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Erotic asphyxiation, asphyxiophilia, or breath control play, is the practice of intentionally reducing the amount of oxygen to the brain during sexual stimulation in order to heighten the received pleasure from orgasm.

Contents 1 Practice 2 Famous cases 3 Cultural references 3.1 Film 3.2 Literature 3.3 Television 3.4 Other 4 See also 5 References 6 Further reading 7 External links

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The act of depriving oneself or another of oxygen for the purpose of achieving or enhancing orgasm is classified officially in the United States as hypoxyphilia, according to the American Psychiatric Association. The APA classifies hypoxyphilia as a mental disorder, as noted by the periodical Psychology Today. Hypoxyphilia falls under the category of psychiatric disorders known as paraphilias, a term that refers to an unusual or unnatural attraction.

Dr. Joseph Merlino, author and psychiatry adviser to the New York Daily News, considers it fundamentally a disorder. "Somebody going into that who doesn't consider it a serious threat to himself is somebody who is not informed," said Merlino in an interview. "It could have a very lethal outcome. It's a pathology, strictly engaging in that, like someone who wants to play Russian Roulette to have the excitement of hearing a click, but the bullet is not coming out. That's a disorder because it has the potential for lethality or serious injury."^[1]

A sexual partner may or may not be involved in the act. If a partner is excluded the practice can be referred to as autoerotic asphyxiation, or AEA.

In the BDSM community, interactions of this nature may be referred to as breathplay or sometimes edgeplay, and generally include a partner. Because like other forms of edgeplay breathplay pushes the limits of "safe, sane and consensual", situations involving breath control can be assessed using the acronym RACK or Risk Aware Consensual Kink. Partners are generally expected within this community to be cognizant of and responsible for the dangers that they may take part in.

Various methods are used to achieve the level of oxygen depletion needed such as a plastic bag over the head or self-strangulation, typically by the use of a ligature (scarfing). The practice can be dangerous even if practiced with care and has resulted in some accidental deaths.^[2]

Historically, the practice of autoerotic asphyxiation has been documented since the early 1600s. It was first used as a treatment for erectile dysfunction and impotence.^[3] The idea for this most likely came from subjects who were executed by hanging. Observers at public hangings noted male victims developed an erection, sometimes remaining after death (death erection), and occasionally ejaculated when being hanged. Note that, however, ejaculation occurs in hanging victims after death because of disseminated muscle relaxation; this is a different mechanism from that sought by AEA practitioners.

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 many do enjoy incorporating asphyxiophilia into sex with a partner, others enjoy this behavior by themselves, making it potentially more difficult to get out of dangerous situations^[4]. Victims are often found to have rigged some sort of "rescue mechanism" that has not worked in the way they anticipated as they lost consciousness.

In some cases autoerotic asphyxiation may have triggered carotid sinus reflex death, but this claim is controversial^{[citation needed]}.

With the exception of the books Autoerotic Fatalities by Hazelwood et al. (1983) and Autoerotic Asphyxiation: Forensic, Medical, and Social Aspects by Sheleg et al. (published in 2006) there has been no comprehensive coverage of erotic asphyxiation.^[5]

The composer Frantisek Kotzwara died from erotic asphyxiation in 1791, probably the first recorded case.

It is a popular subject in tabloids and celebrity gossip magazines, particularly when a celebrity dies as a result of suicide or other mysterious circumstances.

The artist Vaughn Bodé died from this cause in 1975.

Progressive Rock musician Kevin Gilbert died from this in 1996, as did drummer Robin Hanssen.

The death in 1994 of Stephen Milligan, the British Conservative MP for Eastleigh, was a case of autoerotic asphyxiation combined with self-bondage[1].

Michael Hutchence, lead singer for INXS is rumored to have died from auto-erotic asphyxiation in 1997, although suicide was the official cause of death.^[6]

A more recent case is the death in 2004 of the extreme right-wing National Front party member Kristian Etchells.[2]

On March 28, 2007, the New York Times had a front-page story on a teenager who had suffered a heart attack and spent three days in a coma after hanging himself for a "rush". [3]

Recent court cases have come to varied results as to whether the unintentional death resulting from autoerotic asphyxiation falls under the "self-induced injury" clause of standard life insurance policies, which prevents payouts for suicide within 2-5 years of policy purchase. In June of 2003, one US court said the intent was not death and therefore the case was an accident,[4] while another in August 2003 said it does technically fall within the terms since death is the logical result of asphyxiation.[5]

Autoerotic asphyxiation is key to the plots of many books, movies, and TV shows.

