A/HRC/43/49 more debilitating and agonizing than the actual materialization of that fear, and even the experience of physical torture can be experienced as less traumatizing than the indefinite psychological torment of constant fear and anxiety. In particular, credible and immediate threats have been associated with severe mental suffering, post-traumatic stress disorder, but also chronic pain and other somatic (i.e., physical) symptoms. 2. Self-determination (domination and subjugation) 49. A psychological method applied in virtually all situations of torture is to purposefully deprive victims of their control over as many aspects of their lives as possible, to demonstrate complete dominance over them, and to instil a profound sense of helplessness, hopelessness and total dependency on the torturer. In practice, this is achieved through a wide range of techniques including, most notably: Arbitrarily providing, withholding or withdrawing access to information, reading material, personal items, clothing, bedding, fresh air, light, food, water, heating or ventilation; Creating and maintaining an unpredictable environment with constantly changing and erratically disrupted, prolonged or delayed schedules for meals, sleep, hygiene, urination and defecation and interrogations; Imposing absurd, illogical or contradictory rules of behaviour, sanctions and rewards; Imposing impossible choices forcing victims to participate in their own torture. 50. All these techniques have in common that they disrupt the victim’s sense of control, autonomy and self-determination and, with time, consolidate in total despair and complete physical, mental and emotional dependency on the torturer (“learned helplessness”). 3. Dignity and identity (humiliation, breach of privacy and sexual integrity) 51. Closely related to the suppression of personal control, autonomy and selfdetermination, but even more transgressive, is the proactive targeting of victims’ sense of self-worth and identity through the systematic and deliberate violation of their privacy, dignity and sexual integrity. This may include, for example: Constant audiovisual surveillance, through cameras, microphones, one-way glass, caging and other relevant means, including during social, legal and medical visits and during sleep and personal hygiene, including urination and defecation; Systematic derogatory or feral treatment, ridicule, insults, verbal abuse, personal, ethnic, racial, sexual, religious or cultural humiliation; Public shaming, defamation, calumny, vilification or exposure of intimate details of the victim’s private and family life; Forced nudity or masturbation, often in front of officials of the opposite gender; Sexual harassment through insinuation, jokes, insults, allegations, threats or exposing genitalia; Breach of cultural or sexual taboos, including the involvement of relatives, friends or animals; Dissemination of photographs or audio/video recordings showing the victim being tortured or sexually abused, making a confession or otherwise in compromising situations. 52. It must be stressed that the humiliating and degrading nature of abuse does not necessarily relegate it to the realm of “other cruel, inhuman or degrading treatment”, which is sometimes (incorrectly) regarded as a “lesser” wrong than torture. Systematic and prolonged violations of privacy, dignity and sexual integrity are known to instil severe mental suffering, including emotions of profound vulnerability, humiliation, shame and 14