Strangulation refers to constraining an individual from the act of breathing, also causing a lack of circulation of blood by external pressure to the neck. Various tactics of strangulation and suffocation are often present in cases of domestic violence. Strangulation is an ultimate form of power and control where an abuser can demonstrate control over the victim. It is vital to acknowledge that strangulation has devastating psychological effects, and sometimes a fatal outcome.    Difference from suffocation  Suffocation relates to depriving an individual of air impeding their normal breathing process.    

Warning Signs  

  • Bruising on the neck or ears   
  • Ear ringing  
  • Neck pain   
  • Difficulty swallowing  
  • Hoarseness   
  • Tongue discoloration   
  • Swollen tongue and lips    
  • Drooling  
  • Bloodshot eyes  
  • Nausea and/or vomiting  
  • Difficulty breathing   
  • Seizure  
  • Loss of consciousness   
  • Memory loss   
  • Incontinence   
  • Changes in mood or personality   
  • Changes in sleep patterns   
  • Changes in vision

The Dangers of Strangulation  

  • One of the most dangerous and lethal forms of abuse.   
  • Strangulation is a significant predictor of future lethal violence.   
  • Strangulation can cause traumatic brain injuries, often affecting long-term memory.   
  • When a victim has been strangled by a partner in the past, the risk of getting killed by them is 10 times higher.   
  • Unconsciousness may occur within seconds and death within minutes.   
  • Often no outward symptoms are shown from strangulation, but effects can manifest later due to the lack of oxygen and internal injuries.   

Psychological & Neurological Consequences  

  • PTSD, depression, suicidal ideation, issues with memory, anxiety, severe stress, and possible psychosis.  
  •  Neurological injuries and traumatic brain injuries.    


  • Death is not always immediate and can occur days or even weeks after the assault. This is due to the brain damage that often causes respiratory.   
  • Even in fatal cases, there are often no signs of external injury.    

How to Support? 

  • Help them obtain medical attention  
  • Believe them and let them know you believe them   
  • Validate their feelings and offer emotional support   
  • Avoid judgment    
  • Don’t make decisions for them    
  • Educate yourself to better support them   
  • Check-in periodically    
  • Help them understand their options    
  • Connect them to resources that can provide adequate services    
  • Do not share their experience with anyone else  
  • Explore with them the lethality of the assault/abuse   
  • Help them document the abuse 

What reporting option does a survivor have?  

  1. Report to police  
  2. Report to medical providers without a police investigation – medical reporting 
  3. Report to medical providers but remain anonymous to the police – anonymous reporting 


  • Of victims at high risk, between 68-80% will experience near-fatal strangulation by their partner.  
  • Up to 92% are estimated to have suffered some type of traumatic brain injury. 
  • Odds for homicide increased by 750% for victims who have been previously strangled compared to victims who have never been strangled.  
  • Strangulation survivors have the lowest hope scores of all victims of domestic violence.  
  • Strangulation represented a 31% increase in suicidal ideation.  
  • From 2010 to 2020, strangulation was consistently the second most frequent cause of homicide for women killed by men.  
  • The majority of officers killed in the line of duty are killed by an abuser who has strangled their partner. 

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