America’s autoimmune syndrome: How failures in self-recognition contribute to the perception of threat.

By Matthew Steinfeld, Ph.D., Benjamin Kelmendi, M.D., & Philip Corlett, Ph.D.

The White House

This republican presidential primary is notable in recent history for the explicit use of xenophobic and sexist rhetoric by the leading candidates seeking their party’s nomination. Rather than alienating many registered Republicans, to the surprise and consternation of the American political establishment, this kind of hate speech has galvanized a sizable segment of the Republican electorate. These voters appear to endorse the misperception that fellow Muslim and Mexican citizens, undocumented immigrants, and pluralistic values are a threat to American citizenry at large.

Attempts to understand this phenomenon, have involved everything from deconstructing the psychology of the candidates to conceiving of this hate speech as a byproduct of unchecked political ambition. However, a deeper explanation for why this inflammatory speech has become so widely promulgated, may lie in considering how “bodies” (both individual ones as well as the body politic they constitute) attempt to stay safe under conditions of perceived threat. And moreover, how politicians manipulate groups of people by priming them with fear.

The human body stays healthy and safe in large part thanks to the immune system. There is a lot we can learn from the immune system it turns out, for in order to protect the self, the immune system has to make a decision about what is “you” and what is not. In a literal sense, the immune system has to distinguish the cells that constitute our bodies from threatening non-self pathogens like viruses and bacteria, and neutralize threats. However, from time to time, the immune system makes errors.

The misidentification of threat from within can lead the immune system to raise antibodies to its own cells, misperceiving them as ‘not part of the self’ in what is called an autoimmune response. If one’s body learns from the mistake quickly there may be little harm (as it appears that the recognition of one’s own failures in self recognition is partially constitutive of the self). However, autoimmune diseases, if untreated, can cause significant harm, as one’s immune system goes to war with the very body that allows it to function, and which it is charged to protect. In instances where the ability to distinguish self from other are impaired, attempts at self-protection may create painful and damaging conditions that the immune system is attempting to avoid in the first place. The same can be true of countries.

Clues on how to understand the way failures in self-recognition often create the perception of threat in broader social contexts can be found in the work of a number of scholars. One such work is Slavoj Žižek’s 1989 text ‘The Sublime Object of Ideology.’ Deploying a Lacanian psychoanalytic reading of Hegel to highlight the disowned power relations embedded in dialectics, Žižek proposes that all ‘categories of meaning,’ such as Truth, Democracy, Freedom, (and here perhaps we might also add the category of ‘self’) fundamentally lack enduring structures; because the lived experience of these conceptual categories lack formal immutable qualities, they only exist insofar as people lay claim to and enact them. Thus, all sentient ‘categories of being’ have an ongoing ontological problem, that takes place largely outside of awareness, and which is not easily resolved. Namely: how does an entity represent, to itself, that it exists; that it is real ‘thing’ – even when it isn’t. Žižek’s proposition is that this problem has historically been resolved by the identification of another entity that is perceived to be responsible for its own lack of coherence and structural stability, and in so doing allows its ‘self’ to locate and maintain its boundaries and contours. For evidence of this phenomenon, one doesn’t need to look farther than the parallel continuous histories of those countless groups oppressed, marginalized, and blamed for posing an obstacle, and therein threat, to the full flowering of American Democracy (here you could insert the name of just about any modern nation state and their particular form of governance). This ideological tendency according to Žižek is the ‘sublime object’ of all ideology, and for that matter of all meaning-making entities, whereby the fluid and transient nature of perceptual reality is rendered phenomenologically static and solid by locating and aggressing what it perceives it is not.

Now, if there is a genuine threat to an entity, for example fighting off a mugger, aggressive defense may be an adaptive response that preserves the entity’s ability to continue to exist. However, the long-term utility of such a choice, to aggress ‘an other,’ rests on an entity’s ability to be able to distinguish with fine-grained specificity and reliability what constitutes a real threat to internal ecology; for false positives can have tremendous cost. Imagine instinctively attacking an elderly person who approaches you on the street asking you for the time – both they and the mugger are strangers, but not all strangers are dangerous. The evaluation of a benign other as a proximal threat to an entity, and its quarantine or attack as protective solution, is a heuristic that contains tremendous explanatory power in attempting to understand why humans suffer across bio-psycho- and, yes, social contexts.

