How do you view tattoos? Are you okay with them? Does it matter to you what the tattoo is or means? For many people, “body art” is either the object of much criticism or the object of a strong personal association with a belief or person. A parent posed a challenging question to me a few years ago while I trained at a semi-prominent clinic: “Why is the Clinical Director sporting a tattoo in clear sight and she knows that I have trouble trusting doctors in the first place?” I found myself not only floored, but a tad upset by the social stigma that swept into the clinic and across multiple clinicians. What I had failed to realize is that although I saw the situation from various perspectives, clients often felt threatened or defensive after noticing the tattoo(s). But….can you blame them?

As far back as the mid-1800s whenMartin Hildebrandt became the first to open a “body art” shop in the U.S, tattoos have been viewed negatively. Of course, we don’t want to judge unnecessarily or defy a wonderful personality and set of clinical skills because the person happens to be interested in sporting tattoos. But it is understandable (and reasonable) that many patients, clients, families, and fellow-clinicians would question the social status, mindset, and ultimate goal of a professional who openly displays tattoos. Interestingly, some psychiatrists and researchers have attempted to understand the personality of the individual professional interested in pursuing tattoos. What is it about this person that finds tattoos attractive? Are they rebels? Are they “hip” mental health professionals? Are they socially or characterologically disturbed? It’s hard to tell. For many clients and their families, a tattoo would cause them to second guess not only the knowledge of the professional, but also the quality of care given. Many people who question tattooed professionals arenot necessarily being discriminatory, but rather wise and curious. They are exercising their right to question the quality of care they are receiving. Wouldn’t you?

In fact, most corporations, especially healthcare agencies, view covering tattoos as part of a dress code policy, not discrimination. A corporation has the right to dictate what their dress code should be and many say “no tattoos.” This is primarily because of the negative stigma attached to tattoos, potential transference issues with clients, and the research pointing to negative personality traits, deviance, or trouble-making associated with body art.

For decades tattoos have carried a negative stigma and often interferes with being hired, being taken seriously, or even being trusted.Dr. William Cardasis, a researcher studying the mental health implications of tattoos, suggests that people who sport tattoos are more likely to have antisocial personality disorderor sociopathic traits. Can you imagine your psychiatrist, your therapist, your doctor being a sociopath or having some sociopathic traits? It’s hard to believe. But many people like Martha Stout, the author of, The Sociopath Next Door, have warned us it is indeed possible. This reality requires a deeper inspection of all mental health professionals and an evaluation that extends far beyond face value.

The majority of Americans would probably admit that tattoos are often a direct expression of their identity or attachment to a belief or person. Dr Cardassis isn’t claiming that a tattoo alone is what causes sociopathic traits, but rather that the tattoos in his study were a strong indicator of sociopathic personality traits.

It is also important to consider that there are multiple ways to look at the individual sporting a tattoo. For example, there are cases in which an individual received a tattoo as a youngster and is not closely connected to it as they once were. Or the person may be uneducated to the harm they can cause to themselves and others. In other cases, some people simply don’t fully understand (or care about) the stigma associated with their tattoo.

The best questions to ask yourself if you ever encounter a situation like this is: “what does this tattoo possibly mean to this person?” “What is the tattoo saying?” and “How might this affect me or not affect me?” As psychiatristDr. Gerald W. Grumet says “it can be an interesting little window into the soul.” He says that tattoos could signal low self-esteem, impulsivity, andlack of control. There may also be other implications such as sexuality, religious or cult belief, and criminal behavior.

It really is important to closely inspect the character of your mental health professional before judging them based completely on what could have been an honest mistake or way of life for them. However, it is also okay to question your quality of care.

As always, share your thoughts! What would be the point at which you would say “could I request another healthcare provider?”


Abby, S. (2011). The tattooed therapist: Exposure, disclosure, transference.Psychoanalysis, Culture, & Society 16, 113-131.

Grumet GW. Psychodynamic implications of tattoos. Am J Orthopsychiatry 53: 482-92.

ScienceDaily. (2008). Psychiatric forensic patients with tattoos more likely to have antisocial personality disorder. Retrieved July 3, 2013, from

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