Tattooing & Self Harm

Published: 08 June, 2010 - Featured in Skin Deep 186, June, 2010

I will put my cards on the table straight away; I am not a qualified psychiatrist and my experience of self harm extends no further than picking the occasional scab.  I have never, to my knowledge, suffered from any mental health issues, although some may disagree.

However, many people appear to have an insightful understanding of my mental health whenever I reveal my tattoos.  It is a familiar scenario and one that many tattoo owners will have experienced.  Around the dinner table or at the bar, the conversation turns to body art, and very soon you can expect the ever faithful, backhanded insult:

 “Well, isn’t tattooing just a socially acceptable form of self harm?”

Despite being a clumsy, broad brush stroke statement, the ‘self harm’ aspersion is a tasty sound-bite on which a prejudice is easily hung.  It has annoyed me for many reasons, not least because I wasn’t entirely sure if it could possibly be accurate.   

Needless to say there is no one simple answer to the question and a discussion on the Skin Deep website forum revealed a vast array of opinions and experience.  In much the same way that tattoo culture comprises an enormous variety of different folk, the relationship between self harm and tattoos is similarly complex.  But it appears that there IS a relationship and that many self harmers also happen to be tattoo owners. 

One of the people I interviewed for this feature made a very good point, stating that

“Some tattoos can be described as 'mutilation', or 'defacing a body'.  It has to be said that some of the more extreme tattoos, and here I’m talking everlasting job stoppers on the face and hands as well as gross and shocking tattoos, may well be done as self-harm.  A desire to outwardly show what is inwardly felt to be abhorrent or repulsive.  To validate those critics who have destroyed someone’s self-esteem to the point where they truly feel themselves worthless of cherishing.”  

Whilst this is undoubtedly true in a minority of cases, most would accept that this scenario is rare and not representative of tattoo culture in general.

Although examples such as those outlined above would appear to support the suggestion that tattooing is self harm, closer scrutiny shows that the relationship between the two is far from being a direct one.  There is no direct ‘cause and effect’ transaction at work.

There are many differences, but in order to understand them we must define the specific form of self harm that we are talking about.  In strict literal terms, any ‘harm’ or ‘injury’ which a person consensually inflicts upon themselves could be referred to as self harm, and so getting a tattoo could be said to fit this coarse definition.

However, the term ‘self harm’ has some very specific implications pertaining to clinical psychology and this more widely understood definition has little in common with tattooing.  Beyond the physical aspects of the two procedures (ie the breaking of the skin, the blood and pain), there appears to be little correlation with the associated psychologies.


• Pre-meditated and considered behaviour

• Results usually for purposeful display

• Primary attention gains

• Proud of results

• Result is key focus


• Reactive, compulsive behaviour

• Results not usually for display

• Secondary attention gains

• Not proud of results

• Process is key focus


In his 1996 book ‘Bodies Under Siege’ Dr Armando Favazza explores the historical, anthropological and clinical associations between body modification and self harm.  Although the mushrooming popularity of tattooing has dated the book somewhat, it remains the definitive text on the subject and discusses self harm and the psychologies involved at great length.  According to Favazza’s research, self harm and tattooing are only lightly associated, the conclusion being that body modification is primarily a culturally motivated process, rather than a psychologically, biologically or socially motivated one as self harm invariably is. 

Favazza says that ‘cultural practices imply activities that are faddish and hold little underlying significance. Piercing of earlobes
or nose to accommodate jewellery are examples of such practices.’  Given the proliferation of tattooing into mainstream culture since his book was written, I would guess Favazza might suggest the same ‘faddish’ status surely applies to many tattoos.  Often there is no enormous psychological backdrop to a person’s love of tattoos or indeed behind which design they get. 

As Skin Deep forum contributor Monkey Chick (not her real name) brilliantly puts it:

“I am getting sick of people asking me for the story behind my ink.  Come on now, I have a cake tattoo - what story do you think it is?  No, it is not a tribute to my dead baking Grand-mother.  It’s ‘cos I like cakes!”

I’m not sure there is much evidence to support the notion that Monkey Chick’s tattoos are a manifestation of a troubled psychology or a form of socially acceptable self harm.  But who knows?  Perhaps there is some deeply hidden cake-related trauma she has yet to reconcile.

Although many tattoos and piercings can be considered purely decorative, most people do still have deep personal motivations for collecting tattoos.  In the epilogue to ‘Bodies Under Siege’ Fakir Musafar, the father of the modern primitives movement, lists a series of recurring motivations in cultures where body modification has been prevalent. These include rites of passage, peer bonding, insignias of respect, status symbols of bravery or courage, initiation, protection from evil, spiritualism and (most interestingly in terms of this article) physical and psychological healing.  

