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Autoerotic Asphyxia: A Very Bizarre Case

02 Jun

File this under truth is very much stranger than fiction. In this month’s issue of The Forensic Examiner, there was a report of an extremely unusual case of autoerotic asphyxia. It seems that the victim, as part of his masturbatory fantasy, filled a large tub with joint compound, a substance similar to Plaster of Paris. Erotic posters lined the walls of the room and he had a pornographic VHS tape playing. Apparently his plan was to immerse himself in the plaster as part of his self-gratification scenario. Though his choice of materials was odd, this is not an unknown practice. Typically, the person will use a mud bath for this scenario. Apparently, the pressure of the mud restricts chest expansion, causes shortness of breath, and heightens the sexual release.

Unfortunately, as the scene of this man’s death was reconstructed, after he stepped into the tub he lost his balance and slipped under the surface, immediately inhaling some of the plaster. This is not something that is easily expelled from the airways and he died in short order from asphyxia. This type of asphyxia would be deemed mechanical asphyxia, since a mechanical obstruction, in this case the plaster, prevented air exchange and he died from this.

Erotic asphyxia is classified as a paraphilia and is employed during certain sexual practices. If it is employed with a partner, it would be called erotic asphyxia, while if used during a solo session, it would be termed autoerotic asphyxia. Apparently the goal is to deprive the brain of oxygen during the sexual act since many feel that this heightens the intensity of the event. A partner might use a pillow, a plastic bag, or strangulation, either manual or by use of some literature, to cause the oxygen deprivation in the other partner. This practice was featured in the movie Rising Sun. Unfortunately, these things can go wrong in a hurry. More about that in a minute.

In the case of autoerotic asphyxia, the victim usually sets up some mechanism for saving himself. If he puts a plastic bag over his head and secures it with tape around his neck, he must have some way of getting oxygen when the deprivation becomes severe. Usually he will have a knife or some other sharp object to cut the plastic so he can breathe. If he uses a noose or ligature of some type, then he will set up some way of releasing the obstruction. He might hang the rope over a door or from some other fixture and then tie it around his neck in such a fashion as to produce strangulation during the sex act. He might have a loose end that, in case of an emergency, he can pull and release the ligature, allowing himself to breathe. Unfortunately, a lack of understanding of the physiology involved in this scenario leads to tragedies more often than you might think.

Most people believe that during strangulation or hanging the victim dies because he cannot breathe. In some cases this might indeed be the cause, but that’s not the dangerous part. Most of us can hold our breath for one or two or three minutes if necessary, but then we must breathe. We know that we are becoming oxygen deprived and we know that we need to breathe. The sensation comes on gradually and increases in intensity as time goes along. But we have time to take that breath. Unfortunately when any form of obstructing ligature is wrapped around the neck, inability to take in air is not the most dangerous problem. It is the compression of the carotid arteries, the two arteries that lie on either side of the windpipe and that conduct over 90% of the blood supply from the heart to the brain, that is the culprit. When these arteries are compressed to the point that blood flow to the brain is severely restricted, loss of consciousness can occur very quickly, sometimes in 20 seconds or so. The person has very little warning. It’s not like the gradual onset of the need to breathe. The victim here suddenly loses consciousness. As you can see, if the victim is unconscious, he cannot employ his safety mechanism and therefore is found dead from strangulation. The same thing happens in people who are clowning around with ropes and similar devices and acting like they’re going to hang themselves often as part of some childhood or adolescent stunt. The victim can fall unconscious, suffer brain damage, and even die before anyone around him realizes what’s going on. It can happen fairly quickly.

The autopsy in this case showed that the victim had widespread petechial hemorrhaging in his eyes. Petechial hemorrhages are reddish dots of blood found in the sclera (white part of the eyeball) and conjunctivae (the pink tissues that surround the eyeball), and are due to the seepage of blood from the small capillaries in those areas. They indicate increased pressure in the venous system at the time of death. They can be seen in hangings, strangulations, and sometimes in drownings. When an individual in any of these circumstances struggles to draw air into his lungs, the pressure inside the chest is transmitted to the venous system and when the pressure within the vessels rises high enough, blood leaks out of the capillaries and into the tissues in and around the eyes. Sometimes the back of the throat and the airways also. In this victim’s case the pressure rose because he was trying to breathe through plaster. In addition the autopsy showed that he had large amounts plaster in his esophagus, suggesting that he not only inhaled but swallowed the plaster. Must’ve been a terrible way to die.

It you want to know more about sexual asphyxia, and I know that being the inquisitive and voyeuristic soul that you are, you do, check out these links:

Hypoxyphilia/Auto-erotic Asphyxia

MedNet Article

Oxbow Academy Article

 

11 responses to “Autoerotic Asphyxia: A Very Bizarre Case

  1. Jonathan E. Quist

    June 3, 2009 at 6:10 am

    Some years ago, Bill, and acquaintance of mine, died in an autoerotic asphyxiation accident. (I have changed his name and other details out of respect for surviving family; the essential facts are accurate.) I met Bill through a friend of mine, his co-worker, and I coincidentally had a business relationship with Bill’s landlord.

    One Monday, Bill failed to show up for work after a week of vacation. There was no immediate concern; Bill’s car was notorious for its unreliability. That same morning, however, another tenant in his building noticed a dark liquid seeping out under the apartment door, and notified the landlord, who in turn discovered the body and notified the police. They found Bill lying on the floor, a plastic bag over his head and a butane lighter nearby, along with a vibrator and an erotic magazine.

