physical element as well as forcing a person to do something and physical attacks that ultimately target the mind. Death threats, mock execution, or being forced to witness the torture of another person are often reported to be subjectively worse than being physically tortured and are associated with severe sequelae. Other torture techniques include sleep deprivation, overcrowding or solitary confinement, withholding of food or water, sensory deprivation (such as hooding), exposure to extremes of light or noise (e.g., musical torture), humiliation (which can be based on sexuality or on the victim's religious or national identity), and the use of animals such as dogs to frighten or injure a prisoner. Positional torture works by forcing the person to adopt a stance, putting their weight on a few muscles, causing pain without leaving marks, for example standing or squatting for extended periods. Rape and sexual assault are universal torture methods and frequently instill a permanent sense of shame in the victim, and in some cultures humiliate their family and society. Cultural and individual differences affect how different torture methods are perceived by the victim. Many survivors from Arab or Muslim countries report that forced nudity is worse than beatings or isolation. Effects Torture is one of the most devastating experiences that a person can undergo. Torture aims to break the victim's will and destroy the victim's agency and personality. Torture survivor Jean Améry argued that it was "the most horrible event a human being can retain within himself" and that "whoever was tortured, stays tortured". Many torture victims, including Améry, later die by suicide. Survivors often experience social and financial problems. Circumstances such as housing insecurity, family separation, and the uncertainty of applying for asylum in a safe country strongly impact survivors' well-being. Death is not an uncommon outcome of torture. Health consequences can include peripheral neuropathy, damage to teeth, rhabdomyolysis from extensive muscle damage, traumatic brain injury, sexually transmitted infection, and pregnancy from rape. Chronic pain and pain-related disability are commonly reported, but there is scant research into this effect or possible treatments. Common psychological problems affecting survivors include traumatic stress, anxiety, depression, and sleep disturbance. An average of 40 percent have long-term post-traumatic stress disorder (PTSD), a higher rate than for any other traumatic experience. Although the traditional view is that fear causes trauma, Pérez-Sales argues that loss of control explains trauma in torture survivors. As torture can be a