Over the course of his investigation, kessler identifies an underlying factor behind much of our emotional struggles and mental suffering. Its the first new theory on Mental Illness in 50 years. Capture is an intimate and critical exploration of the most enduring human mystery of all, the mind. Please help me give a warm welcome to dr. David kessler. [applause] thank you, monica, and thanks to book passage, one of our favorite bookstores, and thank you all for coming out this evening. This journey, the journey that led to capture, began about 25 years ago for me. Im at fda, we began the investigation into the tobacco industry, and i had to learn everything i could about nicotine. And i became very interested why somebody would pick up a cigarette, smoke one and then 780,000ing more over a lifetime. So i had to learn everything i could about nicotine, about addiction. Then i became very interested in overeating and trying to understand why that Chocolate Chip Cookie has such power over me. The mechanism in both seemed to me to be somewhat similar. A stimulus hijacks our attention based on past learning and past memory. This is this arousal, this increased attention. Theres these thoughts of wanting. I eat the cookie, i have this momentary bliss. Nothing else is getting through in my brain. Two minutes later, i go why did i do that, right . [laughter] and the next time, you know, im exposed to some cue associated with that Chocolate Chip Cookie, right . I do it again. I strengthen those neural circuits. So i had to learn everything i could about those conditioned and driven behaviors. And there was something that seemed to me to be evident, right . That we are all wired, all of us are wired to focus on the most salient stimuli in our environment. What do i mean by a that . If a bear walked in here right now, youd stop listening to me. If you start smelling smoke, that becomes the most salience, the most important tim lie. If i took out stimuli. If i took out a gun right now, that would capture at least most of your attention. So i was very interested. I wanted to understand whether that mechanism that was at play in nicotine and overeating, the question was does that mechanism also involve an array of affective conditions . And, certainly, one of the most important affective conditions depression. Very few families are not touched in some way by someone who has experienced this debilitating illness. So where do you go look . Where do you go really understand what the cause of depression is . I mean, if i ask you what causes depressioning in 2016 depression in 2016, what are you going to say . Whats the answer . Someone. What [inaudible] life. [laughter] drugs, drama [inaudible] genetic susceptibility. Chemical imbalance. It sounds like from all those answers, truth we probably dont know, right . When you think about it, 2016 and were really not sure. Theres no real hard, Scientific Evidence that, in fact, theres a chemical imbalance at play. As i was asking this question, you know, one of the great young writers certainly of this generation, David Foster Wallace, had committed suicide. And i became very interested. He and i went to the same college, he a decade later. But i really wanted to understand what drove david to suicide. Let me read the opening paragraph of the book, really where the book starts. He left more than a dozen lamps burning in his work room. They shone upon the desk and on the unfinished manuscript neatly stacked on top of it. Next to the manuscript was a twopage letter. This was the scene on the evening David Foster Wallace hanged himself. Wallaces suicide at the age of 46 devastated the literary community. He was at the time acclaimed as the boldest, most innovative writer of his generation. His novel was widely lauded by critics and thought to have redefined postmodern american fiction. The manuscript on the desk, which he despaired of ever completing, was published posthumously. The novel contained some of his best work. Despite wallaces frustration with his inability to complete the book, in some ways his life had never been better. He had married four years earlier and was comfortably settled in california with a teaching job he loved. Why then did he take his own life . What was the underlying cause of the depression that governed davids deep unhappiness . Depression. Every time i ask what caused davids illness, his suicide, all i heard was the word depression with a capital d. From an early age, wallace wanted to be exempt from the ordinary. He wanted to excel first as a student and later as a writer. And he wanted others to recognize his genius. He wanted to be read in a hundred years. Yet as soon as he succeeded, if he earned an a or received critical acclaim, he grew uneasy and then despairing. He wanted to be a good person but suspected something crooked about the way in which hed achieve success, something false in himself. Wallace was haunted, as he wrote himself, by the frawj lens paradox. As an adult, he was always on high alert, always sensitive to signs of