Tuesday, 23 August 2011

The Case Assange and the Misuse of the PTSD Diagnosis in Swedish Rape Trials

By Marcello Ferrada-Noli

“Evidence of PTSD occasioned by rape (or RTS) is not a scientifically reliable means of proving that a rape occurred. PTSD is simply a diagnostic category created by psychiatrists, it is a human construct, an artificial classification of certain behavioural patterns . . . It was not developed or devised as a tool for ferreting out the truth in cases where it is hotly disputed whether the rape occurred” (US Court statement in Spencer v. General Electric Co. 1988, at 1075) [21]

In this second part of the series Pseudo-Science in Swedish Rape Trials [22] I further introduce the inquiry into the scientific value of PTSD-diagnosis (posttraumatic stress disorder) at the Swedish courts, concretely as been issued by the "Emergency Clinic for Raped Women in Stockholm" (Akutmottagning för våltagna kvinnor - AVK, Söder sjukhuset) [23]. The analysis as such (to be publish in PART III) is made in the context of potential developments in the Assange case in Sweden. Several sources have elaborated on the eventuality that one woman-accuser of Julian Assange would have been “interviewed” at the said Stockholm rape-clinic for the purpose of documenting and certificate-issuing. The assumption derives from the fact  - as informed in the main Swedish newspaper Dagens Nyheter on July the 7th 2011 - the AVK clinic have issued forensic expert-statements (rättsintyg) at rape trials in "most of the rape cases in the Stockholm area" [24]. Secondly, the documentation and certificate-issuing done by the AVK includes areas of expertise far away gynaecology. They even issue psychiatric diagnoses!

The powerful role of this clinic in the course of Swedish rape trials can be measured by the huge number of expert statements the clinic issues every year to the courts, and which correspond to nearly 50 per cent of all cases processed by the clinic (265 out of 579 new cases in 2010) [24]. The Stockholm Clinic for Raped Women (AVK) started activities year 2005. After that very same year of 2005 the convictions for rape in Sweden increased from an average of 103 per year (period 1975-1980) to 220 per year [25]. The institution of the clinic has clear correspondence with the new Swedish legislation (2005) that widened the rape-concept.

Indeed, the Swedish politicians’ original initiative regarding the establishment of the AVK aimed to provide unbiased medical assistance and psychosocial support to women that have been victimized amid the horrors of rape and physical abuse. It was - and still it should be - a noble, progressive and needed enterprise. However, the hospital facility AVK has become notorious in the Swedish public instead for the following items:

  1. A reportage in the main Swedish newspaper Dagens Nyheter by journalist Stefan Lisinski titled “Clinic for raped women criticizes for certificate", 14 July 2011, picture above) [25] disclosed that the Clinic had issued deceitful statements on behalf of a plaintiff in a debatable case of rape-accusation. In concrete, an expert statement issued by the Clinic head Dr. Lotti Helström, and delivered to the authorities, described a fissure-like wound in the vagina of the plaintiff (the woman accuser) “which can have resulted of a violent vaginal penetration”. The statement was regarded as sufficient evidence for the arresting of the accused man.  However, a separate medical investigation conducted by a forensic doctor before the plaintiff’s visit to the AVK Clinic blunt contradicted Helström’s statement. The forensic doctor had not found such wound at all at the moment of the examination. Further, it was later established that the original file by AVK did mention only a “tiny” (svag) fissure, which apparently did not correspond to what Helström’s later manifested in her statement. The prosecutor decided ultimately to drop the case and the man was freed.  Lisinki’s reportage on the other hand was never published on-line by Dagens Nyheter, as it is customary with important articles of the kind regarding the Swedish legal system. In the context of the international discussion around the Swedish management of the Assange case, such attempts by the mainstream media to difficult access to information entailing critic to the Swedish legal system in rape trials is deplorable, and highly contra-productive.

