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The Survivor's Paradox: Psychological Consequences of the

Khmer Rouge Rhetoric of Extermination

Article  in  Anthropology and Medicine · April 2006

DOI: 10.1080/136484705005162287

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Anthropology & Medicine
Vol. 13, No. 1, April 2006, pp. 1–11

The Survivor’s Paradox: Psychological

Consequences of the Khmer Rouge
Rhetoric of Extermination
Richard Rechtman

From 1975 to 1979 in Cambodia, during the four years of the Pol Pot regime, the rhetoric
of extermination that perpetrators used to legitimize mass murder was a powerful
instrument to deprive individuals of their humankind before killing them. Because every
human community is founded on a metaphor claiming the inalterability of the social
bond beyond the dead, the genocide project aims for its obliteration. By breaking the
possible representation of a continuity and a social permanence between the dead and the
living, the rhetoric of extermination claims, in a terrifying reality, that the only possible
connection between the dead and the living concerns an identical physical condition: the
living have already died or will pass away. This is the point where the rhetoric of
extermination radically subverts one of the major symbolic aspects of the human
condition. In the aftermath of extermination, the social existence of the deceased depends
on the survivors’ capacity to always carry them with them in a shared destiny. For those
who survived, the consequences of this rhetoric may generate a distressful feeling of living
in a world of death that conforms to the perpetrator’s will. The survivor’s paradox is
undoubtedly one of the principal consequences of this will to deprive prisoners of their
human condition. It is a kind of interiorization of the perpetrator’s rhetoric. For the
survivor to leave this world of death could mean abandoning the dead without a
symbolic place where they could exist. But if he/she keeps them only in his/her own
memory, that could signify that the survivor remains captive in the perpetrator’s world of
death. In both cases, the survivor’s attempt to escape this paradox fails with the risk of
confirming the abominable claim of the torturers. In this paper, the author emphasizes
from an anthropological and psychotherapeutic point of view the dramatic logic of this
rhetoric and its consequences long after the fact.

Correspondence to: Richard Rechtman, Médecin Chef d’Etablissement de l’Institut Marcel Rivière, CHS La
Verrière, 78 321 Le Mesnil Saint Denis Cedex, France. Email: richard.rechtman@wanadoo.fr
ISSN 1364–8470 (print)/ISSN 1469–2910 (online) ß 2006 Taylor & Francis
DOI: 10.1080/136484705005162287
2 R. Rechtman
Beyond Post-traumatic Stress Disorder
The major traumatic consequences of the Cambodian genocide perpetrated by the
Khmer Rouge have been very well documented with large clinical and epidemio-
logical surveys in the US (Kinzie et al. 1984, 1990; Boehnlein et al. 1985; Boehnlein
1987a; Mollica et al. 1987; Carlson & Rosser-Hogan 1993), in Australia (Eisenbruch
& Handelman 1989; Silove 1992; Morris et al. 1993) and in France (Rechtman 1993,
1997, 2000b). Based on the American Psychiatric Association classification (APA
1980, 1994), these data confirm the high prevalence of post-traumatic stress disorders
(PTSD) among Cambodian refugees and show that, apart from some cultural
features (Boehnlein 1987b; Eisenbruch 1991; Rechtman 1993), there exists a wide
overlap in post-traumatic symptoms between Western and non-Western populations
(Boehnlein & Kinzie 1995). Even in clinical case reports the similarity seems more
important than the differences with regard to major traumatic stress responses
(Boehnlein 1987a). This does not mean that there is no difference, nor that these
differences, when they do exist, are not relevant for diagnosis or treatment. Rather
it means that from a general theoretical point of view there is evidence that some
human psychological invariants are involved in post-traumatic reactions. Could
PTSD be one of these invariants?
I won’t discuss here the large controversy surrounding PTSD (Boehnlein & Kinzie
1992; Kinzie & Goetz 1996; de Vries 1998). From Maurice Eisenbruch’s radical
relativism (Eisenbruch 1992) to Derek Summerfield’s political criticism
(Summerfield 1997, 1999, 2001), there is a continuity trying to address the issue of
culture against the success of the diagnostic construct of PTSD and even against
the general psychiatric conception of trauma (Rechtman 2004b). As a psychiatrist
working with Cambodian refugees for more than 15 years, I would say that most
of my patients have been severely traumatized. The theoretical framework—whether
psychoanalysis (which I refer to) or DSM-IV (which I don’t)—does not much change
this conclusion. Even without the PTSD criteria, there is much clinical evidence
showing that this population of patients suffers from various symptoms
or distressful memories directly connected to what they experienced during those
terrible years. As an anthropologist as well, widely influenced by Allan Young’s
perspectives (Young 1995a, 1995b), and studying the social construction of the
new category of ‘victim of psychological trauma’ (Rechtman 2002, 2005), I will say
that this anthropological deconstruction does not allow clinicians to view PTSD
as just an illusion. It is not because facts are socially and sometimes scientifically
constructed that they do not exist. From a clinical point of view, there is a major
difference between a clinical category and the way this category might be used
and sometimes misused in practice or in specific political contexts. The whole
history of psychiatry is full of examples of misused categories ‘hijacked’ for other
purposes.
But whatever PTSD is, regarding its empirical validity, its cultural sensitivity, its
construction, its political uses or misuses, its economic implications, etc., this clinical
description of traumatic reactions has in some way diminished the visibility of other
clinical and psychological facts or aspects.
 Anthropology & Medicine 3

