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DYING FOR SEX: CULTURAL AND FORENSIC NARRATIVES OF AUTOEROTIC DEATH.

Vladimir: What do we do now?

Estragon: Wait.

Vladimir: Yes, but while waiting.

Estragon: What about hanging ourselves?

Vladimir: Hmm. It'd give us an erection.

Estragon: (highly excited) An erection! [...] Let's hang ourselves immediately!

Samuel Beckett, Waiting for Godot

It has been my experience that people learning of erotic asphyxia and autoerotic fatalities through a lecture or reading respond with initial disbelief and, as belief takes hold, wonder how it is that there could be such an aspect of human behaviour that they had previously not known.

Park Elliot Dietz, 'Recurrent Discovery of Autoerotic Asphyxia'

The practice of erotic asphyxiation (oxygen deprivation leading to heightened sexual arousal, with the concomitant potential of resulting death) has a history of being described and depicted as an example of the most irrational and bizarre manifestation of non-normative human sexuality. This may account for Beckett's decision to have Estragon suggest it as means of killing time whilst 'waiting for Godot' in his absurdist classic of that name, from 1954, cited above. And, relatedly, novelist of excess William Burroughs's Naked Lunch (1959) and Cities of the Red Night (1981) contain so many descriptions of eroticised hangings that one critic, in a review entitled 'Pleasures of Hanging', described them as displays of Burroughs's 'curious id capering and making faces and confessing to bizarre inclinations'. (1) Indeed, the word 'bizarre' features so frequently as a descriptor of these practices in texts of all kinds that it becomes something of a cliche. For example, in a paper on 'erotized repetitive hangings', Resnik writes: 'although they are bizarre, these deaths are not medical rarities or forensic curiosities'; (2) while another medical doctor and criminologist, Cordner, describes the conditions of autoerotic death as being of a 'bizarre nature'. (3) The terms used by medical professionals to describe the phenomenon differ in no appreciable measure from the lexicon chosen by journalists and headline-writers. Reporting in 1994 on the autoerotic fatality of Stephen Milligan, the UK Tory MP and Parliamentary Private Secretary to Jonathan Aitken, headlines proclaimed: 'Bizarre death of Lawmaker Shakes Tories' (Los Angeles Times, USA, 9 Feb 1994) and 'MP's bizarre death jolts Tories: Body of rising star discovered dressed only in stockings and suspenders' (The Independent, UK, 8 Feb 1994). Incredulity, the distancing of the writer from the practice/practitioners, and an insistence on the 'otherness' of autoerotic death characterise all the above examples.

In this article, I will explore representations of erotic asphyxiation and erotic fatalities taken from a range of discursive fields including forensic pathology, the psy sciences, media coverage of celebrity deaths, humorous internet 'ecards', and, finally, literary fiction in the form of a reading of the novel Breath (2008) by Tim Winton. Breath offers a rare depiction of a female practitioner of erotic asphyxiation, allowing me to evaluate how gender norms and expectations shape cultural understandings of this practice. Given the relative shortage of forensic accounts of female erotic fatalities in comparison to cases of males, the use of a work of imaginative literature is justified. In each case, my analysis of these cultural products will aim to ask what assumptions have to be in place about the nature of 'normal' sexuality, and also about gendered behaviour, to account for the repeated characterisation of this sexual practice as 'bizarre' and as so other to comprehensibility.

In examining diverse discursive representations of this bodily practice, a broadly Foucauldian approach to the history and theory of sexuality and biopolitics will be adopted. Foucault pointed out in 1976, in the first volume of the History of Sexuality, that sexuality is not an ahistorical or natural phenomenon. Rather, it describes a field of knowledge and interpretation that could only be produced thanks to the influence and historical coincidence of the medico-legal institutions that gained traction as shapers of meaning in the modern West, finding their apotheosis in the mid-to-late nineteenth century. Within this epistemological framework 'kinds' of sexual practice were named and classified, to be understood as natural or unnatural, normal or abnormal, according to the workings of normative power. The personages of the 'sexual pervert' and the 'homosexual' were simultaneously produced as categories to describe modern individuals whose sexual practices were understood in sexology--and especially psychoanalysis--not simply as bodily acts, but as clues to reading the essential identity or ontology of the practitioner. This is what Foucault describes as a 'specification of individuals'. (4)

It is with this history of the naming and categorising of sexuality and sexual subjects in mind, that I turn to the topic of erotic asphyxiation and autoerotic death. Rather than interrogating what sexual practices leading to autoerotic death may say about the practitioner, or identifying factors that might psychologically motivate people to experiment with these 'extreme' death-risking practices, in what follows I will explore instead how looking at discourses produced about erotic asphyxiation and autoerotic death, sexual modalities that lie on the margins of comprehension and acceptability, might elucidate precisely how cultural norms of sexuality and gender more generally are established and inscribed. The assumptions and biases guiding definitions of normal and abnormal sexuality are revealed in particularly striking ways by moving the focus of interrogation away from the pathologised practices and the bodies that they produce and are produced by, and onto the interests of those who pronounce on normal and abnormal sexuality, according to the Foucauldian logic that classifying sex is a matter of the exercise of (normalising rather than interdictive) power. Finally, the analysis will reveal the extent to which media, fiction, the internet, and popular culture, along with the more readily recognised 'authority discourses' of sexual science and the medico-legal institutions, are complicit in contributing to the creation of sexual norms and drawing limits regarding acceptable and unacceptable degrees of risk of bodily harm, which are in line with normative socio-cultural agendas. In using erotic asphyxiation as a limit case of the workings of normativity, I reveal the extent to which the Foucauldian method is pertinent still today for thinking about cultural expectations as a form of power. Secondly, I extend beyond the remit of Foucault's own work by considering the precise interaction between gender norms and sexual norms in the example of this limit case, where the former are often minimised or ignored in Foucault's somewhat male-centric works.