These traditional motivations are also often cited by modern tattoo fans.  It should be noted that these motivations are primarily positive and regenerative experiences with primary gains; much different to the underlying negative psychological processes at work in the case of self harm.

There seems little correlation between the primary motivations for getting tattoos and the responses to a survey* into the most common reasons for self harming.

72% To control their mind when it is racing.
65% To feel relaxed. 
58% To feel less depressed.
55% To feel real again.
47% To feel less lonely.
40% To atone for sins.
20% To respond to ‘voices’.
12% To respond to evil spirits.

 (Favazza and Contario 1989.)  *It should be noted that the respondents in this survey were female.  This is noted not for its relevance but simply for the sake of factual accuracy.

Many psychologists will admit that self-harm is not an entirely negative process.  It is accepted that the process of self harm can stop and reverse a downhill spiral of psychological ‘dysfunction’. In some cases self-harmers have stated that harming halted the compulsion towards suicide.  

Most experts agree that a less destructive coping mechanism would be preferable, but there are a minority who suggest that society should simply accept self harm as a valid and effective process.  Favazza himself describes self harm as a ‘morbid form of self help’.  Given that all psychology and behaviour must exist within the framework of what current culture deems acceptable, I’m not convinced that society will embrace self harm any time soon. 

My work and social life often include long periods of time lingering around in tattoo studios and the subsequent interactions with the people passing through them.  One of the reasons the self harm aspersion un-nerved me so, was because I perceived an increased prevalence of self harmers in that tattoo studio environment.  Whilst it could be said that the evidence of self harm is more difficult to conceal in this environment, I must point out that a similar prevalence was not as evident in my work in health clubs as a fitness professional, given that similar amounts of usually covered flesh was on display here too.  Anecdotal it may be, but self harm and tattooing appear related in some way.  Like many areas of society and culture, there seems to be a cross over point where self harm and tattooing meet.

One of the most frequent motivations for acquiring a tattoo is as a means of taking ownership of our bodies, in reclaiming ourselves from the constraints of what is, or is not, socially acceptable.  Tattoos and body modifications of the various sorts are a definitive means of retaining control of the one thing over which we have absolute ownership. Conventional society can take many things from us, but our bodies are always ours to use as we wish.

Given that self harmers experience a loss of control as part of the psychological turmoil they feel, it is not surprising to find some common ground with the world of tattooing.  For those yearning some kind of ownership and responsibility, those who wish to reclaim themselves from other influencing forces, tattooing makes perfect sense.  Many of the people I interviewed whilst researching this article stated that tattoos were a reward to themselves, a positive re-affirmation of their self worth, a display of their strength and their convictions.  These appeared to be common sentiments of both the tattoo fan and those wishing to be free of their compulsion to self harm.

If someone is looking for some correlation between the art of tattooing and the psychological profile of self harmers then this is the closest they are likely to get.  

A Final Thought

“To not have holes in your body, to not have tattoos, may be debilitating – this is something people have to consider.  They may not be getting the most out of life because they don’t do these things – that’s the point.  People may be missing beautiful, rich experiences because of cultural bias and conceit.” Fakir Musafar


Skin Deep Forum Disscussion on Tattoos & Self Harm

LuciiFera: “The tattooing has absolutely no link to self harm in my case. It is done purely for the end result, I find tattoos incredibly attractive, I (don’t) go through that pain as some kind of catharsis. In other word, the pain of being tattooed really sucks. I hate it. But I put up with it knowing that I will have a gorgeous new piece of artwork.”

Combat Kitten: “I continue to use tattoos as a pick-me-up, even when the response is less than positive from those around me. It feels positive but I can’t help feeling that there are two people stuck inside my skin - the more conventional career woman who is sensible, professional and ambitious, and the tattooed gal who is rebellious and extrovert!”

Inky Lady: “I find it quite worrying that some people think of tattoos as “self harming” I consider mine to be self improvement!”

Custom-art-tattoos: “In my opinion the difference between harm and benefit is pretty obvious.No matter if you cut your arm off, get a tattoo or take the dog for a walk, the only difference between benefit and harm is: does it make you happier or more miserable in the long term?   Other people’s opinions really don’t matter, and it rarely hurts to make this clear - It’s *your* body.”

Kitten Pie: “I haven’t ever used tattoos as self harm because they’re too pretty to be associated with that time in my life. I want my body art to represent good times in my life & empowering moments. I don’t want to carry round the worst parts of my life! I already have scars on my body to remind me of that.”


