Dangerous games

Kids give us plenty of things to worry about as they mature: Will they pay enough attention in school to get into a good college? Will they choose the right friends? Will they make the right choice when faced with drugs or alcohol? Will they wait until they’re really ready to experience sex? Current attention to an ancient practice has given families something else to understand and warn children against: choking games.

Choking games, medically known as ‘voluntary asphyxia’ goes by many terms among kids. Black Hole, Black Out, Red Out, Knock Out, Flat lining, Five Minutes in Heaven, Space Monkey, Suffocation Roulette, Gasp, Tingling, are among the names used by kids in different communities[1]. These are terms that parents and grandparents should come to know and recognize as a sign of danger.

In these games, kids physically limit oxygen to the brain, causing a brief, intense rush as the brain automatically reacts to the perceived threat by releasing specific chemicals that cause the feeling of a temporary high. Methods range from holding their breath while a peer applies pressure to the vagal nerve (similar to applying the Heimlich maneuver) to using ligatures around the neck. Analogous to the manner in which many adolescents are initiated to cigarettes or alcohol, a trusted or high status peer presents the opportunity to participate as fun or cool. A teen who does not understand the potential danger may see it as a way to achieve a legal high and gain acceptance with peers. However, like drugs, the rush or the temporary high can become addictive. And I can never repeat often enough that the part of the brain responsible for high-level decision making is   not fully developed until adolescence is over!   Peer pressure, poor judgment and a potential high can make risk taking hard to resist for adolescents in many circumstances .Choking games can be played alone or with peers and are believed to be almost always initiated in groups, although the availability of online information may be changing this. As bad as the group games are, the act becomes more dangerous when a child engages alone. Safety precautions fail and kids suffocate.

Adolescent males may also come to believe that that a sexual climax can be heightened by depriving their brain of oxygen. Known as ‘autoerotic asphyxiation’ this practice has been documented in medical literature since the 19th century. Sadly, most of the documented cases are based on posthumous investigations; up to 25 deaths occur each year when fail-safe mechanisms do fail and a victim is strangled.

Here’s an important point for families with young adolescents: Sexual archetypes, or lifelong preferences, are often set in adolescence as the initial objects or behaviors associated with autonomic sexual arousal become imprinted (in a manner of speaking) in a child’s developing brain. Autoerotic asphyxia can become a dangerous lifetime habit that’s difficult to break. Experts estimate that between 250 and 1200 deaths occur per year from autoerotic asphyxiation but since many cases are mistaken for suicide the real number is hard to know. Identifying and intervening in early ‘choking games’ can prevent this particular paraphilia from becoming a deadly part of a child’s sexual life.

Of course, it is highly unlikely that any adolescent will discuss any autoerotic activities with parents or grandparents. I strongly believe that parents and care takers have the obligation to check kids’ dresser drawers, book bags and other hiding places for indications of drugs, alcohol or cigarettes; similarly, plastic bags or items that can be used as a ligature should be added to this list of contraband. Any indication of children using language similar to the many names used for choking games should be a call to action.  Similarly, check a child’s browser history for searches  indicating interest in these issues.    In any case, kids need to hear from loving adults in their lives that this “game” has potentially deadly consequences and should never be practiced.  Ever.

In an article published by the American Academy of Pediatrics, pediatricians are advised that “provided with relevant information, pediatricians can identify the syndrome, demonstrate a willingness to discuss concerns about it, ameliorate distress, and possibly prevent a tragedy.” The same is true for parents and grandparents.

This article originally appeared in GRAND magazine, 3/2015


[1]   Daniel D. Cowell, MD, MLS, CPHQ , Autoerotic Asphyxiation: Secret Pleasure—Lethal Outcome? PEDIATRICS Volume 124, Number 5, November 2009 pp 1319 -1325

A sex-wise parent’s view on how to prepare your child for back-to-school

While conducting focus groups for my book, The Sex-Wise Parent, the son of a minister shared how his parents prepared him for his first day of school.  I love the lessons from this story so much that I want to share it with parents everywhere.

Tom and his family had just moved to a new town so his father could attend  to a new parish.   Tom was set to attend a school serving boys from first grade through 12th, and at six years of age, this was his first year of school.

Maybe because it was the 60’s, or maybe because of their own childhood memories — whatever the reason — Mom and Dad were pretty sure that  the older boys in  this school would be all too willing to teach little Tom their version of  the birds and bees.  These sex-wise parents sat down with their son together with a book that included charts and diagrams of sexual and reproductive anatomy and physiology.  They explained male and female anatomy and how  people got pregnant, and encouraged him to ask questions.  He recalled  “I asked them if (ejaculation)  was like peeing in there — YUK !”   Decades later, he still recalls their patient answer that “one set of tubes shuts off so the other can work — so that seeds can come out instead of pee.”

The other focus group members and I listened in dumbstruck awe and envy.  How lucky was Tom!   When the older boys teased and told stories about sex, he was prepared with the truth.   Tom’s parents sent him off to his first day of school filled with factual information wrapped up in their family’s values.

Tom also learned that sexual touching  was special and reserved for people in love.  What a contrast to today, when so many kids hear about sexual touching for the first time in the context of a good touch/bad touch sex abuse prevention program.   By teaching Tom that sexual touching was part of a loving, special, grown up relationship, they were de facto teaching him that any grown up who tried to touch him in a sexual way was doing something wrong.  And most importantly, they were modeling that they were open to hearing what he had to ask or say about sex.

Their final words on the topic also warmed my heart.  When I asked Tom if his parents were worried about him telling the other kids about sex he replied, “Not at all.   In fact, they told me that getting to tell a child about sex was a privilege reserved for parents, and it was my job to keep this to myself so other parents get to have the very special conversation with their kids like we’d just had”.

Not everyone has the comfort and skills of Tom’s parents, but any parent can develop them!  I wrote The Sex-Wise Parent to help parents do just  that, and provide helpful resources at my website.  Please —  use these resources to help make yours a sexually safe and healthy family, school and community.