A Quandary Regarding Mental Health + Tattoos + Modern Etiquette

/ Ally Bean

“NAMI is the National Alliance on Mental Illness. We are the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.”

Thanks to the efforts of NAMI it’s Mental Illness Awareness Week here in the USA. This year’s theme is #CureStigma. 

In light of this theme here’s something I’ve been thinking about. I’m unclear about what I should do when I’m in situations like the following one.

I was at a doctor’s office, in the examining room, with a medical assistant who was settling me onto the examining table, getting things ready for the doc.

When she reached across me to grab the blood pressure cuff I noticed that she had a tattoo on her inside left wrist.  What caught my eye was that the tattoo was of a semicolon.

As you probably know, that is the tat one gets when you have, or someone you love has, engaged in self-harming behaviors;  OR when you or a loved one have attempted to commit, or possibly in the case of a loved one succeeded in committing, suicide.

[More on the semicolon tattoo meaning here and here.]

In general I’ve found that people with visible tattoos seem pleased when you notice the tattoo.  They often have a story to tell about their tattoos and I’m willing to listen.

However, in this particular case I was reluctant to say anything, so I said nothing and just smiled like I didn’t know what I was seeing.

So my questions are:

  • Would you consider a visible semicolon tattoo to be an invitation for conversation about what it means to the person with this tattoo?
  • Or would you not say a word about it unless the person with the tattoo brings up the topic?

Anyone got any experience with or advice about how to handle this type of situation? I feel like there might be some kind of modern etiquette involved here, but I don’t know what it is.

87 thoughts on “A Quandary Regarding Mental Health + Tattoos + Modern Etiquette”

  1. Not knowing more, I would say it depends on the setting and person. If it is somebody on a city bus, I would stay quiet. If it is somebody sitting at the table at a friend’s dinner party (if I had any friends and if they were normal enough to actually have a dinner party), I would say enough to see if they would talk about it.

    Liked by 4 people

  2. Ally, what an interesting topic. First, I did not know the symbolism behind the semicolon tattoo. So, thanks for that.

    I think of tattoos like bumper stickers or T-shirts with writing on them. An announcement of sorts: here is who I am/what I believe/how I think. And it’s an invitation. I can see me saying something like “I see your tattoo and I’m sorry.” Then let her respond. I’ve often commented on tattoos, if nothing more than a “wow! How long did that take?” Amazing to me what people are willing to put themselves through.

    At the same time, as Zen-Den said above, setting is important. Were you up for a serious discussion, if that’s where it went? Was there enough time to do it justice?

    Good dilemma, I think.

    Liked by 3 people

    • Janet, I like your idea that a tattoo is like a bumper sticker. I admit that I’m intrigued when I see someone with a particularly interesting tat & I want to know more. Not that I want to get one, mind you. Just that I find the reasoning behind a person’s tattoo and the process of getting one to be fascinating.

      That being said, and going back to Z-D’s comment, the setting of the conversation is important, so not talking about what could be an emotional trigger makes sense to me.

      I’m not a nosy person, but I am a curious person so this quandary puts me at an intersection I am unfamiliar with. 😳

      Liked by 1 person

    • Jill, I’ve never had anyone volunteer to tell me their story re: their tattoos. I’ve commented on someone’s tat and then they’ve been off to the races with their stories. I like knowing why people do things, so hearing those stories can be enlightening &/or heartbreaking, but alway genuine, in my experience.

      Liked by 1 person

  4. Looking forward to reading more and more comments about this. Not sure if getting a tattoo is an open invitation to questions about it. Maybe the person just wanted to express themselves, to themselves, in this way? Would you ask someone their story about they chose a particular hair cut or colour, or an item of clothing to wear?
    I don’t mind talking about my tattoo but I can see that others might not feel as I do. One could say that if you don’t want to be asked, then don’t put your tattoo in a visible area, but I wanted to put mine where I could see it easily, which means others can too.
    I will often tell people I admire their tattoo (if I do) and leave it at that. If they want to tell me the story behind it, that’s great but I will not ask further questions if all I get back is a thank you. Lately though, if I really like a piece, I will ask about the tattoo artist as I am planning on getting more ink done. That’s a safer line of enquiry!

