Auto-erotic asphyxiation: three case reports

Men who indulge in auto-erotic asphyxial practices are rarely encountered by psychiatrists. More often, they come to light at a coroner's inquest, and a verdict of "accidental death" is usually rendered (e.g., from hanging/suffocation). This paper describes and contrasts three cases of auto-erotic asphyxial practices. The first case, of accidental death by hanging, was an apparently highly successful young man who functioned at a high level and was without "serious psychopathology." In contrast, the other two, both survivors of asphyxial practices, manifested multiple paraphilias and other types of psychopathology. The syndrome may be extremely diverse, and survivors who consult psychiatrists require holistic assessment and treatment tailored to multifarious needs.