“Do you know how it feels like to drown?” Women's experience of strangulation in intimate relationships

Background: Strangulation, a risk factor for homicide of women by their male intimates, is associated with substantial negative physical, neurological, and psychological outcomes. Oxygen deprivation due to strangulation can induce unconsciousness within seconds, and brain injury and death within minutes. This study examined battered women's experience of strangulation, how it affected their lives, and resources used for help.

Method: Six in-depth interviews and two focus groups were conducted with 17 women survivors of strangulation by a male intimate. Grounded theory method was used for analysis.

Results: Fifteen women had experienced multiple strangulations, and 14 had lost consciousness in one or more incidents. Perpetrators typically used their hands; objects such as shoe laces, clothing, and wooden board also were used. Women tended to associate the term “choking” with hands and “strangulation” with objects. They experienced a range of physical problems (e.g., difficulty breathing/swallowing, neck pain, hoarse voice, dizziness) that lasted from a week to months, and psychological problems such as nightmares, insomnia, anxiety and fear of a male putting his arms around. Most often, women contacted family or friends for help. When police were called they rarely took action unless injuries were visible. Few women disclosed the assault to a medical provider and rarely did a provider ask them about strangulation.

Conclusions: Strangulation as a cause of brain injury among battered women merits further study. Training police officers to detect and investigate strangulation is crucial. Moreover, medical providers need training in the detection, assessment and evaluation of strangulation-related symptoms and injuries.