditions" (119) — do not give information although they reach the point of disorganization or death. The evidence suggests that a learned reaction pattern, if sufficiently reinforced, can sometimes govern a specific aspect of behavior as long as a man retains the capacity to carry out that behavior.

From the theoretical point of view it is hard to escape the conclusion that a man is best able to give accurate information when he is in an optimal state of health, rest, comfort, and alertness, and when he is under no threat. This would seem to be the optimal situation for interrogation. Any attempt to produce compliant behavior by procedures which produce tissue damage, disturbances of homeostasis, fatigue, sleep deprivation, isolation, discomfort, or disturbing emotional states carries with it the hazard of producing inaccuracy and unreliability.

However, it is often necessary for the interrogator to question people who are experiencing moderately severe effects of illness, injury, fatigue, discomfort, or anxiety. A body of practical experience indicates that relatively reliable information can be obtained from most such people, if the information sought is neither complex nor extensive. The interrogator faces two special hazards under these circumstances. First, the source may have a fairly serious degree of mental disturbance that is not immediately evident and it may escape the interrogator's attention. Second, any informant in a threatening situation is liable to say whatever will please his captors, even though he may not do so intentionally. These ever-present hazards of interrogation are enhanced under adverse circumstances. It may be assumed, in the absence of evidence to the contrary, that the simpler, the briefer, and the more readily verifiable the information that is sought, the more likely is the evidence of the source to be of value.

On the other hand, granting that various procedures designed to make men more compliant will impair their ability to give accurate information, do these procedures not cause men to give more information than they might otherwise have given? Cannot a man be made to reveal information against his will?

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Disordered brain function is indeed easily produced in any man. No amount of "will power" can prevent its occurrence. It can be produced without using physical means, that is, by fatigue or sleep deprivation. Since it may be associated with mental clouding, confusion, lack of discrimination, impaired judgment, and increased suggestibility, it is probably true that most men can be brought to a state where they will agree to statements that are dubious, incomplete, or quite inaccurate. Under these conditions some men will make up entirely fictitious stories incriminating themselves. Therefore, it is usually not difficult to obtain signed "confessions" that are biased, incomplete, inaccurate, or even totally untrue. This is the means by which Communist state police have produced false confessions with great regularity (57), although not with universal success (12, 101, 106, 117, 119).

Most people who are exposed to coercive procedures will talk and usually reveal some information that they might not have revealed otherwise. However, there is no evidence that a man must always reveal a specific item of information that he possesses. Disturbed brain function of the subject does not allow the interrogator to abstract information at will. An interrogator may occasionally trick a disturbed man into revealing bits of information that he had intended to conceal, but information so revealed is likely to be limited and interspersed with unreliable statements. If he elects to do so, a prisoner may endure to death or disorganization without revealing what he knows. Very few men, however, can hold themselves to such rigorous behavior through all the vicissitudes of captivity.

References

1. Aginger J., and Hemmager E. Unusual neural conditions following hunger period of 1945-46. Arch. Psychiat., 1951, 186, 483-495.