Colorful You: Tattoos and Psychotherapy

by Alyssa Siegel

My clients are colorful. I don’t mean figuratively colorful, though I suppose they are that, too. I mean literally colorful. Their skin, by and large, is profoundly and profusely decorated with ink.

Jeff Johnson by Bill Hayard
Jeff Johnson by Bill Hayward

Since drawing this subset of clients to my practice I have been thinking about the relevance of a person’s tattoos and whether or not they should be addressed in counseling. The conclusion I have arrived at in the past, when I was actually actively pondering this and before I set my stance as being “casually nonchalant”, was that I would not bring them up unless the client chose to. That it was not my call to determine how relevant or irrelevant their body art was.

But I feel like I am missing something by doing this and it’s bothering me. It seems absurd and disingenuine sometimes to ignore the obvious. Visible tattoos are as public as your nose, your hair, only more varied. But they are also potentially private and personal and not necessarily open to comment, inspection, or uninvited looks, even positive and appreciative ones. But then again, counseling is personal. Deeply personal! And in the counseling setting I ask all kinds of personal questions. But they are not typically about choices involving personal style. But, but, but! Can you see my conundrum?!

For I am curious. So curious! And I think that’s why, my own curiosity, that has stopped me from asking. I would love to be granted permission to look, absorb the art their skin wears, drinking it in like I do in front of a painting in a museum until fully satiated and no longer distracted. Maybe just a tad longer then a museum painting, as I tend to fly through museums pretty fast. Funny, right? Considering the fact that if a work of art is in a museum it is clearly and widely considered to be exceptional. But though it might make me feel something, it has no personal relevance to me as it wasn’t created by, for, or on someone I know. Back to my point. I have honestly considered a tattoo “meet and greet” at part of a consult or early session. As in, “You can look at mine” (the open to the public ones) “and I’ll look at yours” and then we both won’t continually find our eyes wandering as we try to fit color and shape into the frame of something definitive, recognizable. But that seems awkward. In the least.

Now I know, as a tattooed person myself, that people choose their body art for a million different reasons and for no reason at all. If I were asked to explain why I chose to color myself with the pieces I have, in most cases, I would be hard pressed to come up with a response that was accurate. Or is still accurate, as compared to when I got it. My answer might be long and winding, convoluted, destinationless. Something like what follows.

“I got the birds I have on my inner arm here in Portland and they were representative to me, while in the conceptualization stage, of the mother-child bond, marked by their positions (one facing outward) on a branch and solidified by the placement of a hydrangea, the flower of my grandmother. But when I look at it now (which I rarely do as it has almost disappeared into my body as all other permanent things do), that original meaning seems very far removed. But I do remember the stories that the artist told me as he gave it to me of his own childhood on a reservation and of when he got ink poisoning (blue pigment) and went temporarily insane in a mystical kind of way. That tattoo was kinda a big step for me because it was the first piece that spread further outward on my body and could not be covered up when wearing a tank top or dress.”


“The lotus on my back, one of my oldest tattoos, was one of the only flowers large and dark enough to cover the theater masks and ankh from my high school days when I was really into theater and, um, Egypt I guess. I wasn’t crazy about the Lotus image, it’s more stylized then the pieces I have gotten more recently, which feel more natural, painting-like. But I did like the idea of a flower that stretches from water bottom to surface. I lived in San Francisco at the time. My favorite sushi restaurant had only six small tables and these amazing scallop roles. The street I lived on was crazy steep and parallel parking on it was insane. I am a really good parallel parker now because of it.”


“I got the band I have around my ankle in Seattle. Those were my punk/grunge days, though the tattoo itself is rather dainty. I had bleached white hair then. My friend Maya was visiting from California and she and I went to get tattoos together. She was going to get a lion, I can’t remember where. I went first and she backed out, something she remains thankful for to this day. I actually think that trip was what brought Maya and I closer as friends and in more recent years I have really valued our conversations. Her and her husband and boys taught Jayden and I how to geocache last summer. Jayden was obsessed with it for a while.  Anyway, Seattle. Maya and I went to Orcas Island that trip. We rented scooters, it was the first time I had ever ridden one. I ended up buying my first scooter many years later in Portland. The first one was stolen within the first week. I don’t have a scooter anymore.  Had to sell it to pay off my taxes. I loved riding it when I had it, though. It felt so liberating.”


A tattoo artist I once worked with said that tattoos are not about the tattoo itself but about how you live with the tattoo over time. I like that idea and it feels right to me, fits. I know that for myself, I tend to get a new tattoo, to modify, or to add to a tattoo, around every 1-2 years. Getting a tattoo, for me, starts when the first seed idea drops down into the soil of my consciousness. And it almost always, always takes root until fulfilling it’s tattoo destiny. I live with my choices every day. But sometimes I modify the way that wear them. Or how I feel about them. And that is probably what I love about the process the most. The timeline, the map, the journal. Something that evolves, connecting past to present but always remaining you. Multilayered. I have no idea whether other people feel the same way about their own tattoos and the internal shift that took place while deciding on them. The integration process of living with them.

Maybe someday I will ask.

Alyssa K. Siegel, MS, LPC, CGAC II, The Dance of Therapy

First published on Alyssa’s counseling blog on March 24, 2012.


About Alyssa Siegel 29 Articles
Alyssa Siegel is a Licensed Professional Counselor in Portland, Oregon. She earned her MS in Counseling and her BA in Psychology and is a member of The Oregon Board of Licensed Professional Counselors, The American Counseling Association, The National Board of Certified Counselors, The National Coalition for Sexual Freedom, and The Society for the Scientific Study of Sexuality. She works with individuals and couples and specializes in relationships, sexuality, and women's identity development. Alyssa is a contributing author to the book "Your Brain On Sex, How Smarter Sex Can Change Your Life". For more information please visit
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