the beguiling imposter. In the margins of a book, he scribbled the following grandiosity, the constant need to be and seen as a superstar. Something about this notion stuck and became a reflexive thought, one that head him feel very bald made him feel very bad whenever he encountered something that threatened his sense of credibility, and any number of things could threaten his sense of credibility; critical praise, academic success, romantic attention, someone laughing at his jokes. In such moments his life became a lonely performance. Everything else receded into the background. The feeling encompassed him more strongly each time he experienced it, gaining traction in his mind. Depression, depression, i would hypothesize, involves a continual focus on negative thoughts, experiences, memories and feelings to the exclusion of all else. The process of being captured by the negative seemed to be particularly true for david. It would be impossible to know just how many ways he was gripped by selfdoubt, but it seems fair to say that he was seized by his selfdestructive refrain. He knew it, but he felt powerless to change it. This is what he wrote. Quote what goes on inside is just too fast and huge and all interconnected for words to do more than barely sketch the outlines of, at most, one tine think part of this tiny part of this at any given instant. No matter what his success, david filtered out Everything Else that reflected well on him and took in everything that could be constructed or construed badly. This kind of detrimented filtering can only lead to enormous pain. In this heartbreaking life, a selfperpetuating spiral led to suicide. In other instances, selfharm, it can lead to selfharm of different kinds. Wallaces focus rarely shifted from his tormenting thoughts. He felt as though he existed within, as he wrote, a dark world inside, ashamed, locked in. What some might view as narcissistic behavior, the torment of an artist seeking praise and perfection is more accurately understood in wallaces case as an overwhelming, debilitating sense of anxiety and unhappiness. There were many times when david was funny, happy and loving. Yet he was never able to shift his attention away from what made him feel bad for a sustained period of time. He could not, as he once wrote, quote perceive any other person or thing as independent of the universe alpine. Universal pain. Everything, he wrote, is part of the problem. What becomes salient in depression is the negative perception of the self, the selfdoubts, the failures, the sense of being a fraud. How does such focus, how does such intentional focus make him feel . That definitely south . . Selfdoubt . Incredible, intense sadness. And then what captures . That sadness, that output then becomes the input, and you see this vicious cycle sustaining itself. Is it possible, is it possible to unravel the mystery of Mental Illness, the decipher the underpinnings of a range of intense mental distress . We talk about depression or addiction or anxiety as if they are different afflictions. And, yes, there are different symptoms associated with them. But they are really, i would argue, theyre really responses to a neural process that happens in all of us. Let me suggest and i understand this is a bold assertion, but i think there is a common mechanism underlying many of our emotional struggles and Mental Illnesses. Simply put, a stimulus. It could be a place, a thought, a memory, a person takes hold of our attention, and it shifts our perception. Our attention becomes incredibly focused on that stimulus, the way we think and feel and often what we do may not be what we consciously want to happen. The theory of capture involves three real, essential elements; a narrowing of attention, this perceived lack of control. Obviously, the persons in control, but theres a sense that something is pulling. And a change in affect or emotional state. When something commands our attention in a way that feels uncontrollable and in turn influences our behavior, we experience capture. Capture seizes our attention quietly. We may sense a mental shift, but we do not understand where it comes from. The experience occurs outside of conscious control, and weve surrendered to it before we perceive it. There is an automa disty. It is the way our brains process information. When we are drawn to a particular stimulus, we act in response to a feeling or a need aroused by it. Every time we respond we strengthen the neural circuits that prompts us to repeat these actions. There are grooves, in essence. You can just think about it as certain grooves being laid down. But in essence, these are strengthening the neural circuits. There is a biological [inaudible] neurons that fire together and become strengthened together. Those neural circuits. So theres a biological basis, right . To why certain stimuli, why our attention shifts to certain stimuli based on past learning and past memory. Hi past experiences shape what my attention will focus. As we continue to react in the same ways to the same