Throughout, I will use the deliberately broad term 'erotic asphyxiation' to encompass a number of disparate bodily practices whereby the practitioner is deprived of oxygen for erotic pleasure (usually in a solitary, autoerotic setting, but sometimes with a partner). This umbrella term is deliberately intended to be descriptive and non-judgmental and to encompass the variations in practice and context reported in the literature (from manual or ligature-based strangulation, through suffocation, hanging, and the use of chemicals such as aerosol propellants). In cases where a solo practitioner of asphyxia dies, the phenomenon is usually described as an 'autoerotic fatality'; whereas a person who dies as a result of a partnered or group activity of this kind would be an 'erotic fatality'. Those are the terms I shall use here. There is relatively little existing literature on (auto)erotic asphyxiation, erotic fatalities, and autoerotic fatalities. In particular, with a few notable exceptions, there is a dearth of cultural, humanities-based scholarship that explores the social and gender-political implications of the practices and deaths; such that this article may provide a cultural analytical paradigm for further work of this kind. (5) Existing works on erotic asphyxiation tend instead to issue from the fields of abnormal psychology and other psy science perspectives. In the case of autoerotic fatalities, most work comes from the discipline of forensic pathology, notably Hazelwood, Dietz and Burgess's massive tome, Autoerotic Fatalities (1983), often considered the key forensic pathology text of fatal erotic asphyxiation, which I will discuss below. (6)

The broad association between hanging and ecstasy, on which Beckett has Vladimir and Estragon draw in the epigraph to this article, has a long history that pre-dates the eighteenth and nineteenth-century sexological fashion for naming 'the perversions'. It is instructive to note how this history is treated by Dietz, who provides a chapter for Autoerotic Fatalities (from which I drew for the second epigraph of this article) that sets out to chart the chronology of reported practices of self-asphyxiation. He comments on the existence of found Mayan artefacts that bear witness to this link, including a stone sculpture of a naked man with a rope around his neck and an erect penis, found in Mexico City and believed to originate from the late classic (c. 250-900 AD) or early post-classic (c. 950-1539 AD) period. According to the religious belief system of the Maya, 'the souls of individuals who hang themselves go directly to paradise, where they are received by Ixtab, Goddess of the hanged' (Autoerotic Fatalities, p14). Dietz goes on: 'Whether the ancient Maya had discovered autoerotic asphyxia, as the sculpture so strongly suggests, will perhaps never be known with certainty' (p14). The set of assumptions underlying the forensic author's pondering is telling, and illustrates neatly the problem that the current article sets out to explore. The contention that a people with a wholly different way of understanding bodily practices, and lacking the modern classificatory system of sexuality with which we are familiar, might have 'discovered' erotic asphyxiation per se makes no sense if we adopt a framework that understands sexual practices, acts, and identities, not only as culturally and historically situated, but as gaining their meaning and status as a direct result of dominant local epistemic conditions. Seemingly identical behaviours can thereby 'mean' radically different things according to cultural and historical context. What was considered sexually deviant in Vienna in 1890 may have been understood as divinely mystic in Chichen Itza in 950 AD. So, it is because of the predominance of the classificatory model of sexual knowledge, as described by Foucault, in the modern Western episteme, that voluntary self-asphyxiation is understood as a sexual perversion rather than, for example, as a spiritual practice. The ancient Mayans simply could not 'discover' something that had yet to be discursively constructed.

In fact, history tells us precisely when the practice was written into modern medico-legal discourse as a sexual perversion. This occurred at the end of the eighteenth century, with the case of the Czech composer Frantisek Koczwara (frequently anglicised to Francis Kotzwarra). In 1791, Kotzwarra employed the services of a prostitute, Susannah Hill, whom he instructed to have intercourse with him while a noose was placed around his neck and attached to a door handle, in order that he could strain against it and experience the heightened effects of asphyxiation. When the act of sexual intercourse was completed, Kotzwarra was found to be deceased and Hill was put on trial for his murder. Ultimately, she was found guilty of the lesser crime of accidental manslaughter and was released. The anonymous pamphlet, Modern Propensities, or, An Essay on the Art of Strangling, which includes excerpts from the trial transcript and Hill's own memoir, helped to inscribe the case--and the sexual practice--in the public consciousness. (7) Dietz discusses this case in a chronological, but historically un-nuanced, way; that is he treats it as if it is part of a seamless trajectory both with the producers and consumers of the Mayan artefact described above and with cases of autoerotic fatality described by pathologists and psychiatrists in the late-twentieth century. However, Dietz himself is a player in the discursive process of the production of modern sexuality as a system of classification. In a 1978 paper, (8) he had proposed the adoption of the term 'Kotzwarraism' for the practice of erotic asphyxiation (following the model set down by Richard von Krafft-Ebing in naming 'sadism' after the Marquis de Sade and 'masochism' after Leopold von Sacher-Masoch). In fact, Dietz's suggestion was not much taken up in psychiatry and sexology, since sexologist John Money's coining 'asphyxiophilia' would instead be used in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders in the early 1980s. (9)

One of the most striking features of discourses of erotic asphyxiation, which separates it from the way in which other sexual perversions are discussed in historical and contemporary psy science literature, is that most of the information and commonly-circulating ideas about it have been drawn from the evidence of death scenes, rather than from the reports of living practitioners as told to doctors, psychoanalysts, or sexologists. It is featured most commonly in case studies in journals and manuals of forensic pathology, such as the one discussed above, or as news stories when celebrity deaths are at stake. This means that estimates of the frequency of the practice (among those who do not die from it) are likely to be partial and skewed.

