we have these products that are available to us, against things like anthrax and we have smallpox, if somebody decides to make it in a lab. we do have some mechanisms that are available to us. it's a challenge. how do you have new drugs available? thank you. >> i guess you have had a dressed the biological threat issue. i was going to ask that. and thank you for really an exciting jury n.i. it was wonderful. the book is available. thank you. [applause]

kesler.

why do we look and feel in ways that we do not. >> blows help me give a warm welcome to doctor david kesler. >> stharng you, and thanks to book passage, one of our favorite bookstores and thank you all for coming out. >> the journey that led to

capture, began about 25 years ago for me, at f.d.a. we began the investigation into the tobacco, and, i became interested why one would smoke one and then, 780,000 more over a lifetime. and 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, highjacks our attention, based on past learning, there's this arouse

sal, increased attention. these thoughts of wanting, and i eat the cookie, and i have this momentary bliss and two minutes later i go why did i do that? and the next time i'm exposed to some cue associated with it. i do it again. i strengthen those circuits. so i had to learn everything i could about those conditions and driven behaviors and there was something that seemed to me, to be evident, that, we are all wired, all of us, are wired to focus on the most salient stimuli in our environment. if a bear walked in here right now, you would stop listening to me. if you started smelling smoke that becomes the most important sim my lie. if i took out a gun that would

capture at least most of your attention. so, i was very interested, i wanted to understand whether that mechanism that was in play, in nicotine and overeating, the question was, does that mechanism also involve, an ap ray of effective conditions? and certainly one of the most important effective conditions, is depression. very few families are not touched in some way by someone who is experienced, this debilitating illness. so where do you go look and understand what the cause of depression is? i mean, if i ask you, what causes depression, in 2016? what are you going to say? what's the answer? someone. what? >> life. [laughter] >> drugs. drama.

>> chemical imbalance. it sounds like you know, from all those answers, truth is we probably don't know. when you think about it, 2016 and we're not sure, there's no real hard scientific evidence that there's a chemical imbalance at play. as i was asking this question, one of the great young writers, of this generation david foster wallace had committed zy what side. and i became very interested, he, and i went to the same college. he, a decade later. but, i 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 lamp burning in his work room.

they shown upon the desk and unfinished manuscript. next to the man uscript was a two-page letter. this was a scene on the evening, david foster wallace hanged himself. his suicide at the age of 46 devastated the literary community, he was as the boldest most innovative writer. his novel was lauded by critics and thought to have redefined, american fiction. the manuscript, would be published. the novel, many would argue contained some of his best work. despite his frustration with his inability to complete the book, his life had never been better. he had married four years earlier and was settled in

california, with the teaching job he loved. why then did he take his own life? what was the underlying cause of the depression that governed david's deep unhappiness? depression, every time i ask what caused david's illness, all i heard was the word depression, with a capital d. from an early age he wanted to be exempt from the ord nair. he wanted to excel. first as a student and later as a writer and he wanted others to recognize him. he wanted to be read in 100 years. as soon as he succeeded, if he earned an a-plus he grew uneasy and then disparking. he wanted to be a good person and suspected crooked about the way achieved success. something false.

wallace was haunted as he wrote himself by the fraud fraudulent. >> he was always on high alert. always sensitive to signs of the impossible store. in the margins of a book he scribbled the following. grant me os aty the constant need to be and seen as a superstar. something about this notion stuck and became a thought, one that made him feel very bad whenever he encountered, something that threatened his sense and any number of things could. critical praise. success, romantic attention. someone laughing at his jokes. in such moments his life became a lonely performance. everything else receded into the back groinltsdz. the feeling encompassed him more

each time he experienced it, gaining traction in his mind. depression, i would say 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 self-doubt but he was seized by his self-destructive refrain. he knew it but he felt powerless to change it. what goes on, inside is just too fast and huge, and all interconnected for words to barely sketch the outlines of one tiny part of it at any given instant.

