Clients discussing being sexually choked/strangled in psychotherapy and the ethics involved

What is it about?

Consensual "choking" during sex has become common among adolescents and young adults. However, psychologists might be unaware of the growing trend and the complex ethics involved in treatment. This article fosters awareness by describing the serious dangers associated with sexual choking/strangulation. To our knowledge, this is the first article to explore ethical challenges with clients who discuss sexual choking/strangulation. The authors propose a novel classification of different types of sexual choking/strangulation (e.g., sexual compliance), and provide an example of a fictitious psychotherapy patient who discusses being frequently choked/strangled in her established romantic relationship. Gender-sensitive guidance (e.g., the potential overlap with domestic/intimate partner violence) is indicated for psychologists who navigate the ethical issues involved in treatment. Practical recommendations for psychologists are provided (e.g., include brochures on the dangers in the waiting room).

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Photo by Sydney Latham on Unsplash

Photo by Sydney Latham on Unsplash

Why is it important?

Because sexual choking/strangulation can be deadly and/or lead to brain damage, this article can help save lives by informing psychologists about the dangers. Certain populations are more at risk of being choked/strangled: women and sexual/gender minorities. These populations are at risk of being collectively harmed by this practice, which is likely due to a heterosexist culture.

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