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An Interview with Ryan – Clinical Nurse Practioner

There’s something special about a smoking area. Leaving the chaos of an afterparty to stand in the cold and smoke, Machester drizzle in the air. Piercers everywhere. It’s September 2022 at the Stilleto Piercing Supplies party, the smoking area is refuge for those needing a breather. Initiating inebriated chatter, I’m drawn to Ryan’s calming demeanour. Who is this man I’ve seen loitering in the background of industry events? Who does he work for? Where does he pierce? What the fuck is that on his head? Ryan was kind enough to share his time with me month’s after our initial meeting to talk about what he does, why he loves body modification and how he works to promote self expression and body autonomy.

Gemma: First thing’s first, tell us what you do for a living.

Ryan: I am a clinical nurse practitioner and I work in a high security mental health hospital. I predominantly work with men with personality disorders and possibly other comorbid mental illnesses who have committed serious offences. There’s thought to be a link between their mental health, their personality and their risk.

G: That’s heavy. And although it’s not entirely related to the body modification industry, you’ve been around this scene for a long time right?

R: There’s definitely a cross over there in the mental health and body mod worlds. As a mental health professional and at the grand old age of 42, I realised that I was autistic. Hence the feeling different and not really fitting in etc. In my late teens I’d been exploring what that was about and came across BME and saw people doing all these awesome, incredible things that I was too scared to do. It gave me a bit of an idea about ownership of your own body.

When I was growing up, I didn’t really feel like I fit in or that I was accepted. Almost like my body wasn’t mine. I began getting pierced, experimenting with self piercing, things like that. I just really fell in love with body modification in general.

Speaking of BME, it’s fitting that it’s 10 years today since Shannon Larratt passed away. I’ve got a ritual planned later.

G: What was your first experience with body modification?

R: My first piercing, at the tender age of 19, was a labret piercing with a ridiculously long spike. Well, I say ridiculously long – it certainly was for the time. It was maybe 18mm. And then flood gates opened.

My ex partner wasn’t really supportive about some of the things I wanted to do. I sort of compromised and then got divorced at 28. I said “well, I can just be me. And that’s alright. Maybe some people will accept me for that.”

I’m overly geeky and research everything to death. I had fairly normal piercings to begin with. My original labret piercing is now 16mm. I stretched that, it’s never been cut. It was a little bit uncomfortable, but at the time you couldn’t really buy a labret plug. It was very hard to get hold of. I ended up getting into woodworking to make earplugs and labret plugs, and got working with Delrin and Teflon. Most of my large gauge jewellery I’ve made myself over the years. 

My tragus was punched at 4mm originally and that’s stretched up to 10mm now. Basically the swelling in my ear canal meant that I was deaf for a week after every stretch. I did it in half millimetre increments., I mean, it’s ridiculously silly that you make yourself deaf temporarily for a piercing.

G:  It looks cool though. Can you tell us about your tongue split?

R: Yeah, I like it. It’s something different. 

The tongue split.

I have this odd thing sometimes that if something scares me, I’ll stop and think about it and go, “why does that scare me?” If there’s actually a rational reason for it,  you know, serious risks or things like that. I think, well yeah, that’s a stupid thing and I’m not doing that.

But if it’s just a stupid thing, but not necessarily that risky then I start to think, “well maybe, I could”.

I got my tongue split I guess about 14 or 15 years ago.I don’t know if anybody was offering it in the UK at the time. I’d seen it on BME and it was kind of a new thing. There was talk in the modification community about “Was it okay? Isn’t it cool that the body can do this thing? What’s the better method? How safe is this?” A little bit of experimentation. I had it done with an electrocautery scalpel. 

It was one of the most painful experiences of my life. It is not to be recommended. Tasted weird and smelled like burnt scrambled eggs. I had to sit on a little pad to ground myself as well in case I got electrocuted from it. A very unpleasant and weird experience.

G: That’s really hardcore. Have you been on the other side and performed any piercings or modifications for other people?

R: I made a decision never to do it professionally because I love it and I’m really geeky for it. I didn’t want it to become work and I didn’t ever want to think like “God, just another piercing I have to do”. I like the specialness of it.