no matter what his success, he filtered out everything else that reflected well on him and took in everything that could be constructed badly. >> this kind of filtering can only lead to pain. a spiral led to suicide. self harm, can lead to self harm. wallace's focus rarely shift fred his histormeanting thoughts. he as though he existed within a dark world inside, ashamed, locked in. what some might view as narcissistic behavior, is more accurately understood in his case as a overwhelming 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. he could not as he once wrote, perceive anything as independent of the opinion. everything he wrote is part of the problem. what becomes salient in depression is the negative perception of the self. the self-doubts, the failures, the sense of being a fraud. having such focus, how does it make him feel? incredible intense sadness. and then what captures? that sadness, that out put, right then becomes the input and you see this vicious cycle

sustaining itself. is it possible to unravel the mystery of mental illness? we talk about depression or addiction or anxiety as if they are different and yes, they are different symptoms with them. but, they are really, i would argue, they are responses to a neural process that happens in all of us. let me suggest, i understand this is a bold assertion, but i think glass common mechanism underlying many struggles and illnesses. a stimulus, a place, a thought, a memory, a person takes hold of our attention and it shifts our perception. it becomes focused, on it, the way we think and feel and what

we do, may not be what we want to happen. the theory of capture involves three elements. a narrowing of attention, this perceived lack of control. the person is in control but there's a sense that something is pulling. a change in after if he can't or emotional state. >> capture seizes our attention. we may sense a mental shift but we don't understand where it comes from. the experience occurs outside of conscious control. and we surrender to it, before we perceive t. it is the way our brains process information. when we are drawn to a particular stimulus we act, in

response to a feeling. every time we respond we strengthen the circuits that prompts us to repeat. there are grooves, being laid down. but, you are strengthening the circuits. neurons, fire together, and become strengthened together. those circuits. so there's a basis to why certain stimuli, why our attention shifts to certain stimuli based on past learning and past memory. think past experiences shape what my attention will focus. as we react in the same ways to the same stimulus over time, we are sen a tizing it. it's very important. these are not special circuits.

who has these? when we do it, our thoughts and feelings and actions can arise automatically. >> william james, one of the last great psychologists to talk about attention, he wrote, in one of his lectures, i saw it, the question he asked, why are certain ideas so strong as to coerce attention? how does a stimulus became sail lee end for you or me? it could be bright. but there is also powerful desires, immediate or distant goals, attitudes, towards

adversity and major life events. anything that is meaningful to us can capture our attention. the things, it can be salient to one person but, again, rate no response at all in another. let's go through, i don't have time to go through all the effective conditions. but let's go through some of them and ask the question, what captures us? anxiety. what can it be? >> rather than -- that chocolate-chip cookie, creating thoughts of wanting, what captures my attention can make me fearful. it could be going over. for me it could be going over the golden gate bridge.

but it may not arouse or trigger anyone of you, it could be standing on a ledge. fear of being a fraud. or something bad is going to happen. how about the eating disorders? anorexia, food is sail lee end. >> if i can take an apple and slice it in 80 pieces and i can, over an entire day, just eat that, a slice, every hour or so, how do you think that's going to make me feel? that will make me feel in control. that could make me feel good.

so, is it fear of food or is it that love of control? in trauma, we can be captured by a harm that was done to us, years ago. ptsd. and being abandoned, you read, the chapter, that fear of being abandoned, captured her. high po condrey a, what is it? i became fearful that something is wrong. in the manic phase of bipolar it's fill the void. anything that's going to make me feel better. the constant striving. that's what captures me.