• In the short internet film "Farm Sluts" the protagonist attempts suicide by stapling his tie to an overhead joist and jumping from a chair. He fails because the tie is too long and he ends up just standing on the ground. His mother walks in on him, and he is later reprimanded by his father for engaging in "autoerotic asphyxiation".
• In the beginning of the film Life as a House actor Hayden Christensen playing the troubled teen character Sam Monroe nearly dies from asphyxiation hanging in his closet while masturbating.
• An accidental death in the film The Ruling Class (1972), starring Peter O'Toole
• "Scarfing" is practiced by the character Tate (while listening to women's tennis) in the controversial 2002 Larry Clark film Ken Park (with a non-simulated masturbation scene)[6].
• Full Frontal - The character played by David Duchovny dies of what is portrayed to be autoerotic asphyxiation. This may have been a reference to the fact that the character Fox Mulder, played by Duchovny in "The X-Files," was told by Clyde Bruckman, played by Peter Boyle, that he might die that way.
• Killing Me Softly in which Alice, the protagonist, experiments with autoerotic asphyxiation.
• This practice was also depicted as leading to the death of a character in Rising Sun, a movie based on the novel of the same name by Michael Crichton.
• It appears in the less publicized 2003 movie Young and Seductive, starring Julian Wells, Alana Evans, and Robert Donovan.
• The practice was central to Nagisa Oshima's highly controversial 1976 movie In the Realm of the Senses.
• The main hero of Kirill Serebrennikov's 2006 movie Playing the Victim Valya did some scarfing with his girlfriend.
• Paul Prior, a war photographer in the New Zealand film In My Fathers Den meets a girl in a pub and proceeds to take off his belt and practice erotic asphyxiation which makes the girl pick up her things and leave.
• Mason Verger makes reference to it when speaking about his crimes in Hannibal
• MacIntyre "Mac" Womack, portrayed by Steve Lemme, practiced autoerotic asphyxiation while masturbating in a police cruiser in the film "Super Troopers"
• In the opening sequence of the movie Dangerous Desires,the main character played by Richard Grieco,accidentally kills a woman he is having sex with via putting a scarf around her neck during climax.In a later scene,the same character simulates the same act apon Angie Everhart's character,although Everhart's character fakes her death.

• Marquis de Sade's novella Justine.
• William S. Burroughs' novel Naked Lunch has a number of scenes in which a man is hanged, gets an erection, and ejaculates. This qualifies as a minor theme of the book and is revisited in much of Burroughs's subsequent work.
• Thomas Harris' novel Hannibal features a character named Mason Verger, who performs it in front of Hannibal Lecter. Hannibal gives him drugs, and convinces him to slice off his face. (Although Verger recalls Lecter as having fed his face to his dogs, he is later told that he ate it himself.) At this point Lecter breaks Mason's neck, leaving him severely deformed, and permanently confined to a specialized sickbed or wheelchair.
• In chapter 29 of Kurt Vonnegut's novel "Galápagos", there is a flashback scene to the youth of one of the main characters, the con-artist James Wait, to when he was working as a homosexual prostitute in New York city. In the recounted episode, Wait accidentally kills a European prince who has paid for Wait to strangle him with a silk sash so that he may experience erotic asphyxiation. Wait strangles the prince for longer than instructed so that while the prince does have an orgasm, he dies moments later.
• P. D. James, An Unsuitable Job for a Woman
• Erika Barr, Acquisiti (ISBN)
• Irvine Welsh's book Filth feature a scene where the main character starts choking a girl he is having sex with; when the girl complains "You're choking me,” he responds with “Well, choke me back” and “cut off the gas”.
• Chuck Palahniuk's book Haunted features a story called "Guts," in which a character masturbates with a pool pump located at the bottom of the pool. The character attempts to come up for air after orgasming and is actually attached to the pump via his intestines, creating the dilemma of either dying from AEA or biting through his intestines.
• It has been suggested that Robert Browning's dramatic monologue Porphyria's Lover is about erotic asphyxiation rather than murder.^[7]
• Michael Connelly refers to autoerotic asphyxia due to self-strangulation in his novel A Darkness More Than Night.
• Henrik H. Langeland's novel Wonderboy (2003).
• Robert Rankin referenced autoerotic asphyxia in his novel Snuff Fiction.
• Stephen King's 1408 mentions Henry Storkin who killed himself practicing this act.

