Illustration by Anthony Russo

David Kessler ’73 opens his new book on mental suffering with the suicide, at age 46, of David Foster Wallace ’85. “He left more than a dozen lamps burning in his workroom,” Kessler writes. “They shone upon the desk, and on the unfinished manuscript neatly stacked on top of it. Next to the manuscript was a two-page letter.” 

As commissioner of the U.S. Food and Drug Administration from 1990 to 1997, Kessler became well-known for his crusade against tobacco. He is the author of A Question of Intent, about the tobacco industry, and The End of Overeating, about the food industry and the American diet. Now, in Capture: Unraveling the Mystery of Mental Suffering(HarperCollins, 2016), Kessler argues that a common mechanism underlies addiction, depression, anxiety, mania, obsessive thoughts and violent anger. 

“What was the underlying cause of the depression that governed Wallace’s deep unhappiness?” Kessler writes. “‘Depression’ is a label used to describe a group of symptoms. It is not a cause.” 

An independent scholar at Amherst, Kessler is also a graduate of Harvard Medical School and the University of Chicago Law School. He is a professor of pediatrics and epidemiology and biostatics at the University of California, San Francisco, where he was previously dean of the School of Medicine. 

David Kessler '73
Kessler’s new book is Capture: Unraveling the Mystery of Mental Suff ering. He is a professor at UC San Francisco. Photograph of David Kessler ’73 by Jen Siska

This fall he spoke with Amherst’s Lisa Raskin, the John William Ward Professor of Psychology (Neuroscience), about the hypothesis he presents in his new book.

RASKIN: Your new book pulls together literature, neuroscience, psychology and philosophy to understand the theory of capture. Can you start by explaining the concept?

KESSLER: The hypothesis is that a common mechanism underlies many of our emotional struggles and mental illnesses. Simply put, a stimulus—a place, a thought, a memory, an object, a person—seizes our attention and there’s a shift in our perception. I may sense that shift, but I don’t necessarily understand where it comes from when it happens. The experience occurs outside our conscious control, and we surrender to it before we perceive that it’s going on. 

You hear, “I can’t resist sugar,” or “I can’t resist nicotine.” 

My hand reaches for that chocolate chip cookie before I even think, Do I want that chocolate chip cookie? A drug, a food or a behavior can affect how I feel, and the next time I get exposed to that stimulus, I arouse that same neural circuitry and get caught in a cycle. I pick up that one cigarette and then 781,000 more for the rest of my life. Out of all the stimuli bombarding me, I can only focus on certain things; I’m going to pick out those that are important to me, based on past learning and past memory.

Clinicians in my field have said that between the stimulus and the response is freedom. 

That’s key. There’s always a moment where the more rational, higher cortical circuits allow me to possibly change course. I’m stimulated. I feel a certain way. I’ve not yet acted. But certain stimuli become so strong, so powerful, that in certain instances, after repeated experiences, we probably sense very little opening for freedom. 

Your book begins with David Foster Wallace ’85. What did you learn from talking with his parents, siblings and Amherst friends?

His depression started in late adolescence. I became interested in whether depression involves a continual focus on negative thoughts, experiences and memories to the exclusion of all else, and how someone who’s depressed gets captured by these thoughts and experiences and narrows his or her attention, focusing on only the most negative stimuli. In his writing, Wallace explained the feedback cycle: I focus on the negative, that makes me feel sad, and I end up focusing on what makes me feel sad. 

A negative thought creates the emotion. When you live in that emotion, you think it’s real. 

I’m broken, I’m a failure, I’m never going to feel better: The output of that cycle becomes the input, the next round. It’s self-sustaining. That chocolate chip cookie I can walk away from. Tobacco I can walk away from. But myself—I’m always there. So I focus internally, but I can also focus on external stimuli— you slighted me; you made me feel bad. And I can be captured by an abiding sense of rage.

So is it an addiction, almost, to your own feelings?

Look at psychopathic behavior. It has been viewed as lack of conscience, a failure of empathy. That focuses only on what’s absent in the mind of the psychopath. But take any mass shooter: Something made him enormously angry. I think there are neural circuits that underlie that response. 

You write about the author William Styron. He decides to commit suicide, but after listening to the Brahms Alto Rhapsody, his feelings for his mother are so strong that he decides to save himself. He’s overwhelmed by sadness, and then he’s reminded of his mother and is instantly changed. 

As bad as he felt about himself, something even more meaningful captured him. The most important secret about capture is that one of the most effective ways to be released from it is to find something else that is more meaningful—to replace a form of negative capture with a positive one.

I think about people who have generalized anxiety disorder. One symptom is that they’re anxious about being anxious. They worry about going outside because they worry they’ll become anxious. What would happen if they could lose themselves in something else?

Look at Alcoholics Anonymous. What gets substituted for alcohol—fellowship, sobriety? Something takes the place that’s more important. It’s easier said than done. At Amherst, David Foster Wallace was a student having bad thoughts, and those bad thoughts isolated him: I can’t share what’s going on in my head because people will think worse of me. If you can get to young people at an early stage and explain to them that they’re not bad, that we all get captured by certain things, can you at least alleviate the pain that accompanies the isolation?

Medicine can attenuate the bad feelings, but somebody with social phobia, for example, then has to learn how to live in the world. Studies show medication combined with therapy is most effective.

My sense is that antidepressants quiet the circuitry, and psychotherapy allows those who are suffering to change the context—to find something else that captures them, or at least to manage the negative thoughts.

If you can learn to turn down the noise, to quiet the thoughts, you can understand what you’re saying to yourself.

Being able to understand how our minds work—isn’t that a key part of a liberal arts education? 

No magnetic resonance imaging, no experiment on a snail, is going to allow me to understand the subjective feelings associated with capture.

Absolutely. The liberal arts is also about challenging what we think and the way we think, and being brave enough to challenge assumptions that we’ve always held. That is essential to an Amherst education. 

The sciences are essential to understanding the neural circuitry; any hypothesis has to be grounded in that neurobiology. But no magnetic resonance imaging, no experiment on a snail, is going to allow me to understand the subjective feelings associated with capture. My book focuses on great writers who explain what they are feeling much better than I ever could. You need learning across disciplines. Plato looked at disparate parts of the mind. Socrates asked if we do things that are not in our interest. And a retired Amherst political science professor, George Kateb, helped me understand what captured us in this political cycle. 

Some infants will respond differently to stimuli than others will, and that difference might set them on a course: depending on how they respond to stimuli and how the world responds to them, they’ll be captured by one thing or another going forward. 

Many of us enter Amherst being captured by certain ideas and thoughts. Can the Amherst experience teach us how to be free of some biases or broader experiences, so that when we leave we are captured by different things than when we entered? 

One comforting thing you’re saying is that we all have these circuits. We will all get captured by one stimulus or another, dependingon our history. So, go easy on yourself. 

We can’t look at the neural circuits of Virginia Woolf and David Foster Wallace. That’s not possible. Are some of us more susceptible to capture? No doubt, even if this is a common mechanism, there are different thresholds. The thing that was most important to me was to try to show how we are all vulnerable to capture. It’s not that we’re broken. It’s the way that we’re wired.