One of the major problems with PTSD is perhaps its definition of the event.
Not only are those traumatic events sometimes ‘outside the range of human
experience’, for research has clearly established that the stressors need not be as
unusual as was assumed before (Breslau et al. 1991; Breslau & Davis 1992; Gold et al.
2000; Halligan & Yehuda 2000; Breslau & Kessler 2001). But mainly it is not always
the empirical event that is responsible for the traumatic effect, especially in political
violence and mass extermination. People can sometimes cope with dramatic events
without any need of particular resilience, but they can’t overcome the meaning of the
rhetoric that was associated with the political violence that they experienced.

The Rhetoric of Depriving Individuals of their Humankind

While since the 1980s clinical descriptions of those traumatic experiences that go
beyond PTSD (Rechtman 2005) have been sorely lacking, most testimonies
of genocide survivors stress the dramatic effects of perpetrators’ rhetoric.
Primo Lévi was one of the first to emphasize the existence of a psychological
radical limit beyond which it was not possible to experience the feeling of belonging
to humankind (Lévi 1958). This devastating inner feeling was not only the
consequence of life conditions in concentration camps, but also the expression of
the manifest will of the Nazis to deprive their prisoners from their humanity
(Agamben 1999). ‘Heir ist kein warum’ (‘Here there is no why’), answers the German
guard to Lévi after hitting him for no reason, just to make him understand that ‘here’
he is no longer a man (Lévi 2005, p. 20). The perpetrators’ obsessive attempt to
deprive men of their humankind is obvious in the words they use to give orders or to
pronounce death. Testimonies of survivors accumulated throughout the 20th century
bring evidence of this constancy in the genocide process. From Armenia to the
World War II Holocaust, from Kampuchea to Rwanda, the killing machine has not
only killed in an almost industrial way, but it has also claimed to destroy the human
condition of all those who came under its wheels.1
The claim to deprive men of their humanity is clearly a powerful instrument that
belongs to the arsenal of extermination process (Arendt 1971; Staub 1989). It has to
do with the strategy of denying the reality of extermination by hiding any traces of
mass murder (Coquio 2003) while at the same time asserting that the ‘people’ who
were killed were no longer human beings. This murderous utopia creates its own
language of the extermination that assimilates the dead and the survivors through
same words (Benslama 2001) in order to link the final fate of survivors only to the
reality of dead bodies. I will call this language the ‘rhetoric of the extermination’.
The psychological consequences of this rhetoric remain too often neglected.
Beyond the direct traumatism, the fear of dying or of losing close relatives, the
psychological violence of deportation and deprivation, what are the consequences
of this appalling daily promiscuity between the dead and the living?
From my clinical practice with Cambodian refugees in Paris, I will emphasize the
relations between the Khmer Rouge rhetoric of the extermination and Cambodian
patients’ narratives and symptoms. In those cases, some symptoms are not the
consequence of the traumatic event, but rather the extension of the perpetrator’s
4 R. Rechtman
rhetoric of assimilating the dead and the living to the same destiny of dead bodies.
For example, the painful memory of the deceased, the testimony in the name or in
place of the dead, as well as the feeling of being already dead also reveal a kind of
interiorization of the rhetoric of the extermination. It is as if survivors were still
thinking about themselves the way the perpetrators do, and could not leave this
world of death (Rechtman 2004a). This is, I believe, an important issue in
psychotherapy with survivors, which deserves further study in other populations
of refugees and victims of genocides.