  1. It became known that the Clinic head, Dr. Lotti Helström – also an Associate professor at the Karolinska Intitutet – although being a gynaecologist without specialization in psychiatry, had issued an undisclosed number of expert statements to the courts diagnosing mental status of alleged rape victims. Many among the cases have been diagnosed with Posttraumatic stress disorder, which is presented as causally linked to the alleged assaults. One of these cases - leading to conviction for rape 2009 and later acquitted at the Appeal court 2010 – [26] is analysed here in detail.

Further, Dr. Helström’s excursions in the field of public health and psychiatric epidemiology – while talking to the media or through other means in addressing the Swedish public or colleagues – have been various, erroneous and dangerously misleading. For instance, I will here comment her inaccurate statistical presentations on “violence of men against women” [27], in psychiatric populations [28] or her picture on the epidemiology of traumatic resulting in PTSD [29].

  1. Dr. Lotti Helström - also publicly known as radical-feminist activist - have repeatedly made understood to the media that a purpose of her mission and that one of the clinic would be the obtaining of a higher number of rape convictions at the Swedish courts. In this line, she regrets that the police authority does not fully take her documenting achievements at the clinic [30]. The Clinic is state-administrated (Stockholm's landsting) and public funded.

  1. With regard to the officially declared methods of work at the clinic, as well as the clinic’s stand on scientific objectivity: The head and employees at the clinic maintains that women coming to their examinations are “by principle” to be believed in every word, every statement, any detail and description of both the happenings they narrate as experienced, and – this is a crucial element in our analysis deployed in Part III – regarding the symptoms they say to bear. Only this fact - the official "clinical" attitude at the AVK - would be sufficient to scrutinize every and each of those certificates issued under such subjective premises. What is the point to bring at the courts "certification" of symptoms that are not medically verifiable? Or that they have not been clinically penetrated beyond the narrative of the subject interested in using such diagnose for litigation purposes?  One thing is in any case pristine clear: they should not be regarded as psychiatric diagnoses.

  1. Lastly, it became recently known through a reportage by Ewa Tures published 23 August 2011 both by Svenska Dagbladet (“Läkarråd om bröllopsblod ifrågasätts) and DN (id),  that the same Dr. Lotti Helström had previously issued while in her position at the Karolinska Institute o Karolinska Hospital the most peculiar professional advice to be reach by gynaecologists to immigrant young woman (born in what Sweden euphemistically calls “hederskultur” countries, i.e. "honour cultures"). In order to manifestly overstate a "virginity status" at their weeding night, what the Karolinska University Hospital [31] advices the girls is to puncture themselves with nails-like instruments to produce a certain bleeding. Thus, the immigrant men – supposedly ignorant chauvinist pigs born in "other" countries, a construction typical for Swedish radical feminists  - will be “in the worst case” deceived or in the best case reassured. The "Vårdprogram" Omhändertagande av kvinnor med oskuldsproblematik ("Care-managment of women with virginity problem") was published 2004 by Karolinska University Hospital and the Unit for Sexual Health (SESAM - Enheten för sexuell hälsa).

This is the the advice doctors should give give to the immigrant brides, according to the cited program authored by Karolinska Institute’s Assoc. professor Lotti Helström:

"Blood on the sheet can be achieved in different ways. Most effective is that she immediately after intercourse goes to the bathroom and stick herself in the inner labia. The stinging must be practiced at home in advance so that she should know how hard she must puncture and how much it hurts. (For) Which is worse: to be murdered or to puncture oneself? Hide the needle in the toilet bag, or in the wedding gown (pretending) it was left behind by the seamstress. In case of emergency use a safety-pin that can be hidden in the vagina or rectum.”

According to the article's author Ewa Ture, the counseling is contained in the Program ""Care-managment of women with virginity problem" (Omhändertagande av kvinnor med oskuldsproblematik) published 2004 by the SEASM unit at the Karolinska University Hospital.