Considered at the level of biology, erroneous perceptions of self can be devastating for the sufferer, manifesting as the Schneiderian first-rank delusional symptoms of being under the control of external forces, hearing one’s own inner speech as hallucinated voices, or believing that one is dead or disappearing as in Cotard’s syndrome.

Consider too how failures in self-recognition permeate our psychoanalytic theories. Psychological defense might be meaningfully thought of as one mistaking part of one’s experience as not one’s own. Whether for real or perceived reasons, some thought, feeling, or behavior, is deemed intolerable and pushed out of awareness. “Not mine.” In the moment defensive operations manifest, the “wholeness” of one’s experience, and by extension oneself, is subordinated to the exigencies of the moment, and redefined in light of that which cannot be tolerated. While psychological defense may serve an adaptive function to buffer anxiety and fear in the instance in which it arises, if rigidly over generalized into other contexts and relationships, perceptions of one’s self can become inaccurate. Imagine a person who grows up in a family in which to be heard or seen meant to be hit; and so in order to shield themselves, they gave up an audible voice and sacrificed being seen. While a useful adaptation in that context, years later and in different relationships, not having a voice may make developing meaningful relationships difficult. A shield may keep one safe in battle, but to never put it down once the battle is over may make it difficult for anyone to see behind it. Character pathology makes it challenging to disambiguate where one’s “self” ends, and their interlocutor’s subjectivity begins.

Projective identification might be meaningfully thought of as an interpersonal proof of the same phenomena in which an individual experiences inaccurate self-recognition – albeit between two people. Person 1 projects their split-off or defended parts onto person 2, which once identified with, allows for person 1 to aggress, avoid or engage person 2, as well as what is defended in the process. In both of these instances, the contours of the defended self are in large part defined by failures in recognizing what is self, and what is not. And to reiterate, this phenomenon is in part because ‘self’ is often not experienced as static unless situated in relationship to something, someone, or some other group that is understood as non-self (or with regard to groups deemed “not us”). Racism is predicated upon this very denial of interdependence – applied at the communal level. Members of a community, once construed as ‘other’, are no longer considered part of the communal self, and they are subordinated to in-group concerns. They are “defended against,” and in so doing, communities fracture.

Paradoxically, those pushing stigmatized ‘others’ away, simultaneously need them close. As Kimberlyn Leary writes (p.283), citing Dorothy Holmes and Elizabeth Young-Bruehl:

“Holmes (1992)…describes racial difference as a powerful trigger and container for the projection of unacceptable impulses. Psychoanalysts have mapped the process by which disavowed wishes are projected onto an Other who must then be contained or controlled in order to maintain a sense of safety and superiority. In her study of the “anatomy of prejudices,” Young-Bruehl (1996) notes that racists therefore are obliged to racialized Others. They need to keep them close, if subjugated, in order to maintain the fiction that disturbing impulses are located outside of themselves.”

The misidentification of self under conditions of threat is a pattern that is evident at the level of large social groups as well. Terror Management Theory (TMT) (a social psychological theory of how groups of people buffer the anxiety that arises when there is a perceived threat to their group identity), proposes that when people are primed with their own mortality, the individuals that constitute groups will cohere in ways that redefine who is part of their in-group and who is not. In a series of compelling studies, participants primed with their own mortality were found to be more likely to hold other people’s perceived moral failings to harsher punishment, be less open to those one perceives as ‘other’ immigrating to the United States, and less likely to desecrate cultural icons and sacred objects (like the American Flag). Researchers explain these outcomes by proposing that as a species, we are hard wired to band together with those we perceive as our in-group under conditions of perceived threat, because that was probably quite useful to have survived this long as a species. However, in countries where national boundaries encompass hundreds of millions of diverse individuals from many ethnic and cultural traditions, the perception of threat when there isn’t any based on demographic, religious, and migratory identifiers, has the potential to create rifts between groups of people previously organized by national boundaries. Politicians regularly use fear to attempt to modulate the behaviors of the American electorate.

