Auto-erotic asphyxiation (AEA)

Auto-erotic asphyxiation (AEA) is the practice of cutting off the blood supply to the brain through self-applied suffocation methods while masturbating. By limiting the blood supply to the brain, AEA can induce cerebral anoxia, a deficiency of oxygen in the brain. Oxygen deficiency in the brain is thought to intensify sensations, producing feelings of giddiness, lightheadedness, or exhilaration that can heighten the orgasmic experience. It's also possible that the helplessness and self-endangerment inherent in the AEA enhance sexual gratification for some people.

Of course, this same self-endangerment that may provide a thrill to the person carrying out AEA also weakens one's self-control and judgment, which can result in accidental death. Because of taboos surrounding AEA, the practice almost always remains a secret until a person dies accidentally. Although a death from AEA may often be labeled as a homicide or suicide, It's estimated that between 500 and 1000 deaths occur annually in the United States from this type of masturbation. Both men and women can participate in AEA. 

Depending on how long the brain and body are deprived of oxygen, brain damage could occur even if death does not.  A person participating in AEA also risks lacerating, cutting, or bruising their neck, depending on the suffocation or strangulation technique used. 

Auto-erotic asphyxiation is a dangerous activity because of the risk of death and brain damage. For those interested, a safer option would be to fantasize about suffocation, rather than trying to walk the fine line between heightened sensation and serious brain impairment.  

As little as seven pounds of pressure will collapse the carotid artery, producing unconsciousness within seconds. It’s nearly impossible to regulate the amount of pressure you’re putting on your neck with the wrong kind of bow-tie, and even the best sailor’s knots have a nasty habit of slipping. Deprived of oxygen, the chemistry of your blood changes, which can throw the heart into deadly arrhythmic abnormalities or cause cardiac arrest (science words!). So even if you have the balls to ask one of your friends to hang out while you masturbate with your mom's pantyhose tied around your neck, and even if they get to your naked, fully-erect body BEFORE you choke to death, you could still die of a heart attack while waiting for the EMTs to take you on a very awkward ambulance ride. (ref 1)

On the evening of Wednesday, July 11, 2007, Chris Duchamp, 23, finished his electrical-engineering classes at a college in Ottawa, Ontario, and rode the bus home to his one-bedroom apartment across the river in Gatineau. Duchamp (not his real name) lived alone. Sometime around three Thursday morning, Duchamp took off his clothes. He then strung a length of boat rope through an eye hook he'd driven into the floor, looped it around his neck in a way that allowed him to control the tension, and threaded it through a second eye hook, which he'd affixed to the archway above his head. Then he took the free end in his left hand and pulled.

The next day, Duchamp, a tall, blue-eyed man whom friends affectionately described as a "smart-ass," failed to show up at the movie theater where he worked part-time.

When police discovered his body a day later, slumped over in its cat's cradle of ropes, they found something else, too: On a kitchen table, within arm's length of Duchamp, a laptop computer was flashing pornography.

"The police told me he had committed suicide," says Jean, Chris' father (whose name has also been changed). But his son had no history of depression or mental illness. So Jean pressed the police who'd been at the scene. "I said to the officer, 'Did he have any clothes on?' He said, 'We found him hanging—it's a suicide.' I said, 'Did he have any clothes on?' He said no. I said, 'Well, it's not a suicide.'" Later, when Chris' family scoured their deceased son's computer for clues about his lifestyle, they stumbled upon something disturbing: Not only had Chris been practicing autoerotic asphyxiation (AeA) for years, his circle of friends had been doing it too. They'd even discussed it in online chat rooms. One of those posts, Jean says—left by a friend of Chris' after his death—still haunts him two years later. It read, "He wasn't supposed to do this alone."

Stories like Duchamp's have been appearing periodically in the news for years. This past June, actor David Carradine was found dead in the closet of his Bangkok hotel room, reportedly with a set of cords lashed around his neck, hands, and genitals. And 12 years before that, INXS frontman Michael Hutchence died in a Sydney hotel; he was found naked, kneeling against a door, with a belt nearby. In both cases, suicide and murder were among the initial theories. But Carradine and Hutchence weren't seeking death or pain—in fact, it's likely they were chasing pleasure. Their method—autoerotic asphyxiation—just happened to kill them.

The infrequency with which we hear about such cases seems to suggest that AeA is the province of an obscure minority. But the practice may be more widespread than most of us imagine: One online fetish site for "gaspers" (a slang term for AeA enthusiasts) claims to have received 4.7 million visitors since launching in April 1992. According to an FBI estimate, between 500 and 1,000 Americans die from AeA every year—a range that's comparable to the number of homicides in New York City in 2008—and the majority of them are men. That estimate hasn't been updated since the early eighties, and some experts believe it to be conservative, because the stigma attached to the practice makes people reluctant to acknowledge AeA as the cause of death.

