Scarfing Research Articles

Playing with the self: celebrity autoerotic asphyxiation

Celebrity sexual scandal has long attracted the attention of the popular media and is a motivating force in the construction of celebrity identity. Its aftermath is often carefully stage-managed by agents, publicists and promoters, but always mediated and beyond the control of the celebrity. It is the relationship between celebrity and a particular sexual transgression – autoerotic asphyxiation (AEA) – that is our focus here in terms of how celebrity and AEA have been similarly read and discussed. This is illustrated through a consideration of the diverse case studies of the peculiarly perverse and untimely deaths of INXS front man Michael Hutchence, found naked in a hotel room in 1997, veteran B-movie actor David Carradine, discovered hanging from a wardrobe in a Thai hotel in 2010, and the bizarre reports regarding British Conservative MP Stephen Milligan's death in 1994. In considering the practices and discourses around it, we argue that AEA both reveals and makes sense of the tensions and contradictions inherent in celebrity identity. In particular, the article considers the complex negotiations between the private and public selves, contradictory discourses that seek to make sense of an AEA death and the impact it has on the celebrity persona. Ultimately we argue that the nature and content of the sex act and death reconfigures and fixes the celebrity identity that existed prior to the celebrity's association with AEA.

Deciphering the Neural Signature of Conversion Blindness

Deciphering the Neural Signature of Conversion Blindness

Every Breath You Take: Erotic Asphyxiation, Vengeful Wives, and Other Enduring Myths in Spousal Sexual Assault Prosecutions

L'importante décision de la Cour suprême du Canada dans l'arrêt J.A. devrait faire cesser le recours à la défense invoquant le consentement donné à l'avance, offrant ainsi une protection contre les agressions sexuelles aux femmes qui se retrouvent inconscientes pour quelque raison que ce soit. Même si une analyse plus profonde du cas et de la jurisprudence connexe révèle que les praticiens du sadomasochisme ont peu de raisons de craindre des poursuites criminelles au Canada, la présente analyse met en lumière d'autres problèmes sérieux, par exemple en ce qui concerne les poursuites pour agressions sexuelles entre conjoints, y compris le fait de minimiser les risques reliés à l’étranglement, une volonté de considérer la violence comme agréable et l'invocation constante du comportement sexuel antérieur sans plus d'information sur le contexte, notamment les actes de violence antérieurs du défendeur contre la plaignante. De plus, l'article remet en question la nécessité et l’à-propos de la preuve d'experts dans des cas d'agression sexuelle dans un contexte conjugal.

An autoerotic death in Korea

Accidental autoerotic asphyxia occurring during autoerotic activity is usually considered the unanticipated failure of a sexual stimulation device to induce hypoxia during solitary sexual arousal. Here, we provide the first reported case of autoerotic death in Korea. In the present case, a young man died from asphyxiation as a result of being suspended with his head in a plastic bag. The death was considered accidental and not suicidal. The diagnosis of autoerotic death may be difficult when typical features are absent.

Les jeux de non-oxygénation et l’hypoxyphilie : de l’asphyxie volontaire passagère à l’addiction ?

IntroductionThere are two forms of voluntary and temporary asphyxiation: the “fainting game” better known as “the choking game”, “blackout”, “space monkey” and the erotic asphyxiation. These conducts involve inducing cerebral hypoxia with the aim of developing an altered, euphoric-like state. Unlike the choking game, erotic asphyxiation implies a sexual activity. The objective of our work is to describe these two types of asphyxiation, which are little known by the medical world and nevertheless responsible of numerous complications, including death. MethodWe performed a systematic review (Medline, Science Direct) between January 1988 and August 2011 to identify the frequency, as well as the clinical and psychopathological data, and to present available ways of screening and management. ResultsThese practices correspond to two different categories. The fating game of concerns teenager risk behaviors. Erotic asphyxiation is a characteristic of young adult masochistic activity. Both of these practices pose the risk of evolving towards a behavioral addiction. According to the model of the affective-behavioral addiction, the fainting game has an addictive potential mainly for teenagers displaying mental and other addictive disorders. The erotic asphyxiation dependence is considered to be a paraphiliac addiction, which also features the tolerance mechanism. Consequently, dependent subjects experience the need to escalate exposure in order to reach the same level of pleasure. They increase the number, the time and the intensity of hypoxia, thus heightening the risk of death and complications. A behavioral addiction is therefore regarded as a risk factor. ConclusionWe encourage clinicians to acquaint themselves with the main alert signs (preexisting risk factors, behavior modifications, neck erythema, unexplained somatic disorders) to screen patients for this type of conduct and to take into account such an addictive component in clinical settings.

