For theoretical interest only. No guarantee for completeness or correctness. You are responsible for your actions. If you are suicidal, leave this site and get help. Full disclaimer
“Nothing is so fatiguing as the eternal hanging on of an uncompleted task.” ― William James, American philosopher and psychologist
Suicidal hanging is the act of fully or partially suspending one’s body with the help of a ligature such that the body weight causes certain parts of the body to press against the ligature, resulting in death. This article discusses the most widely encountered form of hanging, in which parts of the neck are compressed.
- 1 Simple, step-by-step instructions
- 2 Mechanisms of death
- 3 Ligature type
- 4 Knots
- 5 Placement of the knot
- 6 Anchor point
- 7 Level of the neck
- 8 Body positions
- 9 Required time
- 10 Frequent problems
- 11 Consequences of failure
- 12 Success stories on the news
- 13 Autoerotic asphyxiation
- 14 Suicide pact
- 15 Tips
- 16 Further reading
- 17 References
Simple, step-by-step instructions
There are many ways to commit suicide by hanging. The following is an easy, quick, and pain-free guide.
1. Find an anchor point.
2. Tie one end of a thin ligature to the anchor point using snuggle hitch knot and make a noose using slip knot with the other end.
3. Test the setup by firmly pushing the rope with your hands.
4. Put the noose at halfway between your Adam’s apple and the base of your neck. (If you visually sectioned the neck into thirds, it would be the first line up from the bottom.)
5. Lean your body forward (not downward) and tilt your head downward.
Mechanisms of death
The arteries deliver blood into the brain, and the jugulars drain blood from the brain. In hanging, several mechanisms of death are possible, in particular:
- closing the carotid and possibly the vertebral arteries[1|2|3], significantly reducing the flow of oxygenated blood into the head → anatomy of carotid artery[1|2|3]
- closing the jugular veins[1|2|3], preventing the outflow of deoxygenated blood from the head, leading to congestion in head blood vessels, pooling of blood in the head, and increased venous pressure and rupture of venules. Closing only jugular vains may involve the unpleasant sensation of an exploding head, popping out eyes or falling out teeth → anatomy of jugular vein[1|2|3]
- compressing the trachea (or windpipe)[1|2|3], hurts, causes suffocation, and triggers the CO2 panic response → anatomy of thyroid[1|2|3]
Usually, the first of the aforementioned is intended: both arteries are equally occluded.
Direct compression of the carotid arteries leads to decrease or loss of cerebral blood flow and brain death. Compression of the jugular veins also results in acute death by causing cerebral hypoxia followed by loss of muscle tone. Once muscle tone is compromised, increased pressure is applied to both the carotid arteries and trachea. Direct pressure on the carotid sinuses causes a systemic drop in blood pressure, bradycardia, and other arrhythmias. Consequences are anoxic and hypoxic brain injury death (Dunn and Lopez, 2019), accompanied by abnormal posturing.
The jugular are easy to compress. Compressing jugulars will result in too much blood flow to the brain, making your head feel like exploding. When the compression isn’t enough to close the arteries (i.e., lack of enough pressure on rope), the pressure in the head builds up so much that even after death, the head is bloated and purple. (Not the way to go).
|Anatomic neck structure||Minimum pressure to collapse|
|Carotid arteries||2.5 – 10 kg (5.5 – 22 lbs)|
|Vertebral arteries||8.2 – 30 kg (18 – 66 lbs)|
|Jugular veins||2 kg (4.4 lbs)|
|Trachea||15 kg (33 lbs)|
|Cricoid cartilage||20.5 kg (45 lbs)|
Upon arrest of cerebral blood flow, a sequence of responses follow, including unconsciousness, followed by dilated pupils, tonic/clonic movements, loss of bladder and eventually bowel control, and appearance of pathological reflexes (Smith, Clayton and Robertson 2011).
Whatever is used should have a sufficient specified breaking strain and be static (i.e., not stretch). The width of the ligature matters. Contrary to popular belief, wider isn’t more comfortable. Yes, it may be more comfortable on the skin initially, but the inability to close the arteries quickly makes it uncomfortable with the extreme head bloating. The preferred thickness is finger size or smaller. If you still want to use a belt, you can’t tie the belt in knots to the doorknob, but you wedge the other end in the door jamb and close the door, as shown here[1|2]
|Excellent (experts’ choice)||BDSM rope (soft cotton bondage rope)[1|2]|
|Very good||550lb paracord[1|2]|
|Good||Necktie (“soft and you can black out quickly with low pain”)
|Competent||Dressing gown cord[1|2]
Normal belt (not a low quality one purchased at a discount store)
Martial arts belt
If a noose is used, the ligature should easily slide through it so it closes well, whereas the noose should not come undone easily when the force on the rope is reduced. It may also be a good idea to lubricate the ligature with soap. This would help the noose tighten even quicker, especially if you’re using a rough ligature such as a rope. Lubricating it in this way will decrease the friction once you push your head down and tighten the noose, and could make it a little more effective and faster.
The rope can be attached to a round pole with a snuggle hitch.
The aim of drop hanging, which is also frequently used in executions, is to break the neck. Participants fall vertically with a rope attached to their neck, which when taut applies a force sufficient to break the spinal cord, causing death. Unless a long drop hanging is planned, such as in drop from a bridge[1|2] or a rooftop[1|2], the hangman’s knot shouldn’t be used, because it causes too much friction.
As an example of long-drop suspension, consider the woman in this video[1|2|3|4]. She uses some kind of cloth and attaches it to a grid. Then, she ties the cloth around her neck and makes the jump. She hesitates shortly and pulls her feet up to stand up again but let’s herself fall down again. No twitching or swinging, it’s a really peaceful hanging. For the long drop or measured drop[Archive] method, generally, the knot is placed under the prisoner's left ear (the subaural position) as was seen in the photographs of Saddam Hussein[1|2].
While a fixed loop[1|2] can work too, a noose would generally appear to be safer. There is absolutely no need to learn any hard complex knots. The more complex the knot is, the more friction it’ll make and the harder it’ll be to compress the neck. There are three possible ways to close the loop:
1- The slip knot is a frequently suggested knot, because it slides easily, can be quickly undone, and doesn’t pinch.
