Autoimmune Subjectivity - a concept in progress

Password: colon

“With the earlier examples of the human body [from Žižek]…the Real becomes the raw flesh of mortality, a corporeality at odds with a subjectivity in denial of its own mortality…” (Sheehan 26).

I created this video work using footage from a 2005 water mane inspection, interspersed with photos from my 2012 colonoscopy, which confirmed my Crohn’s disease diagnosis. In juxtaposing these images, I wanted to evoke the revulsion we feel when we experience the inner workings (or malfunctioning) of our internal bodies in a state of illness. As Slavoj Žižek writes, the demands of daily life require that we suspend the internal body’s functioning in order to relate to it within the symbolic order. In illness, we become aware of the rift between external, symbolic identifiers of self (personality traits, physical appearance, interests) and invisible, internal bodily processes, which we can neither name nor control. Once the body malfunctions, it becomes a sort of machinery, surveyed part by part to identify and repair the broken organ(s). We begin to experience the body as a revolting, diseased object requiring lifelong medical surveillance and intervention. Any prior illusion of bodily control and symbolic coherence in the world is shattered. In illness, we can no longer simply suspend internal bodily processes as usual—we are forced to confront the Real of the body’s mortality. Chronic autoimmune illness, in particular, disrupts the symbolic order both within us (prompting a split in subjectivity, a loss of some perceived former unity between self and body) and around us, rendering the world’s previously coherent scientific-medical discourses and political narratives untrustworthy.

Crohn’s disease is a category of Inflammatory Bowel Disease (IBD), an autoimmune gastrointestinal illness caused by a combination of genetic and environmental factors, of which the most often cited in medical literature is a westernized diet and lifestyle. Frequent antibiotic and NSAID use, along with a diet low in fiber and high in saturated fat, processed foods, and animal products, are now recognized as risk factors for developing IBD and other autoimmune diseases. Such dietary and lifestyle patterns reduce the diversity of gut microbes, which regulate the immune system by breaking down fiber and producing short-chain fatty acids that protect the intestinal barrier. When gut microbiome diversity is compromised, fiber-digesting microbes begin to feed on intestinal mucus instead, causing intestinal permeability (pre-autoimmune “leaky gut”), and trigger the immune system to launch an auto-inflammatory response. In Crohn’s, this produces inflammation and ulceration along the gastrointestinal tract, causing symptoms such as abdominal pain, vomiting, diarrhea, fatigue, and weight loss (from nutrient malabsorption). Current treatments for IBD include pharmaceutical drugs, such as immunosuppressants, thiopurines (also used in high doses against cancer), and biologics, but surgical removal of inflamed or strictured sections of the gastrointestinal tract is also often necessary. Although particular diets, such as the Specific Carbohydrate Diet, have been proposed as complete treatments on their own, the risk of severe and life-threatening complications of Crohn’s (fistulas, bowel obstructions, colorectal cancer, etc.) leads most patients to opt for traditional pharmaceutical treatments and adopt targeted diets as secondary, preventive measures.

Illness forces us to assume a new role—that of a patient subject to endless medical surveillance. Advanced medical technology makes visible the formerly invisible dimensions of the internal body—in the case of IBD, MR imaging and ultrasounds, surgical intervention, and the dreaded colonoscopy/endoscopy procedure reveal the insides of the gut. Images of my gastrointestinal tract projected on screens and attached to procedure reports fragment me into machine-like parts that no longer resemble the whole, cohesive body that I thought was me. These medicalized images of disparate intestinal segments provoke discomfort, and I immediately feel alienated from my body, as though I were an outsider witnessing something I wasn’t meant to see. And in a way, I wasn’t meant to see my insides at all, because I never should have developed Crohn’s in the first place. Capitalist industrial modernity first engineered my illness, then developed technologies and pharmaceuticals to artificially prolong my life (and extend my years as a patient-consumer). Along the way, I was forced to adopt a new subjectivity: Autoimmune subjectivity. An autoimmune subject is created by environmental externalities of capitalism and becomes fully entangled within it, remaining dependent upon medical infrastructure and a constant stream of new medical-pharmaceutical innovations for survival. There is no opting out of medical surveillance and consumption, no escape from a diseased body designed for profit extraction.

In bouts of illness or amid symptom flares, the autoimmune subject becomes acutely aware of their own mortality. Moments of irrational, invisible pain and traumatic, invasive medical encounters preclude the possibility for the usual internal-body suspension Žižek describes. Every experience of a symptom pulls us out of our symbolic-level endeavors and reminds us of our body’s frequent suicide attempts (or, at least, what appears to be illogical self-destruction). The autoimmune body operates with a mystified cellular logic that defies the subject’s survival instinct—a sort of bodily death drive. Autoimmune disease is even a manifestation of death drive in a corporeal sense—the activated immune system attacks its own organs, launching an inflammatory response that destroys the body from inside-out. If left untreated, the autoimmune body quite literally self-destructs slowly, becomes an unusable lump of tissue and veins, and returns to inorganic matter. This bodily death drive places the autoimmune subject at odds with their own life instinct, at odds with the human need for a stable subjectivity within the symbolic order.

It’s no coincidence that autoimmune diseases of all kinds are on the rise in both affluent Global North countries and those beginning to adopt westernized diets and sedentary lifestyles—the animal agriculture, pesticide, chemical, and pharmaceutical industries fund scientific research, influence policy, and smear opponents for profit. As plenty of others before me have noted, these industries are in the business of prolonging our collective illness. In an environment brimming with carcinogenic agricultural runoff, endocrine disruptors in cosmetics, and “forever chemicals” in tap water and cookware, we have no choice but to suspend the miraculous inner functioning of our bodies, subject them to neglect, poisoning, and decay, and dredge forward as we pursue symbolic-level fulfillment.

Autoimmune disease is no accident, genetic anomaly, or individual misfortune—it is the body’s self-destructive impulse against the barrage of toxins, both literal and metaphorical, which make our contemporary world unlivable. Autoimmunity is not an individual genetic accident—it is a profitable externality of neoliberal capitalism. In our dystopian healthcare landscape, it’s profitable when illnesses cannot (yet) be cured, are caused “primarily” by genetics, and can “only” be treated with costly, long-term pharmaceutical and surgical interventions. It’s a public issue that we all have (or will develop) autoimmune diseases—the conditions of industrial modernity and corporate political control have turned us, unwillingly, into autoimmune subjects, yet we’re meant to believe that “bad genetics” caused our illness and pharmaceuticals are our only remedies. The chemical, agricultural, medical, and pharmaceutical industries (along with the government) are not only invested in creating an autoimmune population, they’re also actively forcing us to inhabit new forms of subjectivity, forcing us to move through the world in increasingly self-destructive, atomized, and demoralizing ways.

I have no political prognoses or solutions, only an intuition that health is increasingly inaccessible, and that autoimmune subjectivity will be a primary subject position of the coming decades. This video work is my effort to accept the Real of my body’s fragility and allow others to bypass, from a distance, the bodily suspension we perform within the symbolic, momentarily experience autoimmune subjectivity, and witness the extent of capitalist intrusion into our bodies.

Works Cited

Sheehan, Sean. Žižek: A Guide for the Perplexed. Continuum, 2012.

Skinny Puppy. “Dig It.” Mind: The Perpetual Intercourse, Nettwerk Productions, 1986. Spotify, https://

open.spotify.com/track/5XnOTaIZRMYV8UZzKwa5d5?si=77cdb5bfa7174068.

Žižek, Slavoj. The Metastases of Enjoyment: On Women and Causality. Verso, 1994.