virginia wolf, became very focused on the fear that she was going to be instinewsallized. >> hemmingway, in cuba, is dispatched and told, to get out of cuba. he says, they're using a word about you in washington. the word was traitor. he said i am not political. this is where i where i. this is where i love to be. but that focus, that use of the word, and then he became concerned about his finances and vision, and inability to write

and that he would never write again. >> addiction to be able to hold the same circuits. whenever we encounter a stimulus we are conditioned to behave in the same way over and over again. >> true for alcohol. here's carolyn, the great writer who talk about the effect of capture. focused, on the cue, not the alcohol. but the attention. i loved the sounds of drink, the slide of the cork as it eased out. the distance booze, and the clatter of ice-cubes. it wasn't the drink, it was all cues. in fact, capture is the result -- in addiction the cues

take over. they have no significance in the absence of association. if you have never been a smoker, the sell pain, and the curl of smoke and the image of the cowboy will have no resonance. for john bell luchi died of cocaine and heroin mixtures what were the triggers? if it was a great success, he would use. but the one thing he said, was, i don't understand why i can't stop. i talked about how capture can

lead to behavior and it's harmful. when you're dealing with, things about the self, it's one of the most devastating forms of capture. i could eliminate tobacco, and take all the food cues out. but if it is the self, right, that is the focus, what can't i get away from? you can't 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 a sense of rage? psychopathic behaviors, it has been understood as what? if you read any books they will tell you, that they lack a conscious, a absence of the guilt. these focus on what is absent in

the mine. what then one might and is present along with dylan, harris murdered 13 people, in columbine high school. throughout his journals, very interested in focusing on people's own words. really trying to understand what was going on in the minds of the time of people. you read in these journals that harris poses as someone who add grudge against his peer group, and he resent the high school culture. he gets his year book. this is what he where is, if i could new york the world i would. and he goes on, everyone is always making fun of me because of how i look. how "f-ing" weak i am, well i

will get you all back. ultimate revenge. you people could have shown more respect, treated me better, and treated me more like a senior. maybe i wouldn't have been as ready to tear your head off. you see, right. in this child, the slightest. the slightest, that, you know, in high school, he could not shake. here's what he wrote, i know what all of you are thinking, and what do you do to piss you off and make you feel bad. it wasn't just about him, but what was he going to do to feel better? i feel like god. and i wish i was having everyone being lower than me. i already know that i am higher than most anyone in the world.

ted, the unibomber. hard time adjusting to other people. no question, awkward. very, very smart. decides to become a survival list, in montana. before he started second the bombs, this is what he wrote, i ask you, when you listen to this, tell me what became salient? >> yesterday was quite good. heard only eight jets. today was good but later in the morning there was an aircraft noise. i would estimate about an hour. and then there was a very loud sonic boom, this was the last straw and reduced me to tears. but i have a plan for revenge.

he wanted to be left alone. by silence i don't mean all sound has to be excluded only man-made sound. thunder and cries are magnificent and aircraft noise is an insult. a slap in the face. if a symptom of the evil of modern society. invasion of technology. he wanted to be left alone. but counted the number of jets that would fly. three days before he killed bobby kennedy. he was watching the t.v. broadcast where kennedy promises to sell 50 phantom jets to israel and all of a sudden the christian palestine knee ann took that as a affront.

it created such rage in him. adam, what became salient? mass murder, in, of itself. capture, has more significance when it is ideal logical. they have a powerful allure, to the individuals, he becomes dedicateded to a higher cause which promises to give some meaning. to connect him or her with something greater than the self. it is more than a need to destroy. i am not pleased, i am not giving excuses. but we need to understand that what drives a terrorist attacker, are -- they are captured by an idea.

at some point, in the development, they became endlastled that they are fighting for a cause larger than they are. a truth that transcendses the self. but here's the important part. here's the real key. not only are we captured by something that's meaningful, we can be captured by positive stimuli. they are neutral. it can be positive or negative. the positive influteseses. and, what is spiritual experience? it has been explid as the feeling of absolute dependence of being grasped by an ultimate concern. they may involve moments of release from ordinary perception.