3- Using asymmetric position of the noose (e.g., sitting on the floor[1|2], lying on the floor[1|2], or standing on a ladder[1|2]). A comfortable setups is lying on the bed[1|2|3] and using the bedframe as the anchor point for asymmetric noose, similar to hanging in lying-down position on a slope[1|2].
|Knot type||Step-By-Step Tutorial|
|Snuggle hitch (anchor point)||Knots you need: Snuggle hitch[1|2|3|4|5]|
|Slip knot (partial suspension)||How to Tie a Slip Knot How to DIY Knots Knots[1|2|3|4|5]|
|Hangman’s knot (long-drop suspension)||How to Tie a Hangman’s Noose Knot[1|2|3|4|5]|
Placement of the knot
There are three places for knot. Place the knot on either the back of the neck or the front of the neck.
|Best option: back of the neck (centrally over the occiput or lateral aspects of the neck)||The knot achieves optimal pressure on the front of the neck.|
|Good option: Front of the neck (at or above the chin)||The knot reduces the force applied to the arteries and veins because they are close to the front of your neck not the sides.||Leaning backward[1|2]|
|Worst option: Right or left side of the neck||The knot reduces the force applied to the veins and arteries only on that side, such as when the knot was on the right side of the neck[1|2].|
Usually, one end of the ligature is tied to an anchor point (i.e., suspension point or support). Any of the supports may be too weak. It is crucial to make sure the support is of sufficient strength. You should test the potency of your instrument by tying the loose end of your ligature around the support several times, sticking your hand — not your head — in the noose and pushing down with it more than a few times. If the noose holds, you’re fine. If not, then you’ll have to find another spot.
|Tying a rope to the doorknob and throwing the rope over the top of the door||Rope tied over the door to the other side[1|2|3|4]|
|Door knob||Hanging from the door knob[1|2]|
|Over the door hook||Blocking the carotid artery while not blocking the airway[1|2|3|4]|
|Door frame||Public bathroom[1|2]|
|Doorway pull-up bar||Pipe or bar in shop (short drop)[1|2|3]|
|Bar in closet or wardrobe||Wardrobe clothes rail[1|2]|
|Bed frame||Safety bed rail[1|2]|
|Window security bars||Rectangular window guard[1|2]|
|Ceiling fans and lighting fixtures||Ceiling fan (partial suspension)[1|2]|
|Staircase||Lying down on the stairway[1|2]|
|Roof structure||Horizontal timber beam[1|2]|
|Vehicle||On the back of a truck[1|2]|
|Tree branch||Both arteries occluded equally[1|2]|
|Playground structures||Jungle gym[1|2]|
|Transmission tower (electric pylon)||Using chain instead of rope[1|2]|
Level of the neck
The sweet spot to stick the rope on the neck is on carotid bifurcation (the division of the common carotid artery into internal and external carotid arteries), where carotid sinus massage[1|2|3|4] is performed. In order to reach the ideal spot, place the rope 1―2 fingers widths under the middle of the Adam’s apple and push forward with a slight downward angle. In other words, as demonstrates how choking game[1|2|3|4|5|6|7] is done, instead of weighing down, lean forward and keep your head upright to prevent the pressure on your trachea. Girl’s ligature from the choking game video looks similar to restraint collars[1|2|3|4|5], S&M chokers, or padded black neck brace. Since it’s so thick and padded, it’s some kind of a neck brace or ankle strap[1|2|3] used after an injury. Or you can breath in and out 10 times laying down on floor and quick get up; hold your breath, and do like in the choking game video[1|2|3|4|5|6] and you pass out.
1- The best placement: As forum members have suggested, placing the rope approximately in the middle of the neck while tilting the head downwards made them passing out within seconds. The best placement of the rope is halfway between your Adam’s apple and the base of your neck. Or about one to two fingers widths down from the middle of the Adam’s apple. If you visually sectioned the neck into thirds, it would be the first line up from the bottom. This is the most comfortable spot. The perfect position to put the rope on are shown by ligature marks from front[1|2] and side[1|2] photos. It’s easy to compress everything and pass out in about 10 seconds with no airway restriction or discomfort. By going lower from the the Adam’s apple, you can use the sternocleidomastoid[1|2|3] to compress the common carotid arteries[1|2|3] by pressing it into the omohyoid[1|2|3] with the rope, while still protecting the trachea from the rope with the same muscles. The omohyoid travels deep towards the sternocleidomastoid[1|2|3], which confines the omohyoid muscle[1|2|3] in order to give it its distinctive angle, along with the deep cervical fascia. In short, carotid arteries and jugular are much easier to close off at the bottom of the neck than the top, especially in the standing or kneeling position (as shown in the diagram[1|2|3]), if you lean into it perfectly. Here[1|2] is an example of a girl who leaned backward while her head tilted forward; she could have faced the opposite direction.
2- The mediocre placement: The author of “Choosing a dignified ending” recommends placing the noose at the base of the neck, causing mild build up of pressure while avoiding irritation of the throat, which is protected by muscles at that area. It’s okay to put the rope at the very base of the neck with the rope resting on the collar bones before tightening, but it’s still not the recommended spot. The muscles at the base of the neck are big enough to protect the trachea, but they’re too big to allow you to easily compress the arteries going to the brain.
3- The most uncomfortable placement: Placing the noose high up the neck[1|2|3] will constricts the trachea. Constricting the trachea will causes a urge to cough or a feeling of choking. Forum members have reported that putting the pressure high on the neckline above the trachea was causing them to cough and they couldn’t breathe properly—because anytime they went to swallow, their trachea had to raise, but it was not possible due to trachea being blocker by the cord. Near the jaw, the carotid arteries branch on both sides. Of course, you can compress them up there, but it requires more force because one branch is deeper. This placement of the rope has a higher rate of failure due to the fact there are now 4 paths instead of 2. Not to mention it crushes your trachea.
Finding carotid artery
Place your hands behind your neck[1|2|3] as you would do when stretching. Place your thumbs left and right below your jaw and move them backwards until you reach the gap between your jawbone and throat left and right of your windpipe. You should clearly feel your pulse when applying light pressure. Now you can interlink the tips of your other fingers behind your neck—just below or partially on the end of your skull. All you need to do now is to press backwards and upwards with our thumbs (towards or below the end of your skull) with moderate force. You will go limp within 5 to 15 seconds. If you do not or feel pressure building inside your head, you are either not pressing hard enough or your thumbs are misaligned. You won’t pass out but your body will go almost completely limp for few seconds, best do it while sitting or lying down.
