Strangulation

Strangulation is so important, such an extraordinary leap in the level of violence and danger when talking about domestic violence that it deserves a post of its very own.  When I see a strangulation case cross my desk, it becomes a priority investigation because this one factor raises the stakes to a level just under homicide.  Indeed, we’ve had some cases that were actually able to be prosecuted as attempted murder or attempted rape due to the fact that the suspect put his hands around the victim’s throat and squeezed hard enough to make her pass out, all the while growling, “I’m going to kill you.” 

It’s important to understand that the vast majority of strangulation cases don’t result in death.  Most strangulation incidents occur in a flash and generally only last a few seconds.  When the word strangulation is used, most people have an image of a person using a length of rope, a belt or, if you’re talking about Hollywood, piano wire. 

In the case of strangulation in a domestic violence situation, what is far more typical is that a man grabs a woman with one or both hands and squeezes to the point that she can’t breathe and her vision starts to go dark from a lack of adequate blood flow to the brain.  This is all going on in the context of threats and other acts of violence, so there is every reason for the victim to believe she is about to die.  If any article is actually used, it is often a pillow or a wet towel shoved down onto her face hard enough to create a sense of drowning, sometimes with enough force to actually break her nose and bones in the face. 

There are few things more intimidating than the thought of dying by suffocation.  Victims will talk of being “choked” by their attacker and describe their vision fading and narrowing as if they are looking into a tiny tunnel.  Humans tend to keep hearing things even after their vision has left, and victims frequently report that they could hear the batterer snarling or cursing even as they thought they were dying. 

Choking, by the way, is the term generally used by victims to describe strangulation.  Technically, choking is what happens when something blocks your windpipe from the inside such as a piece of food.  Strangulation is the act of squeezing the throat from the outside, which often results in the clamping off of major blood vessels and the airway.  Whether a victim says choked or strangled is less important than understanding just how dangerously violent this offense truly is. 

This particular act is statistically 99% male on female, and strangulations most often occur at the moment when a woman is denying the man something.  That could be denial of sex, respect, her (as in when she’s leaving), or some item he is demanding such as her cell phone. 

What that means is that strangulation is one of the ultimate control techniques.  In police work, we are all taught what some might refer to as “choke holds” in one form or another.  In recent years modifications in the old school style of police chokeholds have made the techniques less dangerous, but they are still only to be used in the event that a bad guy is about to get the better of us if we don’t try something drastic. 

It doesn’t take a lot of imagination to see how this thing plays out; they argue, she says she’s leaving, he orders her to stay, she grabs her purse, he yanks it away, she slaps him and turns to head out the door, he grabs her and then encircles her throat with his hands. 

“You’re not leaving.  I’ll kill you before you leave me.”  He squeezes, sees her eyes open in absolute terror and, in most cases, shoves her down to the floor right before she goes completely unconscious. 

This accomplishes two things.  First, the actual physical fight is probably pretty much over right about then.  I went through a near-drowning incident once during a training exercise in a river rescue course.  The river tried to swallow me at one point, and it was a little dicey for a few minutes until my comrades got rope to me and dragged my butt out of the current.  Let me tell you, I felt pretty stupid, extremely fortunate to be working with the extraordinary men and women who saved my life, and completely meek and empty of spunk.  I had used up all my fight in the river, and there wasn’t much left in me at all.  When I apply that feeling to what a woman must feel right after she’s just been through her own fight with suffocation, I feel certain that whatever fire she had in her belly was all but extinguished at the moment she thought she was dying from one of the most terrifying methods of death imaginable. 

The second result is that the man has shown her in no uncertain terms that he absolutely controls her life.  Remember the power and control wheel phenomenon from a previous chapter?  For a few seconds there, he literally held her life in his hands.  It was his to do with as he chose.  He chose not to take it, and don’t think for a second he won’t remind her of that in subtle ways in the hours and weeks to come.  How euphoric and god-like to control the destiny of another human being when you are, by your very nature, a person who craves control. 

One of the more ridiculous and dangerous strangulation cases I ever worked involved a giant of a man with the musculature of a professional wrestler.  The man was entirely solid, strong as a tractor, and as selfishly dense as a two-year-old. 

The problem at hand was that his girlfriend got pregnant, a fate he equated with the destruction of his dream to play pro football.  In an argument over what was to be done about the situation, he demanded that she have an abortion.  She refused, so he struck her with one of his enormous paws while repeatedly reminding her that she wasn’t going to get any of his football career money.  She, you should know, weighed not quite one-hundred pounds, and the top of her head came to about the middle of his rib cage, so his blow sent her tumbling backwards. 

He’d slapped her before, but she told us this was the first time he’d ever hit her “like a man,” and she decided she’d have none of it.  “Fine,” she said, “I’ll raise our baby on my own, but you’re going to pay child support,” at which point she grabbed her purse and made to indignantly leave his apartment forever. 

He responded by tackling her.  Tackling her! And she fell in a crushed petite mess on the cement porch outside.  At that point he decided it wouldn’t be good for the neighbors to see all this, so he dragged her back in by the hair and shut his door.  Yes, I said by the hair, and any image you may have just flashed upon having to do with cavemen dragging women captured in raids on other villages is entirely apropos. 

