Criminal Justice Committee 21 May 2025
Thank you for asking me to come and speak to the committee. I could probably talk all day about the impacts of strangulation, but I will not. I agree completely with what has already been said.
We would break the subject down into several issues. One is the immediate medical issue, and death is one end of the spectrum. The neck is a very vulnerable part of the body—major blood vessels and nerves, and the windpipe, are there, so it is very prone to injury. Death could occur just because of a lack of oxygen to the brain. Someone could have a stroke later on because the arteries in the neck got damaged. Like in any part of the body that gets damaged, a blood clot forms, and then bits of blood clot can break off, so the person could have a stroke weeks or months after the event. There could be nerve damage—we have had people come in who have paralysis on one side of their face and have problems with speech and swallowing.
With domestic abuse in particular, and with some strangulation during consensual sex, there can be repeated strangulation and repeated episodes of lack of oxygen to the brain, which I think most people would agree is not a healthy situation. There is a cumulative effect from lack of oxygen to the brain, and someone might, down the line, have cognitive problems and difficulties with executive function, in making decisions and so on.
The psychological impact cannot be underestimated. When we have done research—and when I am examining someone who gives a history of strangulation—one of the questions that we ask is, “What were you thinking?” When we did our research on adults, more than a third said that they thought that they were about to die. That is a very rational thought, because you are about to die if the strangulation continues. That research mainly covered women, but, even when we asked men, although the overall numbers are much lower for men, about 40 per cent thought that they were about to die.
That has an impact on the recovery from that event, and it also feeds into the controlling behaviour—the next time, the person might just have to put their hand on the neck and give it a gentle squeeze. Most strangulation is face to face, eye to eye, and there is a mutual shared understanding, as Fiona Drouet said, that your life is in their hands. It is, therefore, a very powerful way of controlling somebody and what they do.
We also know that there is an increased rate of suicide among survivors of strangulation, because they sometimes feel that there is no other way out.
I will leave it there for now.