You shouldn’t do it more than one or two times a day; otherwise, you will get a headache.
(Sauvageau et al., 2011) analyzed 14 filmed hangings in which rapid loss of consciousness had occurred in 10 ± 3 seconds and mild generalized convulsions in 14 ± 3 seconds. The type of suspension (partial or full), position of the partial suspension, and ethanol intoxication did not influence the timing of the agonal responses. The start of the deep abdominal respiratory abdominal movement occurred significantly faster in autoerotic practitioners (who often play for a longer period with the hanging process before the final hanging), whereas the loss of muscle tone was significantly delayed. Moreover, (Sauvageau, Ambrosi and Kelly, 2012) studied 3 nonlethal ligature strangulations, presented by an autoerotic practitioner. The loss of consciousness occurred in 11 seconds, similar to the time observed in hanging (10 ± 3 seconds). The loss of consciousness was closely followed by the onset of convulsions (7 – 11 seconds), in comparision to 14 ± 3 seconds in hanging. Later phases in hanging are decerebrate rigidity at 19 ± 5 seconds, start of the very deep respiratory attempt at 19 ± 5 seconds, decorticate rigidity at 38 ± 15 seconds, loss of muscle tone at 1 minute 17 seconds ± 25 seconds, end of the very deep respiratory attempt at 1 minute 51 seconds ± 30 seconds, and last muscle movement at 4 minutes 12 seconds ± 2 minutes 29 seconds.
(Sauvageau, LaHarpe and Geberth, 2010) analyzed agonal sequences eight filmed hangings. Rapid loss of consciousness was observed (at 8 – 18 sec), closely followed by convul-ions (at 10 – 19 sec). As for the respiratory responses, all cases presented deep rhythmic abdominal respiratory movements (last one between 1 min 2 sec and 2 min 5 sec).
Historically speaking, the body of executed persons in India of an executed person were kept hanging for less than half an hour (Bansal, 2005). Rare cases of survived hanging after a suspension duration of 5 – 10 minutes and up to 15 minutes (Hausmann & Betz, 1997). Except in vagal stimulation, death is not immediate in cases of hanging. It is unlikely to occur before the end of 5 minutes and may take as long as 20 minutes thus explaining how death can occur tardily in victims of mechanical asphyxia. If there is no injury to the spinal cord and the stoppage of air is not complete, 5 to 8 minutes is the typical fatal period, but it is possible that life may be restored in extremely rare cases after even 30 minutes of suspension (Kodikara, 2006).
- “Waking up” from partial hanging “gasping for air, heart racing, not knowing what just happened”
- Being found too early
- Ligature snaps or anchor point collapses under bodyweight
- Choosing an infelicitous location or time. For example, as apparent in a video clip[1|2|3|4], a teenager attempted full suspension hanging, yet she didn’t complete her suicide. And failure[1|2|3] was the result for a man who attempted full suspension from a traffic light in the center of city. On the other hand, 12-year-old Katelyn Nicole Davis chose a propitious spot further from her home in Polk County in Cedartown, Georgia, USA. By the time people were calling out to her and looking for her, she’d completed her suicide by stepping off of a bucket[1|2|3](Full version: 1|2|3|4]. And success[1|2|3] was the result for a man who attempted full suspension over a bridge.
Consequences of failure
⚠️ Although survival without neurological damage is possible, a failed hanging suicide attempt may result in serious permanent disability.
Even if be saved during the attempt, death still may occur. Such cases of delayed success have been reported by Assistant coroner Anna Morris[1|2], Assistant coroner P. Harrowing[1|2], and Senior coroner Alison Mutch[1|2]. Survival in hanging depends upon many factors but it was mainly duration of suspension, early resuscitive measures and force applied for compression of neck. Time required for irreversible cerebral damage to occur is said to be variable, but consensus of opinion is that if the blood supply to brain has been cut off continuously for less than 4-5 min permanent brain damage is very unlikely (Sane, 2015).
(Amalnath, Jawaid & Subrahmanyam, 2017) and (Ribaute et al., 2019) performed statistical analysis on neurological outcomes in suicidal hanging. (Kautilya, 2011) studied the frequency of neck injuries to inner tissues with regard to the type of hanging, hanging material, position of the knot and weight of the body, in order to to indicate the mechanism of injury to the organs. (Mikellides, 2018) discussed patterns of injury. Injury mainly arises through pressure on the neck veins and arteries. The external compression causes venous cerebral congestion, hypoxic circulation, and reduced arterial cerebral supply. Pulmonary complications include pulmonary edema (ARDS) and bronchopneumonia secondary to aspiration. Thyroid cartilage fractures are the most common with fractures of the hyroid bone and cricoid cartilage seen less often. Other neurological injuries include various spinal cord syndromes, focal cerebral deficits, transient hemiparesis, and larger infractions.
Failed attempts on the news
This is a garland of news reports, with regard to individuals who miscalculated their hanging attempt. These individuals suffered severe injuries. The hope of ending their hopeless lives ended with hopelessness.
Story #1 ― This is the tragic story of Zachery Gray, 17, who was the non-stop target of anti-gay bullies at Zephyrhills High School in Pasco County, Florida. Bullying has always been a major problem in schools, but this time bullies went too far on tormenting him. Zachery’s girlfriend, who was dating him since Januray 2012, had noticed the harassment since then.
The pupil had complained to his teacher that other students had harassed him based on gender stereotypes during a field trip. The temporary solution he received for his permanent problem was to work on yourself and to practice abstract thinking: “If someone calls you a tree, are you a tree? And if someone calls you gay, does that make you gay?” This question drew Zachery towards inside of himself only to ask the ultimate question of himself: to live or to die?
Zachery who didn’t see in himself living in the outside of himself (although the high school days had been ended for him by now) decided to take his fate into his hand. When the abuse surged, the only thing he was thinking was setting himself free. Unfortunately, Zachery didn’t have a solid plan for his attempt. On 18 May 2012, given that bullies tormented him every day at high school, Zachery eventually addressed his problems himself: he walked into a shed behind his home and hanged himself from a rafter. When he was so close to accomplish his goal, Zachery’s mother, who had noticed the taunts at high school, butchered his plan. Zachery survived to accomplish more pain and suffering. He’s severely paralysed; he is now unable to walk or talk and needs 24-hour care.