I might have had opportunities but it’s not really where I wanted to take my life. When I discovered the field of mental health, I knew that was my vocation. I absolutely love it. It’s such a privilege to get to know people in that depth and share some of the most intimate and difficult parts of their life and try and help ’em with it.

Modification I guess is a hobby. Having said that, I’ve self pierced, I’ve pierced family and friends, I’ve thrown hooks [pierced in order to insert hooks] as part of the suspension team. I enjoy the ritual of it. Procedural stuff I’m not so keen on to be honest. So yeah, I’ve done a reasonable bit of stuff and then when I first started hanging around a lot of professional piercers it was slightly terrifying that I knew more about their industry in a lot of the cases. I hope that’s changed a bit now.

At the first UKAPP conference, people would ask me questions assuming that I was a professional piercer. I kind of had to pretend to be a professional piercer to be the first one because they changed the rules at the last minute. Initially it was open to everybody, so I got a ticket and then they said you have to be a professional piercer. My friend was trading there and he told me to come anyway to help him out and he’d vouch for me. Everyone’s just assumed that I’m a piercer ever since. 

G: How long have you worked in mental health?

R: This will be around 23 years I think.

I’d done the typical thing of going to uni as you’re expected to do, and I studied law. I’m kind of a nerdy for the law and always found it interesting. But I knew it would lead to a life of being sat in an office for an awful lot of time, doing a lot of paperwork and memorising a lot of information.

Not things I enjoy. So I dropped out of university and as a person in their early 20s, I was trying to figure out what I wanted to do. I was doing a lot of animal rights protests, I lived and helped at an animal sanctuary where I was living in a caravan. The caravan flooded and I became homeless. I thought, “you know what, I’m a little bit bored of being poor and not doing something.” I randomly found a job as a mental healthcare assistant. I was kind of blown away by it and really just found it fascinating.

G: Some people might consider you quite heavily modified. Can you talk about how that has impacted your professional career?

R: When it comes to qualifying as a nurse, there’s still this weird sort of ‘Florence Nightingale complex’ where if you are a nurse, you should be female and you should be prim and proper and look a certain way.

Even in mental, forensic and secure mental health services, there’s still a degree of that. I think I quite deliberately sort of pushed the boundaries a bit. There were quite a few conversations with managers along the way but I think at the hospital where I work, as I became more experienced and established, I hope people think I’m good at my job and polite and respectful, and how I look has no impact on my job at all.

In fact, if anything, it’s often a bit of a help for engagement. The people that I work with have often come from prison. They’re likely tattooed and pierced themselves. More tattoos than piercing I guess. A lot of the guys I work with are really institutionalised. They’ve never really been outside some kind of care or custodial setting a lot of them, or not for long.

They’re interested. You look a bit different maybe, or not like other people they’ve had bad experiences with. I was doing a review at Broadmoor Hospital, auditing and giving them some ideas on how to work with some patients. The patients I met were absolutely fine with my appearance. Some were a bit wary, but they’re gonna be wary of meeting a new person, regardless of how they look. A lot of people were really interested. But the staff were in uproar. “How have you let this person in?!” The staff were not allowed any facial piercings at all, tattoos couldn’t be above the collar, below the sleeve sort of thing. 

It’s a little pride that I’ve got, certainly at my place of work. I’ve seen there are more staff that have come through over the years, and they’ve got stretched ears and facial piercings. I kind of think, maybe I’ve changed the environment a bit. People have accepted me for how I look so it’s really hard for them to tell somebody else not to have modifications. 

G: It’s good that you may have opened that door for other people because I’ve spent a lot of time in hospitals and it’s always the nurses with piercings or tattoos that make me feel comfortable. They feel more human.

R: Being human is the absolute crux of a healthcare job, which sadly people sometimes forget for a number of reasons. You are a human trying to help another human and that commonality is sort of where you start. I think certainly in terms of my patients, they’re interested in how I look. I’ve talked about suspension with some of my patients, and this might be people that have really seriously self-harmed for example, and they’ve often received a really negative response to that. For understandable reasons, they’ve felt shamed and then we’re trying to figure out what this is about. For some people, particularly with trauma, there is an element of self ownership in that and maybe there’s some crossover with modification in that way. 

