Deep inhale.

Deep exhale.

Good girl, boy, pet, kitten, slave etc etc etc etc.

I reached out to pro-dom Sir Timon and Bhavik Shah, MD, to talk about the pain and pleasure (and risk) of sexual choking.

Why breath play???

On a psychological level, breath play taps perfectly into the fear and thrill of (a lack of) control; someone having full rule over your body by controlling when, how long, and how often you’re allowed to breathe. It’s a sense of powerlessness and vulnerability. It can either be terrifying (in the best way) or intensely trusting, depending on your dynamic with your partner. It’s raw and carnal and infinitely depraved.

Sir Timon, a New York-based professional dom, frequently includes breath play in his sessions with clients. He begins and ends his sessions with a brief breathing ritual.  "My favorite method is integrating blood chokes during orgasm, releasing at the same time. It heightens everything," he to me in an email.

But it’s not all and not just psychological and even when you’re not out for a deeper, life-confirming connection with your playmate, breath play can still be a valuable and enriching part of your scene.

"The physiology behind breath play is interesting," Bhavik Shah, MD, wrote in his email response. Dr. Shah is a kink-aware Urologist listed on, comfortable in addressing kink-related questions. "The decreased oxygen levels can cause you to get lightheaded (or even pass out), but the release of the pressure and the sudden surge of oxygen that results in sudden bursts of endorphin release is the surge that most people seek," he wrote.

That sounds hot, how do I do it?

There are two types of chokes: the air choke and the blood choke.

If you taking away just one thing from article, let that be to avoid air chokes. There's a risk of crushing your (partner's) trachea and your cute scene turning into an episode of ‘My Favorite Murder’ or, in the best case, a rush to the ER, lots of blushing and stumbling as you explain to your doctor why your partner has a near-broken neck.

The "safer" option is a blood choke. "Blood chokes, choking the sides of the neck, constricts the carotid artery, reducing or blocking blood flow to your brain," Sir Timon wrote. "I only integrate blood chokes in my practice, as I feel this is a safer option avoiding any potential damage to the hyoid bone in your throat."

What about the risks?

Breathplay is never completely safe and does pose serious risks.

To Dr. Shah, breath play would ideally be avoided completely. "Sexual activity is an impulse-driven activity, and the level of control required from you or your partner during breathplay to not harm or kill you is very high," he said. "Repeat this over and over again and in some sense, it is like playing Russian roulette, and the more comfortable you and your partner get; the more let your guard down; the closer you are to getting hit by that bullet."

He stresses that you're not only risking death by engaging in breathplay. "Repeated asphyxiation-- even repeated short bursts of asphyxiation risk permanent brain or heart injuries from the decreased blood supply to the respective organ," he wrote in his email. "These risks go up even more if you have an underlying medical condition and you don't want to depend on your partner's ability to do CPR to survive the sexual event."

Can we make it safer?

Breath play can never be 100% safe and is always a risky choice - definitely not the quirky meme that social media has made it into. Breath play is unpredictable and some studies showed that repeated lack of oxygen will cause cumulative brain damage.

None of this is sexy but knowing the risks is the only way to fully know what you're up for.

"The most important thing first and foremost to consider for the person who is on the receiving end of the breath play is that you fully trust the individual doing it," Sir Timon wrote. "If trust is established, it should be very clear to all parties involved what type of play will be experimented with," he said.

Generally, a good rule is to talk about the type of sexy play you'd like to engage in outside of the bedroom, get to know the other person on some level (don't spring it on a one-night-stand), and establish safewords.

"It is everyone's responsibility to ensure there is safety, but unfortunately, it often falls on the receiver/bottom/submissive," Sir Timon wrote. "If you are on the receiving end of breath play, be sure to tell your partner what you like, what you do not like, what you are comfortable exploring and doing, and any limits or boundaries you have," he said, "both parties should clearly establish safewords."

Like everything in sex and love (and life), communication is key. Breath play is no exception. However, a firm hand around your neck does pose some struggles to this communication so, to continue checking in with your partner, you'll need to establish some non-verbal cues.

A few popular options are:  holding something and dropping it as a sign for your partner to ease off and give you space to breathe and check-in, an agreed-upon hand gesture, or tapping a set number of times on their body part.

So now what?

Again, breath play isn't afe. But educating yourself can help. By learning these non-sexy dangers of breathplay, you and your partner are sure to be more risk-aware and slivers safer for the next time you're left gasping for air.