the catalyst may be spiritual, a people, a landscape, a moment of quiet meditation. the feeling have it at times, comes in like a gentile tide. pervading the mind with a tranquil mood of deepest worship. that was the german theo low again. david wallace wrote about this. he didn't understand capture. of it but he understood the relationship between the human and the divine. wallace came to believe there is no such thing as not worshiping, >> our only choice is what to worship and compelling reason for maybe choosing some sort of god or thing to worship, be it j.c. or the week-end mother or

some set of ethical principles, is pretty much anything else you worship, will eat you alive. depression was a label we gave to a group of symptoms and we said what causes that group of symptoms if that label, that name depression. what we need to do is to pull back the curtain so i think if

we could understand, people could at least understand at least understand if you feel a loss of control and you feel something is pulling at you and you are feeling terrible and you don't know why, those are pathways to psychic pain. we all know the real question you want to know is how do you release yourself from sure? the most important secret if you would about capture one of the most effective ways to be released from captures to find something else that is more meaningful. no doubt if you look at buddhism what does it teach? it tries to quiet the stimulus. what a psychocolacci? we try to quiet the reactivity but i think the answer and certainly one of the most effective ways because we are not going to get rid of the circumstances. only death eliminates the circuit from operating. the answers to face one form of

negative capture with a positive form. if there's any hero in the book, i think it's an example of chris ware, the great graphic novelist i am sure you have read his graphic novels. somewhere in this bookstore there's a big box called building stories and if you open one of the works in building stories the first page, the big circle 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 were no longer captured. why, what happened? he had a child and that changed everything. all of a sudden you are no longer the protagonists.

the movie has a new cast. all of a sudden you are supporting actor and you suddenly realize that what u.s. then, that's what you have been all along and that is the way every human being should be and that's the way you really should be living your life. in light of new priorities at least in his case, his social anxiety, his hypersensitivity were in his own words he shifted his own perception. you know all that anxiety is really just a very very self and/or gentle form of melancholy and egotism on the other parts of the dash not that i'm agreeing with him. to change the way he perceives his self-doubt and what he was feeling. sure arouses the focus to act with purpose. the mechanism is not in and of

itself demeaning 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 of often fragmented care thousands of stimuli any one of which can be meaningful and any given time. over time for all of us certain characters and experiences in merge a central. others moved to the tangential soon to be forgotten. gideon 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 there freedom from sure? can we throw a switch and see the entire stage for what it is?

in the most basic sense the answer is know. attention is by its very nature is in self-reinforcing. our environment, each of our own personal experiences, our history, our economic situations we find ourselves the physical situations we find ourselves then is what becomes salient for us it for just patterns that determine how we experience the world and ultimately who we become. the important part, we may not be able to will what captures us but what captures us can be changed. thank you very much. [applause] >> does anyone have any questions they would like to ask?

>> therapies like dbt and 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 are 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 them i think is to change how i respond to a certain stimulus and it gives me tools. again i can't will it but i

think i can put myself in position to be able to have at least a chance of becoming captured by something else. cognitive behavioral therapy i think certainly changing how i perceive my world and dbt the ability to change how i react emotionally and they all tend, we tend to think about them for certain disorders this one works, that one works but really about perceptual chance. they are about trying to find some release. one of the psychotherapist who i talked to in the book, the young psychotherapist, really summed it up when we were talking about freedom and she said, she was very uncomfortable with freedom. i don't think either one in any of these modalities it's you

freedom from capture but i think she focused very much on relief. again, no doubt it's hard work but it's one of the most essential tools that we have. >> good evening dr. unraveling the mystery of mental suffering. first of all thank you for your service to our country. c thank you. [applause] >> i have a particular question for you that has to do with the children are particular organization serves which is the 1.5 million very young children, six to 17 who are incarcerated for juvenile crimes and we have investigated what leads them to those activities and what can

get them out. i am particularly interested in your thoughts on the developmental stage of adolescence and i don't do the work because i'm altruistic. i do it because the kids are fascinating and because of their altruism and loyalty and doma to that stage and i wonder if he could comment about that? >> absolutely. enormous land cycle points about that stage. there is a section and i didn't expect to go there. i really wanted to focus on mental distress and mental suffering and depression and anxiety and ocd and disorders. as you said they have it all but i ended up looking at a number of cases in the book of violence because i was drawn to that.