In a psychoanalytic paper of 1997 about autoerotic asphyxiation, Julien Quackelbeen, Dany Nobus and Karin Temmerman write:
   In our opinion, the 'uncommonness' that is often ascribed to such
   cases refers to their clandestinity, i.e, to the rareness with
   which they come to the attention of medical practitioners,
   sexologists, rather than to the low frequency of AEA [autoerotic
   asphyxiation] itself. (10)


Two reasons these authors suggest to explain the scarcity of self-reporting are that: 'manifestations of [abnormal] human sexuality do not de facto lead to a demand for help' and 'relatives of those who died from autoerotic asphyxiation, in refusing the disgrace, do the utmost to have the case recognised and registered as suicide' (p31). This points up that the 'sexually sick' may not themselves suffer at all from their 'sickness', however, they may go to great lengths to preserve their secret (in order to be able to keep practising their preferred sexual act without interference, or to protect loved ones from shock and shame). That the relatives of those who are involved in, or die from, erotic asphyxiation practices, should feel primarily shame tells a story of the normalising power of discourses about sex in society. It tells that sexuality is a very serious game with rules, and that those who die in this way are deemed to have failed at sex, at successful sexual subjectivity, and, ultimately, at life. A pervasive set of modern beliefs shore up the ideology of what sexuality is and is for.

In her classic essay on the politics of sex, 'Thinking Sex' (1984), Gayle Rubin argued that 'popular culture is permeated with ideas that erotic variety is dangerous, unhealthy, depraved, and a menace to everything from small children to national security'. (11) Her diagram of 'The sex hierarchy: the charmed circle vs. the outer limits' illustrates this point by showing how sex that is 'heterosexual', 'procreative', 'coupled', 'married', or 'vanilla' is placed closest to the centre of the circle, whilst sex that is 'non-procreative' and carried out 'alone or in groups', as well as being 'homosexual' or 'S/M', are found at the outer limits (p13). A fatal autoerotic practice is, logically, the furthest from the healthy ideal of sex that one could imagine in this model of social norms. This is because it literalises, and thereby lends credence to, the cultural fantasy of non-reproductive sex as socially dangerous, as spelling the decline of morality and the death of the natural order, that Rubin identifies in her essay. In turn, assumptions about the nature of sexuality rely on notions of the stability of binary sex and of masculinity and femininity as adducible attributes of maleness and femaleness. Our contemporary cultural understanding of gender is key to the ways in which narratives of erotic asphyxiation and autoerotic death are deployed and interpreted.

One of the major available sources of such narratives, given the perceived scarcity of clinical information about these practices, as attested to by Temmerman et al, is media reporting on high-profile autoerotic fatalities. In their recent article 'Playing with the Self ', Darren Kerr and Donna Perbedy have explored how three reported cases of celebrity fatalities from the past few decades (either ruled by coroners to be the result of erotic asphyxiation, or strongly suspected of so being despite official rulings) reveal considerable differences between the pre-mortem reputations of these men's personae. Stephen Milligan, whose case from 1994 I referenced at the start of this article, died as a result of an act of erotic asphyxiation, while cross-dressed and with an amyl-nitrate-injected orange segment in his mouth. He had been respected as a financial talent and hailed as one of the 'rising stars' of John Major's Tory government, such that the manner of his death constituted a shaming for both the individual and his political party. By contrast, Australian singer Michael Hutchence, who hanged himself in 1997, was associated in life with a strong sex drive, 'rock 'n' roll' extravagance, and a taste for extreme experiences (as seen in the nickname given to him by one journalist: 'Mr Sexcess'). (12) Widespread disbelief among Hutchence's family, friends and fans followed news that the verdict of suicide, rather than of death by misadventure, had been returned by the coroner. (13) Thirdly, cult actor David Carradine, star of Kung Fu and later of Quentin Tarantino's film trilogy Kill Bill, enjoyed a star persona that depicted him as an eccentric personality, obsessed with risk and danger and who liked to keep a loaded gun by his side at all times. He died of accidental (i.e. erotic) asphyxiation in 2009. Kerr and Perbedy detail how, following the death of a high-profile individual by autoerotic asphyxiation, it is common for reporters to try to find augurs of the practitioner-victim's endings in the evidence of their lives. This is a phenomenon that is explicable in terms of Foucault's premise that, in modernity, an individual's sexuality is seen as revelatory of the very essence of their identity; it is a secret that needs to be uncovered. Thus the celebrity is retroactively constructed in light of their death by erotic asphyxiation as shamed and unmanly (Milligan), as thrill-seeking (Hutchence), or as just plain strange (Carradine).

From these brief sketches, it is straight away noticeable that at least two distinct and apparently contradictory stories about Western masculinity (and its failings) are adumbrated, showing up, perhaps, the lack of coherence inherent in the idea of a gender norm (an incoherence which does not, it should be added, render such a norm any less subtly coercive or obligatory. Instead, it renders it only more anxiety-provoking, as it suggests the difficulty, if not impossibility, of the achievement of 'real manliness').