The Khmer Rouge Rhetoric of Extermination

In May 2003, during the Cannes film festival, Rithy Panh, a Cambodian filmmaker,
presented his most recent documentary, S21 The Khmer Rouge Killing Machine.
Already well known for his work on Cambodian memory, Rithy Panh delved more
deeply through his unique description of the mechanism of destruction (Panh &
Chaumeau 2003). For the first time, 10 former prison guards of Tuol Sleng, the
extermination camp of Phnom Penh, were confronted with two survivors. More than
16,000 Cambodians died in this prison during Pol Pot’s regime, while only seven
survived. Only two of them agreed to return to Tuol Sleng and to talk with their
torturers in front of Rithy Panh’s cine-camera. In the documentary, after trying to
present themselves as victims of the Khmer Rouge and claiming that they were not
responsible for their acts, these ‘ordinary perpetrators’ begun to reproduce for the
cine-camera their gestures, their words, and their attitudes toward prisoners.
Without any guilt, without any awareness of the horror they describe, they merely
and clearly expose the daily job of an ordinary extermination prison guard: insulting,
hurting, hitting and killing. As they put it, they never thought they were killing
human beings . . ..
The question is not to know if this claim is authentic; we don’t need to know if
they really thought that the people they were torturing and killing were not human.
Instead we really have to understand that at that time the rhetoric of the
extermination was efficient enough to transform men ‘into something other than
men’ and was an active part of the process of destruction.
This confrontation between the former guards and their ex-prisoners, 25 years
after the fact, brings up to date the murderer’s utopia. The will to deprive prisoners of
their human condition is central in all processes of extermination. It is at the same
time the rhetoric and the effective practice of mass murder. In Kampuchea
particularly, the rhetoric of the Khmer Rouge was eloquent: ‘one gains nothing from
having you alive, one does not lose anything for killing you’ was, among so many
others, the sentence which announced a capital execution. The Khmer Rouges
pushed this rhetoric to an extreme. By depriving the Cambodians that they were
going to eliminate of their ‘khmeritude’, they could pretend to not having
assassinated ‘pure Khmers’. They excluded from the Khmer world those who had
to be destroyed, such that to their torturers, they were not Khmer and so not human.
Some could think that this insistence on distinguishing the pure Khmer from impure
belonged to a racist project and explained, at least in a part, the atrocities
 Anthropology & Medicine 5

