18 A practical guide to the Istanbul Protocol – for psychologists II. COMPONENTS OF THE PSYCHOLOGICAL EVALUATIONS The whole psychological evaluation should be carried out and interpreted according to the information given under the headings of General Considerations, Cautionary Remarks, Ethical and Clinical Considerations and Interview Process in the Istanbul Protocol. The psychological evaluation starts at the beginning of the interview, with the very first contact. Dressing, posture, the manner of recalling and recounting of the trauma, signs of anxiety or emotional distress, numbness or over-excitement, moments of emotional intensity, startled responses, posture and bodily expression while relating the events of torture, avoidance of eye contact, and emotional fluctuations in his/her voice can give important clues about the personal history and psychological functioning of the person. Not only the verbal content of the examinee (what he/she says), but also his/ her manner of speaking (how he/she says it) are important for the psychological evaluation (Jacobs, 2000; Reyes, 2002). The person might have difficulties in recollecting and recounting what he experienced or in talking about his/her complaints. Therefore, non-verbal communication supplies important information about his/her symptoms, as well as some clues for establishing and maintaining an effective relationship that allows the evaluator to elicite relevant data (Jacobs, 2000). The psychological evaluation should provide a detailed description of the individual’s history, a mental status examination, an assessment of social functioning, and a formulation of clinical impressions/opinions. The impact of the symptoms on daily life can be highly relevant for forensic procedures or questions of recompensation of torture cases. If appropriate, a psychiatric diagnosis should be given. The components of psychological/psychiatric evaluation are as follows: 1. HISTORY OF TORTURE AND ILL-TREATMENT “Every effort should be made to document the full history of torture, persecution and other relevant traumatic experiences (see chapter IV, section E). This part of the evaluation is often exhausting for the person being evaluated. Therefore, it may be necessary to proceed in several sessions [if it is possible]. The interview should start with a general summary of events before eliciting the details of the torture experiences[…]” (Istanbul Protocol, § 276). “[…]A method-listing approach may be counter-productive, as the entire clinical picture produced by torture is much more than the simple sum of lesions produced by methods on a list[...]” (Istanbul Protocol, § 145).