A number of comic ecards, which appear on the website www.someecards. com, feature erotic asphyxiation in ways that reveal much about how the practice and its relationship to gender are viewed. In one such card, which is reminiscent of a public health poster, or a 'Your Country Needs You'-style patriotic appeal to duty, we are told that: 'Real men say no to autoerotic asphyxiation'. (14) As Freud (1905) and others have famously told us, jokes are never just jokes, but rather they are barometers of cultural values, common fears, and unconscious anxieties. One aim of a joke is to turn fear into humour, and thereby to displace anxiety. By means of the Freudian mechanism of displacement, jokes also often used to target 'others'--those outside the hegemonic norm, who are perceived to be strange or lacking; in short those who are 'bizarre'. (The category of jokes Freud terms 'tendentious' always entail lust, or hostility, or both.) And, moreover, commonly shared fears of falling short of the standards of the gendered norm can be projected onto 'those others', those perverts, those who are not 'real men', through the passive-aggressive hostility underpinning the architecture of such jokes. From a jointly Freudian and Foucauldian perspective, we can read jokes as discursive artefacts that tell us what it is that is valued in a given cultural context.

Consider two further humorous ecards, both of which exploit the idea of autoerotic asphyxiation as a secret. The first (15) shows a group of people talking and laughing over drinks. The caption reads: 'Sorry I brought up my erotic asphyxiation fetish during the holiday party'. The other (16) depicts one portly Victorian gentleman informing another that 'If you ever die from auto-erotic asphyxiation I promise to rearrange your corpse before it's discovered by your loved ones.' These two cards use the idea of shame in different ways. The first works by juxtaposing a pair of apparent opposites: autoerotic asphyxiation and what is presumably an office holiday party. A shameful, squalid, solitary, secret practice is shown to have no business erupting discursively as a Freudian slip amidst the codified conformity of an organised social gathering. If this scenario demonstrates the shock of shame involved in this lapsus, the other joke card does something else with the secret and its attendant shame: it shares and thereby enshrines them. The assurance on the part of the gentleman that, should his friend ever die from autoerotic asphyxiation, he would be sure to rearrange his corpse before it were discovered by his family, makes the dark and dirty sexual secret into a gesture of male bonding. While, at one level, the disparity between the gentlemen's formal appearance and the subject matter of their conversation works to provoke humour via simple incongruity, this joke also turns solitary shame into the stuff of friendship and solidarity, into something almost heroic or noble.

The two different ways in which masculinity, shame, and a non-normative sexual practice are seen to intersect in the humour of these two ecards offer us a guide to understanding how Milligan's story on the one hand and Hutchence's and Carradine's on the other, may function as recognisable narratives of non-normative masculinity, and, moreover how they fit with prescriptive historical discourses about the correct behaviour of men and the nature of male sexuality. The notable feature of the joke involving the office party is the way in which a secret has been leaked, the truth has slipped out, the male figure who accidentally brought up his fetish is no longer in control: he is unmanned. A primary meaning of an autoerotic fatality, then, is as the revelation of lack of continence on the part of a subject.

In the modern Western imaginary control and rationality are anchored to masculinity, such that the spectre of loss of control signifies effeminacy and provokes shame. Stephen Milligan's body was found in his London residence, on the kitchen table, wearing a pair of stockings, with a black bin liner over his head, a length of electrical flex around his neck and a segment of an orange in his mouth. The manner of his dress during his erotic asphyxiation ritual compounded the sense of unmanliness created by the shameful fact of drug-and-asphyxiation-enhanced onanism that had gone too far. Forensic accounts of autoerotic fatalities reveal that the presence of cross-dressing or the wearing of stylised garments or uniforms during the ritual are relatively often found at such death scenes. In his paper on 'erotised repetitive hangings', Resnik describes a syndrome, most commonly found in young adult males, involving 'compression of the neck' coupled with masturbation, in which 'binding of the body [....] and female attire may be present' (Erotized Repetitive Hangings, p6). This has led some more pathologising commentators to posit an intrinsic psychological link in practitioners of these acts between erotic asphyxiation on the one hand, and, variously, on the other: masochism, psychic hermaphroditism (Robert Brittain's term), and, for psychoanalysts, separation anxiety and castration complex. My aim here, as I have already stated, is not to attempt to understand the meaning of erotic asphyxiation for its participants, nor to analyse the participants psychologically or psychoanalytically through their practices. I am interested, rather, on this point, in the cultural association made between effeminacy and shame that finds articulation in such cases of autoerotic fatality. It is unsurprising that non-normative practices, desires, identities, and gender performances that bring cultural ridicule on subjects, and risk producing shame in them and in those who love them, should find expression in the same ritualistic scene and space (since they are close neighbours in the outer reaches of Rubin's hierarchy diagram).

Worrying about effeminacy, which is linked precisely to weakness and to incontinence (to slipping up), has been a feature of sexological and other psy scientific writing about male sexuality and male masturbation since its earliest days. In the eighteenth century, the Swiss physician Samuel-Auguste Tissot co-opted for medicine a discourse previously belonging to the Church, when he warned of the danger that excessive ejaculation through masturbation could both physically and mentally enfeeble men, and consequently feminise them. (17) The threat described by Tissot resurfaced in a slightly different form in the second half of the nineteenth century in the strange phenomenon of 'spermatorrheoa' panics, in which seepage of sperm from the body was seen to lead to weakness and emasculation in men and, as Elizabeth Stephens points out, in which men's bodies were pathologised as leaky and incontinent for the first time, a form of body-shaming previously reserved for female corporeal functions. (18) In many ways, male masturbation involving erotic asphyxiation seems to thematise and take further the older fear of male weakness through onanism and other forms of bodily loss of control. Not only is the seed lost and the vital spark killed, but, in the case of erotic asphyxiation, the man himself may die in the paroxysm of a non-productive, non-reproductive loss of continence and consciousness.

