A Dangerous Pastime for Teens: The Choking Game

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Patrick Ryan / Getty

A hand around the neck cuts off blood supply to the brain

When Françoise Cochet saw the cord around her son's neck, she knew that he was dead. Fully clothed and still wearing his sneakers, 14-year-old Nicolas had strangled himself sometime after dinner in their apartment in Nice, France. His mother found him the next morning. "I shut the door so my other two children couldn't see, and I didn't touch the body," she says. "I thought that I couldn't live anymore. I thought I needed to die too."

Because Cochet had left her son's body as she found it, police were able to rule out suicide. Instead, they determined that Nicolas had accidentally killed himself playing le jeu de foulard (the "scarf game," as it's known in France), a dangerous activity in which children starve their brain of oxygen to achieve a natural high.

Known by various names around the world — including funky chicken, space monkey, sleeper hold and the blackout, choking or fainting game — the activity involves applying pressure to the neck to stop the blood flow to the brain and then releasing the pressure to create a temporary sense of euphoria. It isn't new: French medical books mention the scarf game as early as the 18th century, and deaths in Britain, Canada and the U.S. have occasionally made the headlines over the years. What is new — and frightening — is that teenagers are now uploading instructional videos to the Internet that glamorize the potentially deadly practice.

"This is disturbing, highly dangerous, very risky, and the practice should be avoided at all costs," says Dr. Steve Field, chairman of the Royal College of General Practitioners in London. "You can have an epileptic fit, you can go into a coma and you can die."

Many teenagers already are dying. Figures on choking-game deaths remain sketchy — a lack of awareness among police means that cases often end up being classified as suicides. The Centers for Disease Control and Prevention in Atlanta estimates that at least 82 people died from the activity between 1995 and 2007. But according to the Wisconsin-based campaign group Games Adolescents Shouldn't Play (GASP), as many as 1,000 young people die in the U.S. each year playing some variation of the game. In France, officials identified 17 deaths in 2009, but they suspect that many more go unreported.

The medical community remains divided over whether to publicize asphyxiation games. "There's a fear that if you raise awareness then other people will start to copy it," Field says. Last year, the medical journal Pediatrics reported that one-third of American doctors had never heard of the choking game and only 2% had ever discussed it with teenage patients or their parents. But it appears that many young people are finding out about the activity on their own — potentially without being made aware of the dangers. In a study in the journal Injury Prevention published last February, nearly half of all students at eight schools in Texas said they knew someone who had participated in the choking game.

The lack of preventive education alarms Cochet, founder and president of the Association of Parents of Young Victims of Strangulation in France. She believes that raising awareness about the game can save children from accidental death. It was only after police explained how her son Nicolas had died that Cochet began piecing together the warning signals she had missed. About six months before his death, he had told her about a "fun game. Then one day he had headaches. Another day I saw that he had marks on the edge of his neck," she says. "I saw all these things but didn't understand what they meant, because I didn't know that this game existed."

Awareness will also help victims' parents overcome the stigma attached to having a child die this way. People frequently confuse the game with erotic asphyxiation, the sexual practice thought to heighten an orgasm. And they frequently assume that victims suffer from psychiatric conditions like depression. In fact, victims tend to be high-achieving students at school, active in sports and well-behaved, according to doctors and some victims' parents. "They aren't playing this game for sexual gratification," Field says. "It's to get a high without taking drugs."

Following her son's death, Cochet and her family moved from Nice to Paris in an effort to move on with their lives. She remains committed to sparing other families from the grief she still lives with. In December, she helped France's Ministry of Health organize a symposium on the choking game, bringing together 200 doctors, physicians, teachers, policemen and bereaved parents from nine different countries. Her English isn't perfect, but when it comes to explaining the risks of choking, she speaks rather eloquently.

"Our children are alone in their bedrooms," she says. "They're getting dizzy, and the great risk is that at any moment their hearts can stop." And when that happens, as Cochet knows all too well, a parent's heart stops too.