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Breath Play: The Air Choke and the Blood Choke

Updated: Oct 11, 2023

The two main practices to induce asphyxia for pleasure

Man choking a woman against the wall.
Shutterstock picture ID 2089156393 by Bk87

I strongly recommend not to practice choking. This article is part of a series intended to show that choking is unsafe, may cause brain damage, and is potentially lethal.

Choking, as it is used during sex or in BDSM, aims to deprive the brain of oxygen to induce mental changes that are pleasurable, either by themselves or because they intensify sexual sensations.

This can be done in two ways: by interrupting the air flow into the lungs (“air choke”) or by interrupting the blood supply to the brain (“blood choke”). This terminology comes from martial arts. There is some debate in the BDSM community about which one is better.

The air choke

Still, most of the choking during sex is done by squeezing the throat with one hand (Herbenick et al., 2022). It is hard to say if this is an air choke or a blood choke. If pressure is applied to the front of the neck, this can close the trachea, producing an air choke. However, applying pressure to the trachea is unpleasant and dangerous, because it can damage the vocal cords, impairing speech. It can also damage the thyroid gland or the trachea itself, which can have serious health effects. The trachea is a very delicate structure made of cartilage, a tissue similar to bone that also makes our joints. This makes the trachea semi-rigid, so applying pressure on it can deform it permanently. Therefore, this form of choking can produce long-term damage affecting breathing, talking and swallowing.

A crushed trachea is life-threatening. You can kill somebody this way.

Another straightforward way to produce an air choke is to block the nose and the mouth with the hand. A person can easily get out of this choke by struggling, which can be both a problem - involuntary struggling can stop the choke - and an advantage - a built-in safety feature.

Deep throating - inserting the penis into the mouth deep enough to block air passage into the larynx - can be a form of choking. However, the gagging reflex would be induced much sooner than air deprivation is felt. Besides, a panicking bottom can bite the cock that is gagging him or her.

Using a pillow or a mask to block breathing is dangerous because the top cannot see the face of the bottom, and therefore cannot judge the level of asphyxiation. This could be prevented by using a transparent bag, but removing it takes too long. Still too dangerous. Some people use a sharp object to quickly puncture the bag, but this risks cutting the face of the person being choked.

The blood choke (carotid occlusion)

The blood choke consists of stopping the blood supply to the brain by blocking the carotid arteries. They run superficially on both sides of the neck and can be blocked by applying a small amount of pressure on the right spots. On purpose or by accident, this is probably what it is done in some of the one-hand chokes that are more prevalent, according to the surveys.

Man choking another man from behind with one arm.
The one-arm blood choke in martial arts. Wikimedia Commons, by Cpl. Benjamin M. George.

A common chokehold in martial arts consists in wrapping the neck of the adversary with one arm from behind, in a position resembling the number 4. This compresses the carotid arteries and jugular veins, but not the trachea, cutting the blood flow to the brain and thus inducing unconsciousness in 10-20 seconds.

However, using this chokehold during sex of BDSM play has the problem that the person applying the choke cannot see the face of the person being choked, and therefore cannot regulate the pressure and the timing to avoid going too far. Unlike in martial arts and self-defense, most people that use choking during sex do not want to induce unconsciousness. Neither should they, since loss of consciousness by anoxia often leads to brain damage.

Hence, the most common way to induce a blood choke during sex is to apply pressure to the sides of the neck with one hand, while looking into the face of the person being choked to evaluate their response.

Which one is safer?

Some people in the BDSM community argue that the blood choke is safer than the air choke for the following reasons:

  1. It affects only the brain and not the rest of the body.

  2. The blood flow can be manipulated quickly and subtly by changing the pressure of the hand.

  3. Changes in consciousness can be induced and restore quickly.

  4. It avoids damaging the trachea and other delicate structures in the neck.

  5. It does not increase the CO2 levels of the blood and hence blood acidity, like the air choke does.

However, the blood choke has dangers that are not obvious at first sight. But understanding these dangers requires some complicated explanations about the functioning of the brain and cardiovascular physiology, which I will give in the next articles.

For now, let me just say that the blood choke is, in fact, more dangerous than the air choke.

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