Why Strangulation Should be Taken So Seriously

News broke this week that the men’s basketball head coach for the Texas Longhorns was arrested and suspended for allegedly strangling his fiancé.

The story brings attention to strangulation, a form of intimate partner violence (IPV) that can be lethal and should be taken very seriously. Here's why.

What is strangulation?

In IPV, strangulation occurs when a person restricts the flow of air to the lungs or blood to the brain by compressing their partner’s neck or upper torso. Sometimes referred to as “choking,” this is a misnomer. Choking happens when an object gets lodged in the airway, such as a piece of food. Strangulation is carried out when one person applies physical force to their partner’s body.

Strangulation is an extreme form of coercion and control through which the abusive person shows that they have the power to determine if their intimate partner will live or die. Strangulation often occurs in the context of ongoing abuse and amidst verbal threats to kill the victim. Many survivors report being strangled more than once, sometimes multiple times during the same assault.

Since the 1990s, research has documented that strangulation is common in IPV – and dangerous. For example, a review of more than 1500 domestic violence and sexual assault records from a forensic medical examiner program found that a nearly a quarter (23 percent) of cases involved strangulation. Most of the strangulation incidents had significant risk of lethality.

Why is strangulation so dangerous?

Strangulation can lead to death and serious physical injuries, even when there are few visible external signs. That’s because strangulation can cause internal damage, such as to arteries and veins, the neck and throat, and the brain.

When strangulation cuts off the flow of oxygen to the brain, normal brain function can be disrupted leading to brain injuries that vary from mild to severe. In recent years, research teams around the country have documented that brain injuries, including those caused by strangulation, are common after intimate violence and linked with a host of physical, cognitive, and emotional difficulties. Some victims may not remember being strangled due to the damage to the brain.

Other physical symptoms can also occur after strangulation, from difficulty swallowing and sore throat to voice changes. The impacts go beyond physical injuries, though. Strangulation predicts significant psychological distress in survivors, including posttraumatic stress disorder (PTSD), depression, and dissociation symptoms as well as suicidality.

Strangulation is also very dangerous because it predicts future intimate partner femicide – that is, the murder of women by their intimate partners.

Actions to Take

Recognizing the dangers of strangulation, we can each take action – whether we are professionals, listeners, and/or in abusive relationships.

For professionals, research suggests that people being victimized by their intimate partners may not disclose strangulation unless asked. This means that healthcare and other service providers have an important role to play in explicitly asking about strangulation as part of regular screening for intimate partner abuse. Brief tools are available to screen for intimate partner violence, including strangulation, such as the Danger Assessment.

As listeners, we should each be prepared to share information about resources when friends, family, co-workers, or others disclose intimate partner abuse. Indeed, my team’s research suggests that being ready to offer information and practical help is especially important in responding to disclosures. This makes sense because it can be very difficult to find and access resources after intimate violence, as research by Leila Wood has shown. As Wood, an intimate partner violence expert, described to me:

Domestic Violence Essential Reads

Denial for the Perpetrator and Survivor of Intimate Partner Abuse

Brain Injuries and Domestic Violence

While some survivors may be aware of IPV services, many report not knowing how or when to access these supports. Information and support making initial contact with IPV services from friends and family can help survivors get the support they need.

To prepare, then, each of us can take a few minutes to learn about resources in our communities for survivors – from emergency shelters and advocacy services to forensic medical exams. For example, forensic medical exams offer a way to get necessary medical care after intimate violence while also gathering evidence, such as photographs of injuries. Forensic evidence can be important to law enforcement responses or when survivors want to seek protection orders.

However, not every community has forensic medical exams available. This means it is especially important for each of us to find out what is available in our community – and take action to advocate for resources when we discover gaps, which are all too common. “Across the country, there is demand for intimate partner services that far exceed our capacity. We need to advocate for increased capacity if we want to prevent strangulation and other lethal forms of IPV,” according to Wood.

For people in abusive relationships, it can be helpful to talk with an advocate about resources and safety planning. Wood emphasized this too, noting that “IPV services, like hotline and advocacy, are free and accessible ways for survivors to learn their rights, discuss their goals and concerns, and address health and safety needs.”

In addition to reaching out to agencies in your community, advocates are available through the National Domestic Violence Hotline by calling 1-800-799-7233 or TTY 1-800-787-3224, chatting here, or texting “START” to 88788.

Wood added that hotline services are also available for friends, family, and community members.

Many of the people who contact IPV hotlines are people supporting survivors who need information and guidance to help a person experiencing violence. We don’t all need to be experts in IPV if we have strong community resources that can offer help and support.

Indeed, there's a role for each of us to play in preventing and responding to intimate violence. Learn more about the role you can play in Every 90 Seconds: Our Common Cause Ending Violence Against Women and future posts here.

To find a therapist near you, visit the Psychology Today Therapy Directory.