The Therapeutic Experience of Being Suspended by Your Skin

The 5,000 year history of the "art" comes down to physics, spirituality, and risk.

A man suspended in Lviv, Ukraine [Pavlo Palamarchuk/AP]

A woman lies face down on a massage table. She is tended to by five men wearing surgical masks and gloves. The men aren't wearing scrubs, though, and elaborate tattoos are visible on three of the men's arms. They insert large fishhooks under the woman's skin: in her calves, thighs, and lower, middle, and upper back. They work quickly and with practiced efficiency, grabbing a good sized piece of skin, pushing the hook into the skin until -- pop -- it slides in and out the other side. There is no blood. The men position the hook's bend around the freshly pierced hunk of flesh before moving onto another piercing.

The woman goes by the name Trigger. She posted a video montage of several of her body suspensions -- a form of body modification that involves hanging a human body by hooks attached to ropes -- to YouTube. In her video description, in an attempt to ward off hurtful comments from both the prejudiced and the Internet's resident ignoramuses, she wrote:

This is a little music video I made to footage of some of my suspensions. Some were hard and painful, some were fun & painful. Either way, I'm always grateful for the opportunities I had to do these suspensions and will never forget what an impact they have had and continue having on my life.

Enjoy this video, but please, no comments about how gross this is... if you don't understand it or agree with it, that's perfectly okay, but there is no need for disrespectful comments.

The rest of the video, after the piercings, shows Trigger suspended. She hangs in a number of positions: from hooks inserted into her upper back, known as a suicide suspension because the suspended person appears to have hanged him or herself; from the skin around her knees; and face down from hooks that run the length of her back and legs in what is called a Superman suspension. A suspension artist, who is responsible for setting up the hooks, ropes, and pulleys for the suspension, monitors the entire process. During some of Trigger's suspensions, a man hugs her tenderly and strokes her hair, rocking her body gently back and forth in the air. For the Superman suspension, she remains in a resting position. During one of her two suicide suspensions, she swings back and forth in a wide arc.

"Really beautiful, thanks for sharing," one commenter wrote.

"Hey, just wanted to let you know that I am finally going up!" wrote another. "Thank you for giving me the inspiration to do this. I have a 4 pt knee scheduled for tomorrow!"

One simply asked, "Why?"


People have been hanging themselves from hooks for perhaps 5,000 years. The most ancient suspensions likely occurred in India, where suspension was a sort of religious penance. Devotees at the ancient Hindu festival Thaipusam, which continues to this day throughout Southeast Asia and is popular among Tamils, sometimes suspend themselves as part of a practice called vel kavadi, a rite in which worshippers undergo some form of hardship as an expression of debt bondage to the war god Murugan. Some who perform the vel kavadi pierce their flesh with skewers -- stand-ins for the spear that Shiva's wife, Parvati, gave to the god of war Murugan to kill the demon Soorapadam -- and hooks. The pierced worshippers sometimes attach ropes to their hooks, which are pulled by other devotees or used to suspend the worshippers in the air. The level of pain the worshipper feels correlates with the level of devotion -- the more pain, the more sincere the worship. Suspensions also occur at the Chidi Mari festival, another Tamil holiday.

Half a world away, on the banks of the Missouri River, the Mandan tribe suspended young warriors in an annual rite of passage ceremony that celebrated the creation of the earth. The Okipa ceremony, as it was called, required initiates to fast and hold vigil for four days, then dance, and lastly perform trials of endurance. The warriors-to-be had to prove their strength to their elders and the spirits. The young men were suspended from the roof of the tribe's lodge by ropes attached to skewers in their chest, back or shoulders. To increase the pain, weights were attached to their legs. Cries of agony were considered cowardly. The warriors would faint and were brought down to be watched over by the men who presided over the ceremony. When an initiate woke up, it signified the spirits' approval.

The new initiates then had their left pinky removed with a hatchet, and finished the ceremony by racing around the village in a race called "the last race." The skewers were still in place, the weights still attached. The Okipa ceremony was first documented by an outsider around 1835 when George Catlin, an American painter on an expedition with William Clark, produced a painting of the ceremony. The last Okipa ceremony took place in 1889. A variation of the Okipa ceremony was made famous in the 1973 film A Man Called Horse when Richard Harris' character underwent a similar ceremony in order to gain acceptance from the Lakota tribe that had taken him prisoner.

