Ashley Kline, LPCC-S, Clinical Services Supervisor

As states move forward with plans for re-opening during the COVID-19 pandemic, it seems that facial masks will be required by work places, as well as in different private businesses and public spaces. Face masks have been identified as a critical tool in fighting the virus, however, masks are posing challenges for survivors of strangulation.

The statistics are not new, but are always difficult to take in – one in four women will experience violence from a partner in their lifetime. According to the Training Institute on Strangulation Prevention, 68% will experience near-fatal strangulation by a partner and is 7 times more likely to be killed by the abuser when strangulation is present.

After surviving traumatic strangulation experiences, common triggers a survivor may deal with in the aftermath include an intolerance to environments where breathing feels difficult (i.e. extreme heat, humidity or large crowds), neck scarves, necklaces, turtle necks, and other restrictive clothing. The use of face masks in the COVID-19 pandemic are proving to be a trigger for survivors of strangulation, as the masks feel restrictive and an individual may feel as though she cannot breathe as freely, which is reminiscent of the traumatic strangulation experience.

It is common for survivors to experience flashbacks and triggers. These trauma responses are normal reactions. There is nothing wrong with you for experiencing this new trigger. Many survivors are now asking how to navigate mask requirements during this time so that they can protect against COVID-19 and also continue to go to work and go about their daily lives in various public spaces.

A few suggestions that may be helpful include:

  • Get connected with a therapist to assist you in managing triggers. It is important to be supported by a professional while managing trauma symptoms.
  • Try different types of masks and facial coverings. Some fabrics may feel more comfortable & less restrictive.
  • Make a plan with your therapist to practice wearing your mask in a safe environment. Set simple goals for wearing the mask. For example, set a goal to wear it for 2 minutes a day at home and gradually increase the amount of time you wear it each day.
  • Focus on breathing and releasing tense muscles while wearing the mask. Wear your mask while listening to a guided breathing or a progressive muscle relaxation exercise. Download the PTSD Coach app for free guided tools.
  • Use distraction while wearing your mask. Try wearing your mask while watching a TV show you like, playing with a pet, or doing an activity.
  • If it still feels too difficult, that’s okay – take a break and be compassionate with yourself. We’re here to help!

Reach out to us for support!

RCC hotline: 330-434-7273 | BWS hotline: 330-374-1111


Learn more about the effects of strangulation through the Training Institute on Strangulation Prevention at