This article discusses non-fatal strangulation, including its methods, legal implications, and the broader issues of violence and coercion. It includes references to domestic abuse, sexual violence, and suffocation, which some readers may find distressing. Please take care while reading.
Non-fatal strangulation (NFS) was recognised as a criminal offence in the UK in April 2022.
NFS refers to the act of intentionally impeding a person’s breathing or circulation by applying pressure to their neck, without causing death, often as a form of control or intimidation. It is often intentional and can occur in different situations such as sexual assault, domestic violence and attempted murder. In sexual environments, it is usually referred to as ‘breath play’. Despite there being laws to protect victims, there were still over 4000 reported cases a year after it was criminalised and it is still prevalent today with over a third (35%) of 16-34-year-olds reporting being strangled/choked at least once during consensual sex. So, what is the impact of non-fatal strangulation and why has it become normalised during sex?
The impact and what it is
Physical consequences: Brain damage due to oxygen deprivation, stroke, seizures, miscarriage, vocal cord injuries, swallowing difficulties, and memory problems can all result from NFS. The brain is susceptible to decreased oxygen levels, and most strangulation injuries are internal; victims have been killed by fatal strangulation without there being any visible injury. For example, damaged blood vessels in the neck would not be visible, but this can lead to strokes in the days, weeks, or even months after strangulation.
Psychological trauma: Survivors often experience PTSD, anxiety, depression, and suicidal thoughts. The fear of death during strangulation creates a form of trauma that can persist for years. Survivors experience the trauma of the assault and the trauma of believing they were about to die, which can create complex post-traumatic symptoms that can be particularly difficult to treat.
Involuntary submission: Many survivors report entering a state of physiological submission or “playing dead” during strangulation, which can later cause feelings of self-blame for not fighting back, despite this being an involuntary survival mechanism. Strangulation is not a sexual act, it is violence.
Control mechanism: Perpetrators use strangulation as a demonstration of dominance. It can be a way of saying, “I can take your life at any moment.” In fact, 53% (42/80) of non-fatal strangulation victims went on to be killed by the person who had subjected them to non-fatal strangulation. 41 of those victims were women, one male was murdered by his brother.
The common methods of non-fatal strangulation are manual, such as chokehold or headlock, ligature (for example, a scarf), hanging, and pressure on the neck from a foot or knee. It can also include covering the mouth and nose. Compressing the chest or any other force that causes resection to breathing. This is not exhaustive. The legislation is widely drafted to include someone who ‘does any other act’. Therefore, any action that causes a person to be deprived of air and affects their normal breathing could be considered to fall within the definition and is, by law, an act of violence.
How has this become a silent epidemic?
The lines of consent have often been blurred by pornography. Rough sex has become increasingly normalised due to easy access to pornography and exposure to rough sex from a young age. Non-fatal strangulation tended to be associated with BDSM and kink scenes but has become more mainstream. It is often done without consent and as if it is a normal part of intimacy. A survey from 2019 found that only one-third of participants considered choking to be rough sexual behaviour.
Research from Durham University also solidifies that pornography is the main driver in normalising violent sex. When shown, the scenes almost always depict men choking women. 4009 opposite-sex porn scenes were analysed, and between 35 and 45% contained at least one act of aggression. Choking was the most common. In 97% of these cases, women were the victims but were often shown as enjoying or being indifferent to the violence. The repeated exposure to pornography is leading men to believe consent to non-fatal strangulation is unnecessary and is a normal activity during sex.
We do not need to access pornography to be exposed to violent sexual scenes and depictions of rape, sexual violence, and domestic violence. Euphoria (HBO), You (Netflix), Fifty Shades of Grey Trilogy, Game of Thrones (HBO) and so on are all popular programmes and films that gained millions of followers. All of these depict violent sex scenes and rarely touch upon the topic of consent. Even our music choices and literature contribute to strangulation becoming normalised. Artists such as The Weeknd frequently reference rough sex, and fantasy novels like A Court of Thorns and Roses depict aggressive sexual scenes without always distinguishing between consent and coercion. When non-fatal strangulation is presented, repeatedly, as exciting or a normal/expected part of intimacy, it reinforces the idea that the act is a normal part of sex. Strangulation is never normal; it is a form of violence.
Social media also has a huge role to play in the normalisation of non-fatal strangulation and in introducing young audiences to NFS. In 2020, The Times published an article investigating the role social media plays in normalising violent sexual acts. They found hundreds of sexual images of choking and strangulation on Pinterest, Instagram, and Tumblr, featuring women and girls. Most of these posts were accompanied by hashtags like #Daddy, #ChokingKink, #BreathPlay, and #Strangle, with captions promoting NFS or depicting fantasies of being abused by men.
People give various reasons for non-fatal strangulation, some claim they do it because they want to be kinky, some because they want to please their partners, and some because it exerts a feeling of dominance. It can fall under categories in the BDSM/kink communities such as ‘breath play’ or ‘power play’ but can also be part of ‘consensual non-consensual role play’. It is important to remember that although not a gendered act, NFS is part of a wider pattern of coercion and control of women by men. There is also nothing safe about non-fatal strangulation. It is dangerous, a risk to life, and can have negative impacts for years to come.
It takes 5 kg of pressure on the carotid arteries to cause unconsciousness.
That is about the same force as gently pressing the brakes on a bike.
It takes 2 kg of pressure on the jugular veins to cause unconsciousness.
This is less force than cracking an egg by squeezing it.
It takes 15 kg of pressure on the trachea to cut off the air supply.
That is similar to pushing a heavy door open with one arm.
Brain death occurs in 4–5 minutes.
The same length of time as boiling an egg, brushing your teeth, or waiting for a kettle to boil.
It is never safe, never okay, and never an innocent act to strangle someone. It is a serious offence and should be treated as such. The best way to begin ending violent acts, domestically and sexually, is by educating ourselves and others on the dangers. If you or someone you know has experienced non-fatal strangulation or other forms of domestic abuse, help is available. Contact the National Domestic Abuse Helpline on 0808 2000 247 or visit www.nationaldahelpline.org.uk for support.