Autoerotic death: a rare but recurrent entity

Autoerotic death has been defined as accidental death occurring during solitary sexual activity that results from a malfunction or an unexpected effect of a device/material or substance that was being used to augment the experience [1]. Although it has been recognized for over 200 years [2], cases in the literature have previously been mistaken for suicide, and a clear definition was not published until 1991 [3]. While our understanding of this entity has improved, diagnostic difficulties persist and there appears to have been recent changes in epidemiological features in certain communities. A variety of different activities may be used to enhance sexual excitement that may be potentially lethal, including cross-dressing in conditions of extreme heat and inserting rectal and genital foreign bodies, however the majority of fatalities involve activities that induce asphyxia [4, 5]. The basis for this is that oxygen deprivation augments the sexual response in certain individuals, giving rise to a variety of techniques being used to induce hypoxia during solitary or shared sexual activity. Given the often elaborate paraphernalia that is found at death scenes in cases of autoerotic asphyxia it is clear, however, that there are also often quite prominent elements of fetishism, bondage and masochism. An important point in cases of autoerotic death is that the manner of death is accidental. This means that cases where death has occurred from underlying organic illness such as cardiovascular disease should not be included within this group [3]. One of the features used to diagnose autoerotic death is the presence of a ‘fail safe’ device at the scene [6]. This refers to a mechanism that enables the practitioner to free him or herself from any device that was being utilized to induce asphyxia. Unfortunately ‘fail safe’ devices are often quite fallible and following their failure, unconsciousness may develop very rapidly if the neck is compressed preventing self extrication [7]. Certain problems may arise in making the diagnosis of autoerotic death. By its very nature the activity is secretive, and so its practice by the victim may have been completely unknown to family members, who may then strongly resist the suggestion. Family members or friends may also alter the findings at the death scene before investigating police attend, due to the perceived stigma attached to such a death. Cases involving females are rare and are made more difficult by the lack of props and sexual paraphernalia that characterize such activities in males [8–10]. Studies have shown that practitioners may be depressed and so there exists the possibility that an individual who has previously engaged in this type of activity may elect to use this as a method of suicide. In the absence of a suicide note, or other evidence of a deliberate self destructive act, this possibility may be overlooked [11]. While the ‘‘Choking Game’’ played by adolescents to induce a euphoric effect uses hypoxia, it is distinguished from autoerotic activities by the absence of associated sexual activities [12]. Although the finding of a complex apparatus at a death scene may point to an autoerotic misadventure, certain suicides may also be characterized by very elaborate preparation with unusual devices [13]. However, careful assessment of the death scene should enable differentiation between these two events. One of the features at the death R. W. Byard School of Medical Sciences, The University of Adelaide, Adelaide, Australia

Every Breath You Take: Erotic Asphyxiation, Vengeful Wives and Other Enduring Myths in Spousal Sexual Assault Prosecutions

The Supreme Court of Canada’s important decision in J.A. should end reliance on the defence of advanced consent thereby helping to ensure that women who are unconscious for any reason are protected from sexual assault. A closer analysis of the case and related jurisprudence also reveals that this decision does not support fears that BDSM practitioners now face heightened risk criminal prosecutions. But it illuminates other serious problems that arise, especially in spousal sexual assaults prosecutions, including minimization of the harms of strangulation, a willing to see violence as enjoyable, and the continued reliance of sexual history evidence without more contextualizing information, especially the defendant’s prior violence against the complainant. It also raises questions about whether and when expert evidence is required in spousal sexual assault cases.

Risky, Kinky Sex and the Public Policy Doctrine: Strangulation Sex or Erotic Asphyxiation

Risky, Kinky Sex and the Public Policy Doctrine: Strangulation Sex or Erotic Asphyxiation

Accidental Death Due to Autoerotic Asphyxia: A Case Report

This paper presents the case of a 26-year-old hotel management student who accidentally suffocated and died while practicing autoerotic asphyxia. The findings suggested that his death was accidental and due to asphyxia by suffocation performed to enhance sexual gratification during masturbation.