So what is reparative when these social autoimmune processes come online? Namely: the recognition of one’s own failures in self-recognition. The psychoanalyst Jessica Benjamin has written extensively on this topic, applied in both clinical practice as well as the social sphere. In contemporary psychoanalytic discourse it is axiomatic that aspects of the therapeutic relationship that are outside of shared conscious awareness will become enacted between therapist and patient. This interpersonal mechanism allows important parts of both parties’ experience to be communicated unconsciously through behavior. In the process and without intending to, analysts may find themselves enacting frightening, overwhelming, or shameful aspects of one or both parties’ inner worlds, and defending against experiencing the feelings associated with them. In disconnecting from their patients’ experiences (as well as their own), the possibility for a ‘recognizing relationship’ becomes impaired. When this happens it is commonplace for the two parties to slip into Benjamin’s now well described dynamic of ‘doer and done to.’ In her language it is the eventual shared understanding of the manner in which a shared understanding of the therapeutic relationship was previously impossible, that is ultimately reparative. One’s recognition of one’s lack of self-recognition serves to restore the capacity for both parties to bear witness to one another as subjects and not solely as objects. In doing so, according to Benjamin, the intersubjective dimensions inherent in healthy relationships are restored.

However as Žižek argues the ‘doer and done to’ dynamic is to a certain extent unavoidable in the construction of selves, and the peaceful resolution of the blurry boundary between self and other is not a foregone conclusion without the person or system that is “perceiving” having an ongoing commitment to acknowledging its errors in perception. When that is not the case, as with the current republican primary front-runner, and political candidates deliberately prime people with fear (see video above) and fabricate threats from within the body politic, Americans can easily slip into “autoimmune perceptions” of America itself; that citizens upholding democratic practice are a threat to democracy (video below). In times when would-be political leaders evidence an unwillingness or incapacity to reflect on the effects of how they perceive threat, it falls to the citizenry, the body of the body politic, to mobilize to bring about corrective action and preempt the further self harm. The coming year will see if the electorate at large is able to offer corrective action through the election of a candidate that views each member of the country as part of a solution, and not as a potential enemy.

America is and always has been incredibly complex. Built into its very foundation, inextricably intertwined – in tension – in perpetuity – irreconcilably, are the histories of privilege and subjugation. It is at once a place where refugees from around the world have found safe haven and new futures, and at the same time, it is a land where slavery and indigenous genocide were formative national activities. Until America is able to recognize this interdependent complexity, and therein, take responsibility for its own failures in self-recognition (that American privilege is bound up in the lack thereof) in a manner that is experienced as reparative, this syndrome will continue to manifest in different forms.

This election cycle is a serious symptomatic expression of a long-standing and chronic disorder built deep into the foundation of our nation; a disorder that idealizes democratic processes contingent on a hyper vigilant posture against potential threats, from within and without. When the perception of threat is inaccurate, and in this case self directed, then we squander one of the most important opportunities we have: to learn from listening to the collective lived experience and wisdom of the nation how to suffer less. When we as a nation cherry pick only certain facts we like, or stories that make us look good, or choose wishful thinking at the expense of the full picture, then we are setting ourselves up for some serious collective suffering. Deep democracy, in the form of a clear eyed engagement with America’s complexities and potential, is essential for America to recognize its tendency for autoimmune responses, to heal, and in doing so to live up to the idealized self that it projects into the world.


Matthew Steinfeld, Ph.D. is a clinical psychologist, an Assistant Professor of Psychiatry at Yale School of Medicine, and a board member for Psychoanalysis for Social Responsibility; Benjamin Kelmendi, M.D. is a psychiatrist and Research Fellow in the Department of Psychiatry at Yale School of Medicine; Philip Corlett, Ph.D. is an experimental psychologist and an Assistant Professor of Psychiatry at Yale School of Medicine.


The views and opinions expressed in this article are those of the authors and do not reflect the official policy or position of any other member of Yale University or its School of Medicine.

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