A Unified Theory of Mental Illness: How Everything from Addiction to Depression Can Be Explained by the Concept of “Capture”

David Kessler--once the Commissioner of the F.D.A., later the Dean of Yale's School of Medicine, and eventually Dean and Vice-Chancellor at UCSF's prestigious Medical School--published a book called Capture: Unraveling the Mystery of Mental Suffering. A bestseller, the book makes the case that all mental illness--everything from addiction to depression to artistic obsessions--can be explained by an underlying mechanism. That mechanism, the key to treating mental illness, is known as "Capture."

To get a brief introduction to Kessler's unified theory of mental illness, watch the animated primer above. It comes courtesy of The Atlantic. Get more background on Kessler's book by reading this review in The New York Times.

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  • Deborah McNish says:

    Bipolar disorder is driven by a swings in energy levels, experienced as intense restlessness or its opposite, leaden de-motivation. Mood, emotion, and cognition alter in tandem with these swings, as the whole mind/body system veers between poles. In other words, attentional capture is not at all at issue except as a byproduct of systemic disruption. Why do we continue to believe that illness like bipolar are primarily “mental” or “mood” disorders? Yet another instance of blaming the victim, disguised as “help”?

  • Christian says:

    Kessler’s theory is already encapsulated completely in the the most basic tenets of Buddhist theory/science of mind: we attach to things, and what we attach to (and how strong, etc.) depends on our personal karma. Karma not as some mystical motive force balancing universal morality, but karma as causality, and the particular set of causalities (whether biological, environmental, sociological, etc.) going back to the beginning of things and before (let’s worry about the beginningless beginning another time). Literally everything that has every occurred anywhere in reality bringing each of us to where we are along with all that that constrains or allows at this very moment.

    Like Kessler’s theory, this is the principle behind all mental distresses.

    It’s true, but Kessler is at least 2500 years behind the curve, and I think it’s incredibly likely that some people had it figured out even before the Buddha even if they didn’t necessarily come up with a comprehensive and practical a system to pass that understanding on to others. Preliterate humanity or prehuman hominids may even have had it largely nailed
    down without ever thinking about it for all we know.

    P.S., When he claims that spirituality tries to distance stimuli, Kessler is mistaken. Some might, but in Buddhism (or at least the Zen with which I am most familiar), the ideal is to work more and more towards allowing the experience of all sensory input without attaching/capturing them. Working towards experiencing whatever is without getting caught by our ideas of it. That’s why so much of the foundational praxis of Zen is about learning to spot yourself capturing, and then letting that go whenever this (hopefully growing) awareness becomes present. Based on one’s own karma (chain of causality), and the fact that most of us share a lot of it (we’re humans who have pretty similar bodies, hormones, brains, we’ve lived extensively in the 20th and/or 21st Century world of things, etc.), it turns out that for a lot of people that the first step in the practice is removing as many of the stimuli that are preventing the ability to work towards that as possible, but that’s just part of putting yourself in a place where you can learn what you need to learn to take on more and more stimuli without capture, aka attaching.

    P..S.S., In regards to bipolar, which I suffer, Buddhism’s take on Karma integrates any what we see as chemical restrictions as real. They are as valid a links in the chains of one’s own trail of causality as any other thing, and seen as something that is a part of a particular person’s own path of practice (e.g., my practice of learning to exist while letting go of attachments includes the need to modulate my chemical processes, perhaps via this medical insurance, seeing that doctor and trying this medicine). I only mention this, because I agree with Deborah that there are biological and chemical components to many conditions. I will add, however, that I have found bipolar disorder massively distorts and strengthens captures, so it still find the capture/attachment-based system of viewing mental distress to be true even when dealing with underlying chemical or neurological processes.

  • Christian says:

    I would suggest that there are many things that can cause a person to capture, and very real chemical imbalances are often part of the cause. Kessler’s theory doesn’t say not to look at one’s chemistry; in fact I believe it implies that one needs to address any reason for a harmful capture, including through pharmaceutical treatment if need be.

  • Leisureguy says:

    It seems to me that the concept provides one way of conceptualizing the phenomena described, finding a way to bring them under a single rubric. Then, when faced with a situation, one can (among other ways) look at it through the lense of “capture.” That might suggest ways of treatment to change the target or break the bond.

    “Capture” seems to me can be viewed simply as a conceptual tool, a way to categorize experience along a particular dimension or point of view. And it might well turn out to be a productive way of looking at things. It wouldn’t be the first time that looking at things in a new way led to innovations and advances.

  • Simeon says:

    I find it fascination that people still cling to, and insist that so called ‘chemical imbalance’ is at the root of mental illness.

    The following is taken from an article by Dorothy Rowe.