Self Harm: Is That the Right Term?

‘Self harm’ is the most frequently used term to describe the behaviours discussed in this feature and so has been adopted by the author throughout.  Quotes from other sources may use different expressions.


“Tattoos have a distinct anti-authority appeal.  The origin of this appeal may come from the Christian proscription of tattooing and the resulting European laws against the practice.  Whatever the source, tattooing today has the aura of the forbidden about it.  

Second, tattooing may have inherent appeal due to the pain involved in the operation and the permanency of the design; thus tattooing is restricted to the brave and he dedicated.  

Third, and most important: in some circumstances, people are deprived of the opportunity to acquire and display the ordinary means of identifying and presenting the self.  

Although all three factors are obviously related it is the final one, that deprivation of the opportunity to acquire and display the usual and desirable means of self-identification that we see as the most basic understanding of tattooing.” Edgar & Dingman – 1963

“Tattooing and Identity” International Journal of Social Psychiatry, Self Harm


Self Harm

“Endemic self-mutilation often exists in repressive settings such as correctional institutions.  Self mutilation in such settings has generally been interpreted as a coping mechanism that offers a means to express defiance, gain transfer to a different unit or to attract sympathetic medical help.” Dr A. Favazza. Bodies Under Siege – 1996


Self Harm Behind Bars

Both tattooing and self harm are both prevalent in correctional institutions.  Whilst some ‘prison tattoos’ have a specific inherent message, there is often a deeper psychological motivation too. Both tattooing and self harm have been interpreted as an expression by the inmate or patient to demonstrate ownership, defiance and retain control of some aspect of their lives.  



Dr. Tracy Alderman Ph.D. is a licensed clinical psychologist and expert on self harm based in the US.  She is also the author of The Scarred Soul: Understanding and Ending Self-Inflicted Violence (New Harbinger Publications) and has written about the relationship between tattoos and self harm. I asked her about the links.

Is Tattooing ANother Form of Self Harm

For most people, I would say that tattooing is self-decoration, not self-harm.  Tattoos are designed to enhance the body’s image and to bring art to our most personal possession – our selves.  While the process of getting a tattoo may be quite painful, the result is often beautiful (hopefully!).  Self-harm, conversely, is a behavior borne from emotional pain and utilized to decrease those overwhelming feelings. Most who self-harm are likely to keep their injuries from others.

Are Tattooed People More Likely to Engage in Self-Harm?

Dr TA - As far I can tell tattooed people are not more likely to engage in self-harm. It may be that we are more likely to notice self-harm on people with tattoos as we are drawn to looking at their flesh a bit more carefully.  That is, while checking out their ink we might just stumble upon a scar or recent injury that we may not have noticed if we hadn’t been looking at their tattoos.  

Are Self-Harmers More Likely to Have Tattoos?

Let me just say, the research to answer this question accurately just doesn’t exist.  That being said, I would speculate that, yes, self-harmers are more likely to have tattoos. Self-harmers often view themselves as different from others, misunderstood, and sometimes invisible.  By getting tattoos, self-harmers become part of a group that is similar in some ways (often misunderstood, different from others) and literally become more visible.  Additionally, those who formerly self-harmed may choose tattoos as a method to cover scars and to create something beautiful from a reminder of a painful time in their lives.


Covering Scars With Tattoos

By Ms Lou Antrobus

"It was such an emotional experience. It was a cut off for an old way of life, a taking away of a crutch. And quite frankly, that still scared me. The pain, over the scars, well it was weird as it was pain, where I had caused so much pain before. 

I have to say I nearly cried. It was like a battle I had won, an end of an era. A rebirth if you wish. I chose tattooing to cover up my own crass handy-work, because it is beautiful. The best compliment I have had since was from my GP who admired it as a brilliant way of creating something positive and pretty out of something that at that point had been dragging me down."


Recent News

Around one in ten 11-25 year-olds – mainly but not only girls – will deliberately harm themselves at some point. According to the Centre for Suicide Research at Oxford  University, admissions of under-25s who have damaged themselves deliberately with a sharp object have risen by 50% in five years, from 1,758 in 2004/5 to 2,727 in 2008/9. 

Source -, Friday 12 March 2010


Author thanks

I would like to thank all of the people who contributed to this article and particularly those who agreed to be interviewed and who shared their experiences.  Thanks also to IA for valuable input and to the contributors to the Skin Deep online forum discussion boards.  


Text: Tony Jones; Photography: Charlotte Langley & Ihsan Kemal


Skin Deep 186 1 June 2010 186