If a woman’s partner has ever strangled her, even once, her risk of being murdered by that same partner with a gun shoots up 750% compared to a woman who has never been strangled.

When it comes to abuse – be it physical, mental, financial, or psychological, it’s all horrible, unjustified, and should never be tolerated. However, not all abuse, not even all physical abuse, is made equal.

Unlike all other forms of physical abuse like hitting, punching, kicking, shoving, throwing objects, etc., strangulation is the single greatest predictor of homicide in abusive relationships.

Strangulation As a Unique Predictor of Homicide

A partner who strangles you is likely to kill you, and soon. That 750% increase isn’t just an increased risk of death in your lifetime, it’s a 750% increase they will kill you within the next year. If a victim has sustained multiple stranglings, the risk exponentially rises. Here are some more startling statistics.

45% of attempted homicides in domestic violence situations against women involved nonfatal strangulation. 70% of women who have been strangled believed they were going to die, and 38% reported losing consciousness. The research is detailed on this – strangulation is a unique behavior that indicates escalating violence.

The personality profile of a strangler is one of rage and homicidal violence. Casey Gwinn, the co-founder of the Training Institute on Strangulation Prevention, says, “research has now made clear that when a man puts his hands around a woman’s neck, he has just raised his hand and said, ‘I’M A KILLER.’ They are more likely to kill police officers, to kill children, and later kill their partners. So, when you hear, ‘He choked me,’ now we know YOU ARE AT THE EDGE OF A HOMICIDE.”

Power Dynamics in Strangulation

Men who strangle their partners are more likely to take their rage and propensity for violence out on others around them, be it children, pets, or even people outside of the home. Former prosecutor Gael Strack and her research team found that in a review of 300 strangulation cases, children were present while the victim was being strangled in four out of every 10 cases.

Edna Sprague, litigation director at New Mexico Legal Aid and who specializes in domestic violence, sexual assault, and stalking, says that studies identify a link between strangulation and homicide, and this isn’t exclusive to their partners. Sprague says up to 82% of offenders who kill law enforcement have a strangulation history.

As former police officer Joe Bianco puts it, “more than two decades of research have revealed that strangulation is the calling card of a manipulative, controlling, dangerous man.”

This is because strangulation indicates a particular dynamic – coercive control. When a victim’s throat lays in the hands of their abuser, a message is sent – one that says, “I can kill you at any time.”

This, understandably, instills fear in the victim and keeps them stuck in a cycle of abuse in which the implied threat of death keeps the victim vulnerable and submissive. In a University of Pennsylvania study, women who were strangled reported three perceived motivations for strangulation.

The first was that it was a way for their partner to exert power and control over them because you are unable to fight back. The second was that it serves as a warning to exert control beyond the assault, discouraging the victim from disobeying them. Third, strangulation leaves behind little evidence.

Strangulation is a brutal and incredibly forceful act. Strangulation, as defined by The Training Institute on Strangulation Prevention, is “the obstruction of blood vessels and/or airflow in the neck resulting in asphyxia.”

What it is not is choking, though many victims may misrepresent the incident as such either because they want to protect their partners or because they have suffered from memory loss due to the strangulation incident and don’t understand the seriousness of the situation. Make no mistake, strangulation and choking are not the same things.

Choking is when an object creates a blockage in the throat, making it difficult to breathe. Strangulation is when external pressure is put on the neck or chest, cutting off airflow and blood vessels in the neck.

This prevents oxygen from reaching the brain, making it incredibly dangerous. In just 5 to 10 seconds, the victim can lose consciousness. In just 15 seconds, the victim can lose control of their bladder. Within 30 seconds, the victim can lose control of their bowels. Tragically, in just 1 to 3 minutes, strangling can result in a loss of life.

The evidence left behind in a strangulation case is hit-and-miss. Only half of all strangulation cases leave a mark, and of those, only 15% can be photographed. This, coupled with the fact that many strangulation victims will downplay the situation by avoiding saying they were strangled and instead say words like “choked,” these red flags can go undetected by police and medical professionals.

