the survivor's inability to withstand it, as well as guilt at surviving, are common problems which discourage disclosure. Additional stress may be added due to uncertainty about the future, any possibility of being sent back to the country in which the survivor was tortured, and the potential lack of close confidants or social support systems. In addition, the presence of social isolation, poverty, unemployment, institutional accommodation, and pain can all predict higher levels of emotional distress in victims who survive torture. Victims with PTSD The development of the diagnosis of post traumatic stress disorder (PTSD) for American veterans of the Vietnam War can be understood as a political act which labeled the collective distress of a defeated USA as individual psychopathology. Proponents of this view, point to the de-politicization of the distress of torture survivors by describing their distress, disturbance, and profound sense of injustice in psychiatric terms. These are not only conceptual issues, because they may influence treatment outcomes. Recovery is associated with reconstruction of social and cultural networks, economic supports, and respect for human rights. The rich research on treatment of PTSDs in veterans has substantially informed treatment offered to torture survivors. It is more appropriate than extrapolation from work with civilian survivors of single events as individuals (assault, accidents) or as communities or groups (natural or man-made disasters). Some literature distinguishes between single-event trauma (type 1) and prolonged and repeated trauma, such as torture (type 2). There is no doubt that (disregarding concerns about the diagnosis) rates of PTSD are much higher in refugees than among people of a similar age in the countries where the refugees settle, and that, among refugees, rates of PTSD are even higher among those seeking asylum. The argument that torture causes unique problems waxes and wanes, and is often associated with claims to particular expertise in treatment, and therefore claims on funding. Gurr et al. describe how torture targets the person as a whole – physically, emotionally, and socially – so that PTSD is an inadequate description of the magnitude and complexity of the effects of torture. When the diagnosis of PTSD is applied, some survivors of torture who have very severe symptoms related to trauma may still not reach the criteria for diagnosis. Categories such as 'complex trauma' have been proposed, and it may be that the next iterations of the diagnostic compendia may modify the criteria. Perpetrator Many people