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Autoerotic asphyxia is presented in literature review form. Etiology, prevalence statistics, and a profile of AEA participants is provided. The author identifies autoerotic asphyxia as a form of sub-intentional suicide. Warning s of AEA are presented. Possible sources of mis-information are given.
Prevention and education recommendations for administrators, faculty, and parents are provided. A suggested reading list is provided. A part time computer programmer and full-time mother comes home from the office early on Friday afternoon to share a video and a pizza with her 15 year old son, Lance. His bedroom seems unusually quiet on this afternoon. Absent is the din of his favorite Smashing Pumpkins CD. She saunters down the hallway while calling his name, pushes open his bedroom door and then collapses on the floor in a flood of emotions launched by a graphic scene displayed in the room before her.
Though he asphyxiation fetish from a bar that would only meet him at eye level, his knees are bent and his full weight hangs from the Disney necktie he wore to his eighth grade graduation. The first two fingers of his lifeless right hand still grip one bow of the knot. It is, without question, the most disturbing and unthinkable of sub-intentional adolescent suicides. The case provided above is a description of an actual incident, which represents many of the common primary components of autoerotic asphyxia cases.
The purpose of this article is to provide asphyxiation fetish reader with information regarding this dangerous behavior and to provide a framework in which to place it in the context of adolescent sexuality, suicide, and education.
The literature in this area is somewhat limited with virtually no articles appearing in the health and education journals directed at prevention of this behavior. This paper provides an objective overview of the behavior, the typical practitioner, a list of contemporary sources of AEA information, and some suggestions for AEA prevention and education in schools.
The risk of sudden death may also serve to increase the sexual pleasure by adding a strong component of mortal danger. Strangulation is most often applied by a single ligature in the form of a noose or slip-knot around the neck Hazelwood, The actual incidence of AEA is likely underreported.
According to forensic researchers Burgess and Hazelwoodteen-aged AEA victims asphyxiation fetish most often found by parents, or other relatives who, because of the graphic, highly emotional, and often shocking circumstances under which the victims are found, may clean up or alter the death scene. Sadly, it may often be easier for parents and relatives to deal with teen suicide resulting from depression or drug abuse than from this puzzling form of sexual behavior.
Denial and repression on behalf of parents and relatives can be expected and likely contributes to the under-reporting of AEA cases Kirksey, et al.
Suicide is the second leading cause of death among young people ages 15 to 19 years according to the American Psychiatric Association When reviewing these data it should be noted that AEA deaths represent a ificant proportion of the overall adolescent suicide rate. Despite the possibility of protective family members and misdirected investigations, conservative estimates place AEA deaths as high as 6.
Therefore, up to 4, teens and young adults may have taken their lives in the past decade through the practice of autoerotic asphyxia. The age range spans from 9 to 80 years of age for male practitioners of AEA Uva, Although one might p that practitioners of this bizarre and dangerous behavior suffer mental illness, this is usually not the case. The adolescent victims are usually well adjusted, non-depressed, high achievers Uva, Despite the potential for a fatal episode, suicidal intent is not usually evident.
The apparent intent is sexual pleasure not self-destruction. Normally, the strangulation device is used to occlude blood-flow to the brain, which creates varying degrees of hypoxic euphoria, diminished ego controls, asphyxiation fetish, light-headedness, and exhilaration, all of which may enhance masturbation sensations and orgasm intensity Resnik, The practice of self-strangulation may also induce or enhance erection.
The spontaneous erections of hanged men have been observed and documented in erotic and non-erotic literature for centuries Joergensen, The involvement of the ligature and strangulation may be symbolic or purely functional. The extent and timing of the strangulation may also vary between AEA practitioners: Some practitioners strangle themselves throughout the encounter from beginning through orgasm and beyond while other practitioners apply the neck ligature initially to induce cerebral hypoxia and subsequent euphoria, and then, at the peak of orgasm, they release the ligature as the flood of oxygen-laden blood to asphyxiation fetish brain is said to enhance orgasm and create an even greater sense of euphoria and sexual pleasure.
Thus, it is the opinion of the author that AEA should neither be classified nor approached as other forms of adolescent suicide. Autoerotic asphyxia therefore, fits best in the classification of sub-intentional suicide, the purposeful participation in behaviors that have a high likelihood of death or serious injury e.
Smith, Consequently, AEA prevention efforts should be modified from those used to prevent most other forms of adolescent suicide. Autoerotic asphyxia is not classified by the American Psychiatric Association APA as a separate syndrome or disorder but may best fit the APA description of paraphilia.
Though AEA is asphyxiation fetish primarily among males, females do participate in AEA behaviors as well but in far smaller s. There are also differences between the techniques of male and female practitioners of AEA. Males tend to use a wider range of practices, be involved in fetishes, and have a greater tendency toward transvestitism and other paraphilias than do females Uva, Females are more likely to be found naked, and dead from a single ligature around the neck with no special clothing props or sexual aids other than electric vibrators or non-powered dildoes.
Thus, transvestitism in itself should not be considered a risk factor to AEA behavior but as an accompanying behavior. There does not appear to be sufficient evidence to conclude that practitioners have a proclivity toward homosexuality, nor does AEA related transvestitism appear to be correlated with sexual orientation.
AEA practitioners do not appear to suffer from gender identity confusion. Asphyxiation fetish AEA cases from other suicide cases may at times be difficult. As stated earlier in this paper, most practitioners of AEA are adolescent and young adult males. Seventy percent of AEA victims are under the age of 30 Uva, Most AEA practitioners are white, middle class individuals although Black and Hispanic male case studies have appeared in the literature.