"It remains something people find out about only after these men are dead," says Dr. Park Dietz, a forensic psychiatrist who's been studying and writing about the phenomenon for more than 30 years. And while it's impossible to know how many deaths from AeA are mislabeled, Dietz says, it's common for the authorities to record them as suicides rather than reveal the more risqu� truth.

An act that combines choking and sex may sound like something exported straight from an S&M dungeon, but it's not. The payoff is not so much psychological as physiological. The neck is home to two vascular superhighways: the carotid artery, which carries blood to the brain, and the jugular vein, which carries it back to the heart. If you constrict these vessels, carbon dioxide builds up in your brain, creating a narcotic effect. Combining that with an orgasm may trigger a dopamine release that intensifies that euphoria—"like taking Ecstasy and having sex," says Dr. John Sims, director of the neurocritical care unit at Massachusetts General Hospital. Occasionally, you pass out—and if that happens while your neck is still constricted, you will die. If, however, you survive, you will likely be overwhelmed by the magnitude of the feeling. In other words, this isn't some masochistic desire to be choked. This is a far more universal longing—to feel good, despite the risks, which include not only death but also damage to the brain caused by oxygen starvation.

Two years ago, newspapers and morning shows were abuzz with talk of the "choking game"—a school-yard pastime in which kids, seeking a euphoric high, would strangle one another until they passed out. Scott Metheny, a Pennsylvania police officer, responded to the phenomenon by helping to start an anti-choking-game website called GASP and teaching police officers and coroners how to recognize cases of death by AeA.

"Basically, the choking game is the gateway drug to autoerotic," Metheny says. "People are experimenting with asphyxiation play—without the sexual element—because they're told it feels good and they feel no damage from it. They put the two together because someone tells them that the orgasm will be so extreme that a regular one's not good enough anymore."

For Jeremy Ellman (not his real name), a 47-year-old real-estate agent in Long Beach, California, it all started with a parachute. He was 13 when his dad brought one home from an army-surplus store.

"I just rolled up really tight in this thing and it accidentally slipped over my face," Ellman says. "And it was very exciting." Pretty soon, Ellman was wrapping pantyhose around his head—sometimes more than five pairs at a time—to constrict his breathing, crawling into sleeping bags backward, and getting himself off "just by wiggling around." Back then, he didn't understand why his orgasms were better. But by the time he was in his twenties, he did—and he was chasing them every day. "When I had girlfriends, we did crazy noose play. I'd have them string me up from the ceiling, and then you kick something over and dangle there trying to catch your breath." Today, Ellman says, he's just your average California dad with a secret. "If you met me, you would have no idea," he says. "I wear Tommy Bahamas, flip-flops. No tattoos, two kids—absolutely normal."

In his late twenties, Ellman had a close call. He was alone, covered "head to toe in pantyhose," tied up and gasping for air, in a pair of handcuffs with a self-release switch that failed. "My left hand would always open the right cuff," he recalls. "But somehow that little switch broke." He tried to get at the switch on the left cuff, he says, but his right hand was wrapped so tightly in pantyhose, he couldn't feel the lever. He had to rip through the hose with his fingers. Then he discovered he'd tied his arms to his chest so tightly that he couldn't get the angle he needed. "That was a crazy 30 seconds," he says. But even then, he admits, it never occurred to him that perhaps he should find a less perilous route to sexual climax. "My thoughts were not that I'm never going to do that again," Ellman says, "but that I'm going to be a lot more careful."

For some, the danger is part of the appeal—and when that psychological aspect is combined with the physical, AeA's allure becomes even more powerful. According to Dietz, who studied 132 cases of death by AeA for his 1983 book 

Lee Harrington, a 29-year-old "alternative-sexuality educator" who teaches a course in Phoenix on "breath and blood flow in erotic life," devotes the first 20 minutes of his class to the myriad ways that AeA can kill you. Harrington himself uses Tantric breathing and gas masks to simulate the effect of AeA. Although he doesn't encourage anyone to practice AeA, Harrington explains that the damage done to the brain is no worse than what occurs during other pursuits. "It boils down to this," he says. "How do I want to lose my brain cells in this life? Do I want to do it by doing lines? By crushing heads on the football field? Or do I want to do it in the bedroom?"