The exact quote from the information included in the DN's article:  

"Så ska bruden sticka sig. Vårdprogrammet är skrivet av doktor Lotti Hellström och heter Omhändertagande av kvinnor med oskuldsproblematik. Det gavs ut 2004 av Karolinska sjukhuset och SESAM (Enheten för sexuell hälsa). Så här formuleras det råd läkaren kan ge till den blivande bruden: "Blod på lakanet kan åstadkommas på olika sätt. Effektivast är att hon omedelbart efter samlaget går på toaletten och sticker sig i inre blygdläppen. Sticket måste övas hemma i förväg för att hon skall veta hur hårt hon skall sticka och hur ont det gör. (Vad är värst:att bli mördad eller att sticka sig?). Göm nålen bland sybehör i toalettväskan eller i brudklänningens fåll (kvarglömd från sömmerskan). Använd i nödfall en säkerhetsnål som göms i slidan eller ändtarmen."

    Continues. . . in Part III

    Notes and References

    21. The full text of the quote is:

    “Evidence of PTSD occasioned by rape (or RTS) is not a scientifically reliable means of proving that a rape occurred. PTSD is simply a diagnostic category created by psychiatrists, it is a human construct, an artificial classification of certain behavioural patterns. RTS was developed by rape counsellors as a therapeutic tool to help identify, predict, and treat emotional problems experienced by the counselor’sclients or patients. It was not developed or devised as a tool for ferreting out the truth in cases where it is hotly disputed whether the rape occurred” quote found in “page 42 Restrospective assessemnts of mental states in litigation.” Robert Simon & Daniel Shuman

    22. M. Ferrada-Noli. Pseudo-Science in Swedish Rape Trials. With an Introduction on the Origins of State-Feminism in Sweden. The Professors blog, 29 July 2011

    23. In the AVK clinic homepage there is a link with an English translation

    24. Source: Stefan Lisisnski “Klinik för våldtagna kritiseras för intyg”. Dagens Nyheter 14 / 7 , 2011 http://maukonen.files.wordpress.com/2011/07/20110714_nyheter

    The article also reports that the AVK clinic "utfärdar rättsintyg för de flesta våldtäktsfall i Stockholmsområdet" 

    25. Source Wikipedia (Swedish): Sexualbrott i Sverige 

    26. SVEA HOVRÄTT DOM B 4280-10
    Avdelning 07 


    28. Lotti Helström, Arma själar del 3: Slaget om hjärnan. Dagens Nyheter, 27 October 2009

    29. Lotti Hellsröm, För kvinnofrid krävs insatser på alla fronter. Läkartidningen nr 7 2008 volym 105

    30. Dagens Nyheter. Nya metoder ska ge fler våldtäktsåtal. 25 November 2008

    media, journalists

    Tuesday, 9 August 2011

    London journalist does interview on negative Swedish-media reporting of Assange case

    by Marcello Ferrada-Noli

    A major update to this post has been published 1st November 2011 in "THIS IS WHY" ("why Sweden is so revengeful against Julian Assange?")

    Karin Wasteson is a Swedish journalist based in London.  She took contact with me recently while working with an article on the Swedish media reporting of the Assange case, for which she had interviewed several sources. 

    These were her written questions, followed by my answers, in which I insert here some links for the readers of the Professors blog.

    1. Why do you think there has been an overall negative reporting of the case by Swedish media?

    There are two main reasons that might explain the negative reporting of the Assange case in Sweden, one is of a political nature and the other has to do with traditions of Swedish journalism.

    A. The political aspects

    In its turn, the political aspects determining or influencing the reporting appear being twofold:

    On the one hand we have the change in the foreign policy and military-strategy main perspective of the Swedish government, namely, abandon of the neutrality-stand and identification with NATO and the geopolitical interests this organization represents. In this line, the government would demonstrate - as they have done in the Afghanistan and Libyan cases - that Sweden is a “loyal partner” and long away from the late Olof Palme’s policy of alignment with the Third World countries. 