News article: 
Story #2 ― Jai Sharkey is the father of 2 children. From Galashiels in the Scottish Borders, he was a hard-working, fun-loving, family man who doted on his young son and daughter. While deep down he was in a dark place, he showed no signs of depression.
In November 2014, after considering suicide for a long time, he chose to act on it. But he forgot one decisive step: fabricating a plan. He chose a floppy way of notify about his body; he messaged a friend beforehand saying, “don’t let my kids see me like this, it’ll break their heart.” He could have chosen a remote location and informed his friend by leaving a note at home or by sending a message just before the attempt (in the remote area). Or he could have chosen a hotel room. But this mistake caused him more problems on top of his current ones.
As soon as receiving the worrying text message, his friend was concerned about Jai, so she called in to check on him. Having gone round there and through the door, she found him.
His failed attempt caused severe oxygen starvation to the brain. Jai Sharkey has been left paralysed, brain damaged, and unable to talk or communicate after a failed suicide bid. The father of two young children suffered catastrophic brain damage.
Following two years in constant care, at age 37, he only had limited movement of one hand. Jai was being cared for at Hawick Community Hospital in the Scottish Borders, where he was regularly visited by his two children, Konnie, 5, and Cooper, 3. He would sit there and watch them. His devoted family tried to raise money for a computer that might give Jai the chance to communicate between his kids and the rest of his family.
Story #3 ― Jack Barnes, then 15, was diagnosed with borderline personality disorder. He, at age 18, made his third suicide attempted. Unlike the previous attempts that were overdose, this time, he had chosen hanging. On the night of his third attempt, 4 March 2017, Jack left the house at 9:30 p.m., sending a text message to her mother. “I have just popped out. Don’t worry xx.” Panicked, his mother called the police. The police, knowing his mental health problems, raised it as an emergency. They found Jack hanging in woodland an hour later. He was dead for ten minutes before police managed to cut him down and take him to Withybush hospital in Haverfordwest.
Because he hadn’t planned for it well, he was found too early. As a result of his negligence in planning, his incomplete attempt had starved his brain from oxygen. From that day, he had to live in vegetative state with no quality of life. His mother, Helen Barnes, shared heartbreaking photos of brain damaged Jack in hope to show the devastating impact of mental illness. Two weeks later, Jack was transferred to a neurology rehab unit at Neath Port Talbot Hospital in Wales where he started to receive physiotherapy and speech therapy sessions—until December 2018, that he, who had learned to blink once for ‘no’ and twice for ‘yes’, eventually returned to live with his mother and twin sister in Pembroke Dock, Pembrokeshire, Wales.
Between letting her son’s suffering ends and suffering with him, Helen chose the latter. She became her son’s full-time caregiver. There wasn’t a day that she wasn’t with him. In March 2019, Jack developed a severe infection and the decision was taken to stop treatment. In the morning of 23 March 2019, three days after his life support had been switched off, Jack, holding his mother’s hand, passed away peacefully at home.
Story #4 ― Jamari Dent happily celebrated his 11th birthday on 7 February 2019. An outgoing, funny kid, Jamari, loved sports and playing. The boy has two older siblings and a younger sister, whom he protected in school. In school, the story was different: Jamari was a fourth-grader with learning disabilities at Carter G. Woodson Elementary in Chicago’s Bronzeville neighborhood. Every day, He was bullied, ridiculed, and physically hurt because of a learning disability.
The harassment started early in 2018, and came to culmination in December 2018 when a group of students jumped the boy in class, but no one from the school ever called his mother, Teirra Black.
“Mommy, I don’t want to go to school tomorrow,” before his suicide attempt, Jamari said. 18 February 2019 was they day he ultimately followed his mental image to end his suffering. Being an 11-year-old child, he didn’t plot very well. He hanged himself from a coat hook with a bed sheet tied around his neck.His 9-year-old sister found him and screamed for help.
The moment his mother found her grievously injured son in his room, she screamed, “Jamari!” She fell on her knees. “What did you do, Jamari?” Other relatives helped perform CPR. Emergency responders found the boy unconscious at his South Side home. He was rushed to Comer Children’s Hospital, where he was listed in critical condition, police said.
More than a dozen people gathered in the chapel at Comer in the evening of 24 February 2019 to pray for him, holding hands and standing in a circle. They prayed for healing, deliverance, and restoration. They prayed for a miracle: the body of the boy be healed. They prayed to whom they’ve already sold their souls to.
In spite of the prays, Jamari suffered from a severe brain injury after the organ was deprived of oxygen for 11 minutes, killing many of his neural cells. Jamari Black left La Rabida Children’s Hospital in Chicago on 14 August 2019, six months after the failed attempt to hang himself that left him badly brain-damaged. He will be requiring a ventilator, a life machine, for the rest of his life to live.
The woebegone mother had asked the school to tackle her son’s tormentors, only for them to ignore her. Black had asked to have her fourth grade son transferred because of the harassment he faced at school. Being furious about taunts made by students and teachers that she blames for Jamari’s injuries, Black filed a lawsuit. The lawsuit names the Chicago Board of Education as well as individual staff members as defendants.
Story #5 ― James Hanson has a lengthy criminal history, which includes arrests for assault, forgery, larceny, grand theft, trespassing, and robbery with a firearm. Hanson, then aged 22, was sentenced to life in prison in 2003 for putting a gun in a teller’s face (not his own face). But the sentence did not stand. After giving testimony to convict another criminal, as well as filing multiple appeals, Hanson was released from prison on 2 July 2019 after serving 15 years.
On 6 August 2019, not even a month after becoming a free man, James Hanson, 39, of Valrico, was accused of robbing a Center State Bank on State Road 60 in Valrico. Hanson Googled “banks near me” shortly before going on the crime spree and used a BB gun during the robbery. However, he panicked afterwards, punched a bank employee in the face, and carjacked a white Lexus SUV with its driver, customer Mathew Korattiyil (who had just parked in the parking lot). Korattiyil, a 68-year-old retired convenience store owner, was forced by Hanson to stay inside his SUV. Hanson drove off to a nearby church, Sacred Heart, where Korattiyil asked to be let free. The suspect told detectives that Korattiyil begged to be released. When Hanson refused, Korattiyil punched him and ran away. Hanson ran after the old man who was trying to escape and excessively strangled him with bare hands, then with the victim’s own belt. Hanson said he removed Korattiyil’s clothes to get rid of DNA evidence and tried to hide the body in the bushes.
