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Breathplay: The Risks, Rewards, and Science of Fetish Asphyxiation

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The popularity of choking in the bedroom is showing no signs of tapping out as it dominates pornography and wraps itself around our sex lives. 

But is the “natural high” that accompanies a hand around your throat ever really safe?

Before a particularly kinky relationship in my 20s, the only choking I had ever experienced was a gentle hand on my throat. One partner introduced me to the incredible highs and terrifying lows of choking. 

The first time I ever experienced choking, the momentary high seduced me into believing it was a safe kink to experiment with. The power dynamic felt euphoric, and the trust I had in my partner made the experience an intoxicating one that I could not get enough of. 

However, after one harrowing experience left me with bloodshot eyes and a bruised throat, I had to know, is there a way to practice this kink responsibly? 

What is breath play?

“Breath play involves restricting oxygen to enhance or intensify sexual experiences,” Aviva Diamond, a professional dominatrix based in New York City, told Cashmere. “This can be done in a variety of ways including choking, using body parts such as hands or ass to cover or smother the mouth and nose, and using masks, plastic wrap, or other materials.”

Once an underground kink relegated to ‘extreme’ pornography, breath play is increasing in prevalence in our bedrooms and on the news. Thanks to the now infamous ‘rough sex defense’ being used to get away with choking partners to death, the dangers of breathplay are widely known. Yet, a staggering 20% of men and 12% of women in one study say that they have choked a partner. Another found that the mean age of first choking/being choked was just 19. Women and transgender and non-binary participants in the study were “significantly more likely” to have been choked than men. 

When a kink is so dangerous that some experienced BDSM players strongly advise against it, is it time for the general population to put the toy back in the box and choose something a little more vanilla?

What is the difference between blood flow and airflow breath play?

Breath play can be separated in two categories: blood flow and airflow breath play. 

Blood flow breath play is the riskier of the two because it involves putting physical pressure on the throat to restrict blood flow to the brain, inducing the high so many kinksters pursue. 

A risky activity for everyone, blood flow breath play should be exercised with extreme caution, particularly among people with a high chance of developing blood clots as they can travel to the brain and trigger a stroke. If someone has been choked hard enough to cause injury, which should never happen in breath play, blood clots can form inside the artery while the body heals, blocking blood flow and potentially breaking off and reaching the brain. 

In blood flow choking, it’s crucial not to place any pressure on the windpipe because this can cause long-term damage, so keep your hands off the front of the throat. To minimize the chance of harm, focus on placing pressure on the sides of the throat to restrict blood flow without damaging the delicate structure of the neck. 

Opting for air-flow breath play is the best way to minimize the risk of breath play. It involves restricting oxygen by putting a hand over someone’s mouth and nose or using a gag, for short periods of time. Restricting oxygen is still a risky activity but doing so without placing pressure on the neck does reduce the chances of physical harm. 

What does breath play do to your body?

Asphyxiation triggers hypoxia–when your body has too little oxygen–and creates a false high of giddiness and euphoria, which is the feeling kinksters are chasing when experimenting with this particular fetish. But the rush may have heavy consequences. 

“The airway is the basic, most fundamental necessity to living,” explained Bruce Bassi, MD. “To deprive the patient of their airway risks killing them. As one becomes hypoxic, their judgment is impaired, and they might not have the insight to communicate their distress appropriately to their partner.”

Lesser choking risks include trouble swallowing and broken blood vessels in the face. Major risks can look like brain damage or death. Anyone with a pre-existing condition, like asthma, has a higher risk of harm from breath play.

So why do people bother? “A lot of people enjoy breath play for the physical sensations it can produce,” says Diamond. “Many people also find it psychologically stimulating to have their partner be in control of their oxygen, especially knowing how risky it is. Your life is literally in someone else’s hands with breathplay, so that mix of fear, excitement, and sex can be a really hot exercise in trust.”

Is breath play safe?

Blown up by the increased availability and extremity of pornography, breathplay has well and truly broken into the mainstream. It shows up in TV shows and films alike showcasing it in sex scenes. Rom-com Long Shot uses it as a comedic device the first time its two stars have sex and it made an appearance in the latest series of Euphoria.

