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Bondage and Suicide

Robert E. Litman, MD; Charles Swearingen, MD
Arch Gen Psychiatry. 1972;27(1):80-85. doi:10.1001/archpsyc.1972.01750250068009.
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"Bondage" is a well-established category of deviant sexual behavior. It includes practices for erotic pleasure of being humiliated, enslaved, and physically bound and restrained. Life is threatened when, as is common, neck binding or partial asphyxiation forms part of the behavior. In the United States there are yearly about 50 such deaths, sometimes suicide, usually by accident. We report two fatal cases rich in details provided by the now deceased. In addition, we interviewed nine men and three women who responded to a notice in the underground press. Subjects were diverse in character and varied in the details of their bondage behavior. All of the men were isolated, depressed, and oriented toward death. Their masochism was first a challenge, then an invitation to death. When they see psychiatrists (for depression), the sexual problems are minimized.

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