After leading deputies on a pursuit, Hanson crashed the vehicle and was apprehended. Korattiyil, however, was nowhere to be found. Hours later, deputies found his body behind The Sacred Heart Knanaya Catholic Community Center, less than five minutes away from the bank. Hanson was charged with first-degree murder. Legal experts said it’s possible the State Attorney’s Office will seek the death penalty.
On 13 August 2019, Hanson was hospitalized because he tried to commit suicide at the Falkenburg Road Jail. Hanson had gone into a yard during recreational shower time at about 8:30 a.m., according to officials with the Hillsborough County Sheriff’s Office. “He had a towel and underneath that towel, he had actually concealed a sheet that he folded up,” Crystal Clark with the sheriff’s office said. Deputies say Hanson tied that sheet to a basketball goal in the recreational area. Officers found him hanging from the goal and performed life-saving measures, the sheriff’s office says. Hanson was taken to Tampa General Hospital where he was in critical condition. “Was he under suicide watch?” reporter Ryan Hughes asked. “He’s not currently under suicide watch. And he was actually cleared by a psychologist, telling them he was not suicidal,” Clark said. Clark said Hanson was initially placed on suicide watch when he arrived at the jail, but he was recently taken off of it. He was currently on administrative confinement, which means he was housed alone in a cell and allowed in the rec area by himself. “During that time, there’s always a deputy who’s monitoring them, checking in every so often just to make sure they’re okay,” Clark said. “Usually the deputy is supposed to check-in at the maximum every 30 minutes and that was the case here with this deputy. The person was going back as he should, checking to make sure nothing was wrong and we’re fortunate that he did come at the time that he did. Our deputies are trained to save lives. They don’t care if it’s an inmate in a jail or just a regular citizen out on the street,” added Crystal Clark. “In the case with Mr. Hanson, when they saw him hanging there, they immediately went into that life-saving mode.”
Hanson’s sister, Susan Correa, thinks her brother tried to kill himself at the Falkenburg Road Jail because of mental illness and the guilt that came with the alleged murder of a beloved local man. The family says doctors told them Hanson is brain dead and won’t pull through. “That’s what’s scary. I’ve lost my brother three times and now I’m losing him for good. There’s no replacing him if you lose your memory, what else?” Correa said. Correa explained that her brother suffers from mental illness and heard voices in his head prior the to the Aug. 6 crime spree.
Hanson was due to be arraigned on 29 August 2019 for the murder of his carjacking victim, but it was revealed in court that Hanson remains hooked up to machines and not physically able to show up for his arraignment. Nearly a month after attempting to take his own life, Hanson showed up in court. Hanson’s condition gradually improved.
Wheelchair-bound defendant James Hanson was wheeled into a Tampa courtroom in the morning of 10 September 2019 for his arraignment on murder and carjacking charges. Hanson had been in the hospital since his suicide attempt at Hillsborough County Jail in August. Pale and gaunt, Hanson slumped in his wheelchair, his red prison jumpsuit hanging loosely on his hunched shoulders, a white bandage affixed to his throat below a scraggly beard. Hillsborough Circuit Judge Mark Wolfe asked Hanson if he could raise his right hand to be sworn in. He looked blankly at Circuit Judge Mark Wolfe but was able to muster a soft, raspy “yes” when Wolfe asked if he understood what was happening during the proceedings. Hanson struggled to lift his right hand a few inches. Judge Wolfe asked if he understood his right to show up for every court appearance, and Hanson slowly replied, “Yes.” With the help of Hillsborough Public Defender Julianne Holt and Assistant Public Defender Jennifer Spradley, Hanson pleaded not guilty to bank robbery and carjacking and first degree murder in the death of Mathew Korattiyil, a beloved grandfather and retired store owner.
“This is a very tough time for our family,” Korattiyil’s son, Melvin, said on 10 September 2019. “We want to make sure my father’s legacy is continued and heard. I thought it was a very cowardly act on his part,” Melvin Korattiyil said about Hanson’s attempt to escape justice. “Our office will continue to prosecute this case to the fullest extent of the law to achieve justice for Mr. Korattiyil and our entire community,” Warren said in a statement.
Success stories on the news
Hanging is common choice of a suicide method; thus, its success stories are abundant. For inspirational purpose, please feel free to read about see a list of people who died by hanging on Wikipedia.
Some suicidal people try to have their death be classified as an accidental. In doing so, they choose autoerotic asphyxiation as their method. Nonetheless, those who genuinely practice autoerotic asphyxiation sometimes are so embarrassed that they wish their manner of death be ruled as suicide.
The "choking game" or autoerotic asphyxia (AEA) is defined as self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia. AEA is deadly. AEA occurs when the person self-strangulates to experience heightened sexual pleasure, using the set of ropes, a plastic bag placed overhead[1|2], or other modes of self-controlled restriction of access to oxygen. Among the most common etiologies of death due to autoerotic asphyxiation are hanging, drowning, chest compression, or inhalation of volatile substances. Erotic asphyxiation involving another person occurs when one individual chokes another during sex in an effort to restrict oxygen level in the brain. Because autoerotic deaths are socially embarrassing, victims’ families sometimes try to hide the traces that point to the sexual nature of the accident (Sendler, 2018). Furthermore, (Mehdi, Nimkar, Darwish, Atallah & Usiene, 2015) summarized the difference in factors between suicidal attempt and autoerotic asphyxiation.
|Suicidal Attempt||Autoerotic Asphyxiation|
|Suicidal ideation or intent, expressed or written intent, or behavioural change||Yes||No|
|History of deliberate self-harm, suicidal ideation, or suicide attempt||Yes||No|
|Significant depressive, manic, anxiety, or psychotic symptoms||Yes||No|
|Safety precautions and self-rescue mechanism||Yes||No|
|Significant relation to other paraphila||No||Yes|
|Significant relation to autoerotic behavior||No||Yes|
|Sexual activity||Diminished or hyper-sexuality||Evidence of solo sexual activity|
Most victims of suicide are not found in the nude, although this is not a conclusive indicator. (Holmes & Holmes, 2009) shared their thoughts on how to make self-killing looks like an unfortunate autoerotic asphyxiation incident.
|Location||The location selected is usually secluded or isolated and affords the practitioner the opportunity to involve himself or herself in a private fantasy. Some examples include locked rooms at home, attics, basements, garages or workshops, motel rooms, places of employment during nonbusiness hours, summer houses, or outdoor locations.
