Playboy article on sexual choking

Sexual choking uncovered in Playboy

Amanda Pasciucco was interviewed for a Playboy magazine article about sexual choking.

So You’re Into Choking…

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One of the common questions I’m asked, both as a woman and the Playboy Advisor, goes something like this: “My girlfriend is into choking. What’s up with that?”

As someone who occasionally enjoys a little light gripping of the neck, that question is something worth exploring because, to be honest, I don’t have the answer. In fact, the question alone brings up feelings of internal shame and embarrassment. Is there something wrong with me? I’m not alone in my confusion. As one man told me for this story, “I like choking, but question women who want to be choked too hard. That’s not because I’m judging, but because I wonder why anyone would want to feel like they’re about to die?”

To come to grip with this increasingly popular sex act—which in its varying forms ranges from breathplay to erotic asphyxiation—I decided to speak with six experts on the subject.

One thing that stood out right away is this important warning: Erotic choking is dangerous no matter your level of engagement or expertise. Before we dive into the physiological and psychological factors at play, let’s start with safety.

Across the board, experts urges extreme caution “We get a lot of mixed messages because of the depiction of it in porn,” says certified sex therapist Kimberly Resnick Anderson, “but sexual choking or breath play is really dangerous. Even in the BDSM community, it’s never safe. There is always a lethal risk.” “Because of the risk, the absolute safest way to practice this activity is to keep it as a fantasy,” Heather McPherson, a licensed marriage therapist explains. “Breath play, erotic choking and erotic asphyxiation are generally terms recognized under the umbrella of edgeplay. This type of activity is recognized as high-risk even for experienced individuals.” And clinical sexologist and psychotherapist Kristie Overstreet says, “The only way to ensure safety is to not participate in this at all.”

But if you still insist on experimenting with breath play, certified sex therapist and author Amanda Pasciucco says to “take a class on the subject. Choking is an easy way to have fun and explore with a partner, but there is definitely a safe way and a dangerous way to choke. Whatever you do, do not put pressure on the trachea.”

McPherson advises, “the person performing this activity should be trained in CPR, highly educated in the physiological effects and keenly aware of the risk involved. It’s important to stay attuned to your partner’s responses and to communicate to each other throughout the experience. Discuss all of this long before play takes place and establish a verbal safe word and non-verbal safe action.”

So what exactly is going on physiologically when a person gets choked? Well, you’re literally robbing your brain of oxygen. “This could bring about a lucid, semi-hallucinogenic state. Hypoxia can occur if you reduce oxygen intake or if you reduce blood flow to the brain. It can make a person lightheaded, giddy and can allegedly intensify an orgasm,” explains McPherson. The rush of oxygen after the release of a choke timed with climax can create “a different kind of orgasm that isn’t replicated in vanilla sex or masturbation,” says Overstreet. “The pleasure-seeking center of the brain gets pushed into overdrive during erotic choking. Pushing the limit and walking the thin line between breathing or not breathing can send a powerful surge of endorphins throughout the body.”

The psychological effect of erotic choking is almost more powerful than the physical, although the interplay of sex and death and chemistry is what makes this practice so intoxicating. One man confessed to me, “I’m in to it giving but I hate receiving—talk about control issues.” A woman said, “For me, it gives me the ability to just lose control for a little while. I feel like I’m always in such control of whatever I’m doing it’s nice to be able to release and let someone else have the ability to take over for those few moments.”

This woman’s experience reflects a pattern observed by the experts working with thousands of individuals for decades. “For women who are being choked, it’s liberating to give up control and trust someone with your life,” says Anderson. “For men who enjoy choking it’s about what a woman is willing to let him do and the fact that this woman trusts him with her life. Both sexes get off on getting as close to death as you can—and cheating it.”

“Through my years of experience with my private practice I have learned a great deal about the correlation between one’s sexuality and their beliefs and attitude on death. An example: many individuals who fear death have a fear of sex. One’s own relationship to death is almost always reflected in one’s sexuality. This includes fetishes such as erotic choking,” says Dr. Stephanie Hunter Jones.

”Often, we do things sexually because we know it turns our partner on. That fact in and of itself can be a turn on for us—knowing that we (our bodies) are supplying the pleasure,” says Dr. Debra Laino. “The control of taking someone’s life (breath) away and then giving it back to them is exhilarating for some. For some it is the depth of love making, which includes a different level of trust and intimacy.”

The vast majority of the 30 women I interviewed enjoyed an occasional light erotic choke, but that seems to be the threshold for most women; less than a third of them express an interest in exploring anything beyond that such as ties or a full choke. My girlfriend summed it up in a nutshell when she said, “Powerlessness, trust and pleasure.”

The BDSM community’s mantra is “Safe, Sane and Consensual.” One man broke that down saying, “For me, as an element of a power play, erotic choking can be fun. As someone who is dominant in the bedroom, I can be into choking with a few essential things in mind: a suggestion by my partner that it is desirable; establishment of a safe word and safe action (three taps on my hip or a pillow; and sufficient awareness of human anatomy. Always focus pressure on sides of neck and avoid pressure to trachea.”