    It is worth to note that changes in those regards started already by the times of the former social democratic government of Göran Persson. This can be illustrated with secret agreements on cooperation with USA services which otherwise had became known through the rendition-flight episodes (political refuges in Sweden handed over in secret to the American services to be transported to interrogation centres elsewhere, as in the case of the Egyptians refugees). During these events, exposed to the pubic by a documentary in the private network TV4 (update: episode also commented in an editorial by DN 12/8 2011), the social democratic politician and former minister of Justice Thomas Bordström was signalled a main actor in the operation. Eventually an investigation on his role was held upon the Swedish Constitutional Committee – with no further consequences, useless to add.

    Sweden's acting in the apprehension of a USA’s number-one enemy - as Julian Assange is characterized - might be a confirmation of the above.

    For these ends, the government have naturally got the support of all the political parties favouring the NATO approach, including the “opposition” (mainly the social democratic party).

    Although is natural and legitimate that a Swedish government - as the USA or any other sovereign country - decides the foreign policy they think it best would serve their national interests, the problem here is of another kind. It has to do with important decisions that have been adopted in secret by government officials and hidden to the Swedish Parliament and the public. It is about the transparency issue.

    Yet another issue is whether that "double play" from the part of the Swedish government is really necessary in the interest of Sweden's foreign policy (DN-debatt 10/12 2009).

    On the other hand, the government has also got the support of the leftist parties and organizations in their case against Assange. This through highlight the “pro-feminist” aspects of the case, all which has served as a symbol for the radical feminism in Sweden in their campaign for moving forwards an even more advanced legislation in the gender-perspective. Assange is presented as the ultimate male-in-power-perpetrator and sexual abuser of Swedish women-victims, a construction that would mirror the “patriarchal” structures of the power constellation in Sweden and elsewhere, according to the radical feminists. 

    It is worth to mention that the Assange accusers, and notably members of the prosecution and police apparatus that have actively pursued or dealt with the Assange case are members of the same radical-feminist organizations or share their ideology.

    In sum, the Swedish crusade against the WikiLeaks founder Julian Assange has shown being compact and having the characteristic of a national cause.

    The above have generated a strong populism-factor around the case, and hence also a profitable source for other political or cultural opportunists in the Swedish forum, in the blogosphere and others authors not previously known as embracing political correct positions. The critical voices on the Assange case in Sweden have became fewer, and had to pay a high price for their objective and ethical stand.

    B.  The Swedish journalist traditions

    As I have previously developed in Newsmill, the “duck-pond” phenomenon in the Swedish journalism consists partly (there are yet other principal factors explained in the article, such as hegemonic nationalistic ideology or media monopoly) in that Swedish journalists, generally referred, do not exercise critical analysis of the wrongdoings of corporate power or government, particularly in cases of “national emergencies”. In these cases, their role has basically been to repeat communiqués released by the authorities. International correspondents have previously observed this phenomenon during past “national crisis” or where the Swedish “prestige” has been in focus, such as the riots of Gothenburg or the alleged Soviet submarine-incursions in Swedish waters.

    2. Do you think it has altered the judiciary process of the case in Sweden and Britain?

    Yes, indeed.

    3. Have you analysed British and foreign media as well?

    I have not conducted such analyses myself, but others have done that, for instance regarding the biased reporting of the Guardian. Guardian had to recognize in a given moment it had censorship against references to articles published in Professors blog on the case Assange. These have been articles also authored by Naomi Wolf or Andrew Craig, not only those of my own.

    4. Are you disappointed by the biased Swedish press, or was this to be expected?

    I would have expected some repetition of the cultural and political nationalistic phenomena mentioned above, but not to the solid extend in which this have now shown in the Swedish case against Assange.  For reasons I have otherwise a high identification with Swedish societal and cultural values, of course I feel disappointed, as very many other academics around the world regarding the Swedish managing of this case. And the attacks of the media have been such biased and also at times detrimental not only through vulgar personal attacks to Julian Assange but also to the few that have dared to criticize the main stream in the reporting of the case.