    Liked by 4 people

    • Deb, I, too, am looking forward to reading more comments about this topic. I feel like the etiquette for interacting with people with tattoos is a new social phenomenon and it is evolving. This topic has been on my mind for the last few months.

      I’m not by nature nosy so if I admire someone’s tat it’s because I really do like it. And for some reason throughout my entire life people tell me things. Thus I seem to hear a lot of stories about the meaning and memories that go with tattoos.

      That being said, I agree with you that I’m not sure that any visible tattoo is an open invitation to start a conversation about it. Especially between strangers.

      Like I said above, I’m in a quandary about this situation.

      Liked by 3 people

      • I’m not by nature nosy either and it bothers me when people don’t pick up on social cues because they are being so relentlessly nosy. I live in what was formerly a public building and people think they have the right to invade my space just because they are curious about it. “But I’m just curious” they say, after I refuse them entry. “I know you are” I say, “but I still don’t let strangers into my home.”

        Liked by 2 people

        • People want to get inside your building aka your home? Honestly, that surprises me [on the one hand], but seems about par for the course [on the other hand]. People be broken anymore, and you never know who it’ll turn out to be.

          Liked by 1 person

          • Yeah, some are actually affronted by the refusal. As if “just being curious” is a valid reason to keep pressing after being given every indication the subject is now closed. I had one woman start opening (to my shocked expression) and continue to keep opening all the drawers in a cupboard of the rental portion of my building while telling me “I know I shouldn’t be doing this, but I am just curious”. WTF!!!!

            Several commenters have made wonderful suggestions on how to acknowledge the semicolon tattoo with tact and grace. Brava!

            Liked by 2 people

            • Amazing, as if being curious gives you the right to do anything! Some people are so self-absorbed that no amount of rational talk will get them to understand how rude they’re being.

              I agree about the commenters. I’m learning how I can better handle situations like this in the future. Gotta love my commenters!

              Liked by 1 person

  5. This is so interesting Ally. I had no idea the significance of the semi colon in a tattoo form. With out wanting to pry into anyone’s personal space, I also feel that part of the problem with mental illness or any serious illness, is our discomfort in having conversation about it. I think I would be inclined to say something like, “I couldn’t help but notice your tattoo & only recently came to understand the significance of the semi colon. I hope that you are doing okay.” It simply opens a dialogue which that person can either chose to continue a conversation or just say thank you.

    Thank you for sharing this! I have learned something today!

    Liked by 7 people

    • Lynn, your words are PERFECT! You’ve handled this situation with tact and understanding without being intrusive. That was my problem when I saw the semicolon tattoo. I didn’t know how to start a conversation, nor if I even should.

      I agree with your assessment about the discomfort some people feel about talking about mental illness. That, I believe, is the whole point of #CureStigma. I have no difficulty going down any path of conversation that a person needs to go, but I worry about starting a conversation unnecessarily via a tattoo– especially with strangers or acquaintances.

      It’s a whole different world we live in, isn’t it? Thanks for your comment. Much appreciated.

      Liked by 1 person

  6. Not knowing the symbolism, I would probably have asked her about it, thinking it odd. The setting was a good one. As someone else commented, if you put a tat in a public place you should expect to have comments. A woman who worked for me (age upper 50s) came in with a tattoo on her shoulder. It was a cross and she did it in memory of her father who just had died. She did not mind talking about it although it wasn’t very visible with work clothes on. Yes I would comment on pink or purple hair too unless it was so ugly that I couldn’t come up with something positive. I always think that people make these statements for a reason and they don’t mind sharing for the most part. If they do, they have pat answers they give and you know.

    Liked by 3 people

    • Kate, you make an excellent point: “people make these statements for a reason and they don’t mind sharing for the most part. If they do, they have pat answers they give and you know.”

      That’s smart thinking. Similar to your experience, I know a woman who has a tattoo in memory of a grandparent, who died in a tragic manner, and she’s open to talking about it, seems to enjoy sharing her memories of the grandparent.