It’s the latter that you must take precautions with during breath play. It’s all too easy to accidentally cause real injury while role-playing. In order to avoid injuries and misunderstandings, make sure it’s always consensual; if a man I didn’t know that well started choking me, it would scare the shit out of me.

Make sure you do your homework. Find an expert to teach you the correct way to engage in breath play. Many local sex-toy shops offer classes in various forms of kink and there are many “experts” online—but as you would when shopping for any kind of expertise online, exercise caution and be discerning about whom you might meet in real life.

“This can be a dangerous pleasure. Never use alcohol or drugs when engaging in this play,” says Jones. “Remember, this type of play can become highly addictive and as with all addictions, can leave an individual with a craving of needing more and more to satisfy them.”

But if just reading this piece gives you a half chub, there’s nothing wrong with you. If you want to explore it, that’s perfectly natural, and I highly recommend it—but do so with caution.

Read the article on sexual choking at Playboy Magazine:


Finally! They are considering having Marriage and Family Therapists (MFT) accept Medicare!


Please cosponsor S 1879 and HR 3032 to support Mental Health Access in Medicare
Legislation to add MFTs as Medicare providers has just been introduced in the US Senate, and was introduced in the US House of Representatives in June. Please follow the directions to urge your Members of Congress to support Medicare MFT coverage by cosponsoring this important legislation. If you have any questions or need additional information, please do not hesitate to contact AAMFT at


The new Netflix show, To The Bone, has been said to be triggering for those who have eating disorders. Anyone have any thoughts on how they could have made the show better?

Newsweek – Teens having less sex!

Teens today are having less sex! But are researchers asking the right questions?


Some experts, such as Amanda Pasciucco, a certified sex therapist with the American Association of Sexuality Educators, Counselors and Therapists (AASECT) and author, argue that something far more insidious is driving a decline in sexual intercourse: easy access to free porn. “Now you can just go on your phones,” she says. “It’s very easy to just Google something, and it’s much easier to have sex with yourself than go through the anxiety of having sex with someone else.”



Eating Coach Control Issues West Hartford CT Hartford CT

National Donut Day

National Donut Day (GET HELP) isn’t very exciting for those with eating disorders…


Story by Meaghan:


I want to tell you about this guy that  I met. I’m not going to use any names because I feel it could really ruin someones reputation. Him and I met about ten years ago. You could say that our relationship has been pretty serious, always ups and downs but when push comes to shove he really has always been there for me. I was a freshman when we met, he has taught me so much about life, love and happiness. He taught me about strength and persistence. He taught me how to love myself, even when I wasn’t very lovable. He taught me self-care, taking time for myself. Throughout high school we had lunch together almost every single day. Once we went to college, things got kind of complicated you could say. I wanted to be alone and figure myself out, and he wanted to support me. I’d push him away and then call him back whenever I needed him. He comforted me when I was scared. He guided me when I felt I couldn’t make decisions and always gave me the greatest advice. He’d constantly show me who my real friends are and push away every negative person that got in my way.


    He’s great, he’d go shopping with me, out to eat, parties and even take me on little vacations. He’s perfect right? The only thing is he insisted that we kept our relationship top secret. However I was treated like a princess, so it was worth it. Wouldn’t you kill for a relationship like that? Having a man that stands by your side for ten years even if it’s just in the role of a friend. Someone who is honest, who fights for you, who is patient and waits for you to discover yourself? Someone who is willing to wait for you and as soon as you are ready, he’s back, like nothing ever changed.


    How lucky am I? I’d say very. I found my Prince Charming at such a young age and the best part is I knew he’d never, ever leave me. No matter how poorly I treated him. No matter how stubborn I was. No matter how many other relationships I got into, I always knew he’d be there. He would never let me be lonely. It’s a dream come true.


   There’s a flip side though. This guy, as much of a dream that he is also did some pretty terrible stuff to me. Do I keep him or do I let him go? That’s where I need your help.


   When I say he taught me how to love myself, I mean- he told me what I needed to do to be beautiful. Make-up, hair-dye, tanning, gym memberships, and the latest ‘diet’ trends. When I was scared he’d teach me control, like “If you ever want to get anywhere in you life you have to learn to punish yourself when you do wrong.” When I was getting dressed he’d tell me I’m ugly, and that clothes will never ever fit me. If I had a friend or a significant other he’d find ways to push them away because the only love I needed was his. He’d help my avoid awkward social gatherings and fight with my loved ones so I could ensure keeping him around. He HATED seeing me in dresses, it just wasn’t a pretty site. He’d comment on how my calves were too big and my thighs shouldn’t touch. He’d convince me that no one loved me, no one cared. Whenever I was alone he’d keep me company. Whenever I was with people he would always be right.there.