Male: move furniture or use sexual paraphernalia
Female: often in their bedrooms or bathrooms, seldom in outside or in open areas, won’t move furniture or use sexual paraphernalia as mush as male do
|Crossdressing||Male: a sexual matter, prevalent, either completely dressed in women’s clothing or dressed in a few articles of clothing such as panties and a bra
Female: mainly a matter of fashion or comfort (wear makeup and exotic lingerie)
|Mirrors||Male and female: positioned somewhere in the visual field of the deceased, prevalent in crossdressing to enhance the imagination|
|Pornography||Male and female: present and nearby, cache of sex toys, bondage ropes, photos and videos of individuals restrained with bondage in various contortions, numerous contents on electronic devices suggesting sexual deviancy or erotic artistry, high activity on porn websites|
|Genital Binding and Body Marks and Bruising||Male: sometimes use rope or some binding device to constrict the penis and testicles, possible marks wrists and ankles and neck indicating how often bind themselves
Female: sometimes rectal or genital foreign body insertion
|Diaries and Writings||Male and female: will provide collateral evidence for the investigators, often a record of all the times and different methods are kept|
As an example[1|2|3], a 22-year-old single white male was found hanging by his neck from a low tree branch with both knees on the ground. A belt was looped around his unprotected neck. The fly of his trousers was open and his penis extended through the opening. Autopsy revealed a fractured thyroid cartilage which was attributed to the pressure produced when the body slipped after the victim lost consciousness. Investigation revealed the individual to be a loner. There was no indication of suicidal ideation and the manner of death was ruled as accidental. Other examples are a webcam video[1|2|3] of a teen who accidentally hanged himself while playing choking game, an Asian man[1|2] who died due to auto-erotic asphyxiation , and a man who practiced auto-erotic asphyxiation in front of mirror using belt[1|2].
Victims of autoerotic asphyxiation may be considered shy by friends because they are not sexually or romantically active. However, they may be married or involved with a significant other person. Interviews and investigations do not disclose any indications of depression or suicidal tendencies. There are certain questions that the cirme-scene investigator considers in determining whether or not the death is related to autoerotic activity. (Geberth, 2014) compiled the involvement sexual asphyxia checklist.
1. Is the victim nude, sexually exposed, or—if a male—is he dressed in articles of feminine attire (transvestism), makeup, and wigs?
2. Is there evidence of masturbatory activity: tissues, towels, or hanky in hand, or in shorts to catch semen? Seminal fluids?
3. Is there evidence of infibulations: piercing or causing pain to the genitalia, self-torture, masochism, pins in penis, etc.?
4. Are sexually stimulating paraphernalia present: vibrators, dildos, sex aids, pornographic magazines, butt plugs, nylon bag, inhalants (e.g., full and empty canisters of butane or nitrous oxide gas), etc.?
5. Is bondage present: ropes, chains, blindfolds, gags, etc.? Are any constrictive devices present: corset, plastic wrap, belts, ropes, or vacuum cleaner hoses around the body, or chest constraints?
6. Is there protective padding between the ligature and the neck: towels, rags, or cloth to prevent rope burns or discomfort?
7. Are the restraints interconnected? Do the ropes and ties come together or are they connected? Are the chains interconnected through one another? Is the victim tied to himself, so that by putting pressure on one of the limbs the restraints are tightened?
8. Are mirrors or other reflective devices present? Are they positioned so that the victim can view his or her activities?
9. Is there evidence of fantasy (diaries, erotic literature, etc.) or fetishism (women’s panties, bras, girdles, leather, rubber, latex, high heel shoes, etc.)?
10. Is the suspension point within reach of the victim or is there an escape mechanism (keys, lock, slip knot, etc.)?
11. Is there evidence of prior activities of a similar nature (abrasions or rope burns on suspension point); unexplained secretive behavior, or long stays in isolated areas; rope burns on neck, etc.? Has the victim improvised an instrument, with safety measures (e.g., standing on the stairs), for his or her repetitive autoerotic maneuvers?
12. Does the victim possess literature dealing with bondage, escapology, or knots?
13. Is there a positioned camera or a webcam? (Check film, videotapes, or livestream. Look for photos and view any videotapes in camera.)
While not all such deaths will involve the above characteristics, their presence will certainly alert the investigator to the possibility of death occurring as the result of sexual misadventure.
Suspended animation: brain facts
The carotid artery that travels through the neck carries close to two-thirds of the blood supply that brings oxygen into the brain. Dixie Regional Medical Center Neurosurgeon Benjamin D. Fox said[Archive] that when the blood flow is interrupted, it causes a person’s brain cells to dip below the line of normal functionality and become suspended in animation, waiting to either die or receive the oxygen necessary to stay alive. When brain cells dip past that line of normalcy into suspended animation, Fox said, that is the point that the person with the restricted blood flow will pass out.
Next to the carotid artery is a bundle of nerves called the vagus nerve. Stimulation of this nerve bundle can cause the heart to stop beating and create a heart attack situation.
“Most of the people that are going to die from (the choking game) … are not really probably dying from the brain not getting blood, which is one thing,” he said, “they’re probably dying because their heart stopped and didn’t start back up.”
Also known as flat liner, space monkey, funky chicken, elevator, purple dragon, space cowboy, rising sun, tap out and many other names, Fox said, the free high is akin to the first time a person gets drunk.
Playing the choking game can have negative impacts on memory, coordination and movement, he said. Frequent and continued passing out by choking will cause headaches and red eyes with burst veins and can even cause irreversible and permanent brain damage.
When someone is put in bondage and lifted off the ground, this is called bondage suspension. Sexual asphyxia or breath control play typically falls under a larger set of activities called edge play. Edge play generally refers to BDSM activities with high levels of physical or psychological risk (Lee, Klement & Sagarin, 2015). Asphyxia is producing using ligatures, inhalants, plastic bags, submerging into water to achieve stimulation by partial drowning. If you have a suicide partner, you can try double hanging with single ligature. Single ligature is used by the couple to ensure both die together (Behera et al., 2016). The participents use one ligature[1|2|3], not two separate ropes[1|2|3].