      I tell you, navigating the world today is sometimes beyond my experiences– and I’ve been around long enough to have had many experiences! 🙄

      Liked by 1 person

      • If the setting is right and my mood is right, I’ll forge ahead. I did once walk up to a blonde with a blue streak in her hair. It was gorgeous and I told her so. Turns out she was a hairdresser so it was done right. Yes, I’m one of those people who will usually say something if I notice something unusual (in a good way). I stay away from funky.

        Liked by 3 people

        • I like people/strangers who compliment me, or anyone, because it means someone is paying attention to more than just themselves. I have a friend with a purple streak in her gray hair & she looks stunning. I can only hope good people like you tell her so! More wag, less bark, eh?

          Liked by 2 people

  7. I wasn’t aware of the semicolon tattoo meaning. Learn something new everyday. I don’t know that I would have said anything to a stranger, but if it was someone I knew I would probably inquire.

    Liked by 2 people

  8. I didn’t know the meaning of the semicolon tattoo either. A tattoo is a lot like wearing the pink ribbon pin for breast cancer, or any other significant emblem, isn’t it? If she is still at your doctor’s office the next time you go, I’d probably mention it to her, casually. Not knowing what it meant, I would probably have said something to the effect of “that’s an interesting tattoo”, and then it would have been up to her.

    Liked by 3 people

    • Carol, you’re right that a tat is like an emblem of something significant in a person’s life. I like your idea of just mentioning that her tat is “interesting” and letting the conversation go where it will. That’s a good approach.

      Liked by 1 person

  9. Just ‘followed’ you after checking out your site via Jill’s comment section.
    😉
    I am interested, like you, in the bottom-line etiquette involved. Sounds old-fashioned but it still permeates 21st century technology (in e-mails and such)

    Liked by 2 people

    • laura, welcome. Nice to meet you. Jill is the best, isn’t she?

      It seems like there must be some kind of etiquette involved with tattoos, discussion of said– especially tats that have a deeper meaning. This week, with its focus on de-stigmatizing mental illness, seemed like a good time to broach the subject.

      Liked by 1 person

    • Margaret, I didn’t say anything because I wasn’t sure if that would be considered rude/nosy/weird. I knew what the semicolon meant and that stopped me. Plus I’m perplexed about tattoo etiquette in general. 🤷‍♀️

      Like

  11. “I couldn’t help but notice your tattoo & only recently came to understand the significance of the semi colon. I hope that you are doing okay.” ~> Well put, Lynn.

    And, thanks, Ally. I have never seen a semi colon tattoo nor read an article about its significance.

    Liked by 2 people

    • nancy, I knew what the tattoo meant, but this was the first time I’d seen someone with one. Lynn certainly had a good response, one that I’ll try to remember. The whole issue of tattoos is new terrain to me. How to be polite? When to be circumspect?

      Like

  13. So, I asked my soon to be 22 year old daughter about this tattoo thing and she gave me a whole different insight. The tattoo can be used as a “solidarity” thing and it can mean that “I know about self-harming behavior so if you have an issue, I’ll be happy to talk with you about it.” so that someone who is struggling can say, “I need someone to talk to right now.” There are also “stages” of the semi-colon tattoo where the first year is the semi-colon, the second year of not harming yourself is to add two more “wings” to the tattoo so that it looks like `;` and the third year of being safe adds two more “wings” so that it looks almost like a flower. That means the person is no longer in danger of harming themselves because they realize that there are other options. As far as just asking someone about it, I like Lynn’s phrasing and I guess it would depend on how involved you want to get with the person and their answer. What a great topic, Ally!

    Liked by 4 people

    • Janet, I LOVE YOU! You and your daughter have made it all so much clearer to me. I never thought of a semicolon tattoo as a way of showing solidarity with other people, yet I get it. I’ve not read about these stages you mention, but again I get it.

      I don’t know that I’m the sort of person to ask a stranger or an acquaintance about their semicolon tat, but now I’ll know what to say [and expect to hear] from someone who I might meet in a small social gathering.

