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Initially the death of the “Kill Bill” and "Kung Fu" star, actor David Carradine, was written off as a suicide. However, reports that there was a rope tied around both his neck and genitals have gained attention and put a spotlight on what could be a case of auto-erotic asphyxiation.

In auto-erotic asphyxiation, an individual cuts off the flow of oxygen to the brain while masturbating. This “suffocation” is usually achieved by using a noose of some kind such as a plastic bag, a gas like propane, or a cord, such as those used by Carradine. The resulting effect is described as a hypoxic state that creates a sense of euphoria and can also intensify orgasm. Some will also bind their penises to restrict blood flow and prolong an erection. Deaths usually result by accident—a miscalculation by a lone individual who fails to release their chokehold before loosing consciousness or through the participation of another individual involved in the act who simply fails to release the strangle before its too late and the other person dies of suffocation.

Researchers that have studied auto-erotic asphyxiation have discovered that the practice may have its roots in an adolescent “choking game”. Adolescents play this game to get a “lightheaded” feeling by cutting off the flow of blood to the brain by using belts, their hands, or ropes around their necks, pushing on their chests with their hands, or by hyperventilating. Once they release the pressure, the blood that was trapped floods the brain all at once and creates the euphoric feeling—which is simply the brain dying, thousands of cells at a time. Parents should watch out for the following signs that their adolescent could be playing the choking game:

  • Suspicious marks on the neck, sometimes hidden by a turtleneck, scarf, or turned-up collar

  • Changes in personality, such as aggressiveness or agitation

  • Any kind of strap, rope or belt lying around for no reason, particularly if it is tied in knots—and attempts to avoid questions about such objects

  • Headaches, loss of concentration, flushed face

  • Bloodshot eyes or any other noticeable signs of eye stress

  • A thud against a bedroom wall—meaning a “fainting spell” in cases of solitary practice

  • Any questions about the effects, sensations or dangers of strangulation

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