A couple of weeks before his death, Chris Duchamp returned home for a weekend visit with his family, and an eerily portentous exchange took place. Jean had recently seen an alarming news segment on television.

"It was just a very brief national-news thing on the choking game," he recalls. "And knowing my son, always looking for the ultimate high, I say, 'You're not stupid enough to do something this retarded are you?' And he goes, 'No.'

"And I believed him." (ref 2)

An Alabama minister who died in June 2007 of 'accidental mechanical asphyxia' was found hogtied and wearing two complete wet suits, including a face mask, diving gloves and slippers, rubberized underwear, and a head mask, according to an autopsy report. Investigators determined that the pastor's death was not caused by foul play and that the 51-year-old was alone in his home at the time he died (while apparently in the midst of some autoerotic undertaking).

While the local paper, which first obtained the autopsy records, reported on the pastor 's two wet suits, the family newspaper chose not to mention what police discovered inside the minister's rubber briefs, a dildo. The man served as the church's pastor for 16 years. Immediately following his death, church officials issued a press release asking community members to 'please refrain from speculation' about what led to his demise, adding that, 'we will begin the healing process under the strong arm of our Savior, Jesus Christ.'

"The decedent is clothed in a diving wet suit, a face mask which has a single vent for breathing, a rubberized head mask having an opening for mouth and eyes, a second rubberized suit with suspenders, rubberized male underwear, hands and feet have diving gloves and slippers. There are numerous straps (11) and cords restraining the decedent. There is a leather belt about the midriff. There is a series of ligatures extending from the hands to the feet. The hands are bound behind the back. The feet are tied to the hands. There are nylon ligatures holding these in place with leather straps about the wrists and ankles. There are plastic cords also tied about the hands and feet with a single plastic cord extending up to the head and surrounding the lower neck. There is a dildo in the anus covered with a condom".

The Doctor who prepared the autopsy said:

“These things happen. We see probably two of these a year. If you’re not used to seeing that sort of thing, it’s probably unusual.” (3)

BBC presenter Kristian Digby was found dead in his apartment yesterday - after a suspected solo sex game went wrong. The To Buy Or Not To Buy host, 32, is thought to have suffocated while starving himself of oxygen for a thrill.

Police officially described his death as "unexplained" - but detectives do not think it was suicide.

A source said last night: "At this time we believe he died from auto-erotic asphyxiation."

Kristian had helped create the home in Stratford, East London, as part of BBC1 show To Build Or Not To Build in 2008. Ambulance crews were unable to revive the 32-year old at the flat in Newnham at 7.45am.

"Officers are investigating."

A post mortem will be held today. Toxicology tests will be carried out to check for drugs. According to reports a belt and a bag were removed from the property for forensic tests.

Erotic asphyxiation refers to intentionally cutting off oxygen to the brain for sexual arousal. Last year Kill Bill actor David Carradine, 72, accidentally hanged himself during a sex act in his Bangkok hotel. INXS singer Michael Hutchence, 37, may have died from auto-erotic asphyxiation in 1997 - although suicide was the official cause of death.

Last night Kristian's agent Jo Wander said: "I am devastated by the loss. He was a lovely guy and a very talented presenter."

He directed Fantasy Rooms, and was a presenter on Holiday, Living In The Sun and That Gay Show.

Last night the BBC said in a statement: "Kristian was a much-loved and talented presenter. He brought a real sense of energy and warmth to all the shows. Our thoughts are with his family."

Dominic, 44, also paid tribute to his former co-host and said: "There's not a bad word I can say about Kristian.

"He was a lovely fun, nice, jolly, decent person." (4)

The mysterious death of actor David Carradine -- perhaps by auto-erotic asphyxia -- focused renewed attention on a practice that is one of the greatest and most dangerous sexual taboos.

The 72-year-old actor was found dead in a Thai hotel room closet in an intricate web of ropes -- one around his neck, another around his genitals and the two tied together, according to Thai authorities. Sex experts say that Carradine's advanced age suggests that he may have been a lifelong practitioner of the secretive and dangerous practice, one that can go fatally awry.

Los Angeles Superior Court documents of Carradine's divorce put online by The Smoking Gun show that his most recent ex-wife, Marina Anderson, accused the actor of "deviant sexual behavior which was potentially deadly." The alleged behavior wasn't described in the court documents.

Also known as hypoxyphilia, the practice is a sub-category of sexual masochism that involves reducing the oxygen supply to the brain while masturbating to achieve a heightened orgasm.

