BDSM Info 1: Minimizing risks with choking and asphyxiation

My slave and I engage in some risky behavior.  There is no doubt that asphyxiation and choking are risky, and there is no 100% safe way to do them.  However, there are ways to minimize the risk.

Make no mistake: this play is dangerous and should never be taken lightly, if you're going to engage in it.  Cutting off oxygen for too long can be lethal.  Done carelessly, it could lead to heart attacks, brain damage, seizures, and other conditions.  

So why do we do it?  It gives us both intense sexual pleasure.  I've been doing it for two decades now, and I have not caused any injuries or death--but I still proceed with great caution.

First, let's define what I mean by asphyxiation and choking.

Asphyxiation: Deprivation of air.  

Choking: Applying pressure to the neck

Choking risks and safety

Let's begin with choking:  Choking is risky because you can do damage to the trachea (windpipe), the esophagus (the path from your mouth to your stomach), the jugular vein, which carries blood back to your heart from the brain, or the carotid artery, which carries blood to the brain.  Some methods of choking may also cause damage to the spine.

Here's what you should avoid in relation to choking:

• Never apply direct pressure to the front of the neck.  Even if you are applying pressure to the sides, you might find your thumbs pressing into the neck.  You can crush the larynx, which will cut off the airway, or you could damage the hyoid bone. 
• Avoid sudden impacts.  Some people are into hanging.  Use extreme caution.  Never do it alone, and never let yourself fall for any distance.  Gravity matters.  You could break your neck or do all sorts of damage.  
• Remember that there are a lot of nerves in the neck, some of which will knock a person unconscious.  Some of them lead to the rest of the body.  Damaging them or pinching them will cause pain or numbness. 
• Focusing pressure on the neck may cause bruising and other damage.  Marks on the neck are going to be visible.  Spread the pressure evenly to avoid marks and minimize risk of damage.   

Best practices:

• Use something wide if you are wrapping it around the entire neck to distribute pressure evenly
• If you are using the hands, be mindful of the pressure you applying with your fingertips and your thumbs.  Keep the pressure even across your palms and fingers.
• Start gently, applying pressure slowly and firmly. 
• Since choking leads to unconsciousness, make sure that the person being choked has a grip on you or has the ability to raise the head or arms, so when they begin to fall, you know to stop.  
• Watch for reactions.  When the reactions slow, you need to stop.  

Asphyxiation risks and safety

My slave and I engage in asphyxiation play more than choking.  Asphyxiation is also known as hypoxyphilia, asphxiophilia, sexual asphyxia, or breath play.  We use plastic shrink wrap (found in rolls in the moving supplies section in your do-it-yourself stores), my hand over her mouth and nose, a heavy memory foam pillow, and sometimes my own flesh.  I press her face against my chest, my thighs, my belly; I also have engaged in sitting on her face, resting my scrotum over her mouth and nose.  It's large enough to cover her face.  

Breath play can also include suffocation by applying one's body weight such a way that the lungs have difficulty expanding and the diaphragm's expansion and contraction is restricted.   Laying on your partner's body can do this.  Tight corsets restrict the action of the respiratory system, as well (which is why women used to faint when they wore them).  Covering the face with cloth (e.g., putting a shirt over the face instead of taking it all the way off, wrapping a scarf around the head, etc.) will restrict airflow somewhat.  Gags and taping over the mouth also work.  We do not do gags because of my slave's TMJ (jaw problem), but we still use tape over her mouth.

Whatever method you use, you have to take the following into consideration:

• Time is a huge factor.  Four minutes without oxygen will cause brain damage for certain, if not brain death.  Cardiac arrest is also a huge risk with low blood oxygen levels.  
• Lack of oxygen can cause unconsciousness, which means the submissive cannot tap out or say her/his safe word.  This is dangerous for all kinds of reasons, but there's also the consideration of consent--if your sub is incapable of consent, you should stop playing immediately.  That aside, your sub cannot alert you of any medical/psychological concerns.  Panic will usually set in before unconsciousness will, but if your sub is particularly good at fighting the panic response, look for slowing of reactions/weaker responses. 
• If you block the mouth, pay special attention to the nose.  The nose can become congested, especially if the submissive ends up crying during play.  
• Under no circumstances should you leave a sub who cannot breathe unattended, but you should also not leave a sub who has any airway restricted unattended,as well.  
• Allow the submissive to catch her/his breath before cutting off the airways again.  This allows the blood oxygen level to normalize, which minimizes the risk of heart attack and brain damage.
• It is essential for the submissive to know that tapping out is acceptable, but you are ultimately responsible for her/his safety.  

Jay Wiseman, author of SM 101, says that there is no safe way to do breath play.  While that may be true, one may as well say that there is no safe way to swim underwater. The risk is the same, as long as you take it seriously, don't deprive your sub of oxygen for long, and let the submissive catch her/his breath between the times you cut it off.  Research on people who hold their breath frequently for long periods, as indicated in this article, has yielded mixed results, but, as the article also says, free divers have neurological responses that fall within the average range, and they hold their breath longer than it takes for most submissives to panic.  Panic usually sets in from fifteen seconds to forty-five, in my experience, with few exceptions.