    At that point in the narrative, which had been incredulous and humorous in tone, I mentioned that I knew Bill, and the landlord quickly changed the subject. I found it ironic that Bill would have laughed heartily at the Energizer Bunny jokes. He had an eclectic sense of humor.

    The purpose of the butane lighter was to enhance the asphyxia – butane is released into the plastic bag, displacing oxygen. I find it difficult to comprehend that anyone would willingly place their head in a bag and remove the oxygen, but I wasn’t in his shoes. Study of a couple of forensic medical texts and conversations with several police officers from Chicago and other area departments have told me that these accidents are, sadly, quite common.

    Bill was a nice guy, quiet with strangers, but a fun personality when among friends. And lonely. A freak or pervert? No, I don’t believe so. He acted out his sexual fantasies alone, in the privacy of his apartment, rather than using a prostitute. And he did not act out his fantasies on unwilling partners too weak to defend themselves. Bill was not a rapist or child molester. Just a sad, lonely young man.

    Epilogue:

    The police called my friend’s boss to identify the body and provide next-of-kin details. The boss took it upon himself to pack up the apartment before Bill’s mother arrived. I don’t know just what story she was given, but some details were certainly withheld to protect her memory of her son. The newspaper account simply listed the date of death, with a cause of “accidental suffocation”.

    If anyone reading this is considering or has engaged in asphyxia-enhanced masturbation, I request that you please consider other means. The brief physical sensation is not worth risking your life.

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  2. Tanya

    June 3, 2009 at 6:36 am

    Doug,

    When I was in med school, the ME’s from Dade County Medical Examiner’s Office would present, weekly, forensic cases. They’d bring great crime scene photos. A couple of these involved auotoerotic asphxiation. One guy, known as a conservative husband and business man, would check into a “third rate” hotel, dress up in Roman soldier regalia, and practice autoerotic asphxiation probably routinely (multple hotel visits). I believe he employed a noose set-up. One time he didn’t check out! He was found, in roman regalia, hung. Wardrobe malfunction?

    Tanya

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  3. Pat Marinelli

    June 3, 2009 at 1:15 pm

    I also learned from a homicide detective that most young male suicides reports are really due to auotoerotic asphxiation. The family usually cleans up any sexual materials ay the scene before the police are called.

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    • D.P. Lyle, MD

      June 3, 2009 at 1:20 pm

      I’m not sure that most are and would be surprised if that were the case, but it is definitely true that many of these deaths are followed by the family cleaning the scene to make the death look like something else.

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  4. Karen in Ohio

    June 3, 2009 at 1:33 pm

    Isn’t it astonishing the lengths human beings will go in order to achieve orgasm? This fascinates me. Thanks for the information, Dr. Lyle.

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  5. Toni Kelner

    June 4, 2009 at 8:46 pm

    I read this post yesterday, I think. Today, David Carradine’s death was announced. My first thought was auto-erotic asphyxiation, and later announcements seem to confirm this. What a terrible shame. Thanks for explaining the details and dangers.

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  6. doris

    June 7, 2009 at 5:44 am

    the death of David Carradine sparked a discussion with friends. Someone said, only men can be stupid like this. I argued this was nonsense and clearly women must try to have the same or similar experiences and concecutively suffer autoerotic asphyxiation. Yet, I could not find much on female cases, neither celbrities nor normalos. Are there any?

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  7. Pat Browning

    June 11, 2009 at 1:51 pm

    I just read this is today’s sfgate.com and was flabbergasted. Had no idea!

    From the Violet Blue column, sfgate.com June 10, 2009
    Quote:N”o one wants to talk about erotic asphyxiation, auto (self-induced) or otherwise. It’s generally thought of as the kind of sex you have if you want to die. Or get damn close to it. But people do it: estimates in the US put the death rate for erotic asphyxia at upwards of 1000 people a year. According to the Metropolitan Life Insurance Company around 250 of its policyholders die from sexual asphyxia each year.”

    Pat Browning

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  8. Diane

    January 15, 2010 at 4:45 pm

    Thanks very much for your article.
    This is interesting to me as I lost someone very close due to auto-erotic asphyxiation.
    I have a question. Is the person at all aware that they are close to death? Meaning, is it so instant that in one moment they are simply engaging in the act, and the next they have become unconscious until death? I suppose there probably isn’t anyway to know this and perhaps each case is different. In the case of my best friend, he wasn’t found until much later in the day and was alone, so I’m curious to know if he had been stuck in a position, unable to self rescue, slowly dying or if it happened fast and without really knowing.
    Looking through his personal writing, he was aware of the danger and risks of this behaviour, citing ‘need to be safe in bondage play’ in one of his entries. There was quite a cover up, not from his immediate family, but the extended. I was the one to ‘clean up’ the place removing items before the family arrived. I believe this was so important and much needed because the shock of knowing the cause didn’t need to be worsened by seeing these items for his family. It happens. It’s so sad. Perhaps Carradine’s death informed more people of the risks or perhaps reminded ones who are already engaging about the risks. I accept the fact people do this…people will do whatever they want, and I don’t think there is anything wrong or bad about it. It’s just so tragic when it goes horribly wrong. So… of course I have thought about his last minutes of life and tried to imagine what exactly happened, and I mean ‘exactly’…. Thanks.

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    • D.P. Lyle, MD

      January 16, 2010 at 11:58 am

      That’s the problem. The person might feel some dizziness for a few seconds before losing consciousness but often it is simply fade to black. And if there is no one there to help, the unconscious person can’t help himself. That’s what makes these activities so dangerous.

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