Ademcontrole

What is ademcontrole?

Ademcontrole is the Dutch word for breath play, known in the literature as erotic asphyxiation. It is the deliberate limiting of someone’s breathing, or of the blood supply to the brain, to bring on a rush or arousal. It happens with a hand, a pillow, a hood or a position. Of everything the scene knows, this is the most dangerous.

What ademcontrole looks like in practice

From the outside, ademcontrole almost always looks smaller than it is. Usually it is a hand resting on the throat during sex, for seconds at a time, with nothing visible happening.

A first example, and at the same time the most common form: a hand on the throat with barely any pressure. Nothing is closed off. What happens is mostly psychological, because the receiver feels that someone else holds the power there. This is the version most people mean when they say they do it now and then.

Between those two examples there is no sliding scale but a threshold. The moment something is genuinely squeezed shut, the nature of what is happening changes.

How ademcontrole works

The effect comes from a shortage of oxygen in the brain, and that can arise along two routes. In suffocation the airway is limited, so less oxygen comes in. In strangulation the blood supply through the carotid arteries is squeezed off, so the oxygen already there no longer arrives. That second route works within seconds, and that is exactly why it is so hard to dose.

What a lack of oxygen does to brain tissue is not subtle. Dugan and colleagues write in The Journal of Emergency Medicine that anoxic brain injury costs 1.9 million neurons and 14 billion synapses per minute, and that the hippocampus is extra sensitive to it because of its high metabolism.

The unpleasant part of their findings is about what you do not notice. Of the patients with memory loss, 49 percent no longer remembered having been unconscious. So loss of consciousness is an unreliable measure: someone can have been gone, come back, and sincerely say that nothing happened.

Why people do ademcontrole

The pull rarely sits in the lack of oxygen itself. It sits in the surrender: someone else literally holds your breath in their hands, and that is the most unmistakable difference in power you can create in a bed.

It happens more often than people think. Herbenick and colleagues surveyed more than four thousand American students and found that 47.3 percent had at some point been strangled during sex, and 43.0 percent had at some point done it to someone else. That makes it not a fringe phenomenon but common behavior among young people.

• For the receiver, the payoff sits in the intensity: attention is pulled fully into the body and there is no room left for anything else.
• For the giver, it sits in the trust that comes before it. Someone who allows this gives away more than in any other act.
• For a couple, it is often the subject where the conversation about limits first becomes truly sharp.

And then the caveat, which weighs heavier here than with any other term in this list. Huibregtse and colleagues compared, in Frontiers in Behavioral Neuroscience, twenty young women who had been strangled during sex four or more times in the previous month with twenty women who had never experienced it. On memory tasks both groups scored equally well. On the brain scan they did differ: the first group showed different activation patterns during the same task. The researchers conclude that repeated exposure is linked to a different use of brain capacity, and that further research is needed.

That is not proof of lasting damage. It is precisely the kind of signal you do not want to see in something presented as harmless.

How people do ademcontrole

Most people do the light variant and call it by the same name as the heavy one. A hand on the throat, no pressure, a few seconds. That is what happens most often in practice.

Beyond that, heavier forms exist, and that is exactly the area where a careful, professional approach is not optional. In the past, things have gone wrong with executions like these, and that is why experienced players are cautious about it. What those forms have in common is that something ends up around the neck or over the head that stays put, and that the person was alone.

So what separates the careful execution from the reckless one is not technique. It is whether someone else is there, whether it was agreed beforehand when to stop, and whether you stop at doubt instead of at certainty.

Misconceptions about ademcontrole

“If you let go in time, nothing can happen.” The problem is that “in time” cannot be seen. The overview by Dugan and colleagues shows that nearly half of the people with memory loss did not realize they had been unconscious. Whoever navigates by the other person’s reaction is navigating by an instrument that can be broken.

