Case Study 7.
Bella: ‘Unwanted choking experience’
Bella (17 yrs) had sex during a hook up at a party on the weekend, and halfway through was choked by her sexual partner. She describes going along with it, but feeling very frightened. She feels distressed about the incident but blames herself because she consented to initial sex.
Validate Bella’s feelings, as unwanted choking during sex can be frightening and distressing. Young people who experience unwanted acts during sex (particularly if they have given initial consent), may also self-blame. They require the same support as provided with any other unwanted sexual experience.
 Assess harm through asking further questions:
  • How do you feel about what happened?
  • How is it impacting you?
  • Have you talked to anyone else about this, and how was that?
  • Assess for any physical harm related to the choking, such as neck and throat pain, neck swelling, voice hoarseness, and recurrent headaches or memory loss, to identify whether referral to a specialist clinician familiar with non-fatal strangulation is needed. See SAAT

General critical-thinking discussions may not be appropriate if Bella is distressed. However, answering any questions regarding choking may be helpful. This could include discussing how choking is normalised in porn and online, but in real-life it is very high risk for both partners (include possible impacts).

Offer discussion to help reduce shame or self-blame, such as exploring how consent is not just the responsibility of the person ‘receiving’ an act. It should always be asked/given/agreed by both parties, for each individual sex act and can be withdrawn at any time.

Note: Young people may feel less comfortable negotiating sexual expectations and consent with casual hook ups, so offer resources that can help navigate this if appropriate. Refer to services such as Hohou Te Rongo Kahukura – Consent in Rainbow communities and Ethical Hook Ups.

Refer to services to talk through the experience, such as Safe to Talk, and/or a specialist clinician familiar with non-fatal strangulation if needed: SAATS. Youth Resources on choking are found here.