programmed and made by the Khmer Rouge with regard to their own population
(Ponchaud 1977; Kiernan 1998). But it is not certain that this assumption is enough
to account for the Khmer Rouges’ radicalism. In fact, the preliminary ‘dekhmeri-
sation’ of Cambodians was a way of extracting any human condition from those for
whom the unique fate was death (Rechtman 2000a). This rhetoric was always active
throughout the process of extermination, as if it was possible to transform men
into ‘something else than men’, in order to justify the crime. Moreover, it allows for
a strategy of denial by saying that there was no crime as long as the victims were
not any longer assimilated as human beings.
But it is also on this aspect that this rhetoric fails. Beyond the performative
statement of the torturer who announces death at the same time as he produces it,
it remains impossible to transform a man into anything other than a man, a Khmer
into anything other than a Khmer, despite the rhetoric of extermination. And it is
precisely what the testimony of the torturers can produce, as long as it is not just
assimilated to a ‘victim’ testimony. Much has already been written about the
testimony of victims (Robin 2003), but there undoubtedly remains much to say or to
write about torturers’ testimony.
I am not talking about the ‘self-traumatized perpetrator’, which is in fact not
a testimony, nor a confession (Young 2002). Nor I am referring to the possible
perpetrator’s guilt. By using PTSD both for victims and for perpetrators, psychiatry
has withdrawn an essential meaning. Perpetrators were aware of what they did, they
knew they were killing or torturing people, but they pretended that at that time they
could think that, and act as if, these people were not human beings. Certainly, in
wartime, perpetrators were often just ‘ordinary men’,2 even in Cambodia. After the
fact, they sometimes expressed guilt, sorrow or regret, but sometimes they did not.
Sometimes they had nightmares or other PTSD symptoms, sometimes they did not.
But these distinctions are probably not of major importance for understanding the
effect that the process of destruction they contributed to produced in survivors.
In fact, many survivors remain captive of their torturer’s conviction and still think
that at that time they were no longer human beings.
This is perhaps the reason why perpetrators’ testimony is so crucial. Not only
because it is essential to establish the facts and to judge the accused. But also because
it reveals a decisive truth, which attests to the failure of the rhetoric of genocide: they
did not succeed in killing ‘something other than men’. As long as this truth is not
established, only survivors remain in debt with the deceased.
Even if the catalogue of atrocities made during the four years of the Pol Pot regime
is roughly established today, the bill of indictment remains hopelessly on standby.
This contradiction undoubtedly delays the construction of a Cambodian memory of
this catastrophe.3 But apart from this denial of justice another problem impedes
Cambodians from overcoming this painful history. This difficulty reveals the
existence of a gap between the summation of singular stories and the construction
of a collective consciousness. On the one hand, the victims’ testimonies account for
the extent of the damage, but leave outstanding what becomes impossible to say,
because it is too painful and too unbearable. On the other, the objective
accumulation of facts and traces of the extermination brings evidence of survivors’
6 R. Rechtman
testimonies but may paradoxically reinforce their burden insofar as they are assigned
to the role of first witness of murders (Agamben 1999).

The Survivor’s Paradox

This contradiction reveals the paradox of the survivor. How can one testify about
his/her survival while he/she must testify at the same time about the death and in the
name of so many others? How can one be the only one who can honor the dead, talk
for them, and make them still alive in his/her memory, while preserving his/her own
existence? How can one avoid once again being assimilated to the dead?
Because every human community is founded on a metaphor claiming the
inalterability of the social bond beyond the dead, the genocide project aims for its
obliteration. By breaking the possible representation of a continuity and a social
permanence between the dead and the living, the rhetoric of extermination claims, in
a terrifying reality, that the only possible connection between the dead and the living
concerns an identical physical condition: the living have already died or will pass
away. This is the point where the rhetoric of extermination radically subverts one
of the major symbolic aspects of the human condition.
All cosmology asserts the existence of continuity between the dead and the living
through collective mourning and grieving. Funeral rites, ritual devotion, ancestor
cults, memories of the deceased in traditional societies always remind the living that
the dead were from the same world and are still there (Hertz 1970). Even Western
societies preserve this symbolic permanency through funerals, mourning, funeral
monuments, commemorations, and collective memory and even search for the body
parts. But both Western and non-Western societies also draw a clear frontier between
the dead and the living. They are not the same kind of beings, and this is a powerful
invariant all over the world, even if it takes various cultural expressions. The dead
and the living can live in the same world, share the same universe, belong to the same
system of values, even meet each other under certain circumstances, but nevertheless
they will never be identical. They will never share the same flesh, the same blood, or
even the same values. They will never belong to the same category of beings.
The assertion that the dead and the living do exist in the same universe objectively
signifies that in fact many differences exist between them. The dead are the closest
figure, although the most radical, of culturally constructed otherness.
In Cambodia, for example, the living and the dead share a common universe.
Everyday life is full of examples, stories, fears and sometimes jokes about different
kinds of spirits, Neak Ta, Khmoc, etc., that also populate the human world (Ang
1986; Forest 1992). They belong to the traditional animist Cambodian religion but
merge easily with Buddhism. Even if the encounter with one of those ‘spirits’
is a common experience (Ang 1980), or sometimes the expression of a traumatic
symptom (Eisenbruch 1991; Rechtman 1992), it is always a confrontation with
a figure of the otherness.
The rhetoric of extermination destroys this symbolic frontier and affirms that there
is no more a place for the dead in the ‘other’ world than a place for the living in the
actual world.
 Anthropology & Medicine 7