About that time he questioned whether or not he was even the father of the child, insinuating that she had been “slutty” and therefore might have gotten pregnant from someone else.  She had not, in fact, been with any other man, ever, and the fact that the father of her unborn child was accusing her of such hurt her to the core.  It made her pretty pissed, too, and she responded by slapping him as hard as her little pixie-sized hand could muster. 

At which point the pounding began.  He never hit her in the face, a fact he repeatedly pointed out to me later, as if this somehow made everything okay.  He did, however, punch her repeatedly in the pelvis in an undisguised attempt to prompt a spontaneous abortion.  After four or five ferocious blows to her lower stomach and vaginal area she was able to roll into a little ball, all the while bawling hysterically and trying like hell to cover her head, ribs and pelvis all at the same time.

I suppose we’ll never know why he made the transition from raining down blows to grabbing her by the throat, but that’s eventually what he did.  We know from talking to both of them later that she had the wherewithal to try to dial 911 with her cell phone, even as he was hitting her repeatedly, and it became clear to us that she had tried hard to keep the phone from him by grasping it to her chest with both hands and holding onto it like it was her only lifeline in the most horrific of stormy seas.  It was, and you’ll be gratified to know that the rest of this attack was recorded and overheard by the emergency call-taker at the 911 Center. 

His response to her using her phone and trying to keep it from him was to wrestle the phone from her grip and throw it across the room (though it still continued to record), and then show her how frustrated he was with her actions by grasping her little neck in his gigantic hands and trying to squeeze the life out of her. 

Maybe something in her bulging eyes, or the fact that she was gurgling and clearly not moving air in and out of her lungs made him pause long enough to realize he was killing her and stop.  He was still calling her a slut and cursing her loudly enough for the responding officers to hear him through the front door when they arrived a couple of minutes later.  

But he never hit her in the face.  Good lad. 

The thing about manual strangulation is that the injuries often don’t show up on the neck right away.  If someone used a rope, piano wire, a shoestring, or an electrical cord, the wound patterns are generally visible and distinctive.  Often you can even pick out the pattern of the braid in a cord or the exact shape of the wire used.  When hands are the tools used to squeeze the throat, it is actually more often than not that external bruising doesn’t occur.  This becomes problematic for police officers who are looking for visible evidence such as redness, bruising or swelling around the neck, especially when the victim is tanned or darker skinned.

The human throat is designed to give a bit so that all those vital things on the inside such as large arteries, the trachea and larynx, esophagus, and cervical spine have a little wiggle room when carnivores try to clamp down on that area with large jaws.  This extra room is what leads to turkey necks and cosmetic surgeries for neck lifts in later years.  It is also a simplified reason for why this area of the body doesn’t visibly bruise dramatically as opposed to the areas over arms, ribs and cheeks where squeezing, grabbing and punching result in small blood vessels being smashed between the force and bone.  

For this reason, bruises around the neck and throat should be given extra attention, because this is a clear sign that the force exerted when the attacker was squeezing was extraordinary.  However, the absence of bruising doesn’t mean strangulation didn’t occur, and thorough investigators will ask additional questions when a victim reports she has been “choked.” 

There are three basic areas to explore when asking questions about the effects of strangulation.  First, it is important to clearly understand what was going on inside her head as her throat was being squeezed shut.  Statements such as, “I thought I was going to die,” or, “I knew he was going to kill me this time,” are pretty compelling and should be part of the police report to show how frightened she was by this action. 

Next, it is imperative that questions pertaining to her pain during and after the event be asked.  A statement such as, “It felt like my neck bones were getting ready to snap,” is a chilling testimony to how far the abuser went that day.  If it hurts her to swallow or take a deep breath, turn her neck, or be touched around her neck or throat after the incident is over, it is critical to the investigation and prosecution that this be recorded in a police report.  It is equally important that this information be documented by medical staff, both for the sake of making sure she gets the proper medical attention and care she needs, and also for the purpose of having medical records that can be used to prosecute the batterer at a later date.

Finally, investigators and medical staff need to know if the victim suffered or is suffering any ill effects from the strangulation such as sore throat, hoarseness, headache, visual disturbances, dizziness, or weakness in the arms or legs. 

Which brings us to a very important element often overlooked in strangulation cases, and that is the need to get the victim examined and treated by medical personnel.  The absence of bruising and swelling on the outside doesn’t necessarily mean there isn’t bruising and swelling going on internally, and one place you definitely don’t want swelling from the inside out is your throat.  A victim who has mild sore throat or hoarseness at the crime scene might well suffocate from advanced internal swelling hours later, so even mild symptoms following a violent strangulation attack must be medically assessed as a priority. 

Police officers, friends and family members of strangulation victims need to strongly encourage and urge her to seek medical attention after such an episode.  Obviously no one can make a victim see a doctor, but the importance of doing so relative to her own safety, the emotional well-being of her worried friends and family members, and to the elements of a successful prosecution should all be stressed when trying to convince her that she needs to be seen right away. 

Yes, it is a hassle to go to an emergency room and, yes, she might get billed by the hospital and, yes, she may not make it to work on time if she goes and, yes, someone other than her will have to take care of her children for a few hours--and yes, her life and long-term health are worth it. 

Strangulation is serious business, and it is far more common than most people ever imagine.  An attack that involves a strangulation episode, even one lasting just a few seconds, represents a dramatic escalation in the level of violence, control, and threat to life, and it should be treated as such by victims, police officers, employers, friends and family, victim advocates, prosecutors, judges and juries.