7 example. Causing an existential dilemma in a person may be the intent behind torture, but it seems unlikely that torturers and educators are only distinguished by their methods: the intention to harm and the perception of this intent suggest torture and repressive violence must be described not only by behavioural and medical criteria, but also by moral, ethical, and political criteria. Thus, it does seem that there are good grounds for thinking about torture as having unique consequences, and consequences that might not be easily covered by the PTSD definition. It is also clear that some kind of conceptual analysis is also necessary as a preliminary to the construction of any syndrome entity, and this will determine the kinds of observations that are made. This will not preclude the approach of existing epidemiology, that of examining persons in populations that have suffered repressive violence, but it may point out the limitations of the approach. As Faust and Miner have commented in their analysis of the epistemological basis of modern psychiatric nosologies, purely descriptive observations do not exist in psychiatry, and all observations are theory-driven (Faust & miner.1986). It is crucial, therefore, to make explicit the theory behind the observation language, and this is as true for torture as it is for any other disorder. Thus, there needs to be an interaction between the two methodologies outlined earlier, and neither will be satisfactory alone. The more difficult epistemological question, that raised implicitly by the concept of Psychosocial Trauma, has scarcely been addressed. As Basoglu has commented, torture (and repressive violence) are political acts, and conceptually this marks off these forms of trauma as distinct from disasters, accidents, and the like (Basoglu.1993). Vis maior may be the same as the hand of man, but this needs still to be established both empirically and logically. It is difficult to clinically and epidemiologically differentiate PTSD and a Torture Syndrome at present, but the problem is not merely a measurement problem, for there remain complex conceptual problems that are not simply solved by more complex models (Turner & Gorst-Unsworth.1990). CONCLUSIONS: Clearly no definitive remarks can yet be made about this debate at this point, but the problems and issues raised deserve serious consideration. The acceptance of PTSD as a psychiatric (and medical) disorder has lead to a focus upon the problems caused by man's violence to man, and to an increasing awareness that violence may be a cause of considerably more harm than is commonly accepted. It has lead, for example, to the understanding that the witnessing of violence may cause disorder no less than the experiencing of violence. It has also lead to the suggestion that the effects of violence can be long-lived, persistent, and even inter-generational. Here, we must of course consider too the perpetrators, and the possibility that, just as victims and survivors of repressive violence may rear damaged children, so too may the violent continue the cycle of their own violence in their children. The definition of PTSD makes visible the consequences of organized violence, but it may equally make invisible many of the processes in the causation of the disorder as well as many of the consequences. Whether torture should be regarded as an "ongoing traumatic stress disorder", and hence distinct, or should be seen as the most severe form of PTSD remains to be seen. The reduction behind psychiatric definitions can have many positive effects: it can facilitate identification of formerly undetected disorders, can lead to necessary descriptive work, and can allow scientific communication. However, reduction is only useful where it encompasses all the relevant variables, which is the cause of the present debate. The deliberate infliction of harm has powerful biological, social, and psychological consequences, and seems to place the stressor concept in torture in rather a different position to the other kinds of stressors known to cause PTSD. It seems to have the quality of evil about it, which may be a reason why it produces such pronounced counter- tranferential effects (Danieli.1988). Evil and politics may not be the common currency of the healing professions, but do we not need to consider whether the attempt to produce a definition by reduction takes the meaning out of torture and repressive violence? REFERENCES: BAKER,R. Psychosocial consequences for tortured refugees seeking asylum and refugee status in Europe, in M.BASOGLU(ED), Torture and Its Consequences: Current Treatment Approaches, CAMBRIDGE: CAMBRIDGE UNIVERSITY PRESS, 1993. BASOGLU,M. Torture and Its Consequences: Current Treatment Approaches, CAMBRIDGE: CAMBRIDGE UNIVERSITY PRESS, 1993. DANIELI,Y. Confronting the Unimaginable: Psychotherapists reactions to victims of the Nazi Holocaust, in J.P.WILSON, Z.HAREL, & B.KAHANA (EDS), Human Adaptation to Extreme Stress, NEW YORK: PLENUM, 1988. EL-SARRAL,E., & SALMI,S. Torture and Mental Health: The experience of Palestinians in Israeli Prisons, (unpublished manuscript) FAUST,D., & MINER,R.A. The Empiricist and His New Clothes: DSM-III in Perspective, AMER.J.PSYCHIAT., 1986, 143, 962-967.