Kinga Jókay, M.D., our pediatrician heard about three fatal cases in the last six months involving young people trying the so called “choking game”. People who self suffocate desire to reach a euphoric state by preventing adequate oxygenation. Sometimes the purpose is seeking sexual pleasure. The risk is significant, as many adolescents die during this experimentation.
Kinga Jókay, M.D. finds it important to talk about this subject and she thinks that delivering accurate information about it is crucial. Her article on the choking game:
The death of a child is always heartbreaking. When the cause is medical, physicians and healthcare systems are blamed. Loss of an adolescent’s life due to an accident is tragic. Faulty equipment, poor judgment and lack of regulations are often held accountable. But when a young person’s life is snuffed out by an unintentional yet self-inflicted injury, we are at a loss for words. Why would a child deliberately prevent adequate oxygenation of his own brain, putting himself at risk for brain damage and death? Who is to be held responsible? How could it have been prevented? Since the motive is pleasure seeking rather than self destruction, we cannot label it as suicide. And we shouldn’t, because we will continue to cover up the problem instead of concentrating on finding a solution.
According to a study conducted in Oregon, in 2008, approximately 30% of middle and high school students have already heard of the choking game and 6% have tried it. Those who engage in suffocating themselves to the brink of unconsciousness in order to achieve a lightheaded, giddy high usually repeat the dangerous, potentially lethal activity.
To evade the subject would be like sending a child out into the Arctic without a coat. Physicians, educators, pastors, counselors and parents share the burden of responsibility of broaching the subject, and teachingchildren that there is no safe way to participate in suffocation activities. Many already have inaccurate sources of information regarding this gruesome “game”, so we shouldn’t give them ideas. In order to prevent neurological damage and death, we should teach them about the consequences of activities leading to suffocation If they understand the danger of asphyxiation, they will be less likely to play Russian roulette with their life.
Each year about 1000 teenagers die of self-induced hypoxia in the U.S. The actual number may be much higher, as many of these deaths are mistakenly labeled as suicide.
What prompts a person to engage in suffocation activities is not clear. Various theories include thrill seeking, peer pressure when performed in a group, a drug-free high, self-medication of anxiety or depression, and heightening orgasmic response during masturbation. The overwhelming majority of deaths happen in boys and men. The average age of a victim of a simple strangulation “game” is 13 years. If sexual activity is involved in the suffocation, it is more likely to be an older adolescent or adult male.
Preventing the brain from receiving adequate oxygen can be achieved by holding the breath, compression of the chest wall, pushing on the arteries in the neck, plastic bags and inhalants, or strangulation with objects such as a rope or a belt. The adolescent can faint within ten seconds, permanent brain damage occurs in three minutes and death ensues in four to five minutes. If voluntary asphyxiation is practiced alone, it is more likely to be fatal.
Researchers are unsure whether autoerotic asphyxiation is a separate but related activity, or a point along the continuum. Autoerotic asphyxiation practitioners often use props like pornography, cross-dressing, and mirrors, and are considered more disturbed. Some of the victims also abuse drugs and alcohol, but overall, they are seemingly ordinary people.
What can we do?
Anyone who raises or teaches children should be aware of the possible signs of strangulation activity involvement:
- Unexplained marks on the neck, bruising, especially if circumferential
- Bloodshot eyes and pinpoint bruising on the face, especially in and around the eyes
- Wearing of turtlenecks even in hot weather
- Unexplained presence of dog leashes, bungee cords, choke collars, clothes tied in knots, ropes, scarves and belts, especially if tied to bedroom furniture
- Wear marks on closet rods and bedposts
- Severe headaches, disorientation, irritability or hostility after spending time alone
- Internet history of websites or chat rooms discussing choking games
Recognizing the signs of a young person experimenting with self-asphyxiation is crucial. Informing him/her of the true perils of the behavior and accompanying him/her to a mental health professional may well save a life.
For educational purposes you might use the video below. We recommend this excellent, teen-friendly, albeit highly disturbing informational video about suffocation activities: