As the session begins, the detainee stands naked, except for a hood covering his head. Guards shackle his arms and legs, then slip a small collar around his neck. The collar will be used later; according to CIA guidelines for interrogations, it will serve as a handle for slamming the detainee's head against a wall.
After removing the hood, the interrogator opens with a slap across the face -- to get the detainee's attention -- followed by other slaps, the guidelines state. Next comes the head-slamming, or "walling," which can be tried once "to make a point," or repeated again and again.
"Twenty or thirty times consecutively" is permissible, the guidelines say, "if the interrogator requires a more significant response to a question." And if that fails, there are far harsher techniques to be tried.
Five years after the CIA's secret detention program came to light, much is known about the spy agency's decision to use harsh techniques, including waterboarding, to pry information from alleged al-Qaeda leaders. Now, with the release late Monday of guidelines for interrogating high-value detainees, the agency has provided -- in its own words -- the first detailed description of the step-by-step procedures used to systematically crush a detainee's will to resist by eliciting stress, exhaustion and fear.
The guidelines, along with thousands of pages from other newly released documents, also show how the CIA gradually imposed limits on the program and eliminated some of the most controversial practices after the agency's medical advisers protested.
Still, by Dec. 30, 2004, the date of the CIA memo that outlines the guidelines to the Justice Department's Office of Legal Counsel, agency interrogators had grown adept at using sleep deprivation, stress positions and sometimes multiple methods to create a "state of learned helplessness and dependence."
"Certain interrogation techniques place the detainee in more physical and psychological stress and, therefore, are considered more effective tools," according to the memo, released under a Freedom of Information Act lawsuit filed by Amnesty International USA and the American Civil Liberties Union.
The CIA on Tuesday declined to comment on the memo, which was written by an agency lawyer whose name was redacted from the document. But agency spokesman George Little noted that the interrogation program operated under guidelines approved by top legal officials of the Bush administration's Justice Department.
"This program, which always constituted a fraction of the CIA's counterterrorism efforts, is over," Little said. "The agency is, as always, focused on protecting the nation today and into the future."
CIA officials also have noted that harsh techniques were reserved for a small group of top-level terrorism suspects believed to be knowledgeable about the Sept. 11, 2001, attacks. Agency officials believe the methods prevented future attacks.
As outlined in the memo, the agency's psychological assault on a detainee would begin immediately after his arrest. With blindfolds and earmuffs, he would be "deprived of sight and sound" during the flight to the CIA's secret prison. He would have no human interaction, except during a medical checkup.
In the initial days of detention, an assessment interview would determine whether the captive would cooperate willingly by providing "information on actionable threats." If no such leads were volunteered, a coercive phase would begin.
The detainee would be ushered into a world of constant bright light and high-volume "white noise" at levels up to 79 decibels, about the same volume as a passing freight train. He would be shorn, shaved, stripped of his clothes, fed a mostly liquid diet and forced to stay awake for up to 180 hours.
"Establishing this baseline state is important to demonstrate to the [detainee] that he has no control," the memo states.
Interrogations at CIA prisons occurred in special cells outfitted on one side with a plywood wall, to prevent severe head injuries. According to the agency's interrogation plan, the nude, hooded detainee would be placed against the wall and shackled. Then the questioning would begin.
"The interrogators remove the [detainee's] hood and explain the situation to him, tell him that the interrogators will do what it takes to get important information," the document states.
If there was no response, the interrogator would use an "insult slap" to immediately "correct the detainee or provide a consequence to a detainee's response." If there was still no response, the interrogator could use an "abdominal slap" or grab the captive by his face, the memo states.
Each failure would be met with increasingly harsher tactics. After slamming a detainee's head against the plywood barrier multiple times, the interrogator could douse him with water; deprive him of toilet facilities and force him to wear a soiled diaper; or make him stand or kneel for long periods while shackled in a painful position. The captive could also be forced into a wooden box for up to 18 hours at a stretch.
Such techniques raised concerns among some agency officials, particularly members of a medical advisory group known as the Office of Medical Services (OMS). When the interrogation program began, the group "was neither consulted nor involved in the initial analysis of the risk and benefits" of enhanced interrogation techniques, according to a 2004 report by the CIA's inspector general.
According to the report, the OMS did not issue formal medical guidelines until April 2003, after the waterboarding of Khalid Sheik Mohammed, the self-proclaimed mastermind of the Sept. 11 attacks.
Over time, however, as the interrogation program was refined and strict guidelines were imposed on the use of certain techniques, the OMS began to play an increasingly pivotal role.
A 2005 Justice Department memo repeatedly referred to December 2004 OMS guidelines in assessing the application of coercive techniques, noting that the "OMS has, in fact, prohibited the use of certain techniques in the interrogation of certain detainees."
The medical office appears to have been deeply skeptical of the use of waterboarding, a simulated-drowning technique that was suspended by 2004. OMS personnel told the inspector general that "the reported sophistication" of the preliminary review of waterboarding was "exaggerated," and it said the power of the technique was "appreciably overstated."
The OMS also raised serious concerns about the medical dangers of waterboarding.
"Most seriously, for reasons of physical fatigue or psychological resignation, the subject may simply give up, allowing excessive filling of the airways and loss of consciousness," the OMS warned, according to the 2005 Justice Department memo.
Modifying the program
Such warnings, combined with congressional concerns about the CIA's secret prisons, gradually led the agency to modify the program. The menu of enhanced interrogation techniques was reduced from about a dozen to six, according to a Justice Department memo. Gone were nudity, walling, water-dousing, stress positions, cramped confinement in boxes and waterboarding. The proposed six techniques to be kept were dietary manipulation, sleep deprivation for up to 180 hours, the facial hold, the attention grasp, the abdominal slap and the insult slap.
The CIA said those techniques were "the minimum necessary to maintain an effective program."
By the summer of 2006, the number of detainees in CIA prisons had dropped below 20, including 14 high-value detainees who were transferred to the secret Camp 7 at Guantanamo Bay, Cuba. Still, as late as 2006, many of the basic conditions remained, according to a Justice Department memo dated Aug. 31, 2006.
The facilities were constantly illuminated, and the agency used closed-circuit surveillance to monitor the prisoners at all times, suggesting that hidden cameras were placed inside cells.
"The detainee is isolated from most human contact, confined to his cell for much of each day, under constant surveillance, and is never permitted a moment to rest in the darkness and privacy that most people seek during sleep," the memo said.
But, to combat mental problems, each detainee was given quarterly psychological examinations "to assess how well he is adapting to his confinement," the memo said. Detainees also had regular access to gym equipment and physical exercise.
"The CIA also counteracts the psychological effects of isolation by providing detainees with a wide variety of books, puzzles, paper and 'safe' writing utensils, chess and checker sets, a personal journal, and access to DVD and VCR videotapes," the document said.
Detainees were even allowed to grow back their hair and beards, which were shaved when they arrived.
"The CIA provides detainees with the option of shaving other parts of their bodies in recognition of specific Islamic practices," according to the 2006 memo.