Though many people who practice suspension see it as a spiritual experience and a way to test themselves, most suspensions today are not performed as religious sacraments or trials of endurance. For some, it's a sort of, "If I can do this, I can do anything," attitude. For others, it is akin to meditation.

Modern suspension has been largely shaped by Fakir Musafar, a man who was born on an Indian reservation in South Dakota with the name Roland Loomis and developed, or brought back, many types of suspension. Musafar performed the Okipa suspension in 1963 and also coined the term "modern primitives" to describe a subculture that practices body modification with a particular interest in rite of passage rituals. For Musafar, and many others after him, body modification is a form of self-expression and spiritual exploration, a way to move beyond the body into a higher spiritual plane. But others who practice suspension today distance themselves from the sort of ritualistic elements espoused by Musafar, and instead choose to hang for the sake of hanging.


Cere Coichetti is the head of the New York chapter of Rites of Passage, a group that facilitates suspensions up and down the east coast. He first was introduced to suspension twelve years ago through his friend Brian, a body modification artist in New York. Brian had a friend, Emrys, who had recently moved to New York from Boston and who practiced suspension, something that Coichetti, though active in the body modification scene, hadn't heard of. Suspension requires a small team of helpers to set up and monitor the suspension, and Emrys enlisted Coichetti and Brian to help him suspend. Within a week or so, Coichetti tried his first suspension -- a Superman.

SHARK300200.jpgA Superman at a suspension conference in Tel Aviv. [AmirCohen/Reuters]

"I wanted to see if I was tough enough to do it," Coichetti said with a smile as we talked over meatball sliders at a restaurant in Williamsburg, Brooklyn. "It came down to a challenge to myself, a test of strength. If I can put hooks in my body -- suspend my near 300-pound frame from little hooks -- then there's nothing I couldn't do. I thought it was going to hurt. I thought it was going to suck. I thought it was going to be the most traumatizing experience of my life."

Coichetti's body is covered in tattoos, and his head, shaved bald, is adorned with a neatly trimmed goatee. In his ears, for aesthetic reasons, he has removed the cartilage around the ear canal in what is known as a conch removal. It's possible to see through the little holes in his ears, but you wouldn't even notice the modification unless you sat down and talked with him. He is lively and expressive, and as he told me about his first suspension, he did a good deal of speaking with his hands.

"So, I go in and I'm ready to go through it," he said, "and once I got into the air, once they lifted me up, it was the most peaceful, serene, blissful experience I've ever had. And it was kind of like, throughout life, you tend to take on negative energy -- by energy I could mean stress -- stress from your job, stress from home, if you're married, if you've got kids -- just stress. And this was just the ultimate stress release. Everything bad that had built up, it was just resetting it back to zero."

"The second I came down, I knew I wanted to go back up."

Shortly after his first suspension, Coichetti began to study the rigging aspects of suspension. He consulted Allen Falkner, one of Fakir Musafar's apprentices and also one of the greatest influences on suspension as a non-ritualistic act, to learn about suspension techniques.

Coichetti says that he has helped people from all walks of life suspend, including lawyers, wrestlers, doctors, acrobats and politicians. Two of Trigger's suspensions in her YouTube video were done by Rites of Passage. The group performs suspensions free of charge, but ask for a suggested donation to cover the cost of hooks and other equipment. Any money Rites of Passage receives in excess of the suggested donation goes to sending the group's members to certification courses in first aid and industrial rigging.

"Suspension can be broken into two aspects," Coichetti said, "basically the medical aspect and the rigging aspect. By medical, I mean the insertion of the hooks, the cleaning, the blood, the skin, how that all works. The hard part about suspension has nothing to do with the body. It's everything above the hooks."

The rigging methods of suspension are borrowed from techniques developed for construction, rock climbing, and stage rigging (think Cirque de Soleil). Those who master the rigging techniques are referred to as suspension artists.

"The term suspension artist is a bit misleading," Coichetti said. Suspension is, he insisted, a skill. "It's not really an art. Anyone can learn to be a suspension artist. It's science. It's math. It's understanding principles and practicing and putting those principles into effect.

"When we go up to install rigging points, we need to know what the ceiling is made of, how it's constructed, what it can support. I need to know what it's already supporting on top of it. If I'm stressing a ceiling at a fracture point where they have an air compression unit on top of it, I need to know that."

The rest, Coichetti said, is all physics, and it boils down to F=MA.

