Autoerotic Asphyxiation: A Challenge to Death Educators and Counselors

Abstract

Autoerotic asphyxiation is a form of erotic activity that has been practiced in many cultures for many years. It has been estimated that approximately 250–1000 deaths each year in the United States are the result of hangings that were intended to enhance sexual excitement. Educators and counselors may be called upon to respond to concerns about autoerotic asphyxiation both in general and in its sometimes lethal consequences. Family members and friends of people who have died in this way may have complicated grief responses because of the unanswered questions and anxieties that are likely to be aroused by autoerotic asphyxiation. Professional caregivers may also be disturbed by this seldom-discussed connection between sexuality and death. There may also be mistakes made in determining whether the death was accidental or the result of suicidal intent. Attention needs to be given to the individual's self-rescue mechanism. This article reviews the scattered literature on autoerotic asphyxiation and includes observations by two psychiatrists and a medical examiner. Much remains to be learned about this practice and the circumstances that lead to a fatal outcome.