We are in the grip of huge physical and psychological threat from the coronavirus. Like all species, humans have clearly evolved mechanisms for both responding to, and avoiding, pathogens. There are similarities between the fear response, as seen for example when there is danger of being confronted by an aggressor or predator, and the fear of pathogens. Both give rise to distrust, anxiety, fear of the ‘other’, ‘disgust’, and autoimmune inflammatory reactions.

I have been watching my own and others’ reactions on the streets. Fear, anxiety and distrust are powerfully present. It feels strange to shirk proximity, move away from strangers and avoid close contact. I particularly feel for children now, as they, as potential ‘spreaders’, are eliciting fear and disgust reactions in many which could have a psychic effect. The brain circuits involved in physical pain are equally active in social ostracism, and children particularly tend to interpret the world through adult eyes, and as Winnicott said, gain their sense of self that way. Who wants to be viewed as a social leper, a dangerous potential pathogen inducer to be avoided?

Avoiding danger is of course is what most species do,  moving away from pathogens, whether avoiding infected foods, forming colonies near plants that pathogens don’t like, or developing internal group hygiene, such as bees clearing out worrying larvae and ants at times doing the equivalent of ‘deep-cleaning’.  Many species do what we are doing now, and actively become more isolated.

When we smell something putrid or ‘off’ we tend to feel, and indeed signal, disgust, and whole areas of the brain, particularly the insula, are activated. Smell is possibly the most powerful sense-organ, but sight (eg awareness of other’s worrying bodily  such as boils or pox) and touch also are used to detect threat. Indeed, trauma victims so often seem to have highly developed sense of smell, especially when the abuse happens at a very young age. Decisions such as what to eat, who to mate with, are influenced by such subtle non-conscious factors.

What we know is that when in a state of stress or when sensing danger, we all tend to be more suspicious and less welcoming of others generally, in psychoanalytic language we have heightened paranoid-schizoid responses. Humans anyway have an innately constituted fear of  those we see as ‘other’. Even babies prefer others who look like them, talk like them, and act like the trusted adults in their circles, but that exacerbates in times of fear and danger, when borders are all but closed.

Social safeness and safeness from pathogens are linked. A classic example is grooming within groups of conspecifics, like primates., Those who are groomed and groom have been shown to harbour less infection-inducing tics and parasites. The additional benefit is feeling good. Higher status chimps get groomed more, especially by low status ones, for example, and grooming fosters a sense of social harmony in which neurochemicals such as oxytocin are released. In humans we have other mechanisms which foster the same things. Singing, dancing, social and family gatherings, which all heighten oxytocin and immune responses, lower inflammatory ones, and are linked with feeling good. Social outcasts, whether primates or humans, tend to have lower serotonin, for example, and higher cortisol. This is a  real danger at the moment when isolation and lack of community is a threat to mental health and especially the psychologically vulnerable..

I had always assumed that in-group loyalty and out-group suspicion, even in babies,  had a good evolutionary rationale as a main predator of infants and children was often males from another social group who might, for example, kill offspring spawned by other men and indeed, kill those other men too. What I had not sufficiently considered is the powerful fear of the ‘other’ carrying genuinely dangerous pathogens. We know this all too well from the accounts of the genocide of indigenous populations in Australia and the Americas, decimated by viruses carried by Europeans.

Fascinatingly of course oxytocin fosters not only in-group trust and cohesion but also distrust of those in out-groups. I again had always assumed this also to be linked to the dangers of attacks from rival groups, but it makes sense that fear of viruses and pathogens is central here too.

It is no coincidence that Trump, in characteristic xenophobic fashion, attacks a ‘foreign’ virus. Pathogens of course are always ‘foreign’ but this conflation of fear of a pathogen and fear of the other is worryingly common. Certainly, anecdotally it is my non-white clients, particularly Asian ones, who have felt most shunned in the last few weeks. We know from social neuroscience that we can non-consciously demonise certain others, such as the homeless and drug-addicts,  and despite what we consciously avow, often our brains, when looking at drug--addicts, or even those of other ethnicities, show less activity in networks involved in empathy and recognising the other as human, such as areas in the medial prefrontal cortex. Instead we often see increase activity in areas of the insula which are linked with disgust signals as well as in amygdala-linked fear and aggressive reactions. Both also are often activated with a threat of pathogens. The worry is that dehumanisation can kick in, the other (e.g the infected, but also the rival shopper) becoming ‘subhuman’. Similar brain mechanisms are thus involved in both Trump-like xenophobia, and in fear of pathogens.

A major health concern is the rise in inflammatory conditions. Inflammation of course is an appropriate response to heal an injury, wound or danger. We need inflammation when we have an injury or when eating toxic food. Our immune antibody army then generally does a great job sending inflammatory cytokines like IL-6, TNF-alpha, CRP, and multiple macrophages etc  in to fight dangerous intruders. However, such immune responses go into overdrive in disorders such as lupus, fibromyalgia and so much more, and cannot tell the difference between the benign and the dangerous. The same happens with trauma, high levels of stress and competition threats, including this virus. It is no coincidence that stress, trauma in childhood is linked to higher levels of most pro-inflammatory cytokines in adulthood. 

High inflammation is also central in depression, and inflammation might have had a specific evolutionarily important role in managing pathogens and disease, fevers and hot temperatures often vital for dealing with viruses and other diseases. High inflammation is also linked to social aversion as well as stress, depressive symptomatology, anhedonia, lethargy, possibly because social isolation decreases infection risk. High cytokine activity comes with threat responses, hypervigilance and much else seen in stress, anxiety and psychological trauma. The same genes are involved in both depression and defence against pathogens, genes that are less present in societies where there is less risk of physical infection, and where there is also less depression.

What we seem to be uncovering is an extraordinary synergy between fear of the other, fear of pathogens, expectation of danger or threat and links with the rise of xenophobia, racism and ‘othering’, and links also between these and depressive and other metal health symptomatology.

Anyway of course, in danger and major stress brain circuits involved in empathy and rational thought go into abeyance as survival-based responses kick in, including panic and aversion, and that is in large part what we are seeing in the panic-buying and hoarding. It is interesting that in more socialised  European countries, those less in the grip of neoliberal competitive ideologies,  there is plentiful food on shelves, unlike in our increasingly competitive one with decimated services, massively cut hospital beds and our main drivers increasingly being individualism, profit and greed.

Assuming that lock-down, isolation and banning foreigners is the right approach for covid-19 ,  we still need to recognise that this comes with dangers to us as a society, such as discrimination, vigilant distrust, depression and much more. There are also real risks in social isolation, and taking away the main sources of emotional wellbeing, which are community and cherished others. In response we need to keep alive influences that combat this, whether friendships, family, forms of self-care. I have noticed myself giving really nice looking people a wide birth, and but if I catch myself I can take a deep breath,  thank them for moving away from me rather than feeling threatened, and while keeping a distance, make sure I have a slightly more open face, smile (heart) as I walk through the places I can still walk.

We can and should, for our own and others’ good, keep alive our capacity to reach out compassionately and kindly to others at a time when such pathways are endangered by heightened threat, fear and disgust reactions, alongside social withdrawal. So, if we need to self-isolate to protect self or others, or if we have to work on the front-line, at the risk of being Polyanna-ish, let’s try to keep hold of compassion, for ourselves and others.