I’m not suggesting anybody should self harm or that self harm is a positive thing, but I do think there is a big cross over with modification and harm reduction. I’m a relatively healthy expression of that. 

G: This dialogue comes up a lot when we talk about body modification. What we do is sort of facilitate a form of self harm through modification. Not only does it fucking hurt, people are in a very vulnerable place when they come in and they’re putting their safety in your hands. A lot of people go through a difficult time and they want to get a piercing at the end of it or a tattoo to commemorate that experience. 

Do you think, as an industry, that we have a positive effect on mental health?

R: There’s potential for an enormous amount of positivity. There’s potential for an enormous amount of harm as well. It’s what you do with it. Like you say, people are at a vulnerable point potentially. Practitioners need a really rigorous understanding of consent, having trauma informed practice. Things like that are getting better in my opinion.

It’s always gonna be a real mixed bag. Remembering to be human and remembering that’s part of your job when you’ve got 20 clients booked in for a day. That’s hard. I mean, that’s part of why I’ve not wanted to pierce professionally. Because I don’t wanna forget the bit that’s important.

G: I think as an industry, and society as a whole, we’ve got much better with talking about mental health and why it matters. Have you noticed that from your side working in the mental health field?

R: I think it’s definitely become more of an open conversation. In terms of the modification community, it’s always been there. People that choose that as a career or are heavily modified, I suspect are more likely to have experienced some difficulties with mental health than the average person in the population. Or at least are dealing with it in a different way and I think there’s always been an awareness of that. Traditionally, the industry has been made of people who feel they don’t fit in very well. They tend to be outsiders. There’s been change in that as well for sure. 

That kind of links to the point of thinking about trauma and thinking about the significance and meaning to somebody. If you pay no attention to that, somebody could have an absolutely appalling experience. If you pay a lot of attention to it, you could make it something that’s life-changing and quite memorable for somebody. 

G: What changes have you seen in your time both working in mental health and being around the modification industry?

R: In terms of the industry, semi regulation seems to have become a thing and I suppose maybe I’m biased by the people that I know and come into contact with because I’m sure there are lots of terrible shops out there. Piercing’s such a new industry, there has been a learning process. I think some of the procedures that I’ve had, some of the things I’ve experimented with and thought that might work in hindsight, it’s absolutely ridiculous. Once upon a time it was a bit more wild west. It was a case of “let’s find out.” Something on paper sounds like it might be a good idea. Let’s see if that works or not. 

The internet communities were where people were sharing their experiences and their information and that’s what really brought us together. It seems that now we have a more professional, slightly more uniform set of standards. It’ll be interesting to see if that becomes some kind of actual regulation or licensing at some point. But I’m very much two minds about that. The wild west part of me wants to say no, let’s all just experiment and that’s wonderful because it’s consenting people. But yeah, I think that’s possibly a minority of people. The majority of people that come into a shop to get pierced, just wanna know that it’s safe and it’s gonna heal.

G:  Absolutely, as a piercer we aim to give you the best possible chance of healing. We make sure the procedure is safe and clean and that we’re using the highest quality jewellery and equipment. But then it’s on the client to follow the proper aftercare and keep in touch if there’s any issues.

R: I suppose that’s part of the problem. You can do the absolute best procedure in the world and if somebody doesn’t take care of it then it can ruin the whole piercing. It’s a relatively unique thing, it’s a collaboration between the practitioner and their client.

And I think it’s really important as a professional to remember that this experience is significant for that person. It might just be your 11 o’clock appointment and you might not remember their face but they know who you are. I’ve experienced that in mental health work as well, I’ve had people thank me for what help I’ve provided them and I’ve honestly not had a memory of them. It can be really awkward at that moment but I’m also really happy that I’ve managed to touch their lives. I suppose, as that relationship develops and you see the same client or a patient over a period of time like some of the guys I’ve worked with now, I’ve known a number of ’em over a decade. So it is a real intense relationship and you know someone inside out.

G: What changes have you seen in mental health care over the years? 