(Roma, Pazzelli, Pompili, Girardi & Ferracuti, 2012) reported a combination of bondage suspension and breath control play as follows:
Having consumed a light dinner accompanied by a large quantity of alcohol, two young women (SU and DE) and an older Italian man went on to play an erotic game that included bondage practices in an isolated, public location at about 4 a.m. that night. The two women, who remained dressed, without either exposing their genitals or receiving sexual stimulation, were tied to each other in a sort of pendulum so as to counterbalance each other, thereby practicing a Japanese erotic figure (Shibari). The ropes were slung over metal tubes in the basement of a local federal income tax building underground. When one woman went down, the other one went up, thus causing a feeling of suffocation that was considered sexually arousing. While this game was being played, DE fainted (and lost urine), which resulted in SU remaining suspended and in both her and SU being asphyxiated for an extended period of time. As the man involved in the game did not have a knife at hand, he was unable to cut the rope immediately. When he did manage to release the two women, DE was dead and SU was in critical condition. The man was arrested and is presently awaiting trial.
Autopsy findings of the victim (DE)
DE, who was 23 years old, 171 cm tall, and weighed 121 kg (BMI = 41.38), was found with 4 ropes that had been used to tie multiple knots around her joints and had been passed several times around her chest. The death can be ascribed to violent mechanical asphyxia. Indeed, the ridges found in the cervical region during the external examination and the underlying hematic infiltrations were considered to be clear signs of hanging. The external examination of the cadaver revealed signs of cervical compression, indicating that a rope had been passed around the neck at least twice. The histological examination confirmed the nature of the lesions, thus proving that they did not result from the suspension of the cadaver, but had been caused by a harmful object on a living subject. The toxicological tests disclosed the presence of a moderate quantity of alcohol and cannabinoids in the blood, though these substances were not directly involved in the young woman’s death. The woman had history of psychiatric treatment. We define this event as an incomplete hanging, in which the death may be ascribed not only to asphyxiation, but also to vascular and autonomic nervous processes. The reason to why DE died and SU did not may lie in differences in the young women’s response to asphyxia as well as in the degree of compression exerted by the ropes on the chest.
The survivor (SU)
SU, who is 24 years old, 164 cm tall, and weighs 83.60 kg (BMI = 30.85), was untied where the event had occurred and was taken to the hospital emergency ward because of acute respiratory failure that required ventilatory support. The acute respiratory failure was caused by prolonged asphyxia, caused by a rope that had been wound around the young woman’s neck. Upon admission to Sant’Andrea Hospital, SU had severe acute respiratory failure and was in a coma (GCS = 3). The alcohol level in her blood was 1.08 and there were traces of cannabinoids in her urine. The coroner (who also examined SU) observed the presence of “red marks around the patient’s neck that could be ascribed to strangulation.” SU was hospitalized in intensive care, where she underwent a CT scan, a chest CT, an MRI, and an EEG. These diagnostic tests did not disclose any pathologically significant findings. Some days later, when SU had regained her alertness, orientation in time and space, and was hemodynamically stable and breathing spontaneously, she was transferred to the internal medicine ward.
- Everyone’s body and every hanging are different. What works for one person might not work for another. Extensive experimentation may be required to find out what works best with limited pain. Carotid compression may be easier in a skinny neck than in a chubby one.
- Test setup by pulling up yourself on rope with hands.
- Remove slack in rope after putting noose around neck and tightening to resting neck circumference.
- Drink a few shots of alcohol, take benzodiazepines (e.g., clonazepam, lorazepam, or mirtazapine), or use hallucinogens inhalants (e.g., chloroform, ether, butane, or propane) to anesthetize yourself. You can also take L-Theanine to reduce your anxiety.
- Pretighten noose, compressing neck swiftly and strongly. Settle into noose hard and fast, relaxing all your weight into the noose all at once, instead of pussyfooting around and easing your weight in. The author of the “Choosing a dignified ending” estimates that the neck circumference needs to be compressed by at least 20%.
- Tilt your head downwards.
- To reduce rope-burn pain, pad neck with a piece of cloth, etc.
- To overcome survival instinct, pretend you are practicing, each time going a bit further; or combine with masturbation[1|2|3] (for instance, auto erotic hanging[1|2] or autoerotic asphyxiation[1|2]). As another example, a video clip[1|2|3] of a young man that was coerced to kill himself in prison showed he had no hesitation.
- Both the tying together of the hands with rope[1|2] or belt[1|2] as well as closing of the mouth were regarded as precautions taken by the victims to prevent any change in mind and an indication of their resolve to go through with the suicide. In addition, placing soft material[1|2] against the ligature loop was thought to be an attempt to lessen the feeling of pain (Demirci & Hakan, 2011). Regardless, placing soft material or padding under the rope will reduce the pressure. So don’t add padding.
- You can test placement by wrapping the rope around your neck without tying a knot. First, crisscross it in the back. Second, grab each side of the rope. Last, extend your arms outwards to the side, tightening it around your neck. If you pass out it will come loose, and you’ll be safe and sound. Practicing loving the high is a great way to get over the survival instinct attached to the sinking or fading away feeling. Or simply hold the end of the rope with the hands, so that you let go automatically after unconsciousness.
- When you hang yourself, it would be good idea to wear a hood that a condemned criminal had to wear for hanging at executions. A hood or a plastic bag over your head makes the corpse looks more peaceful. Your corpse will not shock the person that finds it as much as if he or she has to see your hanged face with protruded tongue. Besides, if something happens to the rope while unconscious, you'll die by asphyxiation. A Japanese teen put hood over his head[1|2|3] and hanged himself.
- If you’re still conscious after a minute, abort the attempt.
- Hofmann, E. (1898). Atlas of legal medicine. Philadelphia: Saunders.
- Minovici, N. (1905). Étude sur la pendaison. Paris: A. Maloine.
- Pressure to the neck :: www.forensicmed.co.uk. Archived from the original on April 21, 2019. Retrieved November 1, 2019.
