Choking - yea or neah

October 30, 2006 11:06 AM

Kinkfilter: I know there’s a big campaign to discourage kids from playing the choking game, and I know people die from autoerotic asphyxiation all the time, but

I also know that lots of people like to get choked for fun while having sex. It seems that most accidental asphyxiation deaths happen when someone actually has a rope or belt tied around their necks and usually only when no one is there to rescue them if things go bad. From the little I could dig up on medline, there’s no conclusive evidence that choking for fun is actually dangerous to a healthy person. But do you have any information that would make you believe otherwise? I’m especially interested to hear from health workers and people who have direct experience with this sort of thing. And of course I’m only asking for my, uh, cousin.

posted by serazin to health & fitness (14 comments total)

IANA Medical Professional, but what I have read indicates that cutting off oxygen supply, even in a healthy person, can trigger fatal arrythmia. Multiply for unhealthy people, and factor in that minor heart problems can go undetected for years.
posted by dirtynumbangelboy at 11:26 AM on October 30, 2006

in the experiance of my friend you get the same effect as cutting off the air supply (great, there's "I'm All Out of Love" for the next hour) by applying firm, steady pressure to either side of the larynx. this slows the flow of blood to the head which has the same sensory effect as choking but with no danger of asphyxiation. it takes paying very careful attention, i'm told, but you should be doing that anyway.
posted by mikoroshi at 12:36 PM on October 30, 2006

Googling "breath play" will get you a number of articles on the subject. They'll explain the risks — including the mundane ones like hitting your head if you faint or hurting your partner if you panic and lash out, but also the very real possibility that one of you will be charged with murder or attempted murder if something bad does happen.

They'll also explain safer alternatives to outright choking. Please consider these. Putting pressure on the trachea can definitely damage it, whether lethally or no. And using force — say, enough force that the bottom can't fight his way free if his life depends on it — makes the whole game much more dangerous.

Hopefully, too, a little reading will demonstrate to you that even among really, really hardcore perverts — people who smile at being hung up by hooks or whipped until they bleed — breath play is considered extreme, controversial and very dangerous. If it's your kink, it's your kink, and we're probably not going to change your mind about trying it. But please educate yourself and take it very, very seriously.
posted by nebulawindphone at 12:48 PM on October 30, 2006

The blood pressure sensor for the entire body is located in the neck, where the carotid artery branches. Pressure on this area can obstruct the artery, cutting off blood flow to the brain. However, the sensor detects that the pressure there is very high. So it sends a signal to the rest of the body (via the brainstem) telling it to do things that reduce blood pressure drastically, like slow down the heart. This is just the wrong thing when you've got pressure on the carotid artery, as it reduces blood flow to the brain still further. Loss of blood to the brain causes loss of consciousness and can provoke a seizure or cause a stroke.

If the artery itself is roughly handled, it can also dissect its interior lining, which is called "carotid dissection;" this is a life-threatening emergency that often proves fatal. And of course there is the danger of larynx or tracheal fracture if those structures are roughly handled.

All in all these things are pretty rare, but they are real risks. I doubt anyone would tell you, "Sure, choking for fun is safe and easy," because it's really not.
posted by ikkyu2 at 12:52 PM on October 30, 2006

That said, all the emergency-department patients I've seen come in with strangulation were billed to me as "suicide attempt." I figure probably some of them were not intending suicide - most folks who strangulate themselves with the intent to die do it far enough away from people that they're not discovered in time - but it's hard to know for sure, because they're comatose and not telling.
posted by ikkyu2 at 12:54 PM on October 30, 2006

Many believe that Michael Hutchence, the lead singer from INXS died of accidental autoerotic asphyxiation, if you want a real-world example.
posted by cholly at 1:05 PM on October 30, 2006

Thanks all so far. And ya, I get that autoerotic asphyxiation is Not Good. But I wonder if the danger there comes mostly from the auto part of the asphyxiation. If you’re alone and hanging yourself and you pass out, no one is there to cut you down.

I have done a lot of reading about this and basically understand the theoretical risk, and I know that this practice is frowned upon, but I think it’s actually pretty common. I don’t think there’s a definitive answer on safety out there since I’ve already done a medline search with little conclusive result. So answers like yours ikkyu2 that come from direct experience are really helpful.
posted by serazin at 1:22 PM on October 30, 2006

Not to suggest that you have DIRECT experience ikkyu2, I mean, I don't either, I'm only asking for my cousin! I swear!
posted by serazin at 1:30 PM on October 30, 2006

In circles I am aware of the most outspoken and analytical critic of breath control is Jay Wiseman, whose name you might Google in that connection.

You might be aware that the vagus nerve is what's sometimes responsible for sudden cardiac arrest when a person falls into cold water. The vagus nerve's also implicated in deaths due to breath control play.

All that said, I have a choke collar that I let one of my tops put on me, and knowing he can throttle me if he wishes is incredibly hot - but yah, that's my kink.
posted by jet_silver at 1:57 PM on October 30, 2006

If you're looking for more mundane consequences, it causes red spots in the eyes from blood vessels that burst. It can look...well, let's just say that it's annoying to find some way to explain away.
posted by digitalis at 6:34 PM on October 30, 2006

Another death-related question... time for me to chime in. I'm a pathologist, and autoerotic asphyxiation is a perennial favorite topic of discussion (yes, we pathologists are an odd bunch). I've autopsied 2 people who died of autoerotic asphyxiation (both young men, late-teens to early twenties).

A few points to consider:
1. Most people who die of autoerotic asphyxiation do not die the first time they experiment with it. They have usually been doing it for a long time and have developed elaborate/complex rituals for the act (renting hotel rooms, fabulous costumes, bizarre electrical devices, etc.). They usually die because the escape mechanism fails (eg. they lose grip of the rope, they pass out before being able to stand up, or the knots are tied weird, etc.).

2. The big controversy in the pathology world is how to label their cause of death. Most people sign the manner of death as accidental (and not suicide) and the cause of death as experimentation (to save the families/victim some embarassment).

3. Along the lines of what ikkyu2 mentioned, since the area you would be choking contains some fairly sensitive blood pressure regulating organs (carotid body) it would be ill-advised to apply pressure there if you had heart problems (bradycardia) or plaque in your carotid arteries (carotid stenosis).
posted by i_am_a_Jedi at 8:15 PM on October 30, 2006 [1 favorite]

The book SM 101 (according to my cousin) has an appendix where the author, a medical professional of some sort (an EMT I think) explains exactly why, in medical terms, breath play is not the wisest idea.
posted by the_bone at 8:39 PM on October 30, 2006

serazin writes "But I wonder if the danger there comes mostly from the auto part of the asphyxiation."

No, as several people (myself included) wrote before you made this comment, the danger is due to other things.
posted by dirtynumbangelboy at 4:14 AM on October 31, 2006

Serazin, if you are wanting to talk to someone who has had direct experience with it please email me, i can tell you what experience i have had and why....
posted by rainbow_2006 at 4:25 PM on October 31, 2006