"Colin Rutherford will forever be separate from everyone else," says journalist Jere Van Dyk.
"He feels completely isolated. He knows all that he has gone through; no one on the outside can begin to comprehend it."
Van Dyk has not met the Canadian hostage, a Toronto man who was recently freed after five years in Taliban custody. But if anyone can come close to comprehending what Rutherford has gone through, it's him.
Eight years ago, he was also the Taliban's captive. Although he was held for a comparatively short 45 days, the experience affected him deeply.
'Gratitude and giddiness'
The first thing Van Dyk remembers about being set free is feeling "enormous gratitude and giddiness."
"Everything's swirling around you, all of the people. All of a sudden you've gone from solitude and fear to having people swarming all around you."
But amidst all the positive emotions, Van Dyk also experienced an undercurrent of guilt. He wondered if he deserved rescue after the trouble he felt he'd caused by getting captured in the first place.
'Readjustment is very difficult'
Guilt is just one of many adverse psychological effects often experienced by hostage-situation survivors, says Scotland-based psychologist David Alexander, who has extensive experience working with hostages.
A former hostage may also feel suspicious, paranoid, and vulnerable, says Alexander. "Readjustment is very difficult. It can be successful, but we shouldn't underestimate how hard it is."
Katherine Porterfield, a clinical psychologist at New York's Belleville/NYU Program for Survivors of Torture who has spent years working with survivors of captivity, agrees that freed hostages often show signs of psychological harm.
"They can experience what we call avoidance and numbing, which are reactions where they find themselves almost shutting down their emotional and psychological responses," she says.
"The avoidance can take the form of the person really consciously not wanting to revisit any of the memories if possible," says Porterfield. However, she adds that this can also be an unconscious process. The person might literally not be able to recall the traumatic events.
Another common syndrome among survivors is post-traumatic stress disorder. Porterfield says patients often experience this as lingering fear and terror.
Though he doesn't like the term PTSD, Van Dyk says he remembers being fearful that the Taliban would find him again. Upon arriving safely back in New York, he says, "I went for a run in Central Park, and I would look all around me for them. … You're so happy, but at the same time you're so afraid that they're there."
How deeply a person is affected by being held hostage is largely dependent on how they were treated, the experts agree.
"Women seem to be more vulnerable," says Alexander, "maybe because the sort of threats that a man can impose against a woman are even more horrible than those he can impose against a man."
Porterfield says the more a person is abused, isolated, or kept from meeting their basic human needs, the more likely it is that they'll face severe post-traumatic issues.
An expert on the Taliban even before being held by them, Van Dyk says it's unlikely Rutherford was physically mistreated.
"Tribal code requires that they feed people, that they treat them with a certain amount of respect."
The Taliban also wants to prove to an international audience that they treat people better than the U.S. treats Guantanamo Bay prisoners, Van Dyk adds. "They want to show the world that they are better, that Islam is better."
But even if Rutherford escaped physical harm, that doesn't mean he's necessarily unscathed. "Mental torture is worse than physical torture," says Van Dyk.
"He very possibly could have been alone in a room, a young man under tremendous pressure, possibly, to convert…Even if they didn't harm him [physically], what did he go through for five years?"
Psychological trauma might not result in physical scars, but that doesn't mean healing from it is purely an internal exercise.
Porterfield says the most important part of reintegration is external factors, like the level of medical and psychiatric care the person is receiving and the person's social supports.
"The person coming back would need that network around him or her of loving people who are there to take him or her back in and be with them as they recover."
Alexander says coming home after being away for so long can be difficult for former hostages, even if they're returning to a loving environment, simply because so much time has gone by.
"If you've been gone for several years, it's weird because people have moved on, children have grown up," he says. The freed hostage and their family can struggle to regain normal dynamics.
Van Dyk says dealing with other people can be tough at first. "Some people will be, of course, extremely welcoming, but others will question you immediately, and your barriers go up and you realize how separate you are."
One of his most painful moments was the first time someone brought up the term Stockholm Syndrome, which refers to hostages expressing sympathy toward their captors.
He was asked whose side he was on, why he was in Taliban territory in the first place. He says Rutherford will have to deal with everyone looking at him and wondering how he has changed.
'Part of your life story'
Some well-intentioned people might try to push the survivor to move past their trauma, but this can actually harm their healing.
"I always say … this is part of your life story," says Porterfield. "No one should expect that you will move past it or forget it or let it go."
Still, Porterfield believes that, with proper support, traumatized people can eventually return to a sense of normalcy.
"People can have tremendous resilience after trauma, even severe extended trauma," she says.
Van Dyk is less optimistic.
"There's that Nietzsche saying: what doesn't kill you makes you stronger," says Van Dyk. "I don't believe that."