Apart from a learned association of sexuality and strangulation or sadomasochistic interests, the behavioral motivations may also be linked to simple thrill seeking that is very common among teens and young adults Uva, Though the practice of self-strangulation is likely painful and therefore considered masochistic when combined with sexual self-pleasuring, only As AEA practitioners age they are more likely to present multiple paraphilias such as bondage and transvestitism according to Blanchard and Hucker It should be emphasized that actual suicidal desire is lacking in the majority of AEA cases that there is no real desire to die.
This fact is most evident from the inclusion of padding of the ligature and the obvious escape mechanisms such as slipknots and suspension points lower than the body height Resnik, Additionally, rarely do teen-aged AEA practitioners engage in suicidal ideations, talk of suicide with loved ones, or display any of the typical adolescent suicide warning s such as giving away possessions, saying good-byes, etc. American Foundation for Suicide Prevention,Jenkins, Further, suicide notes left behind in AEA fatalities may actually be contingency plans in case of accidental death or part of the sadomasochistic fantasy and therefore may not be regarded as genuine suicide notes.
Parents and teachers should be made aware of warning s of AEA behavior. Note that with the exception of ligature marks on the neck, each of these s should be taken in light of other s and related behaviors or symptoms. A single factor by itself may not warrant concern but if a combination of s is evident, concern is warranted.
Warning s include but are not limited to:. Evidence of repetitive hanging such as unexplained marks on the neck or broken or multiple rope abrasion on closet rods from repeated hangings are likely the best and most salient indicators of AEA behavior for parents and teachers to be aware of. This is particularly true for the piercing of sexually sensitive areas such as the nipples, labia, and scrotum. Masturbation is generally a solitary behavior and is not widely about between teenagers. Accompanying fetishes paraphilia are less likely to be talked about. Nonetheless, word of mouth remains one of the more common ways young adults learn of autoerotic asphyxia Winterburn, These media may also present intentional and non-intentional promotions of AEA.
According to court reports, he was found dead, hanging nude from his closet rod with an issue of Hustler magazine open to the article that described in detail the procedure and pleasures to be achieved from autoerotic asphyxia Turner, Even the renowned AEA researcher Robert Asphyxiation fetish has even come forward to denounce the use of television as a medium for education about AEA; so high is the risk of mis-education of teens in the behavior Hazelwood, The most contemporary source of AEA information may be Internet.
As disturbing as it may seem to most parents and educators, there are numerous worldwide websites dedicated to sexual sadomasochism, fetishism, and other sexual paraphilia including autoerotic asphyxia. Clearly, access to potentially dangerous information on the World Wide Web is available and copius. However, in many instances, the sexual pleasure and death connection is neither skirted nor clouded in euphemisms at some websites.
One essay, found at the Black Plague website professes that:. We should get moist and hot and hard at the thought of it. To be swallowed up by blackness is an exquisite pleasure. It is to know ecstasy, but it asphyxiation fetish also to die. While this sort of macabre asphyxiation fetish essay may be intended for adult readers, it can easily be accessed and internalized by adolescent viewers who may be searching for answers to questions they may have about their emerging and often confusing new sense of sexuality. The inexperienced adolescent mind and libido may be unable to distinguish between sexual fantasy and reality, sexual titillation and actual sexual practice.
In light of the fact that risk-taking plays a ificant part in the appeal of AEA behavior, any warnings found in erotic magazines or at erotic websites may actually serve to promote AEA behavior and at the very least, they are likely as ineffective as warning labels on cigarette packages at dissuading adolescent males from smoking. It may therefore be prudent to direct educational efforts as much toward parents and school personnel as to adolescents who may, inadvertently, be inspired to experiment with the behaviors.
Prevention of website visitations by students may be near impossible without close monitoring by teachers. There are several screening softwares and services available such as Bess Bess,Safeplaces Safeplaces,Searcholpolisand Surfwatch Surfwatch, but the effectiveness of these programs is still limited and should not be expected to take the place of adult supervision. High school students and others often discover autoerotic asphyxia quite by accident in American literature. Certainly, student oriented education aimed at preventing or lowering risks to AEA behavior should be presented in the health education classroom however, there are ificant and feasible venues in other secondary school classes.
This type of in-class, cross-curricular education in combination with parental and community education may be the most effective preventative strategy asphyxiation fetish health educators to coordinate and implement to lower the incidence of this self-destructive practice. Although AEA involves components of sexual behavior, it is the opinion of the author that AEA prevention education is best presented as part of suicide prevention lessons as part of a comprehensive health education program.
Presenting AEA as part of a section on sexuality may lead asphyxiation fetish a misunderstanding that AEA is an innocuous variation of expression of human sexuality and not an extremely dangerous behavior. At best, AEA in brain damage secondary to cerebral hypoxia and at worse, it in death. It should be stressed to young adults that AEA cannot be practiced safely and without immediate harm and impending death.
Therefore it may be best to present AEA prevention education from the standpoint of safety, risk reduction, and sub-intentional suicide prevention. Parent and teacher association meetings, which focus on the warning s and symptoms, as well as the relative risk of mis-education, should be organized.
Do not assume, however, that specialists in general counseling possess expertise in this area. Be certain to inquire directly regarding their experience and background in autoerotic asphyxia. In some cases mere sexual experimentation and adolescent risk taking are the only behaviors involved but in other cases, the development of AEA paraphilia is much complex and may require more extensive psychotherapy.
Treatment of AEA paraphilia may include drug treatment in asphyxiation fetish to psychotherapy.Asphyxiation fetish
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Sexual Masochism Disorder with Asphyxiophilia: A Deadly yet Underrecognized Disease