R: It’s become less industrialised. I think it’s better with individual care than it used to be, I’ve been in high security for a long time so I’m not really at a ‘street level’ where you’re working with the community. But I think there’s now a better understanding of trauma in particular, and I think that’s something that absolutely has to be pushed through because my personal view is mental health and trauma are essentially the same thing. That’s not something I managed to come up with myself.

I was doing some teaching and we put together a presentation for a panel of people that use services. Experts by experience. And there was a slide that said, somebody’s mental health problems can be directly impacted by trauma. And trauma may be the root cause of difficulties for people. I think it was the only correction on the whole presentation that they wanted to feed back. They said “no, we don’t think trauma and mental health are linked. We know they are the same.”

In the past I’ve said that I work with people who have committed violent offences or people that have this diagnosis or that diagnosis. But essentially I work with exceptionally traumatised people that have then gone on to traumatise other people. As a society, a lot of our problems are that we’ve got these little cycles of trauma going on. 

In mental health it used to be almost like you’ve been hit by some kind of illness stick. You’ve just got a mental illness and that’s it. I think it’s difficult to accept trauma because it’s harder to deal with than just giving somebody a pill.

G: From my limited time in piercing, everyone seems very accepting and supportive of mental health struggles.

R: There’s perhaps more of an understanding of difference and that need for individuality. I suppose particularly when you’re looking at heavy modification and more extreme stuff, you have to be an incredibly open and curious person to do that. 

G: Can we talk about your experience with body suspension?

R: Getting into suspension was a similar journey as my tongue split. It was something I saw and immediately thought, “That’s scary, I couldn’t do that.” And that became “Why can’t I do that?” I started researching and finding out more. I had another friend and knew a couple of people who were interested, and we sort of got together and talked about it and just decided to really learn. We were deliberately self taught. I think the suspension community tends to sort of build by rote. So somebody’s done it and it’s kind of worked, so this is how we do it then. You’ll get other suspension teams who do it their way and they’re not very good at knowing why. Which is a real contrast compared to the body modification community, particularly when heavy modifications were something of an industry. You have to know why. Because if you don’t, you can really hurt people. 

Ryan faciliating a suspension for a friend

With the suspension team, every team member started to learn all of the different roles and we came up with our own protocol. And then when we finally went out and met other teams that were doing it and started talking with them, nobody knew why they did things the way they did. That’s just the way it’s done. Everyone had their own methods and reasoning but didn’t really share too much.

G: It seems that suspension is a very closed and tight knit community.

R: I guess there’s not many people that do it. It is something that is potentially really quite dangerous. So people can be cagey about giving information and letting people in. And there’s fear of judgement with it as well, it’s something not many people understand. I think most people can understand tattoos as a form of art even if it’s not for them. But you want to hang from hooks?! There’s not always that kind of understanding. 

I think what often gets people involved in suspension is seeing the aftermath for people. Or hearing people that have done it talking about it positively and when you just look at it, it’s not just a performance. I’m sure there’s people that for them it becomes just a performance. But I think it’s probably quite hard to do that because it’s instant mindfulness when you’re suspended. That’s how I think of suspension. You can’t think of anything else. You are there. You’re right here, right now, and this is what’s happening and that’s all your brain is gonna manage. You can’t be thinking about a shopping list or the fact you go on holiday next week, did I leave the oven on? Your brain’s totally not geared for that and I really like that. It’s incredibly zen and there’s things that might float up in your mind. My experience with suspending people and being suspended, is you can’t always predict what things will float up. Your subconscious just kind of puts it out in the moment and you can kind of work through it then. I’ve personally found it an incredibly healing and a powerful experience.

But you can’t go into it going, “I’m gonna have this kind of suspension” because it doesn’t work like that. For me, I’ve seen people go and think they’ll have a happy, high energy suspension and then actually it ended up being almost like a memorial. They’re thinking about that and just the energy from it’s so powerful.

That’s why I love doing it and being around it and being part of that process for people. I do all the bits, I’m geeky about aftercare, I’m geeky about rigging and stuff like that, but talking somebody up, guiding them through the process. It’s almost kind of shamanic because they’re having this transformative process that you are never gonna fully understand but you get to facilitate and you’re there for that. 