stimulus over time, we are sensitizing the learning memory, habit and circuitry of our brains. Its very important. These are not special circuits, right . Who has these learning memory circuits in them . We all do, right . And what happens when we sensitize those neural circuits, and its true of all of us, our thoughts, feelings and actions can arise automatically. William james, i went back to read his papers. Probably one of the last great psychologists to talk, right, about attention. He wrote in one of his lectures i just, i saw in the handwriting the question he asked was, why are certain ideas so strong as to coerce attention . How then does a stimulus become salient for you or me . At the simplest level, it could be just a bright stimulus; color, shape, motion, novelty can all give an object salience, right . But there is also salience in powerful desires, immediate or distant goals, attitudes toward diversity or opportunities and major life events. And ask the question, what captures us with each of these disorders. Anxiety. Rather than that Chocolate Chip Cookie creating thoughts of wonder and anxiety, what captures my attention to make me fearful. It could be going over. For me, it could be going over the golden gate bridge, but that may not at all rows or trigger anyone of you jerked it to be standing on a ledge or fear of being a fraud or expectation that something that is going to happen. Eating disorders in anorexia, food. Rather than overeating and thoughts of wanting is fear of food. That food is going to make me feel bad or sometimes there are multiple captures going on. If i could take eight apple and slice it into 80 pieces and i can over eight entire day just eat that slice every hour or so. How do you think that will make me feel . That will make me feel in control; right . It could make me feel good. So, is anorexia in fact fear of food, or is about love of control . Trauma. We can be captured by a harm that was done to us years ago with post Traumatic Stress disorder. We are captured by eight event that was life changing. Being abandoned. The chapter and sylvia platt, that fear of being abandoned certainly captured her. Hypochondria. What is it . I become hyper alert to some body symptom and not by focusing on the body symptom i become fearful that something is terribly wrong. In a manic phase of bipolar illness it is filled the void, fill the void, anything that will make me feel better. Virginia woolf became very focused on the fear that she was going to be institutionalized. She was afraid that others would label her as going mad, and the one thing she did not want to do because it would interfere with her work was to have hemingway, hemingway in cuba, the ambassador from cuba to washington is dispatched and told hemingway to get out of cuba here he says they are using the word about you in washington. The word was trader. Hemingway said i am not political. This is where i write. This is where i love to be, but that focus, that use of the word , many became concerned about his finances and his vision and inability to write and he would never write again. Addiction. The power of addiction lines in the grip to be able to hold the same neural circuits. Whenever we encounter a stimulus eight neural neural response conditions us to behave in the same way over and over again. Certainly true for alcohol. Here is cow carolyn, great writer talking about the effects of capture. Really focus on the queue, not in the alcohol, but her attention to the cube. I loved the sounds, the slide of the cork as it eased out of the wine bottle, the distant glug glug of booze point into a glass, the clatter of ice cubes in a tumbler. It wasnt the drink itself, it was all the cues. In fact, capture is the, i mean, certainly in addiction it is the queue the cues takeover. Cues have no significance in the absence of the negotiations with past experience. If you have never been a smoker i can assure you the crinkly, but image of the camel or cowboy will have no residents and certainly wont prompt you to have the urge for a cigarette. John belushi died of cocaine and heroin mixtures. Where the triggers . If he did not get into a scene on saturday night live, he would use. If he was cut in a scene and theres Great Success he would use, but the one thing he said was i dont understand why i cant stop. I talked about how capture can lead to behaviors that is harmful, certainly when you are dealing when youre captured by things about the cell. Its one of the most devastating forms of capture. I could eliminate tobacco from my environment and take all the food cues out, but its the self that is the focus of my attention. What can take it away from . You cant escape the self, but what happens when someone is captured not by the self, but when the object is external, when a person becomes captured by abiding sense of rage. Psychopathic behavior, psychotic the prehas traditionally been understood as what . Read any books about a psychopathic behavior and they will tell you psychopaths lack a consciousness, anxious