To turn now to the alternative narrative of masculinity suggested by the ecard featuring the two Victorian gentlemen, we see here also the suggestion that male sexuality hides a secret, the revelation of which could do harm. The secret of male sexuality alluded to is the idea of the excessive, potentially out-of-control, and dangerous force that is male libido itself. While similarly marking a potential loss of control in the spectre of the autoerotic death, in contradistinction to the leaky slipperiness of the loose-tongued figure at the party (whose lack of control equates to effeminacy), the presence of male solidarity and brotherhood--the homosocial relationship built around the secret--lends something grandiose and hyper-masculine to the notion of a desire so strong that it cannot be controlled. And, indeed, a fantasy of mastery that outlives accidental death is suggested here, since the secret will be preserved and will die with the subject of the autoerotic fatality.

Reminiscent of this desire for mastery of experience, Michael Hutchence stated in an interview with Australian News in 1997 that: 'I'm always on the look-out for the ultimate sex-kick ... I want to experience these extreme things myself and not just read about them like everyone else' (cited in Playing with the Self, p62). Kerr and Perbedy liken this to a statement by David Carradine in an interview from 2004, that 'there's a Zen thing of [...] "if you want to learn to fly, jump off a cliff ", right? And either you'll fly or it won't matter. One or the other' (p62). While Hutchence's statement refers explicitly to sexual kicks, and Carradine's to a more existential ambition, both statements contribute to construct the autoerotic decedents as reckless physical risk-takers, playing, Russian-Roulette style, with their sexuality, while mastering fear of loss of control.

The kinds of fantasy and sophistry woven around experiences of sexual excess discussed above echo a trope that is central to nineteenth-century sexological writing on masculinity and male sexual desire, and that survives long beyond that period. Richard von Krafft-Ebing in the opening pages of Psychopathia Sexualis (1886) describes male sex drive as: 'a natural instinct which, with all-conquering force and might, demands fulfilment'. (19) He goes on 'in course, sensual love, in the lustful impulse to satisfy this natural instinct, man stands on a level with the animal' (p1). An ambivalent picture of the male sex drive emerges as magnificently dominant and powerful, on the one hand, and yet, on the other, as threatening to overwhelm the individual rational, moral man, who would stand above 'the animal'. Krafft-Ebing's argument for the danger of male libido unchecked by the social institutions of morality, echoes the language used at Kotzwarra's trial regarding the existence of 'men who, to gratify the most unwarranted species of lust, resorted to methods at which reason and morality revolted' (Modern Propensities, p41). Autoerotic asphyxiation stands in, metonymically, for the secret that is the strength of male desire and its compulsiveness.

Within Krafft-Ebing's sexological system, two potentially contradictory theories of sexual perversion uneasily co-exist. The first identifies it as a degenerate, 'fixated' behaviour, repetitively and obsessively carried out in ritualistic fashion by the deviant few, who are likely also to be mentally and physically enfeebled. The second argues instead that male sexual appetite, as floridly depicted by Krafft-Ebing, is so voracious in and of itself that it tempts all men to perverse experimentation. And a man, having once strayed from the path of sexual health, may be tempted to try ever more extreme practices in order to sate his libido. Marriage, family and capitalistic production are offered by Krafft-Ebing as the proper means of taming or tempering this errant drive and keeping the individual and the population safe from sexual sickness. This is the 'sliding scale' model of perversion.

This idea of the sliding scale evokes the trope of 'jaded' male sexuality that is often linked to practices such as erotic asphyxiation. This is seen in the sexual persona that risk-taking Michael Hutchence embodied. There is a common discourse, and an accompanying set of moral panics, about the danger of that quality of male sexuality that lends itself to jadedness (its 'almightiness' as described by Krafft-Ebing). This is seen in worries about the availability of pornography and its corrupting influence on men that have featured throughout modernity in sexological writing and feminist writing alike, and have adapted and proliferated in response to the birth of the internet and its capacity to deliver instant gratification in the form of ever more diverse (and 'extreme') images. And, it is as the endpoint of this logic that we find one interpretation of what erotic asphyxiation culturally signifies: male libido so saturated with sexual options, and so bored with its more mundane exercises, that it turns eventually to its own annihilation for kicks. Like many perceived sexual and gender deviations, then, erotic asphyxiation is used both to recall the idea of failed masculinity on the one hand and yet, on the other, to suggest that this act is merely the final step, the furthest extreme potential of all masculinity--the nature of which is to be sexually rapacious, experimental and curious. The cultural narrative of male erotic asphyxiation is schismatic and contradictory precisely because the cultural narrative of masculinity is and has been so since the earliest texts of modernity. The question thereby arises: what of female erotic asphyxiation?

Consider a further asphyxiation-themed ecard. (20) The humour here works by refusing the expected disjuncture between the demure, conventionally feminine-looking woman in the drawing and her confession in the caption: 'I'm into auto-erotic asphyxia. What about you?' As we have seen, autoerotic asphyxiation is commonly perceived to be something that men do (and something that they must be ashamed of). And it takes historical (religiously inflected, albeit scientifically appropriated) shame over male masturbation --wasting the seed, being self-indulgent--a step further. The ideology that makes wasted seed a problem, namely the notion that sexuality is for reproduction, brings us directly to the question of female sexuality. For, in hetero-patriarchy, reproduction is what women, who are often synonymous with sex, are understood to be for, too.