Accidental Hanging by a T-Shirt Collar in a Man With Morphine Intoxication

Accidental hanging is rare across all age groups, and it is even rarer in the adult population except in autoerotic asphyxia. Few cases have been reported in the literature, which describe unusual patterns of accidental hanging. This article focuses on an unusual pattern of accidental hanging of a 25-year-old man, who was in a state of morphine-induced central nervous system depression and found dead in a sitting position with the collar of his T-shirt hanging off a jutting-out root of a tree. The hanged collar acted as a ligature compressing the neck.

“Can You Breath?” Autoerotic Asphyxiation and Asphxiophilia in a Person with an Intellectual Disability and Sex Offending

This case study examined the diagnostic features and treatment components for a sex offender with an Intellectual Disability (ID) and multiple paraphilias. In particular, the co-existance of autoerotic asphyxiation and asphxiophilia (performed by a partner), and the associated behaviors of cross dressing and bondage were present; this person also engaged in self-injurious behaviors, maintained a sexual journal, created “home made” pornography, and sexual scripts that he would use with his victims. This study is noteworthy because the complexity of the co-morbid disorders and features has not yet been reported in persons with ID. The effectiveness of the medication regiment and different interventions are also examined.

Could Intra-alveolar Hemosiderin Deposition in Adults be Used as a Marker for Previous Asphyxial Episodes in Cases of Autoerotic Death?

Intra-alveolar hemorrhage and hemosiderin have been cited as possible markers of recent and remote asphyxial events. Little study has been undertaken of the potential significance of intra-alveolar hemosiderin in adults as a potential marker of previous sublethal asphyxial episodes. Ten cases of lethal sexual asphyxia (an entity known to be associated with repetitive sublethal asphyxial episodes) and 20 randomly selected, age- and sex-matched controls had sections of lung stained for hemosiderin. Subsequently, intra-alveolar, iron-containing macrophages were counted. All cases were men (ages 15-50 years; mean 31.8). No significant increase in hemosiderin was found in victims of sexual asphyxia, indicating that asphyxial episodes in sublethal sexual asphyxial activities may not be sufficiently intense or prolonged to cause intra-alveolar hemorrhage or that intra-alveolar hemorrhage in adults is a relatively nonspecific finding. These results do not support intra-alveolar hemosiderin deposition as a marker for previous sublethal asphyxial events in autoerotic asphyxia.

A Case of Suicidal Suffocation Simulating Homicide

This case concerns an unusual suicidal plastic bag suffocation. An elderly white man was found dead and partially disrobed in his apartment lying supine on a sofa with a plastic bag closed by a rope over the head and the upper and lower extremities tightly tied with two other ropes, the end of both arranged into slipknots (self-rescue mechanism). Police investigations found no pornography in the apartment, and circumstantial data alleged no psychiatric disorders or suicidal intentions. The autopsy excluded signs of struggle and sexual intercourse as well as any type of injury or physical illness. Chemical analyses on the peripheral blood excluded acute drugs and/or alcohol intoxication. A differential diagnosis of the manner of death was performed, including scenarios of accidental autoerotic asphyxiation, homicide during either sexual activity or ritualistic, elderly suicide. The collected data most strongly supported the hypothesis of a suicidal asphyxiation simulating homicide to devolve a life insurance to the victim's sons because of economic difficulties.

Autoerotic Asphyxiation: Secret Pleasure—Lethal Outcome?

Autoerotic Asphyxiation: Secret Pleasure—Lethal Outcome?

An unusual death of a masochist: Accident or suicide?

“Autoerotic asphyxia” typically involves an individual hanging or ligature, resulting in self-induced oxygen deprivation brought about by neck compression during sexual activity. Little about the so-called “ atypical forms” of autoerotic asphyxia, which also involve compression of the chest or abdomen, has been published in forensic literature. When death results from such practices, they are usually deemed accidental, however, suicide or homicide must also be considered. The authors present a single case of accidental fatal asphyxia by the simultaneous compression of the neck, chest, and abdomen using a chair-bed. The victim was known to have had masochistic tendencies. In order to confirm the hypothesis of accidental death, the results of crime scene investigations, and autopsy findings, including histological and toxicological analysis, are summarized here.

Autoerotic Asphyxiation: Secret Pleasure—Lethal Outcome?

