We Are What We Do

I have a weekly radio show about psychiatry– you are welcome to check it out either through the links on the home page of my psychiatry practice, or at KFIZ, the radio station that hosts the show.  Yesterday a caller asked about her son, who lives at home but is about to turn 18, and who to her dismay wants to get a large tattoo on his back to commemorate his birthday.  Complicating the matter is the fact that she and her husband are divorced, and (can you see what is coming?) her ex thinks the tattoo idea is just fine.

This discussion can go in many directions;  one thing we discussed on the show is that even at the ripe age of 18 it is a good thing for a ‘child’s’ parents to avoid being split over an issue that involves the child.  Ideally, the parents would discuss the issue in private and come to terms, if not agreement, over how things will be handled–  rather than have one parent put down the other parent for being too lax or too strict, with the son in the middle choosing sides.  As tempting as that sounds to the parent siding with the young man, such a situation will inevitably cause problems down the line when the son uses the ’split’ to justify all kinds of behaviors.

But that isn’t what I am writing about. I’m writing in response to a comment that came up during our discussion; the mother said that her son accused her of ‘judging people based on appearances’, and she felt that she was appropriately chastised for being that way. But was she?

We all go through life with a certain image of ourselves— with a sense of ‘who we are’. Those self-perceptions come out particularly when we are nervous—say during job interviews or during first dates, as in: ‘I’m a very giving person’ or ‘I’m such a ditz!’ Are these perceptions accurate? I don’t have any hard data, but my guess would be… No. From my experiences working with people, the perceptions have little to do with reality. Well, that isn’t quite right—they have something to do with reality, but they are not an accurate reflection of reality. For example, a person may refer to himself as ‘an idiot’, and even consider himself an idiot, because of the ‘reality’ that he doesn’t like the pressure of high expectations, from either himself or from others.

If self-perceptions and declarations are not a good indicator of ‘who someone is’, what IS a good indicator? In fact, is the question even worth asking? Can a complicated personality be reduced to a few-sentence description? I think that a person CAN be described, but only with great caution. There are many things that throw off one person’s assessment of another; for example projection involves the process of seeing in other people the traits that we don’t want to recognize in ourselves. Or for another example, studies have shown that contrary to public opinion, the behavior of children, even children with ADHD, does not change after sugar consumption. What does change, though, is a mother’s perception of her child’s behavior; mothers who believe their child consumed sugar are more likely to judge the child’s behavior as unruly. When evaluating others, we always peer through a lens made dirty by our own idiosyncrasies.

So getting back to the woman accused by her son of being ‘judgmental’ for thinking certain things about people with tattoos… she must REALLY be off, right? She is making assumptions without even talking to the other person! But wait– in my opinion, she is probably seeing things the MOST accurately out of all of the examples that I have described. How can that be?!

What is she evaluating when she makes an assumption about a person based on a tattoo? Contrary to the mothers watching in horror as their children dismantle a university waiting room, the woman is evaluating the other person’s actions in a much more objective way. In fact, there is little room for observer bias in such an example; the answer to the question in her observation is either true or false, tattoo or no-tattoo. So unlike those other mothers she has risk of making a mistake in what she sees. But similar to those practicing self-assessment, she does risk making mistakes in what she thinks. But by being a person separate from the person being assessed, she is miles ahead when it comes to accurate thinking!

What do we ‘generally’ know about a person with tattoos? I suppose the answer depends to some extent on the nature of the tattoo—large or small, hidden or obvious, happy or dark, colored or ‘blue-dye’, etc. There is a guy in my home town who drives a motorcycle, without a helmet, and who has a spider-web tattoo on his face, wrapping around the sides and top of his bald head. What does his tattoo say, compared to the 40-y-o woman with a small rose on her ankle? Or compared to the 70-y- o man with an anchor on his bicep? I could easily go wrong by assuming too much—that the spider-web guy is a mean jerk, or that the rose-ankle woman is looking for a man. I think that it would be a mistake to try to use the content of the tattoo, as we don’t know the attitude of the person when he/she got the tattoo—was it a joke? Was it sarcastic? Was the person drunk? Plus if we dealt with content we would start getting into our own unconscious thoughts about roses and spiders.

But we CAN tell something from the simple fact that the person has a tattoo, the size of the tattoo, and the location of the tattoo– with the understanding that we are talking about generalities, and that the data we collect is only one piece of data that must be consistent with the other data before it is taken as true. This is not rocket science… what can we suspect about a person who has a tattoo on his face and head—something that is virtually impossible to miss? We can assume that this is a person who wants to attract attention. This is a person who perhaps wants to be identified by something—he doesn’t feel that just being ‘joe’ is enough; he wants to be (joe), THE GUY WITH THE TATTOO ON HIS FACE. Why would that be? Just guessing, but I would not be surprised if there was a history of abuse; perhaps a family of origin with a domineering mother or father, so that he became very insignificant—almost invisible. But he isn’t invisible anymore—not with that big tattoo… or is he? That big tattoo does two things for him—he is no longer invisible, but is still protected and in hiding, as it isn’t really him people are noticing— it is the artwork on his face. This fits him because as much as he wants an identity, wants to be noticed, he doesn’t have a sense, deep down, that he is worth noticing or that he HAS an identity.

Isn’t this fun?

How about the woman with the rose on her ankle? What do we know about her? It would help to know when she got the tattoo; if she got it at the age of 35 I would wonder the reason—finding herself after a divorce? Or a busy career woman who took a step back from all of the ‘responsibility’ to take a second look at life? Or if she got it at the age of 18 I would suspect that she wanted to rebel a bit, but JUST a bit… no pierced nose or pierced lips, just something that is rarely seen, and that is only seen by people close to her. I would think she is a bit more introverted, perhaps even shy.

I suggested to the woman—the one with the son who wants a tattoo—that she ask him why he wants to get the tattoo. Does he want to ‘stand out’? Is he making a statement of some sort? It really is not true, if the person says ‘no reason’… it is something that hurts a bit, costs considerable sums of money, takes some time… so there is SOME motivation. I suggested that she try to determine his motivation and then see if there is any way to accomplish the same thing in a way that is not ‘permanent’. Young people are often not able to verbalize or even realize what is motivating them… but that doesn’t mean that the motivation doesn’t exist.

As I mentioned at the start of this post, my thoughts on tattoos began in response to the idea that it was somehow improper to judge a person based on appearance, specifically based on the person having a tattoo. I have probably voiced a similar protest at some point during my youth; at least it sounds like something I would have said. But I now realize that particularly given the problems with other means of sizing up a person, the best way to assess or learn about a person is to look at the person’s behavior. In my practice, a person may talk for hours about how considerate he is; if I have to cancel because of a sick child and the person calls me an SOB, I see the behavior as a more accurate indicator of ‘what the person is like’. Likewise when a patient tells me that he ‘doesn’t know who he is anymore’, or when someone says that she ‘wants to be a good person’, I suggest that the best way to judge who you are is to take a look at what you do.

The idea fits well with another thing that I often talk about; acting ‘as if’. For example, if a person doesn’t ‘feel like’ doing the right thing, or isn’t the ‘type of person’ who would do the right thing, I suggest that he ‘act as if’ he IS that type of person, or as if he DOES feel like doing the right thing. In a short time, after acting like the person he isn’t, he will find that the person he isn’t is exactly who he has become.

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