"When I have a pulley system on a ceiling, if you weigh 100 pounds, I have to exert 100 pounds to lift you off the ground," he said. "Now, you also have motion. You have to figure out the angle of motion, the rate of acceleration. I do it in my head. I have to figure out how much stress you are putting on the top rig, on the pulley, on the rope, on your hooks, on yourself, and I have to make sure everything is within a correct range."

To more easily hoist the weight of a human body, suspension artists make use of mechanical advantage, rigging up complex pulley systems that facilitate the raising and lowering of the suspended person. Coichetti once rigged a woman in a marionette suspension, where hooks were inserted on the woman's back, into her legs, and into her arms, so that the woman was suspended as a living, breathing marionette controlled by Coichetti with the movement of his hand and arm.

"I had to figure out a way to attach all her points to a glove," Coichetti said. "So that going like this," he moved two fingers up and down as if playing a piano, "would raise her left arm, would raise her right arm. And I had to rig it all so that just three inches of motion would create four feet of motion on her side." Moving his arm up and down lowered and raised the woman.

He acknowledged, though, that he had a little help with lifting the woman's limbs with his fingers--most people, he said, when they feel a hook pulling on their arm tend to raise their arm along with the upward pull.


The most visibly jarring thing about watching a suspension is seeing flesh stretch as it supports the weight of the body. It looks like it's about to rip -- sending the suspended person falling to the ground amidst a confetti of torn flesh and blood -- but it's actually quite safe. During a suspension, hooks are inserted under the dermis and into the subcutaneous fatty tissue, a very resilient chunk of flesh.

"Skin is pretty strong," Dr. Nelson Goldberg, a plastic surgeon at the University of Maryland Medical Center, said. "It's basically leather, and in the back it's basically double leather. I think it could easily handle the tension before it would rip."

Dr. Brett King, an assistant professor of dermatology at the Yale School of Medicine, sees suspension as an application of physics and a testament to the human body's remarkable toughness and healing ability.


"You're putting your body's weight worth of force across that tissue," King said, "and it's quite striking that the skin holds up as well as it does. My guess is that, whether or not the practitioners of suspension realize it or not, the people who plant the hooks in the skin understand that there's a tremendous amount of physics to all of this. They must use hooks that are appropriately thick to hook an appropriately broad swath of skin. You can imagine, if you were to take something as thin as a slim nail and kind of loop it under the skin and back out, and then pull the two ends away from the body, it might very well rip the skin. Alternatively, if a much wider nail or hook is sewn underneath and back out across a wide enough section of skin, then suddenly there is enough fabric to support the weight. It's a calculation that involves the total dimension of skin across which you're supporting some amount of weight."

"It's kind of dazzling," he said, "to conceive the entire body's weight being supported by a couple of hooks through the chest."

"It's pretty cool," he added.

When I asked Coichetti to describe the sensation of being suspended, he said, "It's this odd pressure, and it almost feels like--" he paused, thinking. "Do you ever stand in the sunlight, like at the beach, and, not that it hurts, but you can feel when you're burning? Like, 'Aw, man, I can feel the heat. I can feel myself burning. I know I've gotta get out of the sunlight.' That burning sensation. You feel that. It's not painful, but you definitely feel burning. And you feel this odd pressure happening. Once you're in the air for, like, 30 or 40 seconds, that burn fades away. And then you get hit with the euphoria. You still feel the pressure, but at that point in time, you're elsewhere."

"Grab the meat of our best friend's back and just yank up really hard," AJ Karras suggested. "Try to pick them up, too."

Karras, a young woman with pink hair, came to New York City from outside Amherst, Massachusetts, to be suspended for the first time by Coichetti. She was excited, and her boyfriend had come with her for his first suspension, too. Karras has been involved in the body modification scene for about five years, and has been helping out with suspensions and heavier body modifications, mostly types of cosmetic implants, for the last two.

"I saw suspension videos when I was 15 years old," she said, "and I was like, 'Dude, I have to try that. I just have to.' I just always knew that it was part of me."

I asked her what types of suspension she was interested in trying.

"All of them," she said without hesitation. "Eventually. Gotta let my body heal up between, but eventually I want to try as many different and new things as we can think of."

Tearing of the skin can, and does, happen, but it's almost never the sort of dramatic freefall that someone watching a suspension for the first time might imagine. There are certain parts of the body, like the knees and the chest, where tearing is more likely to occur. Tearing happens slowly, and there is more than enough time, Coichetti said, to get the suspended person down on the ground before there is any serious injury. Skilled suspension artists can tell when the skin is beginning to tear, and will inform the suspended person what is going on.