"There's a fine line between the state of hypoxia [lack of oxygen in the brain] and death, and it's in that state that a person becomes highly aroused and it's what allows them to orgasm," said Eli Coleman, chair of the sexual health department at the University of Minnesota. "People usually have safety nets and no intention to die, but something often goes wrong in their calculation," he told ABCNews.com. "Maybe a stool or something they are standing on somehow slips away."

The Federal Bureau of Investigation estimates there are between 500 and 1,000 such deaths in the United States annually, mostly among young men. Many more may be falsely ruled as homicides or suicides. Auto-erotic asphyxia often starts in adolescence, which is why many of the deaths associated with the practice are among young adults. But, the practice is not unknown among girls, according to Coleman.

Because it is practiced alone, AEA is particularly dangerous. It is a compulsive activity that can also escalate, as may have been the case with Carradine, said Coleman. "We know very little about the people who practice this," he said. "Most of what we know is from those have accidentally died."

Forensic experts often rule these deaths as suicides, but the evidence often suggests otherwise: the body is naked, there are pornographic materials and perhaps even semen present.

"It's tragic for families because no one has any suspicion of what is going on," said Coleman. "Usually it's a carefully guarded secret."

Such was the case with Michael Hutchence, the late lead singer of the superstar Australian band INXS, whose death in 1997 was ruled a suicide. The singer was found naked, hanging from his leather belt in a Sydney hotel room with pornographic literature at his feet and no suicide note. Hutchence's wife spoke publicly of their kinky sex life and his desire to try AEA, and a British documentary eventually concluded that was the case.

According to research by Stephen Hucker, forensic psychiatrist from the University of Toronto who is one of the foremost experts in the field, the practice is not entirely modern.

Stone statues dating back to 1,000 AD suggest it was known to the ancient Mayans in Mexico. The Marquis de Sade, whose name was given to the practice of sado-masochism, described it in his 1791 novel, "Justine."

The more common ways of carrying out the practice are self-hanging, strangulation, choking, suffocation and techniques to restrict breathing movements. Self-hanging is the most common method observed among fatal cases, according to Hucker's Web site, Forensic Psychiatry

"Fatalities resulting from AEA practices occur with a frequency of about one per million of the population per year in North America though it is important to note that this figure is based on studies of cases that have been recognized as AEA or Hypoxyphilia," said Hucker.

Usually a rope or ligature is the method used to strangulate the oxygen supply, but others may be present as part of the person's own sexual ritual. Plastic bags and more complicated apparatuses may also be used.

Sex therapists regard this as a paraphilias -- or a socially unacceptable sexual practice. It is often associated with forms of anxiety and depression, though not suicidal thoughts.

Few who seek help because of the shame, which fuels a cycle of guilt, anxiety and then release.

"Many look pretty normal underneath but when they are accelerating this need for a very intense high, what they are doing in medicating some state of dysphoria or unease," said Coleman. "And because it is rather unusual and there is a lot of stigma around masturbation to begin with, the guilt and shame become part of a repetitive cycle of obsession and compulsion."

Teens often discover the practice on their own, rather than learning it from others. Its sensations are similar to the "choking game" played by young children, who get a thrill from the dizziness created by holding their breath.

Divers have also reported a "high" from oxygen deprivation, according to Coleman. "For some people that may be pleasant or something associated with sexual arousal."

"This has been around long before the Internet.We have no idea how they would discover this," said Coleman. "It's not something they learned. It was a puzzlement and we concluded they were learning it on their own."

"We can only start to piece this together from people who have actually survived," he said.

Coleman, who did not consult in the Carradine case, speculates that many, like the actor, have practiced AEA for years.

"It becomes for them a fetish kind of thing and that is what it really takes for them," he said. But often their activities escalate in risk for the thrill, resulting in accidents.

But in the case of teens, accidental death often happens because they are inexperienced in the practice. "For those who have done it a long time, they know the limits and are pretty careful."

Coleman said people, particularly young teens, need to learn about the dangers of AEA.

"There are a lot of things on the Internet and we have no idea how this is impacting people," he said. "We are certainly concerned that [the Carradine case] might lead to an increase."

"We need to educate people about the risks rather than shield people from the information," he said. "A lot of people are engaged in this activity and they don't know the risk."

Carradine's ex-wife Anderson also said in divorce documents that her "pleas for him to get counseling" were ignored. (5)

1. http://www.cracked.com/funny-303-autoerotic-asphyxiation/#ixzz1BBva88sS
2. http://www.details.com/sex-relationships/porn-and-perversions/200909/self-asphyxiation-is-taking-sex-to-a-scary-level
3. Smoking Gun
4. The Sun Sunday, 16 January 2011
5. ABC News