• Six Feet Under, 2002 episode ("Back to the Garden," Season 2, Episode 20) of the HBO television series.
• The Family Guy episode "The Perfect Castaway", features a game of "I Never" where Glenn Quagmire drinks to performing erotic asphyxiation with an illegal alien from Home Depot, then doing the same thing with someone from Jo-Ann Fabrics. Also, in the episode "Breaking Out Is Hard to Do", Stewie tries to pull a plastic bag over his head "just like that boy from INXS", a reference to the band member's death by autoerotic asphyxiation.
• The American version of Queer as Folk, the Showtime television series: In the first-season finale, Brian Kinney (Gale Harold) turns 30, an event looked upon by some in the gay community (jokingly and otherwise) as the year one "dies". Kinney decides to experience scarfing, but his best friend Michael (Hal Sparks) discovers and stops him. Kinney claims he wanted to experience "the best fucking orgasm of my life", but Novotny counters that it would have been "the last fucking orgasm of your life". When it aired, the episode featured a disclaimer about the dangers of the practice and discouraged viewers from attempting it.
• CSI: Crime Scene Investigation, (2005, Season 6, episode 2) of the CBS television series
• In the HBO series Entourage, Johnny Drama asks Turtle if he ever "Jerks off with a belt around his neck".
• The League of Gentlemen
• The 2006 George Carlin HBO Special Life is Worth Losing.
• X-Files, episode "Clyde Bruckman's Final Repose" (first aired Friday, October 13, 1995), the psychic Bruckman (played by Peter Boyle, who won an Outstanding Guest Actor Emmy for the part) implies that Special Agent Fox Mulder will die of AEA.
• "Peep Show", a UK Channel 4 TV show, when Jez says "I'm so bored, dangerously bored, I even considered doing that thing that Michael Hutchence and that MP did".
• The Law & Order: Special Victims Unit episode Ridicule involves a woman who the investigators thought that she had died as a result of erotic asphyxiation
• Upright Citizens Brigade TV show.
• In the FX series Dirt, the character Lucy Spiller achieves sexual pleasure by being choked during intercourse.
• On the HBO Show OZ, the character Robson manipulates Wolfgang Cutler to try AEA, but murders him instead.

• in the opening line of the openine track "The King Is Dead" off of A Wilhelm Scream's 3rd Nitro Records release Ruiner-"The knife,or the rope,or the lemon? this brain and I" the lemon represents Autoerotic asphyxiation.It refers this practice of masturbating with a noose around your neck, with a lemon slice in your mouth to wake you up when/if you pass out: a safety measure.
• The song "Self Suicide" by Welsh rap group Goldie Lookin' Chain includes two references to the death of Michael Hutchence, including the line "Wanking with a bag on your head tied to a door/That bloke from INXS he knew the score"
• The 1960's-1970's underground cartoonist Vaughn Bode died from AEA.
• In December of 2005, Dane Cook, who hosted Saturday Night Live, played a character whose wife told his loved ones that he had died of AEA instead of being in a coma.
• Brutal death metal band Devourment have a song called "Autoerotic Ashpyxiation"
• In the novel Pig by Irvine Welsh, the main character indulges in both AEA and "scarfing".
• The death of British MP Stephen Milligan by autoerotic asphyxiation is briefly mentioned in the song Mr. Robinson's Quango on the album The Great Escape by British rock band Blur.
• The electro group SITD has a song called "Asphyxiation".
• "Asphyxiophilia" is a song by the industrial rock group fetish 69
• The Genitorturers song "Asphyxiate" describes someone engaging in a sexual act involving a cord that is presumably erotic asphyxiation.
• The song "Dead Goon" on Mr. Bungle's self-titled album is about an antisocial youth who dies from autoerotic asphyxiation.

• Autoerotic fatalities
• Anoxia
• Cerebral hypoxia
• Choke hold
• Choking game
• Jane Longhurst

• Robert R. Hazelwood, Park Elliot Dietz, Ann Wolbert Burgess. Autoerotic Fatalities. Lexington, Mass.: LexingtonBooks, 1983.
• Sergey Sheleg, Edwin Ehrlich. Autoerotic Asphyxiation: Forensic, Medical, and Social Aspects. Tucson, AZ: Wheatmark, 2006.
• John Money, Gordon Waiwright, & David Hingsburger. The Breathless Orgasm: A Lovemap Biography of Asphyxiophilia. Buffalo, New York: Prometheus Books, 1991.

• ChokedChicks.com Erotic Asphyxia Community Blog
• Informational Portal about Autoerotic Asphyxiation Syndrome
• BBC News story about the death of Stephen Milligan
• Well Hung: Death By Orgasm
• Jenkins AP. When Self-Pleasuring Becomes Self-Destruction: Autoerotic Asphyxiation Paraphilia
• Turvey B. "An Objective Overview of Autoerotic Fatalities"
• The Medical Realities of Breath Control Play By Jay Wiseman

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Abasiophilia · Amaurophilia · Andromimetophilia · Autogynephilia · Biastophilia · Bondage (BDSM) · Chronophilia · Coprophilia · Dacryphilia · Emetophilia · Ephebophilia · Erotic asphyxiation · Erotic lactation · Exhibitionism · Food play · Frotteurism · Homeovestism · Human animal roleplay · Hybristophilia · Katoptronophilia · Klismaphilia · Macrophilia · Mysophilia · Necrophilia · Olfactophilia · Osmolagnia · Paraphilic infantilism · Pedophilia · Pyrophilia · Sadism and masochism · Salirophila · Sexual fetishism · Somnophilia · Statuephilia · Sthenolagnia · Teratophilia · Tightlacing  · Transvestic Fetishism · Trichophilia · Troilism · Urolagnia · Vorarephilia · Voyeurism · Xenophily · Zoophilia
Japanese terms	Chikan · Hadaka · Lolicon · Nyotaimori · Omorashi · Shotacon · Tamakeri · Wakamezake ·
See also	Human sexual behaviour · Sexology