Strangulation in Domestic Violence A Dangerous Path to Homicide
Written by: Tanya Lamb
Strangulation is one of the most dangerous and lethal forms of domestic violence.Unlike other types of physical abuse, strangulation is a direct attack on a victim’s ability to breathe and consume oxygen, the very thing that gives us life. Besides being utterly terrifying, even a brief episode can have severe, long-term consequences. What many people may not know is that attempts at strangulation are horrendous acts of controland dominance and are often a predictor of violence. This violence often increases and leads to death. Understanding the risks, warning signs, and legal implications of strangulation may and save lives.
What is Strangulation and How is it Defined?
Strangulation is defined as the external compression of the neck that restricts airflow and/or blood flow to and from the brain. It is different than choking, which is an internal blockage of the airway, such as food or another object preventing someone from breathing. A person can be strangled by hands, arms, ropes, scarves, cords or other objects. Another fact that is not well known is that attempts at strangulation are frequently used by abusers to intimidate and maintain control over their victims.
Strangulation, When not Fatal, Can Still Have Long-Term Consequences
Even if a strangulation incident lasts only a few seconds, the consequences can be devastating. Lack of oxygen to the brain can result in being unconscious in 10 seconds and dead within minutes. Victims may also suffer serious injuries that are not immediately visible, such as brain damage, stroke, or internal bleeding. Studies show that up to 50% of strangulation victims have no visible injuries, making it difficult to assess the severity of the attack without medical evaluation. Most people that experience non-fatal strangulation may have no idea they have been seriously harmed.
Strangulation IS a Predictor of Homicide
One of the most alarming aspects of strangulation in domestic violence is its strong correlation with homicide. Research conducted by the Training Institute on Strangulation Prevention found that victims of non-fatal strangulation are 750% more likely to be killed by their abuser in the future.
This makes strangulation one of the strongest predictors of intimate partner homicide.
A study published in the Journal of Emergency Medicine found that 68% of domestic violence homicide victims had been previously strangled by their partner before their death. Strangulation should never be dismissed as a minor form of violence—it is a clear warning sign that an abuser is willing to do something that will cause death to another person.
Hidden Health Consequences
As mentioned previously, because strangulation often leaves little to no external marks, victims may underestimate the severity of their injuries. However, internal injuries can be life-threatening or lead to long-term health complications. Some of the medical consequences of strangulation include:
Brain damage: Even a short loss of oxygen can cause brain damage, leading to memory loss, confusion, difficulty concentrating, and permanent cognitive impairment.
Stroke: Compression of the carotid arteries can lead to a stroke, either immediately or weeks later.
Vocal cord damage: Victims may experience voice changes, hoarseness, or an inability to speak.
Swelling and breathing difficulties: The throat may swell hours or days after the incident, leading to airway obstruction and death.
Psychological trauma: Strangulation victims often suffer from post traumatic stress disorder (PTSD), anxiety, depression, and suicidal thoughts.
Strangulation in Coercive Control
Strangulation is not just about physical harm; it is a also a method of psychologicalterror. Most of us can think of scenes in movies where a perpetrator has control of aperson by strangulation and can remember the fear and terror in the victim’s eyes.
Abusers often use strangulation as a means of asserting dominance, showing victimsthat they have complete control over their life and death. Many survivors describe theexperience as feeling like they were about to die—a terrible trauma that stays with thema long time.
Not only is there physical harm, but the psychological effects of strangulation are alsolong-lasting. Many victims report ongoing fear, hypervigilance, nightmares, and panicattacks. The act of strangulation sends a powerful message: “Your life is not yours, it is mine, and I can kill you whenever I want.” This coercive control and “ownership” that an abuser asserts over his victim makes it even harder for victims to leave the abusive relationship.
Recognizing the Signs of Strangulation
Because strangulation injuries may not be immediately visible, it is essential to recognize the signs and symptoms, which include:
Difficulty breathing or shortness of breath
Hoarseness or loss of voice
Difficulty swallowing or a sore throat
Redness or bruising around the neck (may appear hours or days later)
Petechiae (tiny red spots) on the face, eyes, or neck caused by blood vessel rupture
Headaches, dizziness, or confusion
Memory problems or loss of consciousness
Swelling of the face or tongue
Nausea or vomiting
Legal and Law Enforcement Response
In recent years, the legal system has made necessary strides and now takes strangulation more seriously. Many states in the U.S. have made non-fatal strangulation a felony offense, recognizing it as an indicator of potential future homicide. Prosecutors no longer need to rely on visible injuries to press charges—testimony from victims, medical evidence, and expert witnesses can help establish the seriousness of the crime. This is a huge victory for victims.
Police officers and first responders are being trained to recognize strangulation injuries and encourage victims to seek medical attention. Medical professionals now use forensic exams to document internal injuries, even when external marks are absent. Strangulation should never be treated as a simple assault—it is an attempted murder in many cases.
Seeking Help and Safety Planning
If you or someone you know has experienced strangulation in a domestic violence situation, it is critical to seek help immediately. Victims should:
Seek medical attention: Even if there are no visible injuries, internal damage can be fatal hours or days later.
Contact a domestic violence hotline: Organizations like the National Domestic Violence Hotline (1-800-799-SAFE) offer confidential support and safety planning.
Report to law enforcement: Strangulation is a serious crime. Documenting incidents and seeking legal protection can be vital in preventing future violence.
Create a safety plan: Leaving an abusive relationship can be dangerous, but working with a domestic violence advocate can help victims develop a secure exit strategy.
Strangulation in domestic violence is a deadly warning sign that should never be ignored. It is not just an act of violence—it is an attempt to control, terrorize, and potentially kill. The severe health risks, strong link to homicide, and devastating psychological impact make strangulation one of the most critical red flags in abusive relationships. By raising awareness, improving legal protections, and ensuring victims receive the help they need, we can take crucial steps toward preventing further harm and saving lives. Please remember that victims need support to leave an abusive situation, not criticism.
If you know someone who is experiencing domestic abuse, they can contact the National Domestic Violence Hotline at 1-800-799-SAFE