of anxiety or guilt or failure of empathy, but these focus only on what is absent in the minds. What then one might asks along with dylan cleburne, eric harris murdered 13 people and Columbine High School in 1999. Throughout his journals, very interested focusing on peoples own words, not someone who interpreted. Really trying to understand what was going on in the minds of the people. You read in these journals that harris posed as someone who had a grudge against his. Group who resents the social injustices of a High School Culture that is excluded him. He gets his yearbook and this is what he writes in his diary. If i could knew the world it would. Then he goes on, everyone is always making fun of me because of how i look, how weak im. Welcome i will get you all back. Ultimate revenge. You people could have shown more respect, treated me better, treated me more like a senior and maybe i wouldnt have been as ready to tear your heads off. Thats where a lot of my hate grows from. You see in this child, in this adolescence the flights, the flights in high school he couldnt shake. This is what he wrote i know what all of you are thinking. And what to do to this you often make you feel bad because it wasnt just about feeling bad, those slights made him so bad and all of this would make him feel better. Harris quote i feel like god and i wish i was having everyone officially lower than me. I already know i am higher than most anyone anyone in the world. Ted kaczynski, the unabomber hard time adjusting. No question. Awkward. Very very smart. Decides to become a survivalist in montana wilderness. Before he started sending those bob bombs in the mail on july 24, 1978, this is what he wrote in his diary yesterday was quite good. Heard only eight jets. Today was good in the early morning, but later in the morning there was an aircraft noise almost without intermission. I would estimate about eight hour then there was a very loud sonic boom. This was the last straw and reduced me to tears of rage, but i have a plan for revenge. She wanted to be left alone. He wrote by silence i dont mean all sounds have to be excluded, only manmade sounds. Most natural sounds are soothing with a few exceptions like thunder and raven cries are magnificent and i enjoy them, but aircraft noise is a slap in the face. There is a symptom of the evil of modern society. Invasion of technology. He wanted to be left alone, but he counted the number of jets that would fly over his cabin. 00 three days before he killed by the kid in the. He was watching tv broadcast when kennedy promised to sell 50 fan of jets to israel. All of a sudden, the Christian Palestinian took that as a affront and created such rage at them lands newtown. What became salient . Mass murder in of itself became salient. Shirt is even more significant when the salient object is ideological. After all, ideologies have a powerful word to the disenfranchised. The individual becomes dedicated to a higher cause, which promises to give some meaning to his or her life to connect him or her with something greater than the self. It is more than the need to destroy. I am not please. I am not giving excuses, but we need to understand that what drives at a terrorist attack or are these terrorists are captured by an idea. At some point in the development terrace become enthralled by the belief that they are fighting for a cause larger than they are, a truth that transcends itself. Heres the important part. Heres the real thing. Not only are we captured by something meaningful, we can be captured by positives. Capture is neutral. These will respond to the most date test salient stimuli to our environment. They could be negative, but they can also be positive. Conversion or dedication to a greater cause can result into the opposite, benevolence that positively influences the lives of as. What is spiritual experience . Spiritual experience is described as a feeling of absolute dependence, of being crossed by a ultimate concern. It may involve moments of release from ordinary perception. The catalyst may be spiritual or a stoic in nature, a poem, landscape, mounds of quiet meditation. The feeling at times come sweeping in like a gentle tide pervading the mind with a tranquil mood of deepest worship. Description of eight german theologian who lived several hundred years ago. David wallace wrote about this. Hinders didnt understand capture per se, but he understood the relationship between the human and the divine. Wallace came to believe that there is no such thing as not worship and. Everyone worships heroes. Our only choice than is what to worship and the compelling reason for maybe choosing some sort of god or spiritual type thing to worship be allah or the weekend mother goddess or in viable set of Ethical Principles is pretty much anything else you worship will feature life. Strengthening the neural circuits. In different ways it is possible because capture applies to positive as well as negative experiences. Terrible acts, athletic pursuits, spiritual transcendence. My