      Did I say I love you? Thanks for the insight. 💕😊

      Liked by 2 people

      • I’ll pass the love on to my daughter. She, by the way, has a tattoo across her left forearm of the phrase “La vita e bella” with 6 birds, 5 colored in and 1 just an outline. The words are in MY handwriting. She asked me to write the phrase (and had I known that she was going to get it tattooed exactly I would have written smaller!) because it means something to HER and she wanted to be able to see it. “Life is Beautiful” in Italian because it is and we are, the colored in birds are for the five in our family and the outline is for our first pet cat who died. She got it there because SHE wanted to see it, not because she necessarily wanted it to be noticed. She doesn’t mind when people ask her about it and freely gives the description. She works now as a teacher’s aid for 1st graders and as a barista at Starbucks.

        Liked by 2 people

        • Janet, what a lovely and special tattoo! In your handwriting even. How cool is that? [Very.] I like learning and understanding what a tattoo means to someone. Many people have ones that involve family/life experiences, like your daughter’s. I figure if getting a tat is something that you want to do, then go for it– especially if you’ve thought out beforehand what you want the tat to say and represent to you. Therein is the key, I suspect.

          Liked by 1 person

    • Jan, that’s exactly what I was thinking when I saw the tattoo. I don’t want to start someone down a sad path, but if they’ve put the tat where I can see it, then am I to assume they’re ok with talking about it? Many commenters here have said “yes.” Still, I dunno…

      Like

  15. Very instructive. When the time is right, I will ask someone about his/her tattoos which Ally’s comment prompted me to do: “In general I’ve found that people with visible tattoos seem pleased when you notice the tattoo.”
    Many of my students had tattoos and suggested that I get a cute butterfly on my ankle. I have not yet followed through but there’s still time. 🙂

    Liked by 2 people

    • Marian, I think you’d look lovely with a butterfly tat on your ankle. HOWEVER, I’ve heard that it hurts quite a bit to have a tattoo put on your ankle, SO maybe those students were being passive aggressive when they suggested the butterfly to you– wanting you to experience pain! 😉

      Like

  16. I would think the whole reason behind it being visible is to encourage conversation. I was unaware of the symbolism, but it stands to reason that breaking the taboo of not talking about mental illness is bringing the topic into the light. Of course, my mouth tends to run away from me at times so I’m probably the last person you should ask!

    Liked by 2 people

    • rivergirl1211, you’re logic is where I found myself, too. I thought if the tat is visible, then talking about would be ok, but then I got thinking about the topic of the tattoo & wondered. So I was quiet.

      Liked by 1 person

  17. I have heard about the significance of the semicolon tattoo but I’m not sure I’d say anything unless I really knew the person. I know that I’d be very curious though, so I’ll keep Lynn’s phraseology in mind… very respectful and lends an opening if the person wants it. I also love the information from Janet’s daughter. The tattoo is a great way to reach out to others and offer support. Isn’t the blogosphere wonderful? (Maybe we should come up with a blogger tattoo so that we can discover more people in our tribe.)

    Liked by 2 people

    • Janis, I agree with you about all that you said. Lynn’s words + Janet’s daughter’s knowledge = prepared IF the situation lends itself to conversation.

      I task you with creating a blogger tattoo. Something simple, not too colorful. I hear that getting a tat is painful, so keep it small, please. 🤓

      Liked by 1 person

  18. I noticed a semicolon tattoo on the arm of one of our new assistants this year. We were both on lunch in the tea room, so I made a comment about it to let her know I know what it means. I just tried to do it in a way that we could talk about the concept in general without prying into what her own experience was. She seemed fine with talking about it, but didn’t go into personal details (probably coz that was our first time talking). But I feel like if you have visible tattoos like that, at least some small part of you probably wants to talk about it…

    Liked by 1 person

    • Pistachios, I like your approach to the conversation. Keep it general and informational, then see IF the person with the semicolon tattoo wants to tell you more. After reading all the comments here I tend to agree with you about visible tattoos and how “at least some small part of you probably wants to talk about it…” That’s been my takeaway from this post about modern tattoo etiquette.

