The Highest Price for Pleasure

Last Editorial Review: 1/31/2005

A Deadly Turn-On

By Martin Downs
WebMD Feature

Reviewed By Charlotte Grayson

Imagine a nightmare: You come home to find your teenage son's dead, seminude body hanging by the neck in his bedroom closet, pornographic magazines and women's underwear scattered about the floor.

One mother did, and as many as 1,000 Americans each year stumble upon the bodies of their loved ones in similar situations. These people die accidentally while practicing what's known as autoerotic asphyxiation--strangling or suffocating themselves to heighten sexual arousal and orgasm.

When you rob your brain of oxygen (asphyxia), you experience a high -- euphoria, dizziness, and lowered inhibition -- before you lose consciousness. To make their sexual experience more thrilling, autoerotic asphyxiators masturbate while strangling themselves with cords, ropes, scarves, and ties, or they suffocate by sealing their heads in plastic bags.

The vast majority don't mean to kill themselves. They usually devise some kind of rescue mechanism to stop the asphyxiation once they've climaxed. But the fail-safe often fails. For example, they may tie a slip-knot or hang themselves from something that's shorter than they are, so they can simply stand up to stop the strangulation. But they may get so weak and disoriented from lack of oxygen that they can't pull out the knot or stand up, and they pass out and die.

Kathrin Passig, a German journalist, has been conducting an informal survey to find out why people get into asphyxiation.

Many in her survey were inspired by the Alfred Hitchcock movie Frenzy, which has scenes of women being strangled, and Westerns on TV in which outlaws are hanged. But TV and movies are not always the inspiration: "When I was 12 years old, I tried holding my breath for as long as possible and found it sexually stimulating," one person said. Another said: "My girlfriend and I were 13 years old. We had a pillow fight for fun. She suddenly got on top of me and as a sign of victory put her hands around my neck and cried, 'I win!' This was very exciting and I got an erection."

Autoerotic asphyxiation is one of the few sexual practices that remain hush-hush, mainly because forensic scientists and psychologists won't talk about it outside their professional circles. They're afraid of giving kids ideas.

They are worried about kids in particular because teenage boys are the ones who most often die from it. Suicide is one of the most common causes of death for teens, and it's believed that many deaths ruled as suicide are actually autoerotic asphyxiation accidents. Police investigators may miss signs that might lead them to conclude it was a sexual accident, or family members may "sanitize" the scene before the police show up -- removing the pornographic materials, lubrication, sex toys, and in cases where cross-dressing is involved, women's clothes. Not all autoerotic asphyxiators like to put on women's clothes, but it's common enough to have become a stereotype.

Mark Clark, a detective sergeant with the Scottsdale, Ariz., police department, argues that even if sexual asphyxiation is kept out of the media, kids will discover it on their own. "It should be talked about," Clark says, adding that after kids get into the practice they look for information on how to do it more safely, and they must be told that there is no way to do it safely.

Clark had a younger brother who died from autoerotic asphyxiation in 1993 and also says he has just seen too many ghastly sexual asphyxiation death scenes while on the job.

He says a good way to educate kids would be to approach asphyxiation in a nonsexual way: A lot of kids learn that it arouses them as a result of trying it because they've heard the practice can get them "high." So Clark says, "Teach them that they can die from that. You don't have to talk about the sexual end of it," he says.

"It is, at the very least, damaging, and at the worst, absolutely lethal," says Andrew Jenkins, PhD, professor of health education at Central Washington University. Even if you don't have an accident and die, asphyxia causes permanent brain damage over time.

In addition to the solo practice of sexual hanging, some couples incorporate it into bondage, domination, and sadomasochistic (S&M) play. They may be under the false impression that it's safe if someone is there to cut the rope.

"It's always life-threatening to a greater or lesser degree," says Jay Wiseman, author of S&M 101: A Realistic Introduction. Wiseman is regarded as an authority on erotic asphyxiation in the S&M community. He isn't a doctor, but he is an emergency medical technician, and he lectures around the country on safety in S&M play.

One of the dangers of sexual asphyxiation is that it can trigger a heart attack. Deprived of oxygen, the chemistry of your blood changes. Those chemical changes can throw the heart into deadly heart rhythm abnormalities or cause and cardiac arrest. So you can die even if a partner loosens the noose. "The probability of a successful resuscitation is pretty low," Wiseman says.

There are as many sexual turn-ons as there are things in the world, and no one can keep you from feeling the way you do. If asphyxiation is your thing, however, it's best left to fantasy. Jenkins puts it in no uncertain terms: "This practice is not an acceptable variation of sexual behavior."

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