Physical and mental health effects of coercion: An application of Biderman's framework to human trafficking

This study examines the coercive conditions of human trafficking that contribute to physical and mental health problems for survivors. In-depth, semi-structured, qualitative interviews were conducted with survivors of labor and sex trafficking (n=12) in Los Angeles. Participants, a diverse group of women trafficked into Los Angeles from 10 different countries, were asked about health problems they experienced during and since their trafficking experience, and their perceptions of the origins of these problems. Themes were analyzed in the context of Biderman's framework of coercion, a model previously used to describe the compliance of prisoners and torture victims. Participants were subjected to a range of exploitative tactics described in Biderman's framework including: social isolation; monopolization of perception; restricted movement and exposure to the outside world; induced debility and exhaustion; humiliation; threats to self and family; demonstration of omnipotence; and enforcement of trivial demands. All participants reported experiencing some combination of verbal, emotional, physical, or sexual abuse and humiliation. Even those who were not subjected to physical abuse suffered deeply from their trafficker's coercion and manipulation. More than 90% described the role that fear played in keeping them psychologically “trapped” even when physical restrictions were reduced or eliminated. Our study demonstrates how coercion perpetuates the submission of human trafficking victims to their traffickers, negatively impacting their health and well-being. Consistent with previous studies, our findings suggest that coercion contributes to severe and enduring health problems for trafficking survivors, long after the experience of trafficking has ended.