> What happens physiologically to make someone unconscious during this kind of hold?
If it’s properly applied, the arteries that provide blood to your brain get constricted, and your brain will lose consciousness to conserve oxygen. Assuming the hold is released quickly (within a few seconds) the blood flows normally again and you wake back up. If it’s improperly applied, then your trachea gets crushed, you might not be able to get air into your lungs, and you will probably die without immediate emergency medical treatment. If it’s properly applied and then held for a long time (like more than a couple of minutes) you get permanent brain damage and shortly after, death.
> How do you know you’re not suffocating someone or causing serious damage?
You don’t really ever know for sure, but with practice and understanding of how to apply the technique you can feel when it’s right and when it’s wrong. You can tell a lot by how your opponent struggles. If they are frantically trying to pull your arm off of their throat, then there’s a good chance you are crushing their trachea. If the choke is applied properly, they won’t feel a sense of urgency to release it, and instead will just feel very calm and quickly fall asleep. If it’s done properly, it should take almost no effort to apply the choke and it should work within about a minute the first time, and much faster if there is a second time. With training, you can use references in body position to figure out if the choke is correct or not. For example, in a rear naked choke, your opponents chin should be lined up with your elbow point and the meaty part of your forearm and your bicep should be lined up with either side of the front of their throat. Your choking arm should be relaxed and just held in position so that it molds to the shape of their neck. Guillotine chokes are much harder to apply as blood chokes, but there are similar feedback mechanisms you can use.
Chokes in general are very, very risky because the difference between “everything is fine I just took a quick nap” and “permanent brain damage or death” is literally just an inch or two, or a few extra seconds. They can be an excellent alternative to breaking someone’s joints or beating them to get them to stop being a threat, but the tradeoff is that if you make even one small mistake, there is a very, very real risk of death.
Anyone who intends to use chokeholds for any reason needs to get training from a qualified instructor who has a very good understanding of the details involved. Then you need to practice _a lot_ with a training partner who knows how to give good feedback so you can develop the muscle memory to apply the choke properly in the middle of a life-or-death situation, where adrenaline is surging and you are not likely to be able to consciously pay attention to the details.
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