To choke or not?

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Set me straight on choking: is it the deprivation of air or are you actually supposed to press on the sides of the neck? I’ve heard there is such a thing as “safe” and “unsafe” choking. What’s the difference?

— Anonymous, from Tumblr

Sarah: Okay, so I checked with an experienced BDSM educator (who is also a friend), and she told me that, yes, there is such a thing as safe choking, and when you’re pressing on the “sides of the neck,” you’re supposed to compress the arteries running beside the esophagus and not the ol’ wind pipe itself. The motion is a squeezing-with-fingertips kind of thing and not really “choking” as in depriving someone of oxygen. That’s what the squeezing does to the brain, leading to a lightheaded sensation that can be fun.

Debby: I cannot recommend any constriction of the neck/throat in good conscience and, in fact, this is one area where many BDSM educators draw the line (some arguing that erotic asphyxiation crosses the lines of “safe, sane, and consensual”). Other BDSM educators say no way, no how…. unless maybe the one doing the choking is also trained in CPR, in case needed. In the 15 years I’ve worked in sex research/education, while I am absolutely aware of people engaging in choking and other forms of breath play without incident, I’ve also seen far too many cases of people of all ages dying (or having a partner die) from breath play. Of the deaths, many were young people trying out autoerotic asphyxiation (hanging themselves alone), but others were seasoned, experienced kinksters who had choked a partner many times without incident until one day their partner/spouse died mid-play. When I was in grad school, one of my mentors (a medical doctor and sex researcher/therapist) was called to a nearby town in Indiana to essentially do a “town hall” style talk for parents, professionals, and teenagers about the dangers of breath play after several young people in the community had died from such play. I’ve also known colleagues who were called in to be expert witnesses in these court cases, which typically do not end well for the surviving partner who may be charged with assault or murder. One woman I know is a BDSM-related sex worker and also an attorney and a few years ago she invited me to a talk she gave about BDSM and the law - for those of you who follow such cases, you may know that even emails or contracts where two or more people specify all the things they consent to do to one another don’t typically hold up in court because ultimately judges and juries tend to agree that one cannot consent to be assaulted, let alone killed.

Here’s the other thing: even if you think you have safe “technique” down, that may not matter if the person you’re playing with has asthma, diabetes, cardiovascular disease, panic attacks, seizures, or other conditions that may breath play particularly risky (diabetes and cardiovascular disease, by the way, are increasingly prevalent in the US). Some courts have also found people guilty of engaging in sexual activities with a partner/spouse who consented to breath play and who was unconscious even briefly - during the subsequent sex, given that people are supposed to give consent in an ongoing way during sex. I could go on and on… or you could check out Google Scholar where you will find tons of case reports of medical incidents (stroke, death, etc)... or you can even search terms like “safer breath play” and find that many BDSM educators caution against it or, if they promote it, they tend to disagree even amongst themselves what constitutes safe play (I found websites with conflicting information about safe vs. unsafe practices). Finally finally finally, remember: most people aren’t playing with someone seasoned and unfortunately far too many people see choking in porn and think it would be fun to try at home but have zero idea what they are doing. In a recent study my team asked college students about the good and bad things they felt had come from porn in their own lives. Some women described partners who tried to choke them during sex as one of the negative things that they felt had come from porn, and I doubt many of their partners had attended a “safer breath play” workshop. So my take? Don’t do it but if you’re going to do it anyway, at least never, even do it with someone who hasn’t asked specifically for it.

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