A psychiatrist, a lifelong Republican, and a White American who chose to confront his own biases — and write about it honestly
Dr. Anthony M. D’Agostino is a psychiatrist with decades of experience studying human behavior, motivation, and the forces that shape how we think. Born and raised in Chicago, he spent his career not only treating patients but examining the social and cultural patterns that drive division in American life. This book is the result of that lifelong inquiry.
For over four decades, Dr. D’Agostino practiced psychiatry at the highest levels, studying not just individual behavior but the social forces that shape all of us.
Dr. D’Agostino earned his medical degree from the University of Illinois College of Medicine. He completed his residency at UIC, UCLA, and UW Madison. He served as Chairman of Psychiatry and Chief Medical Officer at Alexian Brothers from 1979 to 2011, and is a Distinguished Fellow of the American Psychiatric Association.
This book was not written from the outside looking in. It was written by someone who lived with these questions his entire life.
Dr. D’Agostino grew up as a White, Catholic American in Chicago and spent most of his life as a Republican voter. He did not write this book to preach or to assign blame. He wrote it because he recognized his own biases and believed that honest self-examination is the first and most necessary step toward understanding the racial divide in America.
Drawing from his psychiatric expertise and his personal experiences, he explores how prejudice forms, how tribalism shapes political identity, and why so many well-meaning White Americans still struggle to engage with race honestly.
Weekly conversations that go deeper into the themes of the book—exploring how bias shapes our politics, our communities, and ourselves.
Weekly episodes diving into the history, psychology, and politics of prejudice. No sugarcoating. No easy answers. Just honest exploration of why we’re still fighting the same battles.
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I read a lot of nonfiction in this space as part of my work. Most books on race in America fall into one of two traps: they preach to the already converted, or they soften the argument so much that nothing useful survives. D'Agostino does neither. Prejudice, Racism, and Tribalism is written by a retired psychiatrist who is white, Catholic, and Midwestern, and who is entirely clear about what that means for his blind spots. That self-awareness is not a disclaimer. It is the methodology. D'Agostino approaches the subject the way a good clinician approaches a difficult diagnosis: with curiosity, with humility about what he does not know, and with a commitment to precision in how he uses language. The central contribution of this book is the distinction between three terms that most people use interchangeably. Prejudice is human and universal. Tribalism is biological and ancient. Racism is structural and specific to systems of power. D'Agostino argues, and argues well, that conflating these three things does not advance the conversation. It shuts it down. Readers who have spent years uncomfortable with how these terms get thrown around will find this framework clarifying in a way that nothing else has been. The psychiatric training shows throughout, and it is the book's greatest strength. D'Agostino understands how childhood, family language, and culture wire us for bias before we are old enough to question any of it. He does not use that knowledge to excuse prejudice. He uses it to explain how deeply it is embedded, which is a very different thing. The chapter on how unconscious bias operates in medicine is one of the sharpest pieces of professional self-examination I have read from any physician. This is not an academic text and it does not pretend to be. Some readers may want more data, more footnotes, more cross-cultural comparison. That is a fair observation. But the book is not trying to be a sociology dissertation. It is trying to start an honest conversation with people who have been unable to have one, and on those terms it succeeds completely. The writing is warm, direct, and genuinely curious. It reads like a very smart man working something out in real time, which is exactly what it is. From a publishing standpoint the ratings are small in volume but the quality of the reader response is exceptional. People are not just reviewing a book. They are describing specific moments where a single sentence changed how they see something. That kind of reaction does not come from competent writing. It comes from honest writing, and D'Agostino has that quality in abundance. If you are a white reader who has avoided this conversation because every entry point felt like an ambush, this is the book you have been waiting for. And if you are not white, this is the book worth putting into the hands of the people in your life who need it most.
Anthony D'Agostino's Prejudice, Racism, and Tribalism is one of those rare books that challenges readers without alienating them. Rather than lecturing or assigning blame, the author invites readers into an honest examination of how prejudice, fear, and tribal thinking have shaped societies throughout history and continue to influence modern America. What impressed me most was the book's balanced approach. D'Agostino combines personal experiences, historical context, and thoughtful questions that encourage self-reflection. He doesn't ask readers to feel guilty about the past; instead, he encourages them to understand it so they can better navigate the present. The discussion of how fear and division can be used for political and economic gain was particularly insightful. The writing is accessible and engaging, making complex topics easier to understand without oversimplifying them. I appreciated that the author explored racism as part of a broader human tendency toward tribalism, showing how these patterns have appeared across cultures and civilizations throughout history. Perhaps the book's greatest strength is its emphasis on introspection. The recurring question—"What would I have done?"—forces readers to confront their assumptions and consider how they might have responded in different historical circumstances. It's a powerful exercise that makes the book feel personal rather than purely academic. Whether you agree with every point or not, this book provides valuable historical perspective and encourages meaningful self-examination. It's a thoughtful, well-researched primer for anyone interested in understanding the roots of prejudice, racism, and social division in today's world.
Great book. Highly recommended.
D’Agostino wants to clear the air by distinguishing between racism, which he defines as a systemic power structure that privileges Whites and disadvantages Blacks, from prejudices and tribal allegiances, which he sees as endemic in every society and, though often hurtful, not supported by embedded established interests and thus not as harmful.
Using himself as an example, the author, a psychiatrist and long-time Republican, emphasizes the importance of culture on self-definition along with the ever presence of self-interest in decision making. At the same time, he contends that corporate and Republican interests have learned how to entrench and enrich themselves (pharmaceutical companies and MAGA Republicans being prime examples) by twisting language and playing the race card to skew policy debate, thus tricking Whites into thinking that their economic interests are opposed to Blacks and aligned with corporate profits.
An extra benefit is the author’s uniquely engaging voice—approachable, forthright, and historically informed. This is a one of a kind book.
I really liked that the author included a lot about his own personal experiences living with these factors; I think this helps the reader put the book in perspective. I also loved the abundance of statistics
I found this book to be deeply engaging, clearly articulated and thoughtfully presented. Dr. D'Agostino writes with great care and clarity. The book begins by simply defining terms, and patiently untangles several complicated and overlapping concepts. Once he has defined these central ideas, Dr. D'Agosotino spends the rest of the book explaining how differentiating between prejudice, racism and tribalism makes it possible for us to more clearly understand our current cultural moment. His self-awareness and ability to soberly assess his own natural and learned and prejudices is refreshing and makes it clear that this book's purpose is not to preach at others, but to make sense of the world for himself as much as for his readers.
I appreciated the way this book engages with global and U.S. History. I never had the feeling that the author was cherry-picking examples to support a pre-drawn conclusion. Instead, with every chapter, he traces our modern ideas of justice and identity back to their biological and historical roots. There is no sense that the author is promoting any party or idealology. Instead, he invites the reader to join him in honest self-appraisal, through a historical and sociological lens.
I found the distinctions between the three title concepts, (Prejudice, Racism, Tribalism) to be a genuinely helpful way of sorting through many current political debates. While Dr. D'Agostino does not offer any easy solutions, he does set an example through his honest reflections on his own prejudices, and his assessment of the self-interest that motivates all people. If identifying the cancer of systemic racism is a step towards ending it, then this book presents an excellent path.
My overall take on the book is that I absolutely love it, 5 stars and I will re-read this book because it is so dense with knowledge, wisdom and experience. The book is like a beautiful masterpiece of art with interwoven fascinating historical facts and events. The historical references help further grab the attention of the reader as it's contextualized with life experiences and perspectives from the writer's magnificent mind himself. It is by far a book for the ages.