Ritual of Native American origin linked to sun worship , in which the subject is raised by piercing deep run in the chest, with the purpose to provoke a state of altered consciousness caused by the release of endorphins. It is rarely emulated by fans of body modification . The O- Kee- Pa is a ritual , which is celebrated by a Native American tribe , the Mandan, located along the banks of the Missouri River . In the adolescent age , males had to deal with this rite to become warriors. The O- Kee- Pa was beginning 4 days prior to the actual ceremony , refraining from eating, drinking and sleeping. The boy was then dressed and painted in the face and body , and the ritual continued with the inclusion of two hooks in the wooden chest and then lifted off the ground. In this position , the future warrior, was left literally hanging with your own skin , without the help of the hands or arms , causing excruciating pain but at the same time a state of unconsciousness with the release of endorphins and the impressive increase of adrenaline. According to the tribe in this state , the boy could rise to a higher mental level and become a strong and brave man . However, the risks and the perceived pain was immense. Within this practice BDSM suspension and resumption of the chest is simulated as a technique of " body modification " and performed with steel hooks using the proper precautions to reduce the risk of infection ( sterile goods , disposable gloves , etc ...) . Nevertheless, the "suspension of the chest " should not be confused with the O- Kee- Pa , since this was a religious ceremony , with meaning and ritual complex in retrospect.