“We scheduled his next appointment, and I took payment for the session. I turned to open the door to my office as I always do, and I said take care and that I would see him next week. As he walked past me, he turned back and said, ‘You know, tattoos are a choice, and God did not choose for you to have tattoos.’ He just kept walking. I was shocked. It was unexpected. I didn't know what to say; it happened so quickly and quite literally in passing. It was not in a hateful tone at all.”

So began a spontaneous and unsolicited conversation during my counseling internship class – I always offer students the opportunity to reflect upon their previous week’s sessions, whether seemingly innocuous or salient. In this instance, one of the interns hesitantly brought up a clearly uncomfortable moment at the end of a recent session with a teenage adherent of the Church of Latter-Day Saints. His departing remark took her quite off-guard in the moment and led her to process whether she might have better served this young man by concealing, rather than exposing her tattoos.

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What seemed apparent to me was not whether she should or shouldn’t conceal her ink (her agency did not explicitly prohibit exposure of tattoos), but that this was a unique teachable moment both for her and her young client, but also for me, as her clinical supervisor.

I did not want her to roil in shame and guilt over the concern that she might have somehow hurt the therapeutic relationship and this client, leaving him avoidably confused. Had she just covered up! I wanted to create an atmosphere of both acceptance and challenge, in which she could explore the relationship between choices she made as a clinician and person and the impact of those choices, whether intended or not, upon her clients. And I knew the rest of the interns were listening for lessons they could take from the conversation, as they reflected both upon this specific situation and those with their own clients.

In those moments, I was both the supervisor, cognizant of seizing the lessons inherent in that teachable moment, but also the therapist, reflecting on similar moments I have had with my own clients at the self-doubting and shifting intersection of self-concealment and self-exposure. I, too, am visibly tattooed, at least if I roll up my sleeves, which I most invariably do when working with clients, both literally and figuratively. I wanted what I have learned on my road to becoming a therapist to be useful to these nascent clinicians. I also did not want to force them down my road, even if I could.

Over the next week, I reflected on that conversation, wondering about its impact on this particular intern and the group. In the next group supervision, she offered the following:

“Dell [a fictitious name] did come back to counseling, and he actually brought up the subject of my tattoos and his faith before I could even close my office door! He said after he left, he immediately felt bad for the way he approached the subject of my tattoos and that he thought a lot about it and was concerned I wouldn't see him anymore, as he said he enjoyed our time together and that I was incredibly helpful. He said when he left he started thinking about why people get tattoos and what they mean to them. He came to the conclusion that for some people, tattoos are as meaningful to them as his CTR ring (Choose the Right, which is a saying in the Church of Latter Day Saints). He asked if his conclusion about tattoos was true and what mine meant to me. I said that I could not speak for others with tattoos, but that mine meant very much to me.

I described them as time capsules, memories, a reflection of me; stories, and that they mean very much to me, just as his faith does him. I told him there was no need to apologize, and I appreciated his kind words. I also applauded him for taking the time to reflect and educate himself about the subject, as I will not be the only human he encounters with tattoos. I also told him that I thought a lot about what he said and that I researched a lot about the Mormon church, so I could have a better understanding of his views. We agreed that this new understanding of one another strengthened our professional relationship and that we both learned from one another and in working together.”

My supervisee impressed me with her expanded world and self-view, one that was broad enough to take in all visitors to that intimate space of therapy. She closed by saying, “I learned how tolerant I can be, when something I love and cherish is judged so quickly and harshly, and that people have the capacity to grow and open their minds to differences even when their religions may not agree.”

I was honored to be part of the learning process, initiated by my clinical curiosity and desire to guide my interns forward on their own journeys. Indelible impressions were made on all.

File under: The Art of Psychotherapy, Musings and Reflections