you will remember, i was struck, i watched the entire trial of james holmes. that was the aurora, neuroscientist ph.d. student dressed up as that man and killed dozens of people in aurora, colorado. what struck me, he's 22, 23 by the time he commits the act. you go back and try to understand how these circuits build over the 22 years of his life and at the age of 13 he says i start having these very bad bots. he started inking about hurting himself, started thinking about hurting someone else. and he is asked, why didn't he seek help?

he says i couldn't. because if i did come if i told i was having bad thoughts, i was in essence captured by these thoughts that we all have, my parents would view me as a bad and you just sit there and listen to that and listen to that. and you just think, you just wish you could have interceded and gotten him the appropriate mental health but to explain to him, and this is what i think is absolutely key. if there is any thing that i could emphasize, for me after spending the last several years writing the book, it is people who suffer, they are not broke in. some do her rent is in terrible things and we can't excuse them.

but there is a continuum. if i told you, if i just said to you on this planet there is an organism, there's a species in that species has the ability to think and it has the ability to act rationally but the species also has the ability to be captured by certain stimuli and to focus on the stimuli and those stimuli affect how the species feels that that's the way people are design. and i said to you, if you just knew that i logically what would you expect the world to look like? what would you expect people to be captured by? and the answer is, there's a whole range of things. some are going to be captured by spiritual experiences and some are going to be captured by hatred of others and some will be captured by hatred of self and some will be captured by

drugs. if you want to test sure, if you want to test the hypothesis you have to go further than just looking at the world around us that certainly the goal to me is to be able to explain to people what is going on because that is at least a first step. >> you talk about the neurological basis. what kind of hard evidence do you have to go along with some of these phenomena or any special cases? >> so, there are about 120 pages of footnotes in the book. i'm happy to go through that the what is important is, i mean they are our scientific methodologies. there are fmr i's and we can look and increasingly when you look at the eighth neurological

literature, you see the importance of salience in a range of disorders and you can measure attentional capture and affect, affective response. just go back to your basic neurobiology. any theory has to be able to explain in terms of how neurons work. so what can neurons due? neurons can fire up preferentially and that preferential firing cannon in fact be strengthened, so in fact narrow circuits can respond to certain stimuli over other stimuli. so when you realize that attentional capture, correlates with havner on his work and then you look at the specific evidence in the range of disorders, increasingly, again

no one has really looked across-the-board. you have to look at the literature in each and every disease condition but i think you are finding increasing evidence for an attentional bias whether it's in depression or mania or anxiety or possession. >> are there any more questions? >> hi pair. i was wondering, i guess with the release of the latest dsm and it seems like diagnosable disorders are becoming more and more granular and disorder of affliction is considered pathology and i was wondering how i guess you're underlying theory would then kind of guide the development of treatment of disorders today?

what direction do you see that? >> i think dsm has been very helpful in categorizing certain conditions and giving people some sense of, based on which categories you could apply, what it has failed at is the underlying etiology and i think most people understand. i mean there is value in it, but are really asking what's going on? i think the more we learn, the more we will come to understand that it's not specific narrowed narrowed -- yes it can play a role in this disorder or that disorder but to really understand how neuro-circuits really become intensified, how

those neuro-circuits get laid down, i think that's what speaks. the reality is, the reason why this has been, once those neuro-circuits get strengthened, how long do they last and they respond so they can last a lifetime. but the good news is we can lay down new neuro-circuits and i think increasingly those who provide care understand that the goal is to try to lay down those neuro-circuits. thank you very much. [applause] >> we have the after kessler spoke at our cash register.

if you want them to sign a book or you have questions for him you are welcome to come. [applause] [inaudible