Torture aims to destroy its victim through the strategic and intentional use of pain to damage the physical, social, and psychological integrity of the individual. A core issue is the resulting multifaceted presentation of somatic, psychological and social problems in the same individual, leading to severe functional limitations and participation restrictions. Chronic pain considers one from the highest symptoms for torture survivors. This literature review of 25 studies will focus on the neurophysiology, and sensitivity of the nervous system after experiencing torture, the changes that happened at the brain level, and the pain system from a neuroscience point of view, and then the study will highlight the evidence-based practice for biopsychosocial intervention for torture survivors in treating chronic pain. The study findings and conclusion show that torture causes noticeable alterations to the brain and nervous system that manifest in the survivors as high PTSD symptoms, chronic pain, feelings of disempowerment, lack of control, personal boundaries being destroyed, or stress, with intermittent or continuous physiological hyperarousal. The classic fight-or-flight response to a perceived threat is a reflexive nervous phenomenon that has obvious survival advantages in evolutionary terms. When a person experiences severe circumstances like torture, which is often accompanied by intense fear, horror, and helplessness, the systems that organize the constellation of reflexive survival behaviors become dysregulated and hypersensitive like critical anatomical and neurophysiological alteration and chronic changes in the pain system, so, it’s mandatory for the rehabilitation team to understand these changes and create a setting that takes into consideration these experiences. Research on chronic pain aims to understand the various risks and protective influences of biological, psychological, and environmental factors that are known to contribute to chronic pain disorders after torture.
Effects of Torture on the Brain’s Neurophysiology and the Pain System, as well as the Efficiency of Using a Biopsychosocial Approach in Treatment