A/HRC/43/49 or wrongfulness, but to clarify to what extent the generic prohibition of torture covers methods not using the conduit or effect of severe physical pain or suffering. 22. Second, the discussion of psychological methods (i.e., techniques) of torture should not be conflated with that of the psychological effects (i.e., sequelae) of torture. In reality, both physical and psychological methods of torture each have both physical and psychological effects (E/CN.4/1996/15, para. 118). Thus, the infliction of physical pain or suffering almost invariably also causes mental suffering, including severe trauma, anxiety, depression and other forms of mental and emotional harm. Likewise, the infliction of mental pain or suffering also affects bodily functions and, depending on intensity and duration, can cause irreparable physical harm or even death, including through nervous collapse or cardiovascular failure. In terms of severity, psychological and physical stressors have been shown to inflict equally severe suffering (A/HRC/13/39, para. 46). 15 From a psychophysiological perspective, therefore, the distinction between “physical” and “psychological” torture is of predominantly conceptual, analytical and pedagogic benefit and does not suggest the parallel existence, in practice, of two separate and mutually exclusive dimensions of torture, or of any hierarchy of severity between “physical” and “psychological” torture. 23. A third, distinct aspect of the psychological dimension of torture is its inherently psychological rationale (i.e., target). From a functional perspective, any form of torture deliberately instrumentalizes severe pain and suffering as a vehicle for achieving a particular purpose (A/72/178, para. 31). Methodologically, these purposes can be pursued through the infliction of “physical” or “mental” pain or suffering, or a combination thereof, and in each case will cause varying combinations of physical and psychological effects. Functionally, however, torture is never of an exclusively physical character, but always aimed at affecting the minds and emotions of victims or targeted third persons. 16 Many methods of physical torture deliberately create and exploit debilitating inner conflicts, for example by instructing captives to remain in physically painful stress positions under the threat of rape in case of disobedience. A similar inner conflict can be induced without physical pain, for example, by instructing the detainee to masturbate in front of guards and inmates, again under threat of rape in case of disobedience. Thus, the distinction between “physical” and “psychological” torture does not imply any difference in functional rationale but, rather, refers to the methodological avenue through which that rationale is being pursued by the torturer. Distinguishing psychological from physical “no marks” and “no touch” torture 3. 24. While methods of torture entailing visible bodily injury are generally not referred to as “psychological torture”, the term is sometimes conflated with “no marks” torture, the aim of which is to avoid visible traces on the victim’s body, and with “no touch” torture, the aim of which is to avoid inflicting pain or suffering through direct physical interaction. In reality, however, both “no marks” torture and “no touch” torture may also be of a physical nature and, in that case, are distinct from psychological torture. 25. More specifically, although the aim of physical “no-marks” torture is to avoid visible traces on the victim’s body, its purposes are still pursued through the deliberate infliction of severe physical pain or suffering. Some physical “no marks” techniques achieve the intended physical pain or suffering immediately and directly, such as beatings with insulated objects on selected parts of the body, simulated drowning (“waterboarding” or “wet submarine”) or asphyxiation with plastic bags (“dry submarine”). Other physical “no marks” techniques involve the prolonged and/or cumulative infliction of initially “low intensity” physical pain or suffering, calculated to gradually evolve to unbearable levels of severity, such as forced standing or crouching, or shackling in stress positions. While all these techniques are calculated to avoid physical marks visible to the naked eye and inexpert observer, many of them still produce physical sequelae – such as swellings, abrasions, contusions and irritations – which experienced forensic experts can reliably 15 16 Başoğlu, “Torture and its definition in international law”, p. 37. Sveaass, “Destroying minds”, pp. 313–314. 7