Even just piercings, tattoos and other modifications, it’s a similar kind of thing. It can be that. To understand that you can be overwhelmed and that is okay, and that you’re strong enough to do it. It’s often quite euphoric as well for both physical and spiritual reasons, I guess. 

This is the bit that’s the crossover between my professional work as a nurse and the modification world. It’s that real, intimate core of who we are, that transformative experience and that wanting to guide somebody through their bit of the journey. 

G: The patients you work with, are they in hospital long term?

R: Yeah, by any kind of ‘normal’ standards it’s long term. A really quick admission might be a couple of years, something like that. Most people would go on to another secure facility, either a prison or more often they’ll go to a medium secure hospital. It’s kind of handing them off on that part of their journey and trying to guide ’em through that and prepare them for it. You never really get to know the end outcomes for people, it becomes a bit fuzzy as people work further through the system. I know there’s guys I’ve worked with that have been completely hopeless and never thought they’d get anywhere, but they’ve got partners and families and jobs and just cracking on with life now. So it does happen and it’s important to bear in mind. It’s not fast and the rewards often aren’t immediate in my job. Remembering that this can happen and holding hope for people, that’s a big part of it. 

Things can get better for people however bad it’s got. 

Image courtesty of Church of Body Modification

G: That is incredible. You are doing such an honourable service to people. What else do you get up to?

R: Since 2010, I’ve been Minister for the Church of Body Modification. I’m the only minister outside of North America now. I don’t talk about it a lot and this seems like an opportunity. 

Essentially all the stuff that we’ve been talking about, that bodily autonomy, the spiritual transformation that can happen through modification -that’s basically what we believe. Whatever else you believe is up to you, but that is the core tenant. It is your body and you can utilise that as part of your spiritual journey.

I think people hear the word church and think it’s going and doing hymns or having to believe in a certain dogma or whatever. In this sense it means assembly in terms of, you know, we are a group of people that believe this and I think that’s important. It’s really sad that it’s not always recognised in the modification industry. I think it’s a real shame that in terms of heavier mods and things very much in legal grey area, but the consensus seems to be no we won’t invest in this industry after Mac’s trial. And that was it, it was never raised as a defence. I dunno whether it was pertinent to those cases or not but actually if that is a spiritual practice for somebody, in this country’s legal system, we’ve got human rights to have access to that. And I think some of the downside of the commercialization of the industry and it becoming bigger, while standards have improved as a result, I think it also can become more like a purchase or a fashion accessory. Which it always has been for some people and that’s fine. But it sometimes belittles the fact that modification could be hugely important to people. 

G: The more clinical and the more restricted that we get, I do think it takes away that human element of it. We’ve improved as a industry but we’ve lost a bit of that experimentation and that grassroots, punk edge. 

R: And it limits people’s ability to explore the body. The weird irony about our legal system is not only can you not consent, you can’t now do things with your own body or you can’t do them safely. You know, if you want to chop your own hand off, not that I’d recommended it, you can legally. But if you get somebody else to do that, definitely not fine.

Obviously that’s an extreme example, but when you’re talking about a tongue split or ear pointing it’s a pretty different thing, isn’t it? It’s not so obviously permanently disabling, which is maybe why it might get the judgement. 

G: I’m a big believer that people should be able to do what they want with their bodies as long as it’s safe. But who is to say what is safe? Where do we draw that line? 

R: To an extent, that should be the individual’s choice surely. If you wanna do something unsafe with your body, as long as it doesn’t impact others, well that’s okay. I think it’s different when you’re doing something unsafe with someone else’s body and this is when we get into a lot of blurry grey areas with it.

G:  There’s a lot of heavy modification going on in places like Southern America at the minute. If you want to cut the tip of your nose off, you are well within your rights to. But is that disabling to you? Is that then impacting on other people? Is there a safe way to do that? Should there be psychological intervention? And who gets to make those rules. It generates a very interesting conversation about body autonomy. 