goal with capture is a way to look at mental suffering. My goal is to try to pull back the curtain. Depression was a label we gave to a group of symptoms. Then we said, what causes that group of symptoms and we said that label, that name, what we need to do is to pull back curtain because i think if we could understand that if people could at least understand if you feel a loss of control or something is pulling at you, if you are to feeling terrible and you dont know a lot why those are pathways to psychic pain. Now, i know the real question you want to know is how do you release yourself from capture. The most important and secret if you would about capture is that one of the most effective ways to be released from capture is to find Something Else that is more meaningful. No doubt if you look at buddhism what is a teacher and as it tries to quiet. What are the antidepressants like they try to quiet the reactivity. Com. I think the answer in one of the most effective ways because you are not going to get rid of the circuits. Only death eliminates the circuits from operating. The answers to replace one form of negative capture with a positive form. If there is any hero in the book , i think, it is exemplified by chris ware, the great graphic novelist. Some of you im sure havent read his graphic novels. Somewhere in this bookstore there is a big box called building stories and if you open one of the works in building stories, the first page, the big circle it says i want to go to sleep and never wake up. Chris suffered from enormous heartbreaking depression. But, then something changed. This is what chris told me. All of a sudden you are no longer the protagonist. Why, what happened . He had a child and that changed everything for him. All of a sudden you are no longer the protagonist. The movie has a new cast. All of a sudden you are a supporting actor and you suddenly realize that what you have thats what you have been all along and thats the way every human being should be and thats the we really should be living your life. In light of new priority it became clear to him at least in his case, his social anxiety, his hypersensitivity to his own words and this is the way he shifted his own perception. He said, you know, all that anxiety are really just a very selfindulgent form of melancholy and egotism on the part of the bear that is the way he changed work not that i am agreeing with him, but he changed the way he perceived himself down. What she was feeling. Capture allows us to focus, to be moved, to act with purpose. The mechanism does not in and of itself give meaning to our lives. Rather, it allows us to search for and experience meaning. Over the course of a lifetime, each of us creates a coherent account out of the jumbled often fragmented cares. We are bombarded with thousands of stimuli any one of which can become meaningful at any giving instance. Over time for all of us certain characters and experiences emerge essential. Others is proof to tangent so, soon to be forgotten. He summed it up well in a few words we tell ourselves stories in order to live. We become captured by certain things and we need to make sense out of our world. Is their freedom from capture . Can we throw a switch and see that entire stage, every trap door and spike and raptor for what it is . In the most basic sense the answer is, no. Attention is by its very nature selective and self enforcing. Our environment each of our environment, each of our own personal experience, our history, our economic situations we find her self, physical situations we find ourselves in dictates what becomes salient for us. It forges patterns that determine how we experience the world and ultimately who we become. But, the important part, we may not be able to will what captures as. But, what captures as can change. Thank you very much that mike. [applause]. [inaudible] [inaudible conversations] therapies like cbt would not be therapeutic or helpful in light of being captured, so i would like to hear what you think about those modalities as possible therapy. There has been a lot of many different schools of psychotherapy, many different tools, but when you look at what is at the core of all of that, i mean, its to change how i respond. How i respond to a certain stimulus and it gives me tools. Again, i cannot will it, but i think i can put myself in position to be able, i mean, have at least a chance of becoming captured. Cognitive behavioral therapy, i think certainly changing how i perceive my world. In dvt the ability to change how i reacts harshly and he may all tend to we think about them for certain disorders, this one works, that one works in there really about trying to find some relief. One of the psychotherapist who i talked to in the book, a young psychotherapist really i mean summed it for me when she we were talking about freedom. She said she was very uncomfortable with freedom. Coming i dont think any of these gives you freedom from capture, but i think she focused very much on release and again, no doubt it is hard work. But, its one of the most essential tools that we have. [inaudible conversations] good evening, doctor kessler. First of all, thank you for your service to our country. Thank you. [applause]. I have a particular question for you that has to do with the children that our particular organization serves, which is the 1. 