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Killing them once isn't enough.
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He has to resuscitate his victims
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until he can't bring them back again.
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So why the change from choking to multiple drowning?
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With the damage to Jake's throat,
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the unsub Wasn't able to successfully resuscitate him.
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Resuscitating them makes him feel more powerful.
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Which means he has no power in his everyday life.
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But the change in victimology is interesting.
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Nick Skirvin was the smallest,
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but he had the most defensive wounds on his body.
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He fought back the most.