Voluntary asphyxiation among children, preteens, and adolescents by hanging or other means of inducing hypoxia/anoxia to enhance sexual excitement is not uncommon and can lead to unintended death. This study addresses autoerotic asphyxiation (AEA) with the intent of increasing pediatricians' knowledge of the syndrome and awareness of its typical onset among young patients. AEA is characteristically a clandestine and elusive practice. Provided with relevant information, pediatricians can identify the syndrome, demonstrate a willingness to discuss concerns about it, ameliorate distress, and possibly prevent a tragedy. A retrospective study was undertaken of published cases both fatal and nonfatal and included personal communications, referenced citations, clinical experience, and theoretical formulations as to causation. Characteristic AEA manifestations, prevalence, age range, methods of inducing hypoxia/anoxia, and gender weighting are presented. All sources were used as a basis for additional considerations of etiology and possibilities for intervention. AEA can be conceptualized as a personalized, ritualized, and symbolic biopsychosocial drama. It seems to be a reenactment of intense emotional feeling-states involving an identification and sadomasochistic relationship with a female figure. Inept AEA practitioners can miscalculate the peril of the situation that they have contrived and for numerous reasons lose their gamble with death. Pediatricians should be alert to the earliest manifestations of AEA. Awareness of choking games among the young and, of those, a subset who eventually progress to potentially fatal AEA is strongly encouraged among all primary care professionals who may be able to interrupt the behavior.

The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified

The category of "Not Otherwise Specified" (NOS) for DSM-based psychiatric diagnosis has typically retained diagnoses whose rarity, empirical criterion validation or symptomatic expression has been insufficient to be codified. This article reviews the literature on Telephone Scatologia, Necrophilia, Zoophilia, Urophilia, Coprophilia, and Partialism. Based on extant data, no changes are suggested except for the status of Partialism. Partialism, sexual arousal characterized by "an exclusive focus on part of the body," had historically been subsumed as a type of Fetishism until the advent of DSM-III-R. The rationale for considering the removal of Partialism from Paraphilia NOS and its reintegration as a specifier for Fetishism is discussed here and in a companion review on the DSM diagnostic criteria for fetishism (Kafka, 2009). In the DSM-IV and DSM-IV-TR, the essential features of a Paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons that occur over a period of at least 6 months (Criterion A). Given consideration for the erotic focus of Partialism and Autoerotic Asphyxia, amending the operational criteria for Paraphilia should be considered to include an atypical focus involving human subjects (self or others).

Death From Auto-Erotic Asphyxiation in a Long-Term Psychiatric Setting

Death from auto-erotic asphyxiation is a startling phenomenon that is on the rise both in the general population and within psychiatric facilities. While these auto-erotic behaviors may lead to death, it is seldom the client's intention to do harm; rather, the intent is to heighten masturbatory sensations. After describing this phenomenon, the authors discuss implications for nursing care.

Asphyxial Games in Children and Adolescents

Asphyxial games, as played by young adolescents, and going by various names, are not new phenomena. What seems to be different at present is an increase in lethality introduced by the increasing use of ligatures and "playing" the game alone. The authors present a properly certified but insufficiently appreciated case followed 2 years later by 2 closely spaced but unrelated deaths in young adolescent males that made known this practice in New Hampshire youth. Other cases presented to the author from other jurisdictions are reviewed in aggregate. Presented are characteristics of victims of this practice that may help distinguish these deaths from suicidal asphyxia. A relative paucity of literature regarding asphyxial games outside the realm of autoerotic asphyxia gives rise to certification difficulties given the high prevalence of youth suicide.

The relationship between serial sexual murder and autoerotic asphyxiation

This case series documents and examines the association between autoerotic asphyxiation, sadomasochism, and serial sexual murderers. Autoerotic asphyxiation, along with other paraphilias found in this population, is reviewed. Five cases of serial sexual killers who engaged in autoerotic asphyxiation were identified worldwide: four from the United States and one from Russia. Case reports for each are provided. All (100%) were found to have sexual sadism in addition to autoerotic asphyxiation. Furthermore, two (40%) had bondage fetishism, and two (40%) had transvestic fetishism, consistent with these paraphilias co-occurring in those with autoerotic asphyxiation. Overall the group averaged 4.0 lifetime paraphilias. Some possible relationships were observed between the offenders’ paraphilic orientation and their modus operandi, e.g., all of these serial killers strangled victims—suggesting an association between their sadistic and asphyxiative paraphilic interests. The overlap of seemingly polar opposite paraphilias in this sample – sexual sadism and autoerotic asphyxiation – is explored from a historical and clinical perspective. Multiple commonalities shared between these five offenders and serial sexual murderers in general are addressed. A primary limitation of this study is its small sample size and empirical basis; the results may not be generalizable beyond the sample. The findings from this study support the supposition that crime scene behaviors often reflect paraphilic disturbances in those who commit serial sexual homicides.