BDSM Bullshit: Risk Stratification for Breath Control Play (aka Abstinence Only “Education” is Crap)

There is a LOT of bullshit out there about breath control play. This time I can even provide quotes and sources!

“if you think that this is an area where having a partner limits the danger, then youre wrong. It is in fact just as dangerous either way. The idea that being with a partner makes this safer is completely illogical.” -

“I know some of you out there are going to insist on cutting off someones oxygen anyway, and normally Id give you tips on how to do it as safely as possible if you absolutely must do it but theres no way to do this safely, or even any more safely. So, generally, I beg of you, dont do this. Its not safe.” -

Let me say at the start that breath control play, ANY form of breath control play, is not safe. Any type of breath control play carries an immediate and unpredictable risk of serious complications and even death of the submissive (see this post for some specifics), which would almost surely result in serious criminal charges and likely a murder conviction for the top. I personally do not practice any form of breath control play, because I consider the level of risk unacceptable. I strongly recommend that others simply abstain from any form of breath control play.

However, taking the position that all types of breath control are EQUALLY risky, as is done in both the posts above (and many others) is irresponsible and shirks a responsibility to truly educate. Abstinence-only breath control play is like abstinence-only sex education- how well has that worked out? (Thank you @hyperkinky for that analogy.) All types of breath play are dangerous. They are unpredictably dangerous. But does anyone truly believe that a person getting drunk and doing solo auto-erotic asphyxiation by tying a piece of rope around their neck and off to a hard point and leaning into it (because they’ll surely stop before becoming totally unconscious, right?) is the same thing as someone putting a hand over the nose and mouth of their partner for 30 seconds during sex? THESE ARE BOTH BREATH CONTROL AND THEY ARE NOT EQUAL. Its possible, for a given two people, that the latter person could die and the former person (doing the riskier play) could live. Its possible. However the former activity is more likely to result in death more of the time.

Making a claim that all types of breath control are equally risky is like saying all forms of motorcycle riding are equally risky, and there’s no way to make motorcycle riding safer. We can all agree that getting on a motorcycle while intoxicated without any safety gear during a rainstorm is much more dangerous than riding sober with appropriate safety gear on a sunny day, right? Yet both are inherently dangerous activities. Its possible that the sober rider could get hit by a semi truck, and the drunk one could get home safely. As an aside, I’m so risk adverse that I also will not ride on a motorcycle. According to this website (and several others), about 4000 people die each year in motorcycle accidents. Compared to fatalities in car crashes, the motorcycle accident statistics show that motorcyclists are 37 times more likely to die in an accident each year. This is shocking considering that motorcycles only comprise 2% of all registered vehicles.

All the time, we do risky things (like riding motorcycles!) that could kill or damage us. And all the time, we take rational steps to try to decrease our risk, while also knowing that the risk doesn’t drop to zero. And that’s the trouble- when the party line in the kink community is that IT IS ALL EQUALLY RISKY AND DON’T DO IT we lose the ability to figure out what types of breath play are more like riding a motorcycle with a helmet, and what types are more like riding drunk in a rainstorm without safety gear (this is not intended to be a perfect analogy, and I’m not in any way stating that the risk profiles are identical).

At the recent breath control panel, we did an exercise where we listed a number of different types of breath control play, from self-controlled breath holding to suffocation with a turkey bag to solo auto-erotic asphyxiation with plastic wrap. We then asked each panelist to rank how risky they perceived that activity to be, on a scale of **I think that is extremely stupid and would almost surely kill you** to **In some situations I find the level of risk associated with that type of play acceptable, and sometimes do that myself**. This exercise was intended to look at each panelists’ perception of physical risks (not getting into the very real psychological risks of these types of play) and with the understanding that the bottom was young and had no known health problems (unless the scenario specifically stated otherwise). The point wasn’t to come up with the ONE TWUE RANKING OF WHICH TYPES OF BREATH PLAY ARE SAFE. Quite the opposite. The point was to show that all types are risky, and that even reasonable people who are all experts on breath play in some sense can disagree with regards to what is more risky or less risky. Risk assessment of this sort is by nature somewhat subjective and involves some conjecture (there are no controlled scientific studies on different types of breath control play to show the exact odds of complications for a given situation).

Some interesting trends emerged from this exercize. For example, whenever an implement was involved, most panelists increased their level of perceived risk. Consider a choke across the front of the neck (pressing on the trachea) with a night stick vs. with fingers. Smothering someone using hands was perceived as less risky than smothering someone with a turkey bag tightly over the head, which in turn was perceived as less risky than solo play with a turkey bag tightly over the head (which was considered you- out of the gene pool levels of stupid by all the panelists). This is because, as one panelist put it, if I’m smothering you with my hands and I walk away, you are no longer being smothered. If you’re tied up and I’m smothering you with a tightly secured turkey bag and walk away, you die. If you’re using a tightly secured turkey bag by yourself and you pass out, you die. ANY ONE OF THOSE THINGS COULD KILL YOU. But the risks are not identical.

Another point that the no-way-to-do-breath-play-safer crowd misses is that the risk profile for breath control play is different for different people. As just one example, studies on carotid sinus massage (CSM)(which has many parallels to breath control play) show that someone who’s had a recent heart attack is at increased risk of going into a bad heart rhythm, even dying, after CSM. Doing strangulation play with a 65 year old smoker who had a heart attack last month is just NOT THE SAME as doing it on a healthy 20-year-old. Now, that 20-year-old could have a plaque in their carotid that could break off and result in a stroke. There is still risk, and unpredictable risk at that. But levels of risk are not identical.

A couple places the analogy between breath control play and other risky things people do to their bodies breaks down (it’s not a perfect analogy in a number of ways, as I mentioned before)- play CAN be done “safer,” like scuba diving and downhill skiing and motorcycle riding can be done “safer.” HOWEVER, if you break your neck when downhill skiing, the law automatically considers this to be an accident. When you damage someone during breath play, you’re pretty much automatically in jail, probably up on a murder charge if they die, and the jury will not be sympathetic. Also, I would consider the risks of breath control inherently more unpredictable than the risks of those other activities (though all are inherently risky, and unpredictably so to varying degrees- but variable risk is a fact of life).

A final side note on that Queer Kink article- I completely agree with, and appreciate, their idea of using mindfucks to stimulate (but not actually practice) breath control play. With most kinds of risky play, especially breath control, I’m a big advocate of involving the bottoms mind in the play, and making it a lot of thunder without much lightning. However unfortunately there are other problems with the article, including stating that the hyoid bone and the Adam’s Apple are the same thing (they just aren’t, google it) and that breaking the hyoid bone results in death (while breaking your hyoid bone is *really bad* and complications from this could kill you, it is certainly possible to survive having your hyoid bone broken). Lets try to get accurate information out there. The RACK model allows for risk- but we have to be educated about what risks were really taking.

**Disclaimer- Have I mentioned that I do not advocate for breath control play of any sort? I do not practice any form of breath control play. They are all risky. They all can kill you. In case that wasn’t clear.