       He made me sick. I never wanted to leave my house, I couldn’t work, I couldn’t sleep. I was scared and nervous, I couldn’t make a move without him noticing. I wasn’t allowed to cry, or be angry, or be anything but “happy.” If I felt anything else, he’d become enraged, he wouldn’t leave me alone. he convinced me that I’m not worthy. I was fat. I was ugly and he always had to be number one in my life. He gave me what I wanted, attention. He was manipulative, he made me cling to love. He was intimidating, constantly reminding me that I had to earn the body image I longed for. He was always there for me, he loved me despite my longing to be beautiful, despite always failing him.


     Does this still sound like a fairytale? Is love like that worth it? If love means something different to everyone shouldn’t I accept this man? I should love him back. Here’s the scary thing though, I don’t. I’d be lying to you if I told you I even wanted him around. Honestly I want him to leave forever.


   Don’t you want to help me get away from this man? Once we break up would you want to watch chick flicks and eat ice cream out of the carton with me? Why could I so easily tell a friend to get away from a relationship like that but I’m stuck? Can people really convince you of all that? How many second chances do I have to give someone?


   Now, what if I told you this man doesn’t really exist. What if I told you I completely made him up? Would you get me a one way ticket for the crazy train? Here’s the thing. He does actually exist. His name is Ed. He lives in my brain and everything I just told you is very true. When I told you we met for lunch every day, I meant in the bathroom. Ed is an eating disorder. It’s a mental illness. My body isn’t perfect, and  I rarely go to the gym. But if I was dealing with a break up and you showed up with ice cream, I’d have to refuse because it’s just not worth the extra calories. It’s always there. I’ve been fighting this for months, you could even say years.


   Eating disorders are the cancer of the mental health world. The only difference is there isn’t a chemo or radiation. It’s just as deadly. For an eating disorder I am the chemo, the radiation, the strength and the cancer. It effects your muscles, slows your heart rate down, reduces your bone density and can even cause heart disease. Anorexia nervosa has the highest fatality rate of any mental illness. Eating disorders are a daily struggle for ten million females and one million males in the United States.


   You see, I’m far from alone. This IS serious. Anyone can struggle. This “relationship” I’m in is just as serious as an abusive relationship, it’s similar to having an addiction to heroin. Except I’m addicted to the feeling of having an empty stomach. I physically can’t JUST have one more bite. I can’t just STOP my desire to be a size 0.


    I can’t just call the police and say I’m in danger. I have to become smarter than my own mind. I have to face challenges every day because I can’t just run away from food. You can’t escape your own mind, or your heart.


    I’m okay and I’m surviving. Every day brings new struggles and new accomplishments.It’s not easy- but the moment you realize that recovery is worth it everything changes. The fight becomes worth it, the exhaustion becomes worth it. And in the end, you gave up a relationship and you may feel lonely. What you gain is irreplaceable though.


   You gain a clear mind, an adventurous spirit. You gain love- maybe not from others but for yourself, and the others will follow suit. Loving yourself means happiness, confidence, strength, courage and compassion. You gain pride, you gain insight, you learn how to actually fight.


   This doesn’t mean Ed won’t call, or text, or show up in a commercial, or even knock on your door he may even barge in. However he will find someone happy to be eating ice cream out of a carton because they can finally enjoy good company. Because that’s my decision and getting rid of him, gives me back control of my life and after all isn’t that what I wanted from the beginning?


   Be brave, take chances. Talk about your struggles with loved ones. Seek help, because being able to think and make decisions for yourself is worth far more than fearing life. I’m 24 years old, I’m no longer claiming to “have” an eating disorder, because I am far too busy recovering from one.

Spelling Bee

The #spellingbee is trending! The person who won could “visualize” the word before even spelling it! If we as adults could visualize our goals in this same way, I think we would be achieving more wins in life!

the sex healer, therapist, cnn, hartford, connecticut, west hartford, life coaching, lcat, amanda pasciucco

Better Sleep – CNN Feature

Headspace Article!

“We’ve all seen the hundreds of articles that promise “mind-blowing” sex. And maybe you’ve even bookmarked a few to refer back to later, only to find out that the quick tips and methods have failed you, yet again.”


Click the link!



I was asked the question recently about “what is a pornosexual?” I have heard people say that they have a sexual interest in their porn, and that is it. They report that they are not interested in sexual activity while in person and their whole sexual life is alone with their pornography.


Go and read the full article for yourself. Click right here.

Thirteen Reasons Why

#thirteenreasonswhy you should see a sex therapist.


  1. Most couples issues are sex related anyway!
  2. Sex is an overlooked source of eating disorder issues.
  3. Because you are embarrassed about your body.
  4. Spruce up your routine sex life with your partner.
  5. To find out what turns you on.
  6. Explore your sensuality and what that means to you.
  7. Find juiciness within your mundane life.
  8. To love how your body looks naked.
  9. Because learning the human anatomy and how it works for pleasure is interesting!
  10. You’re not having sex with your partner daily!
  11. To get more powerful and frequent orgasms.
  12. Introduction into alternative lifestyles.
  13. To learn how to become tantric.