My experience of what I now call ‘Non Visible Strangulation’


“I was put in a position of vulnerability and was exposed to further experiences of re-traumatisation and re-victimisation because my invisible injuries were not believed. I felt violated by those there to protect; my trust in Health betrayed. Seven years later I was found to have life-threatening traumatic brain injury and cervical spine injury from the strangulation and suffocation that I had reported”


Time has not taken the pain from previous experiences of domestic abuse, which like many women started during pregnancy. From 1990 I experienced physical and brutal violence to my head, back and body pre and post-pregnancy, coercive and controlling behaviours with long-lasting post-separation financial and economic loss and rape. I’ve also experienced what I now call “non-visible” strangulation and suffocation, which compounded previous abuse experiences. It’s been an exhausting eight-year fight to get the Health Service and Statutory Agencies to recognise my experience, because I was not initially believed. Instead, ‘mental health’ and ‘age-related’ was used to describe my experiences.


Im unaware of the time-lapse because complex trauma and triggers can either slow down or speed up perception, and PTSD and complex trauma seemingly deliver disorderly flashbacks. But what I do know, is that I did not consent to strangulation and suffocation”


I initially found the courage to report my experience to local police.  I hadn’t been in the area long as I had received a managed move due to stalking and harassment. This was to be a joint force investigation since experiences with the offender occurred in different counties over a period of time. I further reported to a national and local domestic abuse charity, two sexual assault referral centres, three psychiatrists, many doctors and a Locum GP, from two different Health Practices and counties, since a further managed move was necessary. The responses were extremely varied, but nevertheless psychologically damaging and with devastating long-lasting consequences to health and wellness, social, family, relationships, housing, welfare benefits, risk and safeguarding, career, financial and economic loss.

I presented calmly to a female officer who didn’t seem to understand me, rather she questioned why I had not reported earlier. I responded that it had happened on my Birthday and I was surprised to be here this early as I hadn’t had time to process it”.  She then preceded to fire questions and all I remember was her final hammerblow statement, “But you have no visible signs of injury”. I became frustrated because apart from having reoccurring flashbacks, headaches and being in shock I couldn’t actually articulate what had happened, or how it had affected me. I simply couldn’t find the words, so I closed down. The officer looked annoyed and I palpably felt her disbelief (as I had with the doctors that I presented to) as she hurriedly swept through formalities and talked about a joint force investigation. I started to glaze over and within thirty minutes, I was out of the door.

I recalled the officer saying that someone would be in touch, but later that evening I had forgotten the precise formalities and the order in which they were to follow. I was exhausted, stressed, overwhelmed and confused, my ears were ringing and my head painful and heavy. I heard from officers involved maybe twice by email in eight years, during the open and pending joint force investigation.


“I found to my detriment that a coordinated community response to Domestic Abuse was not forthcoming, which was especially perplexing as I was receiving managed moves from county to county. Without interagency communication the situation became a snowball effect, which effectively paralysed every aspect of my life”


I felt less than, numb, paralysed and triggered by her words, which laid as heavy as the dead weight amateur super heavyweight boxer upon my then 51kg frame, crushing my chest and ribs, whilst the palm of his hand pushed down hard, compressing my throat. I remembered consenting to sex, but not to strangulation and suffocation. I don’t know if I had passed out. I remember freezing and shutting down. It was dark and I was unable to breathe, talk or move.

Although I encountered too many professionals who were unable to help, I finally met a psychiatrist who was a specialist trained in Domestic Abuse and I discussed with her my intergenerational experiences and ‘Non-Visible Strangulation’ (NVS). To my surprise, she understood this to be Complex Trauma and PTSD and I thanked her, mostly for acknowledging my experiences, but mainly because it was the first time I had experienced a specialist trauma-trained response. ‘I felt believed, and for the first time I felt safe’.


I was in constant pain and despair, I found myself in a position of begging a female Locum for a scan of my head, as I knew I had suffered symptoms of an acquired brain injury. I explained past violent experiences and she immediately requested a cerebral scan and advised Domestic Abuse on her referral


Seven years and several moves later, I was finally accepted into the NHS Recovery Team, where I presented with multiple complex issues arising from Health and agencies not understanding nor believing my account of NVS. This was a huge undertaking for the NHS Recovery Team’s head, who actively went above and beyond to support and help address multiple agency failings. The NHS Recovery Team is a seamless trauma-trained response support service with no end date and it’s important to stress that without this approach; the teams commitment, dedication and specialist input, I certainly wouldn’t be here today. Rupture and repair, my trust restored.

I’m calling for victims who experience non-visible strangulation and asphyxiation to be treated as a Never Event, like sepsis. Especially for women and girls double disadvantaged, and/or with additional vulnerabilities and disabilities to receive a positive Health ‘No Closed Door’ and an ‘I Believe Her’ approach, and a ‘Trauma Trained Response’ upon reporting to frontline services.


Written by Miriam | Survivor

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