      Liked by 2 people

  19. Like others, I was not aware of the symbolism of that tattoo. I generally do not remark on such things. But that’s just my introverted style. They can’t feel awkward if you don’t say anything.

    Liked by 2 people

    • Eilene, I so relate to your last sentence. I’m a highly sensitive introvert, albeit a curious one, so when other people feel awkward around me I feel it, too. Oddly enough I rarely start conversations with strangers, but sometimes, with tattoos, I get interested. Go figure.

      Liked by 1 person

    • joey, I did exactly what you said in the situation I was in. But afterward, me being me, I wondered if I should have said something about the tat and its meaning. The whole getting tatted phenomenon has brought with it a whole new etiquette, I feel.

      Liked by 1 person

  21. I didn’t know about the meaning of that tattoo. If I had said something, it might have been the wrong thing. When I remember that that’s always a possibility, I tend to stay quiet. Now that I know, I’m probably still likely to stay quiet, unless I know the person a little bit. I think the situation would be important.

    Liked by 2 people

    • Dan, I’m not nosy so my natural inclination in any situation is to talk about pleasantries. But in this particular case, knowing what I did, I wondered later IF I should have said something. Having read all the comments on this post I think I did the right thing in that situation, although if it happens again I’ll know what to say should I want to start a conversation.

      Liked by 1 person

  22. I have never heard of the semicolon tattoo thing before.. and being someone who finds any reason possible to avoid bringing up conversation with strangers, I can’t really give you advice either way.

    My awkward tattoo moments would involve women who have a breast tattoo that is visible in their cleavage. As you said, tats are generally eye catching by design… but what would the lady think if she caught you looking there? I’m sure the thought was when they got a breast tattoo that it would be hidden from the public….. but not from certain angles. To look or not to look, that is the question…

    Liked by 3 people

    • evilsquirrel13, you make a good point about visible tattoos that are in places that maybe shouldn’t be so visible. 😳 I can understand your prob. The whole tattoo trend is fascinating to me, but I have no interest in getting one. They’re everywhere, literally and figuratively.

      Like

  23. As many have said, setting is important. In a professional/doctors’ office setting, I’d probably leave it alone – in a more causal setting/with friendly/open company, might comment – depends on that moment’s attitude and mood picked up from the wearer. Tattoos can be very personal, and I wouldn’t want to intrude if there was any negative feelings of the wearer that might surface. True some tattoos are badges of honor or surviving another year, but still, so much information should be only shared with the whom the wearer wants it to be known by. But then again, I’m a pretty private person who feels people share way too much these days. Not always healthy.
    WE just had a tattoo convention locally – so many elegant and lovely designs (and some really should have thought more before getting those….)
    Interesting enough, I recently learned that in Mexico some of the people who are returning “home” due to visa/immigration/aging parents and grandparents issues (lots of those from around here) have found that in Mexico it is difficult to get a “good” job even in restaurants/coffee shops as there tattoos are considered signs of gang and cartel affiliation/membership.

    Liked by 3 people

    • philmouse, you’ve hit the nail on the head. I consider the meaning behind the semicolon tattoo rather personal, yet those who have them are showing me an aspect of themselves that I may, or may not, want to know about. Many tats seem like I’m getting a glimpse into someone else’s life that I don’t need to know about, sharing too much about themselves.

      Growing up when and where I did tattoos were only admired when they had a military connection. Any other body art was considered vulgar or showy. While I don’t think that way, it’s fascinating to learn about Mexican culture and the less than favorable response to a tattoo– like how things were when I grew up in the conservative midwest.

      Liked by 1 person

  24. I probably wouldn’t have asked, but instead sent out strong introvert-y/empath “I see you” vibes. If I was going to get that tattoo, it would be, to me, like a bat signal to others who might be in the same boat, as it were, and also a reminder for myself about the challenge and how I was trying to overcome it. As an introvert-y type, I probably wouldn’t want people asking me about it, but I don’t like people getting personal anyway, unless I REALLY know them, that is.

