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On Teenagers and Tattoos by Andres Martin, M.D.

Tattoos and piercings have become a part of our everyday landscape. They are ubiquitous, having entered the circles of glamour and the mainstream of fashion, and they have even become an increasingly common feature of our urban youth. Legislation in most states restricts professional tattooing to adults older than 18 years of age, “high end” tattooing is rare in children and adolescents, but such tattoos are occasionally seen in older teenagers. Piercing, by comparison, as well as self-made or “jailhouse” type tattoos, are not at all rare among adolescents or even among schoolage children. Like hairdo, makeup, or baggy jeans, tattoos and piercings can be subject to fad influence or peer pressure in an effort toward group affiliation. As with any other fashion statement, they can be construed as bodily aids in the inner struggle toward identity consolidation, serving as adjuncts to the defining and sculpting of the self by means of external manipulation. But unlike most other body decorations, tattoos and piercings are set apart by their irreversible and permanent nature, a quality at the core of their magnetic appeal to adolescents.

Adolescents and their parents are often at odds over the acquisition of bodily decorations. For the adolescent, piercings or tattoos may be seen as personal and beautifying statements, while parents may construe them as oppositional and enraging affronts to their authority. Distinguishing bodily adornment from self-mutilation may indeed prove challenging, particularly when a family is in disagreement over a teenager’s motivations and a clinician is summoned as the final arbiter. At such times it may be most important to realize jointly that the skin can all too readily become but another battleground for the tensions of the age, arguments having les to do with tattoos and piercings than with core issues such as separation from the family matrix. Exploring the motivations and significance underlying tattoos and piercings can go a long way toward resolving such differences and can become a novel and additional way of getting to know teenagers. An interested and nonjudgmental appreciation of teenagers’ surface presentations may become a way of making contact not only in their terms but on their turfs: quite literally on the territory of their skins.

The following three sections exemplify some of the complex psychological underpinnings of youth tattooing.

Identity and the Adolescent’s Body

Tattoos and piercing can offer a concrete and readily available solution for many of the identity crises and conflicts normative to adolescent development. In using such decorations, and by marking out their bodily territories, adolescents can support their efforts at autonomy, privacy, and insulation. Seeking individuation, tattooed adolescents can become unambiguously demarcated from others and singled out as unique. The intense and often disturbing reactions that are mobilized in viewers can help to effectively keep them at bay, becoming tantamount to the proverbial “Keep Out” sign hanging from a teenager’s door.

Alternatively, [when teenagers feel] prey to a rapidly evolving body over which they have no say, self-made and openly visible decorations may restore adolescents’ sense of normalcy and control, a way of turning a passive experience into an active identity. By indelibly marking their bodies, adolescents can strive to reclaim their bearings within an environment experienced as alien, estranged, or suffocating or to lay claim over their evolving and increasingly unrecognizable bodies. In either case, the net outcome can be a resolution to unwelcome impositions: external, familial, or societal in one case; internal and hormonal in the other. In the words of a 16-year old girl with several facial piercings, and who cold have been referring to her body just as well as to the position within her family, “If I don’t fit in, it is because I say so.”

Incorporation and Ownership

Imagery of a religion, deathly, or skeletal nature, the likeness of fierce animals or imagined creatures, and simple inscription of names are some of the time-tested favorite contents for tattoos. In all instances, marks become not only memorials or recipients for clearly held persons or concepts; they strive for incorporation, with images and abstract symbols gaining substance or becoming a permanent part of the individual’s skin. Thickly embedded in personally meaningful representations and object relations, tattoos can become not only the ongoing memento of a relationship, but at times even the only evidence that there ever was such a bond. They can quite literally become the relationship itself. The turbulence and the impulsivity of early attachments and infatuations may become grounded, effectively bridging oblivion through the visible reality of tattoos.

Case Vignette. A, a 13-year old boy, proudly showed me his tattooed deltoid. The coarsely depicted roll of the dice marked the day and month of his bith. Rather disappointed, he then uncovered an immaculate back, going on to draw for me the great “piece” he envisioned for it. A menacing figure held a hand of cards: two aces, two eights, and a card with two sets of dates. A’s father had belonged to “Dead Man’s Hand,” a motorcycle gang named after the set of cards (aces and eights) that the legendary Wild Bill Hickock had held in the 1890s when shot dead over a poker table in Deadwood, South Dakota. ‘A’ had only the vaguest memory of and sketchiest information about his father, but he knew he had died in a motorcycle accident: the fifth card marked the dates of his birth and death.

The case vignette also serves to illustrate how tattoos are often the culmination of a long process of imagination, fantasy, and planning that can start at an early age. Limited markings, or relatively reversible ones such as piercings, can at a later time scaffold toward the more radical commitment of a permanent tattoo.

The Quest for Permanence

The popularity of the anchor as a tattoo motif may historically have had to do less with guild identification among sailors than with an intense longing for rootedness and stability. In a similar vein, the recent increase in the popularity and acceptance of tattoos may be understood as an antidote or counterpoint to our urban and nomadic lifestyles. Within an increasingly mobile society, in which relationships are so often transient – as attested by the frequencies of divorce, abandonment, foster placement, and repeated moves, for example – tattoos can be a readily available source of grounding. Tattoos, unlike many relationships, can promise permanence and stability. A sense of constancy can be derived from unchanging marks that can be carried along no matter what the physical, temporal, or geographical vicissitudes at hand Tattoos stay, while all else may change.

Adolescents’ bodily decorations, at times radical and dramatic in their presentation, can be seen in terms of figuration rather than disfigurement, of the natural body being through them transformed into a personalized body. They can often be understood as self-constructive and adorning efforts, rather than prematurely subsumed as mutilatory and destructive acts. If we bear all of this in mind, we may not only arrive at a position to pass more reasoned clinical judgment, but become more sensitized through our patients’ skins to another level of their internal reality.