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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Relat­ed Con­tent:

Stanford’s Robert Sapol­sky Demys­ti­fies Depres­sion, Which, Like Dia­betes, Is Root­ed in Biol­o­gy

Stephen Fry on Cop­ing with Depres­sion: It’s Rain­ing, But the Sun Will Come Out Again

Intro­duc­tion to Psy­chol­o­gy: A Free Course from Yale Uni­ver­si­ty

Free Online Psy­chol­o­gy & Neu­ro­science Cours­es


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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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