All celebrity cases of autoerotic death recorded in recent years have been of male decedents. This does not, however, mean that (non-celebrity) women do not die in this way. Indeed, the available forensic literature reveals that some do, as in the case described in The Handbook of Forensic Pathology by Abdullah Fatteh (1973), and excerpted as 'Sex Hanging in a Female' in the Amok Journal's special issue on erotic fatalities (1995). The case describes a 19-year-old female decedent by autoerotic hanging, who was found with her body bound with rope and dressed, in the words of the pathologist, in 'the attire of an Oriental "harem girl"'. (21) A paperback copy of an erotic novel, open at pages that contained scenes describing how women would be hanged around the walls on hooks, after being sexually used in a harem, was found near the body. This case echoes the incidence of 'cross'-dressing/ dressing up, bondage, and stylised costume that has been remarked upon as a prominent feature in the male cases examined. But there are so few reported cases of this type featuring women, and so little written on them, that no syndrome of specifically female psychopathologies linked to this type of death scene, such as those theorised by Resnik and Brittain for male autoerotic fatalities, has been formulated.

However, if it is the case that there are fewer female autoerotic deaths, this does not necessarily mean that fewer women engage in erotic asphyxiation practices than men. It may instead mean that women are better at ensuring they do not accidentally die, it may suggest that they practise it to less extreme degrees than men, or that they do it with a partner so that any fatalities that do occur are more likely to figure in the statistics of manslaughter/ murder victims than in the woolly hinterland between suicide by hanging and erotic fatality figures. Psychoanalysts Temmerman and Quackelbeen make this argument in their paper 'Autoerotic Asphyxia from Phenomenology to Psychoanalysis' as a direct redress to Hazelwood, Burgess and Groth's gender-stereotypical assertions in Autoerotic Fatalities that autoerotic asphyxiation is mainly found among men because men 'participate to a greater extent in unconventional sexual practices than do women'. (22) This is a necessarily unsubstantiated claim, as there is no reliable way of proving the extent of a phenomenon that is largely based on self-reporting.

Given the lack of media coverage of autoerotic deaths in women, we are forced to turn instead to fictional representation if we wish to explore cultural attitudes to this phenomenon when the practitioner is female. Australian novelist Tim Winton's Breath (2008) offers an exemplary case study of cultural attitudes towards gendered asphyxiation, by juxtaposing the activities of surf-obsessed, breath-holding male youth, Bruce Pike, and those of his older, married lover, Eva Sanderson, a devotee of erotic asphyxiation. The novel is constructed from the point of view of Bruce's first-person narrative. The scene is set by describing how he and his best friend Ivan Loon or 'Loonie', who 'liked anything with an edge on it', challenge each other to ever more dangerous water-bound adventures. (23) The following quotation is a typical description of their behaviour:

Loonie and I acted out the impulse [...] We held our breath and counted. We timed ourselves in the river and the ocean, in the old man's shed or in the broken autumn light of the forest floor. It takes quite some concentration and will power to defy the logic of your own body, to take yourself to the shimmering edge. It seems bizarre, looking back, to realise just how hard we worked at this. We were good at it and in our own minds it's what set us apart from everyone else. (Breath, pp41-42)

Reviewer Cathleen Schine describes Winton's novel as valorising the 'Macho Romanticism' and 'Heroic Sensibility' that it portrays. (24) Indeed, obsessive risk-taking as a form of heroism is legitimised throughout the fictional narrative by means of the intimate identification the reader is invited to engage in with Winton's colloquially-voiced male narrator, and the sympathy that it is designed to engender.

By contrast, the treatment of Eva is more ambivalent and considerably less sympathetic. Much of the second half of the book details Bruce's sexual affair with Eva, who is viewed wholly from the boy's (and, by extension, the male author's) heteronormative point of view: 'She wasn't quite the stuff of my erotic imaginings. True, she was blonde and confident in that special American way, but there was nothing Playboy or Hollywood about her' (Breath, p164). Consider the scene in which Eva reveals her preferred sexual practice to Bruce and asks him to watch while she hangs herself. Bruce recounts:

I looked at the padded collar and the brass ring that did the work of a slipknot. From where I lay I could smell the sweat and perfume in the leather.

You hang yourself?

Sure, sometimes.

Why?

Because I like it. [...]

So how do you know when to stop?

Practice, I guess. You should know.

Me? Gimme a break.

Come on, Pikelet, she said soothingly. I've heard you guys talk. Spots, stars, tunnel vision. (Breath, p181)

Eva insists on the similarity between her erotic practice and the boys' sporting adventures, and asks that Bruce stay and watch her for safety, to act like a 'dive buddy' (p181). The narrator's refusal to see the similarity between the phenomenological and bodily experiences they both practise recalls at once the misogyny which dictates that the young male narrator should objectify this not-quite-Playboy blonde rather than identify with her, and the cultural insistence on separating out bodily activities categorised as 'sexual' from all others, however similar in kind they may physiologically and/ or experientially be.