R: There’s something arbitrary and there’s something cultural about it. Certainly in terms of the extremity that people will go. A part of me does think, why are we making rules about what people can do unless we need to protect somebody from themselves. Which I guess sometimes we do, but we probably need to do that less than we think

I suppose all types of modification, no matter what the extent, have an element of permanence. In some regards even a piercing, you are kind of disabling yourself. If you’ve got a lip piercing for example, it might cause some dental damage. A tongue split, you might have a bit of a speech impediment. But on the grand scale of things, it’s not a big thing. 

G: Are there any meet-ups or events within the Church of Body Modification?

R: Not really anymore, it’s exceptionally small now. In the BME days it had more hype. And what you’ve got now is a handful of people that identify in their free time and do a little bit with it. Occasionally in the States there’s been advocacy in legal cases. A lot more, it’s just kind of an advocacy role, letting people know it’s okay. Really just educating that, yeah, this process can be a spiritual experience if you want it to be. Don’t limit yourself if you don’t want to.

I think people see it cynically and some of the origins were cynical on part of some of the people. But even with that, it doesn’t mean that the basic tenants aren’t true. 

I must admit, in my early conversations with my work and management, it was very much “What are these piercings about” and I knew that they were really strict on dress code. That was much more important than someone’s performance. And I didn’t lie, but I did say, you know, primarily it’s kind of a religious thing for me. That person left me alone from that day.  

Generally each one of my mods encourages that sense of self ownership and identity. There are certain things that are aesthetic. I’m afraid I’m mostly one of those people that everything has a little story for me. It’s an aspect of myself, it’s a reflection sometimes of my life and my relationships. It might seem weird but I’m a bit shy. I wouldn’t have things written in script on me that are easy to identify. I’ll have a picture or a pattern or something that’s in runes, glyphs that the vast majority of people would never be able to figure out. 

There’s an odd dichotomy of being a visibly modified person, and in part I think it’s the cost for me of being happy in myself. It gets complicated because, if I’m honest I kind of want people to notice that I’m a bit different and have set myself apart and I like challenging people’s perceptions.

They think I’m gonna be a violent thug and I think I’m actually quite a kind, reasonable human being. As reasonable as any of us get. I think something that I’ve come to appreciate as I’ve got older is people will ask me questions. I’ll have strangers stop me in the street and ask about the markings on my head. “Is that a tattoo? Is it branding?”. It’s great that people are curious and I can maybe educate them a little bit or bring something a bit colourful to this sometimes dull world. That’s no bad thing

I like being a modified professional. Something I’ve found interesting, as I’ve got promoted and mixed with people higher up the food chain, they’re people who don’t ask anymore. And my guess is they kind of go, “well, you’ve ended up at this meeting, so you must be a relatively sane human being.” I’d like to think that any misconceptions or judgments they had, I’m able to demonstrate that I’m okay and maybe they’ll go away with a little bit of that in mind.

G: I think it is really important that people see somebody expressing themselves the way that you do, in a professional role. You might have to work a bit harder than other people, unfortunately, but if you’re good at your job, your modifications will not hold you back.

R: Being one of the early people to do something you are gonna get discriminated against, but hopefully people will be less so in future.

I remember a really interesting conversation with Anna when she said about how hard it had been as a woman in the industry and she was kind of okay with it being hard. I don’t wanna speak on behalf of Anna and she may have changed her mind on things now. But I think, it’s great that she’s worked hard to be respected in her industry but it shouldn’t have to be harder for people because of how they look or identify, 

I can’t really complain in terms of discrimination because I’ve deliberately set out knowing it would make my life harder. A lot of people that get discriminated against, don’t have a choice. That’s just how it is.

G: So we pierce a lot of teachers and they always comment about how they have to punish students for having body piercings because that’s the policy. It’s unfortunately hypocritical and it’s policing autonomy in my opinion.

R: What the hell are we teaching people as a society that you can’t express yourself and you can’t be yourself. It’s an awful message culturally.

It’s definitely a value that I hold dear, you should just be able to be you. Whatever the hell you are, whoever you are. I would love a society that’s more accepting of each other.

If you ever get the pleasure of meeting Ryan, he sure is an incredible human and a wonder to be around. Very grateful for his time and yours if you made it to the end. Keep being you, whoever the hell you are.

A kind message to the Church of Body Modification from BME founder Shannon Larratt. Rest in peace.

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