"When someone is in the air and they're swinging around," Coichetti said, "and I see that tearing has begun, I'll stop them and be like, 'Your skin is beginning to tear. It's not an issue right now, but in about a minute or two it's going to get to the point where you need a stitch or two. Are you comfortable with that?' If someone's in danger of the skin completely opening, we bring them down. They don't have a choice. But if you're suspending and you're at this moment, most people go, 'Leave me up here, suture me later.'"

You can find examples of suspensions gone wrong on the Internet. At a certain point, skin gives out, as King said. In most cases when a suspended person falls, though, the fall isn't due to the skin actually ripping. Improper insertion of the hooks, in conjunction with a high degree of motion, can result in the hooks sliding out. Professionals who are attempting suspensions at great heights or suspensions that involve a good deal of motion will rig up a safety harness that acts as a failsafe should the hooks come out for some reason.

One video on Hook Life, a blog that caters to the suspension community, shows a Russian suspension team suspending a man in an abandoned warehouse. The man freefalls from a great height, then swings back and forth. He is harnessed in. Hook Life, though, added a lengthy disclaimer before posting the video, warning readers, essentially, not to try this at home. Coichetti's biggest concern about suspension is that people will try to imitate what they see on the Internet without the proper medical and technical knowledge required to perform a safe suspension.

Both King and Goldberg considered infection to be the greatest risk during suspension, but knowledgeable suspension artists use sterilized hooks, needles, and gauze when suspending someone to minimize the risk. Some scarring is inevitable, but when Coichetti showed me a point on his leg where he had suspended seven times, I wouldn't have noticed anything if it weren't for a white spot in a tattoo, evidence of where hooks had been. There is, as King suggested, a high level of physics and medical knowledge being put to use during a suspension, and Coichetti says safety is his number one priority. He is a certified first responder, meaning he is trained in providing pre-hospital care for medical emergencies, and a volunteer fire fighter. Most of his team are certified in first aid care, and two of the suspension artists in the Rites of Passage Boston chapter are paramedics. If someone has a medical condition that would complicate a suspension, he consults the person's doctor to clear him or her for suspension. He has turned some people looking to suspend away due to the medical risks that a condition presents.

"It's up to the individual to figure out if the harm involved -- which, realistically is very minimal -- is worth what they get out of it," Coichetti said. "And the answer for suspenders is yes. Shock can be life threatening, but, I mean, you break your leg, you go into shock. Shock is on a spectrum," he made a wide space with his two hands, "we're just fucking around in this range," he said, using two fingers to indicate the very low end. And, he says, if something ever were to go wrong, the first thing he would do would be to call an ambulance.

That feeling of shock is what many who suspend are looking for -- the rush of endorphins, serotonin, and other chemicals that results in a sort of high. Some see it as a spiritual experience. Others find it exhilarating, and laugh while they are suspended. A subset of those who practice suspension do it as a type of performance art, choreographing lurid and shocking spectacles that are performed in front of audiences.

"A performance is there to shock the hell out of you," Coichetti said. "They're going to scream, they're going to make it look like it's the most bloody, painful, awful thing in the world. And it's all an act to get a visceral reaction out of the audience."

Performance suspensions, Coichetti said, with their focus on shock value, can cheapen the type of suspension that he practices, which focuses more on creating a unique experience tailored to the suspended person.

"I feel like it puts out the wrong public perception about what we do," he said.

"Spirituality is very important to me," Coichetti said. But, he clarified, "I'm very technical. I look at, when I'm doing a suspension or any kind of ritual, what physically is going on. I want to know what's causing this euphoria. We're in a world nowadays where I don't have to go, 'Oh, the state of euphoria is caused by this god raining down on me.' This state of euphoria is caused by these certain chemicals being released because of these physical triggers. I will absolutely suspend you and have a drum circle going on, beating on drums and chanting; not because I'm a hippy, but because I know steady bass rhythms allow your brain to function at a theta level and it allows you to trance easier."

"Now, even though I'm very technical and I want to get into the chemistry of this, it's still a spiritual experience. Is it spiritual to a god? To the world? To myself? I don't know, I'll figure that out one day," he said with a smile. "All I know is that my end result, regardless of how I get there, is a feeling of complete freedom."