title: Shibari: double hanging during consensual sexual asphyxia.
abstract: We describe a case of shibari, a double hanging sexual asphyxia practice, which ended fatally for one of the two women involved. We present the autopsy findings and a psychiatric and psychometric evaluation of the surviving participant. The survivor had a borderline personality disorder, had suffered sexual abuse as a child, and had a history of illicit substance consumption, self-harm behavior, and sexual dysregulation. This case study raises doubts regarding the safety measures adopted by participants in masochistic practices and the engagement of people with psychiatric disorders in these extremely dangerous games. Further case studies of living participants in such games are likely to shed light on this practice and facilitate treatment.
authors.affiliation: NESMOS Department (Neurosciences Mental Health and Sensory Organs) Sapienza, Faculty of Medicine and Psychology, University of Rome, Level 3, Room 113, Via di Grottarossa, Sant'Andrea Hospital 1035-1039, 00189, Rome, Italy. paolo.roma@uniroma1.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Roma
authors.forename: Floriana
authors.initials: F
authors.lastname: Pazzelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferracuti
mesh_terms: D000059:Accidents; D000328:Adult; D001237:Asphyxia / Q000150:complications* / Q000523:psychology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008398:Masochism / Q000150:complications* / Q000523:psychology; D010262:Paraphilic Disorders / Q000150:complications* / Q000523:psychology; D016728:Self-Injurious Behavior / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology*; D017741:Survivors