You cannot have failed to notice the huge rise in popularity of tattoos. Many Christians believe that tattoos are forbidden in Scripture. The NIV rendering appears to leave little room for doubt 'Do not cut your bodies for the dead or put tattoo marks on yourselves.' (1) However, there is debate about what the passage actually means. To begin with, tattoo is a Maori word. Moses didn't exactly use it!

When read in context, in this passage God is speaking specifically to his covenant people Israel, telling them to stay far from the religious practices of the surrounding people. The prohibited religious practices include eating bloody meat, fortune telling, certain haircuts related to the priests of false cults, cutting or marking the body for dead relatives, cultic prostitution and consulting psychics. All these practices would lead God's people away from him and toward false gods. In this context, we find the term translated 'tattoo marks'. (2) This marking is not body décor, like modern tattooing, but marking one's self in connection with cultic religious worship. (3)

Now there are some negative parts to modern tattoo culture. But my intention here is to encourage a re-evaluation and understanding of the modern-day use of tattoos to connect better with people who have tattoos. I am going to highlight a particular healing and restorative therapeutic use of tattooing which is bringing hope to increasing numbers of people.

Tattooing has existed for thousands of years. In places such as Japan or Ta Moko in New Zealand, traditional and tribal tattooing has long roots.

Tattooing, as we know it today (or 'Western tattooing') began around 1870 with the first purpose built electric machines used from around 1891. The practice of tattooing gradually evolved as an art and in popularity, especially between the two World Wars when nationalist fervour inspired patriotic tattoos.

When I nursed on a surgical ward in Southampton in the 1990s, many of our patients were sailors. The majority of these men sported colourful tattoos - on all sorts of body parts! Women were largely absent from the tattoo scene until at least the 1970s, which was partly because women before the 1960s were still expected to get permission from men for a tattoo.

Recently, I walked through a city centre and counted six tattoo shops in a 50-metre radius which seemed to have more female than male customers with an age range from about 18 to 40+. Tattoos are inked on people of all ages (minimum age 18 in England). Even Dame Judi Dench got her first tattoo for her 81st birthday! The extraordinary increase in demand for and status of the tattoo in the last decade, in part influenced by celebrity culture, signals attitude changes. It suggests how the tattoo, once a symbol of rebellion, is now a status symbol and has growing appeal among the middle class. Whether we like it or not, tattooing has entered the mainstream of Western society, especially among the younger generations. In dismissing or vilifying tattoos, Christians are at risk of losing touch with a large part of the community.

I understand some of the concerns about tattoos and there are some real potential negatives, of which I've highlighted a few:

Negatives

• Historically, tattooing has been linked to 'primitivism.' It was a Western art movement that borrowed visual forms from non-Western societies, and attempted to align itself with world views seen as more 'pure', and 'spiritually authentic'. This can underline a deep spiritual hunger, discontent and lack of identification with mainstream culture. This surely is an opportunity for us to minister God's love and acceptance.
• Tattooing can become addictive. It can attract those vulnerable to addictive behaviours. Tattoos are permanent and people have to live a lifetime with rash choices in image, subject and location of a tattoo.
• In past decades, notoriously bad sterilisation of needles and shared inks spread blood-borne diseases including HIV and Hepatitis C. Thankfully today this is rare and usually only found in untrained tattooists, in unlicensed shops.

Positives

• Today there is better sterilisation, equipment, inks, artists and designs. There is also better training. Most tattoo artists undergo a two-year apprenticeship with ongoing training, conventions and competitions keeping their skills current.
• It is increasingly recognised as an art form alongside graphic design and other contemporary arts. Certainly, the artists I watched were incredibly talented. Many had canvas art pieces up on the shop walls of their more 'traditional' art.
• Many clients with tattoos cite increased self-confidence, appreciation of meaningful body art, the aforementioned status tattoos bring and being able to use their body as a 'diary' of their life. The tattoo is an external mark of a personal narrative.

One study has commented...

'Tattoo narratives contain motifs which typically include why the wearer decided to get tattooed, how he or she came up with the design, how long the individual has been thinking of getting one, the actual tattoo experience and what it means to him or her now. Also like conversion narratives, tattoo stories centralize one experience- the tattoo - and relate what changes have occurred in the tattoo wearer's life since that central, defining point.' (4)

Now we realise that the narrative of God's salvation goes deeper and lasts eternally. But it is worth noting that some younger Christians tell about their coming to faith in tattoos, the external and internal narrative coming together.

Therapeutic tattoos

Another 'positive' of tattooing is the therapeutic role it has for self-harm survivors. I have witnessed first-hand the joy and healing it brings to people who have scars and disfigurements that they desperately want covered up. Here is hope to the afflicted as they are covered with art, a thing of beauty to them instead of a thing of shame. It reminds me of the redeeming mercy our Lord has for us forgiven sinners, as God declares through the prophet Isaiah:

'And so, I will forget the wrongs you have done. ...It is I, I, who wipe out, for my own sake, your offenses; your sins I remember no more. ...I am He who wipes the slate clean and erases your wrongdoing'. (5)

Sadly, there has been a threefold increase in the number of teenagers who self-harm in England in the last decade, especially (although not exclusively) among adolescent girls. According to a World Health Organisation collaborative study of 2013/14, as many as 20% of school children aged 12-15 years reported self-harming. (6) In the three years since, The Times recently reported that the number of girls aged between 13 and 16 who harmed themselves rose by 70%. (7)

Tattooing over the resultant scars has become a growing area of practice for all the tattooists that I spoke to, and not just the domain of a few specialists. One girl I witnessed having a tattoo bravely shared with me her story. At 15, due to anxiety, stress and social pressures, she had a 'low period' where she developed a 'coping mechanism of self-harming'. Although mentally she is recovering from this challenging time, the resulting scars on her thigh, some of which have hypertrophied, still remain several years later. For a long time, she felt unable to wear a regular swimsuit or be in social environments where she had to bare her legs, for shame and fear of being judged. She tried creams, laser treatment, and even surgery over the subsequent years to bring improvement. None of these worked. She tells me the NHS won't fund treatments, and that skin graft surgery was deemed unsuitable by the consultant. She began to read about the growing and successful use of tattoos to cover scars.

As I see the finished tattoo on her thigh that has covered incredibly well the underlying scars, I see the beam on her face and the new level of self-confidence shining through, I view the tattoo artist in a new way: as a therapeutic healer. Some patients are even opting for post mastectomy tattooing instead of nipple re-construction. (8) I wonder if the NHS needs to consider tattoo treatment as one of its options for scars, when traditional methods have limited effect. (9)

So do we need to readjust our thinking, and be open to regard some forms of tattooing in a new and more positive light? Could we be more humble and prayerful, and work at breaking down intergenerational and interclass barriers?

We know a wonderful narrative of God's salvation and healing in our own lives. God is the ultimate redeemer - he redeems lives, spiritually, emotionally and physically. But, in grace, could there also be a place for the use of tattoos as part of the healing that God can bring a person who has struggled with scars (either of their own making or not) or disfigurements all their life? This gracious God even redeemed his own Son's scarred hands and made them a thing of promise and beauty: 'See I have engraved you on the palms of my hand'. (10)

Pippa Peppiattis CMF Head of Nursing