Both dead and living are identical and merely destined to disappear without
leaving any trace or memory.
Killing the dead could be the metaphor of extermination, as if it were possible to
destroy the symbolic existence of the deceased in order to deprive the living of their
humanity.
This paradox is often devastating for survivors. In the aftermath of extermination,
the social existence of the deceased depends on the survivors’ capacity to always carry
them with them in a shared destiny. Nevertheless, and at the same time, this
faithfulness maintains the terrifying assimilation between the dead and the living, as
if they were still sharing the same identity. It is in their accounts, in their testimonies,
but mostly in their own sufferings, in their agitated sleep, as in their psychological
symptoms that the Cambodian survivors see their dead and help them to stay alive,
at least in their consciousness. The psychiatric practice with Cambodian refugees
regularly shows this permanence of the dead in survivors’ daily lives (Tobin &
Friedman 1983; Boehnlein 1987a; Eisenbruch 1990; Rechtman 1992). Sometimes in
the persecuting presence of ghosts or corpses, sometimes in the painful memory of
those that disappeared, but always in an obsessive way combining both the fear of
seeing them return back each night, with the anguish that they could disappear
forever. Each survivor not only carries the marks of his own wounds but, moreover,
the wounds of those who are no longer there to testify. Even if this long and painful
mourning is also a way of not definitively giving up the dead, the price of this fidelity
is exorbitant, as no collective space is available to additionally gather together but in
a different way theses memories of the dead.
While the perpetrators reveal themselves as just ‘ordinary men’, they show the
articulation of the double logic of the extermination. On the one hand, a relentless
killing machine that tortures, destroys and eliminates men, thanks to the complicity
of low-level executioners. On the other side, a rhetoric of extermination based on
a ‘naturalization’ of the otherness, which claims to transform these men into
something other than men. But the terrifying success of the first one does not
prove that the second one also succeeded. As Robert Antelme pointed out in his
famous book on the Holocaust L’espèce humaine: ‘they can hurt, kill, destroy . . .
but they will never be able to transform a man in something other than a man’
(Antelme 1957).
The survivor’s paradox is undoubtedly one of the principle consequences of this
will to deprive prisoners of their human condition. It is different from the survivor’s
guilt, whereby the survivor is always asking him/herself why he/she is alive while the
other died.
The survivor’s paradox is a kind of interiorization of the perpetrator’s rhetoric.
If indeed the survivor leaves this world of death, that could mean abandoning the
dead without a symbolic place where they could exist. But if he/she keeps them only
in his/her own memory, that could signify that the survivor remains captive of the
perpetrator’s world of death. In both cases, the survivor’s attempt to escape this
paradox fails with the risk of confirming the abominable claim of their torturers.
During psychotherapy with Cambodian refugees, the survivor’s paradox arises at
very different times. It can be seen when refugees recall painful dreams or encounters
8 R. Rechtman
with khmoc,4 especially when the process of therapy suggests a symptomatic
improvement. While the patient is on the way to leave this world of death, something
stronger than his/her will seems to take him/her back to this land of horror. The main
difference with usual traumatic symptoms, like reexperiencing the traumatic event, is
that these painful encounters are not interpreted as the memory of a particular scene
or event, while some others are. Rather they describe these scenes as an attempt by
someone very close to them to take them to the world of death. The confusing feeling
of belonging to a world of death persists even after practicing ritual to honor
these dead.
One of my patients who lost all of his family and many friends during the Pol Pot
regime has very frequent nightmares. He was deported and worked in a paddy field.
Like many others he suffered humiliations, violence and starvation, and then he
managed to escape to Thailand just before the Vietnamese arrived. He survived
largely because he was able to hide his past as part of Lon Nol military forces. During
therapy he would differentiate between the dreams in which he reexperienced
witnessing murder, or the fear of being arrested and killed for his military
background, and the other dreams in which khmocs wanted to catch him. He never
expressed any guilt for surviving insofar as he never said that he was alive. He used to
say about this second kind of dream, in which the dead were sometimes weak,
that he knew he was much more one of them than one of the living. Even if it was
painful, he could not leave them and let them disappear forever. While the therapy
helped him to cope with the traumatic nightmares, it had no effect on his feeling of
belonging to a world of death. So I decided to interpret this resistance and told
him that
there is no need to let the Khmer Rouges win a second time; they wanted you dead or as
someone living as a dead man, but they failed. They did not have this power to
transform a human being that way.
The therapy is now engaged in a new path of trying to find a place to leave the
burden of the dead, but without forgetting them. For the first time in his life he
seems able to accept that his torturers were not as powerful as they pretended and
as he thought before. His life is now not so much devoted to the dead, as he wants
to testify that he is alive despite the will of the Khmers Rouges in order to
demonstrate that they failed at least in transforming men. The work of bereavement
can therefore begin.