As might be expected from what is essentially a gender-conservative narrative, Eva is punished in a very conventional way for her unconventional behaviour. Firstly, she falls pregnant--that time-honoured plot device for correcting female deviance and straightening out the lovemap of a wayward female character. And she announces the news of her gravid condition to her young lover in telling terms, bespeaking the end of pleasure: 'Go home [...] The fun's over now' (p192). Secondly, her narrative is concluded by autoerotic death, while the male characters, who had been taking equally reckless physical risks in the water, live to surf another day: 'Eva was found hanging naked from the back of a bathroom door in Portland, Oregan. A Salvadorean hotel employee found her with a belt around her neck. The deceased had been the sole occupant of her five-star room, the cause of death cardiac arrest as a result of asphyxiation' (p206). The description of her death signals a shift in register from Bruce's colloquial first person to the impersonal reportage style of police report or 'Reuters column' (p206), marking the official inscription of Eva as an autoerotic fatality statistic.

In summary, then, Breath teaches us several lessons about cultural attitudes to gender and to death-related sexual practices that are similar to those found in descriptions and reports of non-fictional erotic asphyxiation. Firstly, it conveys that what may be seen as brave and noble in one context (such as sporting feats performed by virile youths) is perceived to be shameful, stupid, and base in the realm of the erotic, where it is codified as a 'sexual perversion'. (Bruce describes Eva's appearance mid-asphyxiation as 'squalid beyond imagining' (Breath, p190).) Secondly, what may be a quasi-admirable form of 'risk-taking' by a 'manly man' (e.g. Hutchence) would become bizarre or shameful when found in an 'unmanly' man (e.g. Milligan) and, of course, in a woman, since misogyny is the very stuff from which the pejorative discourse of male effeminacy is made in the first place. Thirdly, we note that Eva in Breath is portrayed as selfish and adolescent; fifteen-year-old Bruce observes: 'Yes we had some things in common, Eva and I. At twenty-five, she was as solipsistic as any teenager' (p171). This is a familiar discourse: the practitioner of sexual perversion, who writes an alternative narrative for sexuality in which the outcome of the exercise of desire is something other than reproduction, is dismissed as 'immature'. And the non-reproductive woman, who resists fulfilling woman's 'proper' role and purpose, is perceived as the most selfish of sexual personages. (That Eva compounds the perversion of resisting motherhood with that of erotic asphyxiation, carried out by an underage, adulterous partner makes her eventual punishment all the more inevitable.) Finally, while the male 'breath-players' of Winton's book have no harm come to them, despite their risk-taking antics, the dissident sexual female is corrected with pregnancy and then punished with death. I describe her death as 'punishment' from within the logic of the novel because it, like the rest of the book, is narrated from a heteronormative mainstream perspective (the very perspective from which Rubin's charmed circle is constructed). Whether a death that occurs during an act of autoerotic asphyxiation would be viewed as a punishment and failure, or as a triumph and success (or as something else entirely) by the practitioner is a question that is rarely, if ever, asked in cultural narratives of erotic asphyxiation, owing to the shortage of practitioners volunteering to discuss their sexual behaviour, and guided by the overwhelming assumption that life must be the desired outcome of sex and that dying for sex is never a risk that is worth taking.

We have seen that mainstream media discourses use fatal erotic asphyxiation to label male public figures who die from it as either examples of failed and weak masculinity or of excessive, risk-taking hyper-masculinity, echoing established ideas from foundational texts of sexual science about the problematic nature of male sex drive. But, in either case, what is at stake is a delicate balance between non-normativity and gender conformity: being either not enough or too much of a man. Yet, if erotic asphyxiation is linked to failed masculinity, to not 'being a real man', how much more reviled and pathological does it appear when the practitioner is a woman. This is because women are decidedly not supposed to be perverts and are not allowed to seek the expression of excessive sexual desire to the detriment of social duty (rather, in the role of wife and mother, they were traditionally seen as the gatekeepers of the wild, beastly male libido of their sons and husbands). And--crucially--women are supposed to be reproductively-driven, primarily motivated by the desire for a child, the perpetuation of life, rather than the search for selfish, erotic pleasure. The female autoerotic fatality, embodied in Tim Winton's fictitious Eva, is thus a doubly othered, doubly pathologised subject.

Finally, erotic asphyxiation, in coupling the ideational thrill of proximity to death with the risk of actual bodily death, is the ultimate non-reproductive sexual practice. It is a practice that literalises the deathliness that has, from the very inception of sexology and psychiatry, been associated with the sterility of homosexuality and with the danger of the so-called sexual perversions or paraphilias. Therefore, we can go so far as to state that it represents both an individual example of a non-normative sexual practice and a limit case that risks destabilising the field of 'sexuality' itself, where this is an ideological category that presupposes utilitarian and normative aims motivating bodily behaviours. Acts of erotic asphyxiation, especially in their autoerotic forms, are statements that the pursuit of ecstatic bodily sensations and/ or altered psychological states may be ends in themselves --even as they risk constituting literal ends for their practitioners.

DOI: 10.3898/NEWF:89/90.08.2016

Lisa Downing is Professor of French Discourses of Sexuality at the University of Birmingham, UK. She has published widely on sexuality and gender studies, death studies, and cultural studies. In particular, she is the author of several major books, including: The Subject of Murder: Gender, Exceptionality, and the Modern Killer (Chicago: University of Chicago Press, 2013); Desiring the Dead: Necrophilia and Nineteenth-Century French Literature (Oxford: Legenda, EHRC, 2003), The Cambridge Introduction to Michel Foucault (Cambridge: Cambridge University Press, 2008), The Subject of Murder: Gender, Exceptionality and the Modern Killer (University of Chicago Press, 2013) and, forthcoming in 2014, Fuckology: Critical Essays on John Money's Diagnostic Concepts (co-authored with Iain Morland and Nikki Sulllivan, University of Chicago Press).