While practicing BDSM with safe words, breath play can be a positive experience. However, choking without consent is both a huge breach of trust and assault. Yes, assault.  

More people are reporting being choked without prior discussion or the precaution of safe words and signals. A 2019 report by the BBC revealed that a third of women have experienced unwanted violence during sex, including choking. 

Any sexual play requires prior consent, but due to the risks associated with breath play, the importance is magnified with breath play. Before experimenting with any new kink, communicating your boundaries and establishing a system of regular check-ins, safe words, and limits is paramount. 

“Breath play can make some individuals feel dizzy and even faint, so making sure the person having it performed on them is in a safe and comfortable position is important,” advises Ness Cooper, a clinical sexologist and therapist. “As the dizziness can last for a short period of time afterward, making sure that the individual moves into other positions slowly is important.”

Communication is paramount to safety with breath play

If you intend to practice breath play with your partner, or really any kinks, identify safe words and wordless cues. These golden words and signals are designed to communicate when one partner needs to cut off play for any reason at any time. Developing non-verbal signals for breathplay is also essential, such as physically tapping out. Some kinksters recommend stoplight safe words: red for stop, yellow for slow down or lighten up, and green for being all good.

“In order to play safely with breath play, it’s important to know your bottom well and understand that in an emergency, they might not be able to signal that there is a problem,” said professional dominatrix Ruby Enraylls. “Breath play is, unfortunately, one of the few BDSM activities that can’t be safely worded out of during normal play if there’s a problem. And if there’s a problem, it could be lethal.”

Ultimately, there is no way to choke someone or be choked without risk. It will always be dangerous, but for some people, it is a kink too enticing to say no to. 

Breath play without choking 

Breath play is not limited to choking, despite being the most prevalent way the kink is explored. An array of options live under the breath play umbrella, meaning you can avoid choking and not miss out on anything. Yes, you can mimic the experience and feel the thrill of domination without actually risking your life. 

Try simply holding your breath, only restricting airflow from the mouth or nose, or using breathable masks that echo the feeling without the additional dangers. You can place a hand on the throat without exerting any pressure. The threat of domination can be just as intoxicating as playing it out. 

Doctors and dominatrixes alike warn of the risks of all forms of breathplay, but they cannot loom over every couple in every bedroom, so the decision lies with you. Finding the balance between risk and sensual satisfaction is a delicate process that should be undertaken carefully and with consideration. 

While only you know what will inject passion into your sex life, at least recognize the risks before engaging in any new kink. Do not allow arrogance to walk hand-in-hand, or hand-on-throat, with your arousal. Choking comes with a “risk of death” warning label for a reason. 

Make sure to have a long conversation with your partner, and learn their safe words, triggers, and limits before experimenting with breath play. Each of you should also speak to a doctor before experimenting with heavy breath play. You don’t want an undiscovered heart condition discovered because you got too kinky.

The golden rules of breath play

Before you and a partner begin to explore breath play, make sure you follow these golden rules. 

  • Make sure you have had a full physical from a doctor within the last year. Lack of oxygen can trigger cardiac arrhythmia, or irregular heartbeats, which can be dangerous for people with some heart conditions.   
  • Only ever place pressure on the sides of the neck and never on the windpipe (at the front of the throat) or Adam’s apple area. 
  • Communicate and use safe words and cues throughout. Good cues include having them hold a ball in their hand and physically “tapping” out. 
  • Check-in regularly with the partner being choked. The choker cannot lose themselves in the moment and forget the life they are holding in their hands.  
  • Do not engage in breathplay with first-time partners. Only experiment with trusted partners. 
  • Take regular breaks from choking. Regular choking comes with heightened risk, and rest is crucial. 
  • Do not use makeshift home items, such as rope, belts or collars as breath play toys. They can put extra pressure on the windpipe. 
  • Start with short amounts of time restricting oxygen and build up very slowly. 
  • Always tap out earlier than you think you need to. Your brain works slower when it’s deprived of oxygen so it will take a minute for your body to catch up. 
  • Do not experiment with it if you are an amateur kinkster. Play with the array of options at your fingertips but leave breathplay and choking to the experienced.
  • If you want to try it, visit an experienced dominatrix who can induct you slowly and carefully.