I've literally seen videos of FSH where they're clearly conscious throughout and struggling with their hands trying to undo the knot.
Poor execution of the procedure doesn't necessarily mean FSH is worse. (You can do it wrong even in PSH; your only advantage here is that your body is in contact with the ground, and you can easily stand up and abort the attempt. There are plenty of testimonials/failed attempts to read on the forum.)
If you don't do your research (or use common sense) and act impulsively, things won't turn out well.
Mistakes can be prevented with information and understanding of how the method works.
For example, a few images of neck anatomy are enough to understand the basics: your
carotid arteries are on both sides of your neck, and you're supposed to compress both to stop oxygenated blood flow to the brain (
neurons without oxygen begin to die quickly). The front of your neck (below the jaw) is the softest and the easiest area for the rope to penetrate
deeply. The knot should be at the back of the neck and will be in contact with your vertebrae, which are hard. This way, the pressure will be concentrated at the front and on the sides, and the ligature knot (Arbor Knot) will close behind the neck (where the pressure will be less, since the rope rises to the anchor point). The classic "
V-shaped groove mark" on the neck of people who hanged themselves.
You will inevitably feel pain all the seconds you are conscious; it will be an instinctive reflex to bring your hands to the area where the damage/danger is occurring; your neck is supporting/enduring all your weight and it is being compressed by the ligature.
CTB is a very tragic and difficult decision; many may come to regret it and try to save themselves.
Some may be able to achieve it depending on their setup, others will not be so lucky (also, consciousness can be lost quickly, leaving no time to do anything, as your muscle strength weakens at that moment)
Mentally you know what will happen; death awaits.. the unknown. I doubt anyone will have the calm mind of a monk at that moment.
This is a good example of last-minute regret; the girl was able to free herself by opening the
door (anchor point) and causing the rope to come loose. She never even took her hand off the doorknob (a "firm" support for her body), creating a chance to save herself.
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