Recognize the Warning Signs

There are three different types of strangulation – manual, ligature, and hanging. Manual strangulation is done with a person’s hands. Ligature is the use of materials such as a rope to strangle someone. Hanging is when the victim is suspended with a ligature around their neck. 97% of strangling victims are manually strangled.

Strangulation can cause lasting physical and psychological effects. It’s important to know what warning signs to look for, as strangulation victims can die days or weeks after the strangulation incident from blood clots, carotid artery dissection, or respiratory complications.

Besides the lasting physical damage, victims of strangulation can also develop PTSD, memory loss, anxiety, and suicidal ideation. Memory loss is a particular concern because some strangulation victims may not be able to remember that they were strangled.

The key warning signs of strangulation include hyperventilation or difficulty breathing and bruises or scratch marks around the neck and underneath the chin. The victim may have bloodshot eyes, a raspy voice, difficulty swallowing, and swelling of the lips and tongue.

Many victims lose control over their bowels if they are strangled for a certain amount of time, so urination and defecation are telltale signs. Medical professionals should look for fingernail impressions, neck pain, coughing, tenderness beneath the chin, bite marks on the inside of the mouth, and redness in the face and/or neck.

It’s crucial for victims to seek medical treatment after being strangled. Victims should be assessed for neck and spine injuries and head trauma. Police surgeon Willliam Smock, M.D., says it’s essential to order a computed tomographic angiogram (CTA) to scan the soft tissues and vascular structures of the neck. The Training Institute on Strangulation Prevention in the USA recommends imaging up to 6 months post a strangulation incident.

Strangulation is an inherently dangerous activity that doesn’t take much strength or force to restrict the airways or even kill the victim. Women are particularly at higher risk of strangulation because of the higher reported rates of IPV among women. 1 in every four women faces interpersonal violence from a partner in their lifetime.

Men may underreport domestic violence because of the stigma against being a male abuse victim. However, because of the biological differences between men and women, women are at a disproportionately higher risk of being strangled by male partners.

While the research on same-sex abusive relationships and strangulation is not as clear-cut as the research on heterosexual relationships, this study showed that injury was reported more frequently in same-sex relationships. Strangulation should be treated with the same seriousness, whether it occurs in heterosexual or same-sex relationships.

How to Get Help

If your partner has ever strangled you or abused you in any way, you need to make a safety plan immediately. This is a personalized and practical plan that will keep you safe and prepare you to leave the abusive situation, even if you aren’t ready yet.

You can call the National Domestic Violence Hotline at 1�’800�’799�’SAFE(7233) 24 hours a day for support or access to important information like safety planning and being connected to local shelters. This line is for both men and women in abusive relationships.

This hotline will connect you to local domestic violence shelters free of charge, and many will help women pay for rides to the shelter if they don’t have the means to afford it. It’s important to understand that you are at high risk when leaving an abusive relationship which is why a safety plan is important to have in place.

If you have children, you will want to teach them how to call the police in an emergency and that they should flee the situation if things ever turn violent. Contact friends and family to let them know what’s going on.

A safety plan will ensure you have things ready if you need to leave in the middle of the night, like having a packed bag full of clothes, access to money, an escape plan, and a safe place to go. You can use the Domestic Violence Hotline’s Safety Plan tool to create a custom-made plan that works for you.

It will help you get your finances in order, have a place to go when you are ready to leave, know how to prevent your abuser from contacting you or finding where you are, establishing a support network, and gathering evidence to provide to the police should you want to file charges.

Closing Thoughts

Recognizing strangulation for the threat against your life that it really is can save lives, as can recognizing the signs of strangulation. If a partner has ever strangled you, the statistics bear out that this won’t be the last time. For your safety, you need to make a plan to leave.

While some states penalize strangulation as a felony, in other states, it’s only a misdemeanor. It can be difficult to prove strangulation occurred. Even when immediately reported, strangulation often doesn’t leave any visible marks.

If you decide to press charges, you will want documentation of medical records like C.T. scans, MRIs, ENT scans, witness statements, and other documentation of abuse. The important thing is for you to keep yourself safe by exiting the relationship with a practicable safety plan and the support of loved ones. A relationship that involves any level of strangulation is a ticking time bomb for homicide.