Wednesday, December 23, 2015

The choking game

This time, it was 13-year-old Memphis Burgess.

The Colorado Springs seventh grader with the purple Mohawk and goofy grin was discovered in his closet 11 days ago, crouching on his knees, his face against the wall, as still as death.

“I thought he was messing with me,” his father, Brad Burgess, told KKTV. “I shook his shoulder. That’s when he turned around I noticed he was all blue and not breathing.”

A soft rope lay on the floor nearby.

The Burgesses don’t believe their son killed himself intentionally. They think that he wrapped the rope around his neck in an attempt to stop the flow of oxygen to his brain for a brief high. It’s a pastime known at Memphis’s school and elsewhere as “the choking game.”

This time it was Memphis Burgess. Nine years ago it was William Bowen, a 15-year-old from Frederick County, Md., who accidentally asphyxiated himself with a terrycloth towel. Almost a decade before that, it was Judson Thompson, 11, who was found strangled by a dog collar in his home in Manitoba.

All told, the game is thought to be responsible for more than 1,000 deaths since 1934, according to GASP, an advocacy group that aims to put a stop to the activity. The victims are almost always kids like Memphis: teenagers trying it alone, unaware of the fact that their “game” has a long and deadly history.

While the “choking game” has been around a long time, some experts fear that it could become more common because of social media, including YouTube videos portraying it.

Martha Linkletter, a 37-year-old pediatrician in Ontario, said her patients are often surprised that she’s heard of the game when she asks about it.

“They can’t believe this super-old pediatrician knows about it. They think it’s this subversive, underground thing, that ‘no parents even know what we’re doing,'” she told The Washington Post.

But Linkletter, who co-authored a study about YouTube and asphyxiation games, recalls people playing the “game” at slumber parties when she was a child. In fact, people have been asphyxiating themselves for centuries, even millennia — not seeking death, but something at its very edge, the dark, dreamy high of almost-oblivion. It’s been part of religious ceremonies and occult rituals, even sex — in the Victorian era, men would visit “Hanged Men’s Clubs” for erotic encounters that involved depriving their brains of oxygen. Then as now, the pursuit was sometimes fatal...

Various surveys have found that 5 to 10 percent of middle schoolers have played the choking game.

Self-asphyxiation has a reputation as “the good kid’s high,” according to Salon — a way to achieve euphoria without drugs or alcohol. And discussion of the game online can make it seem like a joke.

While working as a pediatric resident several years ago, Linkletter surveyed dozens of YouTube videos of the “choking game” for a study in the journal Clinical Pediatrics.

“They make it look like a funny, awesome activity,” she said of the videos. “Everybody is laughing, giving high fives, even when someone is having a hypoxic seizure on the ground. … That can normalize it. It makes it seem like everyone is doing this.”...

But studies do seem to agree that most choking game fatalities come when a person attempts it alone.

“There’s no one to relieve the pressure when it goes too far,” Linkletter said.

These deaths appear to be happening more often, Linkletter said, perhaps in part because teenagers are more likely to find out about the choking game online and try it on their own. GASP has counted 672 choking game deaths in the past 10 years, more than twice as many than occurred in the decade before that.

But reports of deaths may also be more common because people are more aware of it, and less likely to rule an accidental death a suicide. There are stories from survivors like Levi Draher, a San Antonio teen who emerged from a three-day coma after strangling himself with a rope slung across his bed frame in 2006 to become a scared-straight motivational speaker, reciting his tale of near-death and resurrection in high school auditoriums across the country. Lifetime made a movie about the game in 2014 (though it’s not clear how many 14-year-olds a Lifetime movie might reach)....

At a service for Memphis Burgess on Friday, one of the boy’s friends approached the grieving mother and confessed that he, too, had tried the choking game.

“He promised he would never play again,” Annette Burgess told KKTV. “So I know that [Memphis’s] life is at least going to have an impact.”
See: Breath-holding spells  4/13/15


  1. Busse H, Harrop T, Gunnell D, Kipping R. Prevalence and associated harm of engagement in self-asphyxial behaviours ('choking game') in young people: a systematic review. Arch Dis Child. 2015 Dec;100(12):1106-14.



    To assess the prevalence of engagement in self-asphyxial (risk-taking) behaviour (SAB) ('choking game') and associated morbidity and mortality in children and young people up to age 20.


    Systematic literature review.


    Electronic database search of MEDLINE, Embase, PsycINFO, CINAHL, PubMed, Web of Science Core Collection, BIOSIS citation index and the Cochrane register with no language or date limits applied. References of key papers were reviewed, and experts were contacted to identify additional relevant papers.


    Systematic reviews, cross-sectional, cohort and case-control studies, and case reports examining SAB with regard to individuals aged 0-20 years, without explicitly stated autoerotic, suicidal or self-harm intentions were included.


    Thirty-six relevant studies were identified, and SAB was reported in 10 countries. In North America, France and Colombia, awareness of SAB ranged from 36% to 91% across studies/settings, and the median lifetime prevalence of engagement in SAB was 7.4%. Six studies identified the potential for SAB to be associated with engagement in other risk behaviours. Ninety-nine fatal cases were reported. Of the 24 cases described in detail, most occurred when individuals engaged in SAB alone and used a ligature.


    The current evidence on SAB among young people is limited, and stems predominantly from North America and France. Awareness of SAB among young people is high, and engagement varies by setting. Further research is needed to understand the level of risk and harm associated with SAB, and to determine the appropriate public health response.

  2. Linkletter M, Gordon K, Dooley J. The choking game and YouTube: a dangerous combination. Clin Pediatr (Phila). 2010 Mar;49(3):274-9.



    To study postings of partial asphyxiation by adolescents on YouTube and to increase awareness of this dangerous activity as well as the value of YouTube as a research tool.


    Videos were searched on YouTube using many terms for recreational partial asphyxiation. Data were gathered on the participants and on the occurrence of hypoxic seizure.


    Sixty-five videos of the asphyxiation game were identified. Most (90%) participants were male. A variety of techniques were used. Hypoxic seizures were witnessed in 55% of videos, but occurred in 88% of videos that employed the "sleeper hold" technique. The videos were collectively viewed 173550 times on YouTube.


    YouTube has enabled millions of young people to watch videos of the "choking game" and other dangerous activities. Seeing videos may normalize the behavior among adolescents. Increased awareness of this activity may prevent some youths from participating and potentially harming themselves or others.


    The following information has been accumulated from the Victims lists. This data has been summarized in a few different ways. Please click on the links below to view the data. We have requested data from additional sources and will update the site when this becomes available.
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    Statistics by year and country
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