- Ballur, M. (2013). Analytical study of deaths due to hanging cases reported at Dr. BR Ambedkar Medical College Mortuary during 2010-2012. M. D. (Forensic Medicine). Rajiv Gandhi University of Health Sciences. [Full Text: 1|2|3|4|5]
- How to hang yourself threads on Sanctioned Suicide forum
- "Steven"'s Suspension Hanging Reference. Archived from the original on February 100, 2017. Retrieved October 14, 2019. [Archives: 1|2]
- Dunn, R. and Lopez, R. (2019). Strangulation Injuries. StatPearls Publishing LLC. [PubMed: 29083611][Full Text]
- Smith, B., Clayton, E. and Robertson, D. (2011). Experimental Arrest of Cerebral Blood Flow in Human Subjects: The Red Wing Studies Revisited. Perspectives in Biology and Medicine, 54(2), pp.121-131. [PMC: 3848716]
- Choosing a dignified ending. Thoughts, experiments, and notes on choosing suicide by hanging [Full Text: 1|2|3|4|5|6|7]
- Khokhlov, V. (2001). Calculation of tension exerted on a ligature in incomplete hanging. Forensic Science International, 123(2-3), 172-177. doi: 10.1016/s0379-0738(01)00543-6. [PubMed: 11728744][Full Text: 1|2|3|4|5|6]
- Sauvageau, A., LaHarpe, R., King, D., Dowling, G., Andrews, S., & Kelly, S. et al. (2011). Agonal Sequences in 14 Filmed Hangings With Comments on the Role of the Type of Suspension, Ischemic Habituation, and Ethanol Intoxication on the Timing of Agonal Responses. The American Journal Of Forensic Medicine And Pathology, 32(2), 104-107. doi: 10.1097/paf.0b013e3181efba3a [Full Text: 1|2|3|4|5|6|7|8]
- Sauvageau, A., Ambrosi, C. and Kelly, S. (2012). Three Nonlethal Ligature Strangulations Filmed by an Autoerotic Practitioner. The American Journal of Forensic Medicine and Pathology, 33(4), pp.339-340. [PubMed: 22922552][Full Text: 1|2|3|4|5|6]
- Sauvageau, A., LaHarpe, R. and Geberth, V. (2010). Agonal Sequences in Eight Filmed Hangings: Analysis of Respiratory and Movement Responses to Asphyxia by Hanging*. Journal of Forensic Sciences, 55(5), pp.1278-1281. [PubMed: 20487156][Full Text: 1|2|3|4|5|6|7]
- Bansal, R. (2005). Ethical chllanges for medical professionals in India: Role in capital punishment. Punjab Academy of Forensic Medicine & Toxicology, 5. [Full Text: 1|2|3|4|5|6|7|8]
- Hausmann, R., & Betz, P. (1997). Delayed death after attempted suicide by hanging. International Journal Of Legal Medicine, 110(3), 164-166. doi: 10.1007/s004140050057 [PubMed: 9228568][Full Text: 1|2|3|4|5|6]
- Kodikara, S. (2006). Uneventful Recovery from Suicidal Hanging. Medicine, Science and the Law, 46(1), pp.89-91. [PubMed: 16454468][Full Text: 1|2|3|4|5|6]
- Amalnath, S., Jawaid, M., & Subrahmanyam, D. (2017). Neurological outcomes following suicidal hanging: A prospective study of 101 patients. Annals Of Indian Academy Of Neurology, 20(2), 106. doi: 10.4103/0972-2327.205773 [PMC: 5451605]
- Sane, M. (2015). Course of Near-hanging Victims Succumbed to Death: A Seven Year Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi: 10.7860/jcdr/2015/11189.5647 [PMC: 4413082]
- Ribaute, C., Darcourt, J., Patsoura, S., Ferrier, M., Meluchova, Z., & Gramada, R. et al. (2019). Should CT angiography of the supra-aortic arteries be performed systematically following attempted suicide by hanging?. Journal Of Neuroradiology. doi: 10.1016/j.neurad.2019.04.001 [PubMed: 31034897][Full Text: 1|2|3|4|5|6]
- Kautilya, V. (2011). Study of pattern of neck injuries in cases of hanging with special reference to carotid injuries. M. D. (Forensic Medicine). Rajiv Gandhi University of Health Sciences. [Full Text: 1|2|3|4|5|6]
- Mikellides, G. (2018). A Serious Suicide Attempt Causing Brain Damage?. Annals Of Clinical And Laboratory Research, 06(03). doi: 10.21767/2386-5180.100251 [Full Text: 1|2|3|4|5|6]
- Demirci, S., & Hakan, K. (2011). Death Scene Investigation from the Viewpoint of Forensic Medicine Expert. Forensic Medicine - From Old Problems To New Challenges. doi: 10.5772/18161 [Full Text]
- Sendler, D. (2018). Lethal asphyxiation due to sadomasochistic sex training — How some sex partners avoid criminal responsibility even though their actions lead to someone’s death. Journal Of Forensic And Legal Medicine, 56, 59-65. doi: 10.1016/j.jflm.2018.03.012 [Full Text: 1|2|3|4|5|6]
- Mehdi, A., Nimkar, N., Darwish, N., Atallah, R., & Usiene, I. (2015). Distinguishing Suicidal Attempt from Autoerotic Asphyxiation. Psychiatric Annals, 45(6), 285-289. doi: 10.3928/00485713-20150602-02 [Full Text: 1|2|3|4|5|6]
- Holmes, R. M., & Holmes, S. T. (2002). Psychological profiling and rape. In Profiling violent crimes: An investigative tool (3rd ed.). (pp. 172–184). Thousand Oaks, CA: Sage. [Web: 1|2|3|4]
- Geberth, V. (2014). Sex-Related Homicide and Death Investigation. Hoboken: CRC Press. [Full Text: 1|2|3|4|5]
- Lee, E., Klement, K., & Sagarin, B. (2015). Double Hanging During Consensual Sexual Asphyxia: A Response to Roma, Pazzelli, Pompili, Girardi, and Ferracuti (2013). Archives Of Sexual Behavior, 44(7), 1751-1753. doi: 10.1007/s10508-015-0575-4 [PubMed: 26076926][Full Text: 1|2|3|4|5|6|7|8]
- Behera, C., Rautji, R., Kumar, R., Pooniya, S., Sharma, P., & Gupta, S. (2016). Double Hanging with Single Ligature: An Unusual Method in Suicide Pact. Journal Of Forensic Sciences, 62(1), 265-266. doi: 10.1111/1556-4029.13247 [PubMed: 27861888][Full Text: 1|2|3|4|5|6]