“I only squeeze on the sides, that is safer.” Pressure on the carotid arteries closes off the blood supply to the brain and works within seconds. That is not the mild variant; that is the fast one.

“You rarely hear about it, so it must not be a big deal.” What rarely comes out is about executions where someone was alone. About brain injury that no one recognizes as such, you hear nothing at all, and that is exactly the risk that stays.

“It is the same as a firm grip.” A hand on the throat without pressure is an exchange of power. A hand that closes something off is a shortage of oxygen. The same movement, two completely different things.

What I make of it

Breath and choke play are on my yes-list, and I have been doing it for twenty-five years. That is exactly why I have grown stricter about it instead of looser.

Most of the time people mix up the light and the heavy variant. Someone once had a hand on her throat, found it exciting, and asks for “the same but harder”, without knowing that “harder” here is a different category and not a higher setting. That conversation I always have before anything happens, including in the run-up to a BDSM date.

And one thing I hear from women that you read nowhere: for almost everyone the pull sits in the hand, not in the shortage of oxygen. Once you know that, you can reach nearly everything people look for in it without ever closing anything off.

What you can do

• Never do ademcontrole alone. Almost everything that has ever gone wrong here happened without anyone who could step in. This is the one rule that knows no exception.
• Agree on a stop signal that works without a voice. Someone with no breath cannot say a safeword; so agree on a hand gesture, for example two taps.
• Start with the hand without pressure and stay there a few times. If that already gives what you are looking for, you do not need to go further.
• Stop at doubt, not at certainty. Go to a doctor or the emergency room if there has been loss of consciousness, if someone cannot remember the minutes afterward, or with pain on swallowing, hoarseness or a headache that persists.
• Never use anything that stays put. No rope, belt, strap or piece of clothing around the neck, not even loosely.
• Talk it over the next day. Memory loss about the session itself is a signal, not an anecdote.

More about ademcontrole

On this site there is the most on this subject. The introduction to breath play explains how it feels, the difference between breath play and choke play sets the two mechanisms side by side, and the hidden dangers of choke play is the piece I have inexperienced players read first.

Beyond this site, the article by Dugan and colleagues is free to read and the best starting point if you want to understand why a lack of oxygen is so easily overlooked. The study by Huibregtse and colleagues is also open access and shows how carefully researchers phrase this.

Sources

• Anoxic Brain Injury: A Subtle and Often Overlooked Finding in Non-Fatal Intimate Partner Strangulation. Dugan, Patch, Hoang & Anderson, The Journal of Emergency Medicine, 2024. Provides the rate at which a lack of oxygen costs brain tissue, and the finding that 49 percent of patients with memory loss did not remember the loss of consciousness.
• Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks. Huibregtse, Alexander, Klemsz, Fu, Fortenberry, Herbenick & Kawata, Frontiers in Behavioral Neuroscience 16, article 881678, 2022. Compares twenty women recently and repeatedly strangled with twenty who never experienced it; equal performance, different brain activation.
• Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. Herbenick, Patterson, Beckmeyer et al., The Journal of Sexual Medicine 18(6), 1024–1041, 2021. Provides the figures 47.3 percent ever strangled and 43.0 percent ever strangled a partner.

Related terms

• Glossary. Ademcontrole is the best-known form of edgeplay; the others are further down the same list.
• Breath control. The main English page for the same act, with the research on why that reassuring word misleads.
• Edgeplay. The category ademcontrole is the best-known part of.
• Facesitting. Smothering instead of neck compression, with its own risk profile and a stop signal that does not depend on speech.
• Gas mask. The object that sits over the airway, and what happens once the filter is covered.
• Bagging. The heavy variant with a bag over the head, with the same risks and its own page.
• Smothering. The form where the mouth and nose are closed off instead of the neck squeezed shut, with its own risk profile.
• Asphyxiophilia and choke play are the other close neighbors of ademcontrole.
• Breathwork. The same breath, but steered by yourself, with the research on its effect alongside.