(1.) T. M. Disch, 'Pleasures of Hanging', book review, New York Times, March 15, 1981, 14-15, p15.

(2.) H. L. P. Resnik, 'Erotized Repetitive Hangings: A Form of Self-Destructive Behavior', American Journal of Psychotherapy, vol. 26, 1972, 4-21, p4. (Hereafter Eroticized Repetitive Hangings.)

(3.) S. M. Cordner, 'An Unusual Case of Sudden Death Associated with Masturbation', Medicine, Science and the Law, vol 23, no. 1, 1983, 54-56, p56.

(4.) Michel Foucault, The Will to Knowledge, The History of Sexuality 1, (trans) Robert Hurley, Harmondsworth, Penguin 1990, pp.42-3.

(5.) Exceptions include my own previously published works on erotic asphyxiation: Lisa Downing and Dany Nobus, 'The Iconography of Asphyxiophilia: From Fantasmatic Fetish to Forensic Fact', Paragraph, 27(3) (2004): 1-15 and Lisa Downing, 'Beyond Safety: Erotic Asphyxiation and the Limits of S/M Discourse' from Safe, Sane and Consensual: Contemporary Perspectives on Sadomasochism, Darren Langridge and Meg Barker (eds), Basingstoke, Palgrave Macmillan, 2007, pp119-32. Another exception is a recent article on celebrity autoerotic fatalities, on which I will draw in this article: Darren Kerr and Donna Peberdy, 'Playing with the Self: Celebrity Autoerotic Asphyxiation', Celebrity Studies, 4(1) (2013), pp58-70 (Hereafter Playing with the Self).

(6.) Robert H. Hazelwood, Park Elliott Dietz and Ann Wolbert Burgess, Autoerotic Fatalities, Lexington, Massachusetts and Toronto: Lexington Books 1983. (Hereafter Autoerotic Fatalities).

(7.) Anonymous, Modern propensities, or, An essay on the art of strangling, &c.: illustrated with several anecdotes: with memoirs of Susannah Hill, and a summary of her trial at the Old-Bailey, on Friday, September 16, 1791, on the charge of hanging Francis Kotzwarra, at her lodgings in Vine Street, on September 2, London, J. Dawson, nd (Hereafter Modern Propensities).

(8.) Park Dietz, 'Kotzwarraism: Sexual Induction of Cerebral Hypoxia', Medical Criminological Research Center, McLean Hospital, Belmont, Massachusetts, unpublished ms, 1978.

(9.) See Lisa Downing, Iain Morland and Nikki Sullivan, Fuckology: Critical Essays on John Money's Diagnostic Concepts, Chicago, University of Chicago Press 2015, p46.

(10.) Julien Quackelbeen, Dany Nobus and Karin Temmerman, 'Autoerotic Asphyxiation: A Sexual Praxis in Neurosis and Perversion', Clinical Studies: International Journal of Psychoanalysis, 3(1) (1997): pp31-54, p31.

(11.) Gayle Rubin, 'Thinking Sex: Notes for a Radical Theory of the Politics of Sexuality', in Henry Abelove and Michele Aina Barale (ed), The Lesbian and Gay Studies Reader, New York & London, Routledge 1993, pp3-43, p12.

(12.) Miranda Sawyer, 'Mr Sexcess: An Interview with Michael Hutchence', The Advertiser, 19 April 1997.

(13.) Katrina Jaworski, The Gender of Suicide: Production, Theory and Suicidology, London & New York, Routledge, p118.

(14.) See: https://www. someecards.com/ usercards/viewcard/ ad27c4e592b105e 4c70758a19a76daeb/

(15.) See: https://www. someecards.com/ usercards/viewcard/6 b636aa59d4c224f55 7dbd5aa64de53d0d/

(16.) See: https://www. someecards.com/ usercards/viewcard/ eea3c10dfaeb6ef8c 6eb386707343c36/

(17.) Samuel-Auguste Tissot, Onanism: A Treatise on the Diseases Produced by Masturbation, trans. A. Hume [1723]; New York, Garland 1985.

(18.) See: Elizabeth Stephens, 'Pathologising Leaky Male Bodies: Spermatorrhea in Nineteenth-Century British Medicine and Popular Anatomical Museums', Journal of the History of Sexuality, Vol. 17, No. 3 (Sept, 2008), pp421-438, p. 442.

(19.) Richard von Krafft-Ebing, Psychopathia Sexualis, with especial reference to Contrary Sexual Instinct: A Medico-Legal Study, translation by Charles Gilbert Chaddock of the seventh enlarged and revised German edition, Philadelphia and London, F. A. Davis 1893, p.1.

(20.) See: https://www. someecards.com/ usercards/viewcard/ MjAxMi02ODIxMz JkYTMwYzZkYjkw

(21.) 'Sex Hanging in a Female', Amok Journal, Sensurround Edition: A Compendium of Psycho-Physiological Investigations, ed. Stuart Sweezy, Los Angeles, Amok 1995, 58-59, p58.

(22.) Karin Temmerman and Julien Quackelbeen, 'Autoerotic Asphyxia from Phenomenology to Psychoanalysis', The Letter: Lacanian Perspectives on Psychoanalysis, Autumn 1996, 49-70, p56.

(23.) Tim Winton, Breath, London, Picador 2008, p31. (Hereafter Breath).

(24.) Cathleen Schine, 'Walking on Water: Breath by Tim Winton', New York Review of Books, August 14, 2008, http:// www.nybooks.com/ articles/2008/08/14/ walking-on-water/ last accessed 31/05/2016. (Upper case letters Schine's own).
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