    5. Do you think Assange can expect a fair trial in Sweden if he is extradited?

    No, sadly. Both the PM and high officials in the juridical system have already profiled the case with their public declarations. Yet, the main reasons behind are partly the national or strategic interests in play – as explained introductorily – and partly the trial by the media, which have been exercised against Assange in Sweden. Further, as it has been demonstrated in the juridical tradition of Sweden, women accusing men can get along with hard sentences against the men even without the need of presenting evidence, as it is in most of the western countries. One of these cases was the sentence to prison against the Chilean political refugee Tito Beltran [1] – also a worldwide celebrity as opera tenor - accused of rape on the basis of a Swedish woman's declaration made nine years after the episode in reference. No evidence was needed. The lawyer of the woman-accuser who obtained the sentence was the social democratic politician and former minister of Justice Thomas Bordström, mentioned above. This politician is the partner of the law-firm Bordström & Borgström that nominally pursue the case against Julian Assange.

    And above all, because it has became a matter of prestige. This, I would say, is a sacred item in Sweden.

    Svenska dagbladet, a main Swedish newspaper, illustrated its 17 Feb 2011  article Idyllic picture of Sweden is darkened” with a montage showing the notorious criminal Göran Lindberg -- a world-reviled, convicted serial rapist (including the rape of a 14-year old child) – portrayed together with Julian Assange and his lawyer Mark Stephens. A conspicuous columnist of the newspaper Aftonbladet refers 13 Feb 2011 to Julian Assange as “a paranoid idiot who refuses come to Sweden to confront trial”.  The competitor newspaper, Expressen, describes 13 Feb 2011 in its cultural page “the sexual pleasure of Mr Assange is just an inescapable element for his severe compulsive needs that are beyond. . . (text from Does Sweden Inflict Trial by Media against Assange?)


    [1] The verdict stated: "According to this court, we found the plaintiff's story credible and that fully meets the requirements to form the basis for a conviction"-
    The lawyer defending the plaintiff was the social democratic politician and former minister of Justice Thomas Bordström. The "evidence" mentioned later in the verdict against Beltrán referred to declarations of two friends of the plaintiff which would "have heard" an account from the part of the plaintiff after the alleged happenings. Also in this case, it was not the plaintiff who have made a complaint to the police against Beltrán. It was another woman (Monica Dahlström-Lannes, known in Sweden as activist and campaigner  concerning sexual-offence cases) who after her own private investigations and interviews on the case filed the complaint to the police - nine years after!

    Dahlström-Lannes was a board-member of the same organization, ECPAC, in which  the social democratic politician and former minister of Justice Thomas Bordström was also a board-member. However, Bordström denied in the court hearings that he knew Dahlström-Lannes.

    At a later stage, journalist Karin Wasteson send to me the draft of her text in which she had summarized my statements. The text here below, added a minor update:

    "Professor Marcello Ferrada-Noli provided a witness statement to the first court hearing. He has conducted an independent study of the media coverage of the Assange case and analysed all articles in Swedish from 11 January to 11 February 2011. According to his study, 56 per cent of the articles contained negative reporting. 38 per cent was about Julian Assange as a person.

    He says: “In Sweden journalists follow a tradition of not questioning official policies, particularly on foreign-affairs issues. The mainstream media side with the government without being critical. As a results, most journalist-reporting in Sweden on those issues appear just politically correct or very naïve.”

    Ferrada-Noli says: “Journalism is supposed to be a critical source of information of what the government is doing. It is supposed to observe, criticize and scrutinize power. This has not been done in this case because a constellation of political factors”, he says.  His thesis being that the Swedish case against Assange is politically motivated and has primarily to do with Sweden’s new alignment in the geopolitical scenario and he Swedish main-stream media is constrained because of ownership interests. Another political factor influencing the media reporting of the case, he says, is that “it has being used by the radical feminist movement flagging a further legislation on rape.”

    He continues: “It's a Kamikaze attitude, and this is only hurting Sweden in the end. What happened with Assange was that the eyes of the world was turned to Sweden and everyone saw the flaws of the legal process regarding rape in this country.”

    Other articles on the affair Assange in the Professors blogg