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Strangulation in Domestic Violence:
A Huge Red Flag

"I would always remember soreness and bruises on my neck. My neck would be sore for at least four or five days." (Survivor)
In domestic violence, any reported history of strangulation places the victim at a higher risk for more serious violence or homicide by their intimate partner. This type of assault can have serious, permanent, or even fatal damages to the victim’s throat or brain. One in four women will experience intimate partner violence (IPV) in their lifetime, and of those, up to sixty-eight percent experience near-fatal strangulation by their partner. The perpetrator uses strangulation as a form of power and control over their partner by controlling their breathing. One abuser made his wife believe the strangulation was her fault. “He immediately started telling me, ‘I was trying to calm you down.’ That’s why he was holding me down to the bed by my neck.” He said, “I was trying to get you to settle down because you were just so crazy, I just had to restrain you.”  Victim, “I kind of believed him in that moment.”
 
Strangulation should not be confused with choking. Choking refers to a blockage inside the throat (like a piece of food) making it hard to breath. Strangulation refers to pressure applied from the outside, cutting off airflow and/or blood vessels in the neck, preventing oxygen from reaching the brain. This can result in a loss of consciousness within five to ten seconds or death within a few minutes.   

A victim will often leave injuries to their neck while trying to regain control of their airway and many times leave the assailant with scratch marks on their face and hands. A victim may be kicked, hit or pushed down the stairs after the strangulation.   

Signs of strangulation are not always visible. Only half of strangulation victims had marks on their necks, and only fifteen percent of marks were visible. In most cases, bruises may not appear until one to three days after the event and are often cited by law enforcement as “no visible injuries” immediately after the incident.
 
Strangulation is recognized now as one of the most lethal forms of violence. There is a thin line between unconsciousness and death. Strangulation sits just before homicide on the continuum of domestic violence risk assessment.   

Unfortunately, the majority of victims show signs of traumatic brain injury (TBI), but never receive a formal diagnosis in part because they rarely have visible injuries. Thus, emergency rooms don’t generally screen them for a TBI. Victims are labeled “difficult.” Law enforcement may dismiss them as being drunk or having a mental illness. Rather, TBI is causing some of these behaviors and symptoms.   

“Jane” complained of a sore throat and had a husky, hoarse voice.  Victims may experience trouble swallowing, hyperventilation, shortness of breath, or an asthma flare-up. Headache, dizziness, blurred or decreased vision or memory losses are symptoms. Behavioral signs may be present following strangulation. Victims may report anxiety or appear restless. They may exhibit a decreased ability to concentrate or focus. Other signs are depression, insomnia, or anxiety weeks, months or years later. Some victims may develop PTSD, thoughts of suicide, memory problems, neurological injury and even delayed fatality. They may have changes in vision, swelling of the tongue or bloodshot eyes. Tiny red spots (petechiae) caused by ruptured capillaries may appear on the eyelids and under the eyes, on the face and the neck in and above the area of constriction.   

A study published in the Journal of Emergency Medicine found that women who survive strangulation by a partner are seven times more likely to be the victim of an attempted homicide and eight times more likely to be a victim of homicide. 

"Most abusers do not strangle to kill. They strangle to show they can kill. When a victim is strangled, she is on the edge of homicide." (ABA's Criminal Justice)

Contact the Victim Advocate at (318)992-2067/cwilson@lasalleso.com) for assistance if you are a victim of domestic violence. If you are in immediate danger, dial 911. 
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