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Blackburn 101: The Most Lethal Form of Domestic Violence

If we were to do a survey about the deadliest form of domestic violence, which option would you pick?

a) Punching/hitting

b) Gunshot

c) Strangling

d) Knife wound

The answer may surprise you: strangulation is the most lethal form of domestic violence. It is also one of the most common forms of physical abuse — 23 to 68% of female domestic violence victims experience at least one episode of strangulation in their lifetimes. It’s critical for us to know more about this form of domestic violence so that it can be properly recognized and addressed by medical professionals, attorneys, judges, advocates, friends and family. Here are some facts about strangulation:

1. What is strangulation? It is a form of asphyxia (lack of oxygen) through closure of the blood vessels or air passages of the neck from external pressure on the neck. It can be achieved manually, using hands, forearms, or even the abusers’ legs, or through ligature strangulation, where a cord or a rope-like object is used to put pressure on the neck.

2. Strangulation is one of the most terrorizing and lethal forms of violence used by abusers (typically male) against their intimate partners (typically female). This act symbolizes power and control over a victim. The sensation of suffocation is terrifying for the victim. A single traumatic instance of strangulation or even just the threat of it can instill such fear that the victim can be trapped in a pattern of control and become even more vulnerable to additional abuse.

3. Victims of just one episode of strangulation are seven times more likely to become a homicide victim at the hands of this same abuser. This is why experts consider strangulation to be “lethal force” and to be one of the best predictors of future homicide in domestic violence cases.

4. The neck is the most vulnerable part of the body. Blood and oxygen flow from the body to the brain through the neck. More serious injuries happen from neck trauma than from any other part of your body.

5. It does not take much pressure to strangle someone. In order to survive, the brain needs a continuous supply of oxygen; without it, brain cells quickly malfunction and die. Minimal pressure on the neck can prevent blood flow between the brain and the heart. Unconsciousness can occur within just 10 seconds, and brain death within 4 minutes. It takes only 4 pounds of pressure to block the jugular veins, 11 pounds of pressure to block the carotid arteries, and 33 pounds of pressure to block the trachea (air flow). This can be compared to the following types of pressure exerted in normal, everyday activities: 20 pounds of pressure to open a can of soda and 80 to 100 pounds of pressure in an average handshake.

6. Strangulation may leave little to no evidence on the skin. A study of 300 domestic violence cases involving strangulation revealed that up to 50% of victims had no visible injuries.

7. Even without visible injuries, strangulation can cause substantial (and sometimes delayed) injuries. This may include unconsciousness, fractured trachea/larynx, internal bleeding, artery damage, dizziness, nausea, sore throat, vocal changes, lung or throat injuries, neck swelling, breathing problems, ringing in the ears, vision changes, miscarriage, loss of memory, paralysis, and more. Beyond physical injuries, strangulation can cause psychological injuries such as post-traumatic stress disorder (PTSD), anxiety, depression, memory problems, amnesia, and nightmares. Delayed injuries are common, including the possibility of delayed death due to strangulation.

8. Signs and symptoms of strangulation include voice changes, scratches or fingernail marks, redness, swelling or abrasions on the neck, petechiae (tiny, ruptured capillaries that look like red spots) on the eyes, neck or face, breathing changes, and swallowing difficulties.

Because strangulation can leave no physical marks, it may be overlooked by medical personnel, law enforcement, lawyers and judges. If it is minimized or dismissed, victims of strangulation may be exposed to serious health issues, further violence and even death. It’s crucial that we recognize strangulation for what it truly is: an incredibly violent way to control and abuse an intimate partner, and one of the most common and lethal forms of domestic violence. Understanding this type of abuse and calling attention to how dangerous it is may help to save lives. Spread the word by sharing this blog post, or simply by telling others about what you have learned. If someone tells you that they have been strangled or choked, take them seriously — and make sure that they get medical attention, and are aware of the services offered by Blackburn Center and other organizations. You can also get involved in the broader fight to end domestic violence by volunteering for our organization, or donating to support our mission or our emergency shelter for victims of domestic violence. Together, we can make a difference!

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