breathplay safety patrol post!
let me PLEASE start with two things; the first is that I absolutely believe in RACK (risk aware consensual kink) and PRICK (personal responsibility informed consensual kink). I’m not telling anyone what they can or can’t do or can or can’t find hot, I am just discussing the oft-ignored risks and responsibilities involved. the second is: this used to be my favorite physical way to do kink. I was getting strangled to the point of losing consciousness almost every session, often multiple times a session. and then I learned the risks and decided this was a hard limit for me. all I aim to do is discuss the risks so people can make their own informed decisions around breathplay.
there are a few kinds of breathplay. there’s suffocation (blocking the airways, like with hands or a pillow), choking (like you do on food— something going so far back in the mouth that it blocks the airway, like with a penis or dildo), or what MOST call choking, which is actually strangulation (using something like hands to externally cut off the supply of air to the lungs by putting pressure on the neck). that “choking” kink you have is almost certainly a strangulation kink if it has anything to do with hands around your throat restricting your air supply. strangulation is mostly what I’ll be talking about here.
there is NO safe way to strangle someone. there is only least safe and closest to safe (which is still a huge risk).
strangulation gets treated like one of the most basic kinks out there. I’ve heard it called “basically vanilla”— hell, a younger, less educated me called it “basically vanilla”. it is not. it is rather extreme edgeplay. you are participating in something that is designed to harm or kill the person on the receiving end. if you do not treat it as such, you’re 10 steps behind on safety. everything you do from the moment you begin to strangle someone should be done with the knowledge that this could kill them, will harm them, and it is your responsibility to not kill them.
if you’ve had any safety education in strangulation, you’ve likely been told to avoid the front of the neck/throat. this is smart! this is good! you can easily, with a smaller amount of force than you think is necessary, crush a windpipe. this causes irreversible damage and may require an emergency tracheotomy to get them breathing again. if you are going for the front of the neck, you should be up at the jawline, as far away as possible from the windpipe or laryngeal prominence (Adam’s apple). if you’re going to go for this frontal strangulation, a few seconds at a time (watching for change in breathing, panicked/disassociated eyes, color of the face), you’re less at risk for the long term damage. less.
if you’ve heard not to go for the front, you’ve probably heard to compress the sides of the neck instead. this avoids the windpipe and trachea. it is still extremely high risk. if you’re NOT trying to induce unconsciousness (we’ll get there), you actually may be better off going for the just-below-the-jawline method (always squeezing with the in-between of your index and thumb, not squeezing with your thumbs themselves).
if you’re squeezing the sides, you’re squeezing something called the carotid arteries. these each supply about 40% of the brain with the blood it needs. when you are squeezing these, you are restricting up to 80% of the oxygenated blood your brain needs. carotids can have something called furring, or atherosclerosis. atherosclerosis is plaque buildup in the carotids. when this furring is dislodged, such as by manually squeezing the carotids, it can and does cause strokes. atherosclerosis is almost always silent (meaning you will not know you have it) unless there is a severe blockage or clot— or the furring is manually dislodged. carotid arteries also have baroreceptors, which are little sensors that detect blood pressure. when the carotids have undue pressure placed on them, it tricks these baroreceptors into thinking your blood pressure has dangerously spiked, which causes them to send out a warning signal and drop the blood pressure in all of your organs. when the blood pressure drops in all your organs, the tissue is deprived of oxygen and nutrients, which in turn can cause emergent shock, which in turn can shut down your organs, which in turn can cause permanent organ damage, coma, and death. the baroreceptors thinking your blood pressure is too high also causes your heart to pump slower. so, less oxygenated blood in the brain, drastically decreased blood pressure, drastically lowered heart rate— all of these things can cause seizure, stroke, cardiac arrest, organ damage, coma, death.
even just in restricting blood flow to the brain, you’re causing damage. the brain has very little ability to store oxygen, so when oxygenated blood isn’t getting to your brain, your brain cells start dying off. quickly. brains also don’t store fuel, and it can easily take only seconds for someone to lose consciousness.
as soon as you pass out, you can no longer consent, safeword, say HEY THIS SUCKS PLEASE STOP, nonverbally safeword, anything. all of that aside, your brain and body now think you’re dying (because, well, the person doing the thing that makes people die has now gotten your body to the point that it says, hey, we’re dying). you may have seen in strangulation porn (or in real life) the way the body can start convulsing, shaking… this is the body fighting back against dying. passing out actually isn’t primarily caused by the lack of oxygen. going unconscious is actually caused by the excess of CO2. you breathe in oxygen, you breathe out CO2 (which is toxic and cannot be safely stored by the human body). if you’re not breathing, you’re storing up that toxic CO2 to dangerous levels— which can be deadly if left untended to. most often, the body starts breathing again as soon as you pass out (as long as the strangler immediately pulls off the pressure. please, please, if your stranglee loses consciousness, stop strangling them). it doesn’t always. if this occurs, immediately get emergency medical help.
regardless of any of this, once you reach the point of unconsciousness, you have absolutely caused at least slight brain damage by reducing the oxygenated blood to your brain and increasing the amount of CO2 in the body, killing brain cells. dead brain cells do not regenerate (they can be replaced at a very low rate). this compounds every time you engage in strangulation. a good comparison is like doing whippits— you get that high because you’re depriving your brain of oxygen, and your brain cells die. the more you do whippits, the more brain cells die off. ask me how I know, lol.
aside from any of the risks to heart and brain, you can damage the throat very easily. you can fracture the hyoid, which can lead to anything from discomfort to abscesses to airway obstruction that can cause death. you can tear or cause swelling in the delicate tissues and structures that exist in the throat and neck.
my final bit of risk education here is that if you end up needing emergency medical help, the strangler can 1000% end up in immediate legal trouble. in most places, physically violent kink cannot “legally” be consented to and it is not always left up to the “victim” whether or not they want to press charges. no, the concept of a “video where the person receiving states their consent” is not acceptable in a court of law. countries that I know for sure have distinct laws around this specifically for strangulation are England and Wales. that’s not to say you’re good to go anywhere else— that’s just to say those places have SPECIFIC laws. if the stranglee ends up needing emergency medical attention for being strangled, almost anywhere is going to be a legally dangerous place to be the strangler. absolutely anywhere you are in the world, if you god forbid accidentally strangle your partner to death, you can be charged with at the very least manslaughter. at the very least.
NONE of this is to tell you what to do. it’s simply a response to the current culture and attitude of “choking [sic] is so basic”. RACK is extremely important to me and a whole lot of people are going around not actually being aware of the risks. please do what you will. please have fun doing it! but please, please understand that this is never safe and it is never simple and it is not beginner friendly.
carotid artery disease (atherosclerosis and furring)
atherosclerosis and stroke
hypotension (blood pressure and organ failure)
the brain does not store oxygen
hypercapnia (excess of carbon dioxide)
low-rate brain cell replacement
strangulation second most common cause of stroke in young women
study on neurophysiological response in those that have been strangled
study that focuses on one patient who suffered a hemodynamic ischemic stroke after strangulation but considers on a whole the risk of hemodynamic stroke with strangulation
strangulation and brain injury
a lot of this is based around violent attacks but there is some consideration for strangulation that is consented to. the only differences between nonconsensual strangulation and consensual strangulation are intent and emotion and those things don’t impact how the body responds to consensual strangulation gone wrong.