    Liked by 4 people

    • Tara, I like your “vibes” approach to expressing empathy and concern. That makes sense to me, but I’m sure that I wasn’t doing that when I saw this tattoo. I was flummoxed and felt confused. I have learned from commenters here that if you have a tattoo it is expected that someone at some time will ask about it. I don’t think I’d like that, so no body art for me.

      Liked by 1 person

  25. Hi, Ally – Great question. As I previously didn’t know anything about what a semi-colon tattoo meant, I likely would not have asked. Now knowing this, I still probably would not ask, but may be more alert to any potential clues that the person wished to share.

    Liked by 3 people

    • Donna, I think you’re onto something with your “be more alert to any potential clues that the person wished to share.” I’m not one to butt in so asking about this tattoo is not something that would naturally come to me, but seeing one on this medical assistant made me realize that maybe I should say something. I dunno. It’s a different world now, isn’t it?

      Like

    • Joanne, the comments on this post have been illuminating and I love it. After reading all of them I’ve decided that I did the right thing by not say anything to the medical assistant. In the future, if it’s a personal setting, I might say something to the person with the semicolon tattoo. Maybe.

      Liked by 1 person

  27. Oh gosh Ms Bean, you do set a thought-provoking conundrum. I cannot say for certain how I’d have reacted (can we ever?) My memory being what it is, I’d have known it meant something, but not been able to recall what. Had I recalled, I like to think I’d have paused to consider the setting & circumstances.

    With the benefit of having time to consider, one option that occurs is that she may have the tattoo as a sign of solidarity, indicating to those who might be suffering that she was a safe pair of hands to open up to. Thanks for the question.

    Liked by 3 people

    • Deb, it was an odd moment. I knew the meaning of the tattoo, but I didn’t want to be nosy… yet knowing the meaning and that there is a push to de-stigmatize mental illness, I felt like I should say something… but I didn’t. Having now talked about this quandary here I feel better prepared should/when this situation happens again.

      I agree with your assessment that considering we were in a medical office, the tat may have been a way for her to quietly indicate she’d be open to hearing about anyone’s experiences. At the time this happened, I didn’t think of that.

      Like

    • alicia, thank you for telling me that. I’m getting the impression from the comments on this post that talking about any visible tattoo is ok. And from my point of view, I have to admit, could be quite interesting.

      Liked by 1 person

    • Erika, your comment is what I’ve come to realize is the norm. Of course, there’s still the issue of what is the right setting. But overall I feel like I know how to handle this situation in the future.

      Like

  30. Part 2
    I really believe that everyone can benefit from improving the immune system and sometimes the sinus cavities are ignored by docs.
    and it could be part of the root cause –
    much stuff can hunker down in there and it comes out while you sleep or just pulls from health .

    so check out doing a daily sinus rinse with the hack from bullet proof – and get my fav –
    neil med sinus rinse bottles – they are under ten dollars and easy easy easy – and effective.
    —
    also – a long time ago I recall a nurse (years of experience) talking about eyes and outlets for people having chemo –
    and so it also ties into what Dave was saying how the eyes are these big outlets – and my point is that if I were you I would do intestinal cleanses, clean the sinus cavities regularly, and then take a mix of supplements that heal the immune system – and do not stop until you fix the TERRAIN –
    that is all.
    the terrain is all….

    Liked by 3 people

  31. one last thing – you have to get some activated charcoal (and please do not feel like you have to reply to all my comments here)
    you might already know about it –
    but activated charcoal is wonderful for so many things – like some folks use it when they get tats as it pulls the ink from the blood stream.
    and so it is used in ER rooms to help with detox
    it can pull toxins out of a spider bite
    and if you do facials with it – and get it on your eyes – It can help keep the area clean. also, some folks put charcoal in the inside of their nose once a day to help keep healthy – the nose (and sinus) is so important to health –
    Dr. Axe and Bulletproof blog (dave) have some awesome info on charcoal – hope that helps even a little and peace to you

    Liked by 3 people

Comments are closed.