Erotic asphyxiation

Physiology

Author John Curra wrote, "The carotid arteries (on either side of the neck) carry oxygen-rich blood from the heart to the brain. When these are compressed, as in strangulation or hanging, the sudden loss of oxygen to the brain and the accumulation of carbon dioxide can increase feelings of giddiness, lightheadedness, and pleasure, all of which will heighten masturbatory sensations."

Author George Shuman describes the effect as such, "When the brain is deprived of oxygen, it induces a lucid, semi-hallucinogenic state called hypoxia. Combined with orgasm, the rush is said to be no less powerful than cocaine, and highly addictive."

Concerning hallucinogenic states brought about by chronic hypoxia, Dr. E L Lloyd notes that they may be similar to the hallucinations experienced by climbers at altitude. He further notes that no such state occurs in hypoxia brought about by sudden aircraft decompression at altitude. These findings suggest to him that they do not arrive purely from a lack of oxygen. Upon examining the studies on hypoxia he found that "abnormalities in the cerebral neurochemistry involving one or more of the interconnected neurotransmitters, dopamine, 5-hydroxytryptamine, and β-endorphin had been reported in all the conditions associated with hallucinations."

History

Historically, the practice of autoerotic asphyxiation has been documented since the early 17th century. It was first used as a treatment for erectile dysfunction. The idea for this most likely came from subjects who were executed by hanging. Observers at public hangings noted that male victims developed an erection, sometimes remaining after death (a death erection), and occasionally ejaculated when being hanged. However, post-mortem ejaculation occurs in hanging victims after death because of disseminated muscle relaxation; this is a different mechanism from that sought by autoerotic asphyxiation practitioners.

Practice

Various methods are used to achieve the level of oxygen depletion needed, such as a hanging, suffocation with a plastic bag over the head, self-strangulation such as with a ligature, gas or volatile solvents, chest compression, or some combination of these. Sometimes, complicated devices are used to produce the desired effects. The practice can be dangerous even if performed with care and has resulted in a significant number of accidental deaths. Uva (1995) writes “Estimates of the mortality rate of autoerotic asphyxia range from 250 to 1000 deaths per year in the United States.” Cases have also been reported in Scandinavia and Germany. Autoerotic asphyxiation may often be mistaken for suicide, which is a major cause of death in teenagers.

Accidental death

Deaths often occur when the loss of consciousness caused by partial asphyxia leads to loss of control over the means of strangulation, resulting in continued asphyxia and death. While often asphyxiophilia is incorporated into sex with a partner, others enjoy this behaviour by themselves, making it potentially more difficult to get out of dangerous situations.

In some fatality cases, the body of the asphyxiophilic individual is discovered naked or with genitalia in hand, with pornographic material or sex toys present, or with evidence of having orgasmed prior to death. Bodies found at the scene of an accidental death often show evidence of other paraphilic activities, such as fetishistic cross-dressing and masochism. In cases involving teenagers at home, families may disturb the scene by "sanitizing" it, removing evidence of paraphilic activity. This can have the consequence of making the death appear to be a deliberate suicide, rather than an accident.

The great majority of known erotic asphyxial deaths are male; among all known cases in Ontario and Alberta from 1974 to 1987, only one out of 117 cases was female. Some individual cases of women with erotic asphyxia have been reported. The main age of accidental death is mid-20s, but deaths have been reported in adolescents and in men in their 70s.

Autoerotic asphyxiation has at times been incorrectly diagnosed as murder and especially so when a partner is present.

Lawyers and insurance companies have brought cases to the attention of clinicians because some life insurance claims are payable in the event of accidental death, but not suicide.

Famous cases

In fiction

The sensational nature of autoerotic asphyxiation often makes it the subject of urban legends. It has also been mentioned specifically in a number of works of fiction.