    ‘There never has been any evidence that any brain chemical was depleted when a person was depressed. However, psychiatrists kept hoping that one day their hypothesis that depression was caused by a chemical imbalance would be proved to be right. Now, thirty years after the hypothesis was first produced, the Royal College of Psychiatrists and the Institute of Psychiatry have accepted that depression isn’t caused by a chemical imbalance. But you’ll find this out only if you visit their websites. They haven’t issued a press release saying, ‘We were wrong.’’

    http://www.dorothyrowe.com.au/articles/item/192-the-real-causes-of-depression-february-2007

    But let’s look at this logically. When I am hungry, the ‘chemicals’ in my body that are connected with blood sugar levels, and all the other aspects of my digestive system will be different from when I am not hungry. Insulin levels are changed. Am I suffering from ‘chemical imbalance’ hunger? Or am I suffering from a lack of food, due to my environment not having the right sustenance in it at present?

    Of course, the various neurotransmitters in the brain fluctuate depending on our mood and emotion, but to say that they are the cause of those fluctuations is missing the fact that every human exists within, and is in constant relationship with, it’s environment. That fact means you cannot separate out who someone is, into a neat package, without also noting where they are, and with whom. In an nutshell, who we are (as opposed to what we are) is formed over time, in relationship with our surroundings, and the people we come into contact with. The human psychology is not a ‘thing’ with a solid biological, physical presence, that can be measured, but the result of the relationship formed between our physical selves and the world we inhabit. Who we are exists in the space between those two things.

    This idea of Capture fits that perfectly. We ALL have the capacity to get depressed, it is part of being human. Same with all the other mental ‘illnesses’. How we interact with our world, the relationships we form with those around us, and ourselves determines what ‘captures’ us.

  • Robert says:

    So now everyone’s victim, well no, causality is supreme, it has no adherence to blame. Their is no victim, just perception, there are no bad guys or good girls, its all relative. Every action has its opposite, its just simple arithmetic in the end. We perceive things as illness or dis’ease’ but its only a perception. Truth is always simple, never complicated by emotives or feeling.

    Discern this reality, we are not our emotions. They mere symptoms of cause, loss of innocence through trauma is a paramount cause of psychological imbalances in people, not words like: “driven, energy, restlessness,or phases like leaden de-motivation”. I do agree that illness is not a mood disorder or a mental imbalance its cause is usually spiritual in nature, not always but usually.

  • Will Hall says:

    I’m a therapist with 13 years experience working with a wide range of mental illness diagnosis. It is common for people to cling to simplistic defenses like “you are blaming the victim” when an honest approach is presented, but I can assure that no, it doesn’t mean you are blaming the victim or lacking compassion when you come to terms honestly with the realities of what is know and not known about mental illness and addiction.

    So I appreciate the honesty here about 1) there is no support for chemical imbalances or simplistic disease models explaining mental illness diagnosis and 2) drugs used in treatments essentially dampen stimuli, they don’t treat disease. Refreshing and clears the way for an open discussion and exploration about how to actually help people (who can certainly choose to dampen their experience with medications but need to understand it as such).

    However Kessler is just repackaging some simplistic thinking as a breakthrough to grab some of the marketing that titles such as Blink and Tipping Point. There’s no breakthrough here. It’s obvious that people with problems suffer from the problem of focusing on their problem, and the solution has always been to discover what exactly they are focusing on, what the history and story behind the leadup to that focus is all about and how it works.

    Common sense therapists and support communities call that listening closely to a person to help understand them as the way to help them. If re-packaging this as “capture” and seeking the deep roots of previous “captures” and the steps to how “capture” works can orient us more to deep listening to the experience of clients, then great. But it’s not some great psychology theory breakthrough, it’s a buzzword for something that should already be obvious when you just step back from the hype and diagnostic confusion and just take the time to listen with caring deep curiosity to people’s immediate present moment awareness and the backstories and meaning that got them to it.

  • Will Hall says:

    I’m a therapist with 13 years experience working with a wide range of mental illness diagnosis. It is common for people to cling to simplistic defenses like “you are blaming the victim” when an honest approach is presented, but I can assure that no, it doesn’t mean you are blaming the victim or lacking compassion when you come to terms honestly with the realities of what is know and not known about mental illness and addiction.

    So I appreciate the honesty here about 1) there is no support for chemical imbalances or simplistic disease models explaining mental illness diagnosis and 2) drugs used in treatments essentially dampen stimuli, they don’t treat disease. Refreshing and clears the way for an open discussion and exploration about how to actually help people (who can certainly choose to dampen their experience with medications but need to understand it as such).

    However Kessler is just repackaging some simplistic thinking as a breakthrough to grab some of the marketing of titles such as Blink and Tipping Point. There’s no breakthrough here. It’s obvious that people with problems suffer from the problem of focusing on their problem, and the solution has always been to discover what exactly they are focusing on, what the history and story behind the leadup to that focus is all about and how it works.

    Common sense therapists and support communities call that listening closely to a person to help understand them as the way to help them. If re-packaging this as “capture” and seeking the deep roots of previous “captures” and the steps to how “capture” works can orient us more to deep listening to the experience of clients, then great. But it’s not some great psychology theory breakthrough, it’s a buzzword for something that should already be obvious when you just step back from the hype and diagnostic confusion and just take the time to listen with caring deep curiosity to people’s immediate present moment awareness and the backstories and meaning that got them to it.

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