Notes
[1] The abundance of this literature of the extermination makes impossible any exhaustive
citation (see, for example: Haing 1988; Altounian 1990; Simon-Barouh & Pho 1990; Semprun
1994; Hatzfeld 2001, 2003).
[2] While Hannah Arendt has used a similar expression to give a political meaning of the daily
mechanism of extermination without any attempt to reduce individuals’ implications (Arendt
1966), Lifton uses the expression ‘ordinary men’, in his famous book Home from the War, to
give a psychological explanation of the atrocities perpetrated by US armies in order to reduce
soldiers’ responsibilities (Lifton 1992).
 Anthropology & Medicine 9
[3] In France the CCVKR (Comité Cambodgien pour les Victimes des Khmers Rouges
[Cambodian Committee for Khmer Rouge Victims]), created in 1999 by several Cambodian
intellectuals resettled in France, is trying to recall all refugees’ testimonies and plays an active
role with other human rights groups to bring the Khmer Rouge before the International
Criminal Court. For example, the CCVKR has taken the initiative to commemorate in Paris
the 30th anniversary of the fall of Phnom Penh with the whole Cambodian community and
French official representation. The aim is clearly to pursue the Khmers Rouges in court
through the claim ‘the importance of a trial in honor of victims’. In the US, the Cambodian
Genocide Program plays a similar role (http://www.yale.edu/cgp/).
[4] In Cambodia, cremation allows the deceased to enter a new cycle of death/rebirth of
Buddhism, while those who suffer a violent death are refused these rites; their souls are thus
destined to roam about and haunt the living. Khmoc is the generic term designating those evil
spirits, but it also means dead body/corpse (Ang 1986). The encounter with a Khmoc is
therefore a quite common experience in rural Cambodia (Ang 1980) which can occur in
different contexts (Forest 1992). But the murder of hundreds of thousands of Cambodians
during the Pol Pot regime, and the witnessing of those scenes by the survivors, increased the
risk of a Khmoc encounter because of so many uncremated bodies. Even in a foreign country
the spirits of the deceased may come and haunt the living and this has many implications in
transcultural clinical practice.

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