5 million, very Young Children six to 17 that are incarcerated for juvenile crime and we have investigated what leads them to those activities and what can get them out and im particularly interested in your thoughts of the development on stage of adolescence and i dont do the work because im out to his stick. Idea because the kids are fascinating and because of their culture was on an loyalty that is endemic to the stage and i wonder if you have comments seem absolutely. Enormously insightful point about the stage. There is a section and i did not expect to go there. I really wanted to focus, i mean, on mental stress and mental suffering and depression and anxiety. Also, ocd and eating disorders. You said they havent all, but i ended up looking at a number of cases in the book of violence. Armstrong there. You will remember i was struck i watched the entire trial of james holmes. That was the aurora theatre neuroscientist phd student who dressed up as batman and killed dozens of people in aurora, colorado. He is 22, 23 by the time he commits that act. You go back and try to understand how these circuits built over the 22 years of his life and at the age of 13, he says i start having these very bad thoughts. I started thinking about hurting myself. I started thinking about hurting someone else. He is asked, why didnt you seek help and he says i couldnt. Because if i did, if i told people i was having these bad thoughts that i was in essence captured by these intrusive thoughts that we all have, my parents would view me as bad. You just sit there and you listen to that and you listen to that as a doctor or therapist or a parent and you just say you just wish you could have interceded and said to this young man and got him the appropriate Mental Health care, but to explain to him, i mean, and this is what i think is absolutely key, if there is anything that i can emphasize, i mean, for me after spending the last number of years writing the book is that people who suffer are not broken. Some do horrendous and terrible things and we cant excuse it, but there is a continuum. If i told you, if i just said to you there is on this on this planet there is an organism, species in that species has the ability to think and act rationally, but that species also has the ability to be captured by certain stimuli and not shake those stimuli and focus on the stimuli and those stimuli in effect thats the way the people are designed and i said to you, if you just knew that biologically, what would you expect the world to look. What would you expect people to be captured by . The answer is, there is a whole range of things. Some will be captured by spiritual experiences. Some will be captured by hatred of others and some will be captured by hatred of self, some captured by drugs. I mean, if you want to test capture and test the hypothesis you dont have to go much further than just looking at the world around us, but certainly the goal is to be able to explain to people whats going on because thats at least the first step. [inaudible] you talk about the neurological basis. What kind of hard evidence do you have two go along with some of these special cases . So, if you theres about 120 pages of footnotes in the book. Happy to go through that because whats important is coming there are scientific methodologies. There is fm are eyes and increasingly when you look at the neurological literature, neurobiological literature you see the importance of science in a range of disorders and you can measure affective responses to just go back to your basic neurobiology. Any theory has to be able to be explained in terms of how neurons work. So, what can neurons do . They fire. Neurons can fire preferentially. And that preferential firing can impact be strengthened, so that infect neural circuits can respond to certain stimuli over other stimuli, so when you realize that attentional capture really correlates with how neurons work and then you look at specific evidence in a range of disorders you increasingly having again, no one is really looked across the board. Have to look at the literature in each and every disease condition, but i think you are finding increasing evidence for attentional bias whether its depression or mania or anxiety obsession or focus. Notable. [inaudible] [inaudible] hello. So, i was wondering i guess with sort of the release of the latest ds m and it seems like diagnosable disorders are becoming sort of more and more granular in the sort of afflictions that are considered and i was wondering how i guess your underlying theory would then kind of i dont know, guide the development of treatment of disorders today, i guess. What direction you see that changing in research. I think that dsm