Translator: Leonardo Silva Reviewer: Mile Živković
Good afternoon. How was the Venlo burger?
Good?
Let me ask you some personal questions:
which one of you is in a romantic relationship?
Please, raise your hand.
(Laughter)
I'm not hitting on you, guys. Trust me, no.
Which one of you is lucky enough to have a couple of friends around?
Again, a lot of people.
So, I should conclude you all have a lot of people around you.
So, which one of you knows someone who suffers from mental distress,
or even a mental disorder?
It's a lot harder to raise your hand now, isn't it?
One out of four people in the Netherlands suffers from mental distress
and one out of ten people suffers from a condition
that we could diagnose as a mental disease.
Please, look around you.
My talk is about you and the people in your lives.
I want to show you how our relatively non-severe mental problems
can go from bad to worse very quickly,
and how often we create these situations ourselves.
I also want to show you
how our healthcare system fails to address complex problems
and how we can use the power of suffering in order to evolve.
I want you to meet Jane.
Now, we all know Jane.
She could be your neighbor, your relative, your average colleague.
Jane is a 40-year-old woman,
and she's married, has two children, a son and a daughter,
and she works as a secretary in a large company.
One day, Jane doesn't show up for work.
She was feeling tired for a while,
and she reports to her family doctor and he advises her to take a good rest.
So, that's what she does: she goes home and she takes a good rest,
and this rest takes up to four weeks.
After four weeks, she gets back to work.
Six months later, she drops out again: same symptoms, but worse.
Again, she reports to her family doctor and he diagnoses her with burnout.
He prescribes her antidepressant medication
and, again, advises her to take a good rest.
This time, this rest takes up to four months.
After these four months,
she goes back to work, still on medication.
Two months later, she drops out again, third time within a year.
Severe depression.
She's referred to specialized mental healthcare
for a very intensive treatment,
and, after one year of intensive treatment,
she ends up at home, losing her job permanently,
still depressed.
So, what's going on?
Why isn't her medication working?
Why isn't the therapy working?
The real problem that Jane is facing is that she has an addicted son
stealing from her every day,
manipulating her every single day,
lying to her, threatening her.
So, every time she was sent home by her family doctor to take a rest,
she was sent straight into hell.
The question that comes to mind is:
why didn't Jane tell her family doctor about her addicted son?
She only asked him to help her with her depression.
But, on the other hand, the family doctor knows her son.
In fact, he knows the whole family, and he also knows her son is addicted.
How come he's only focusing on the symptoms Jane is presenting?
And how come the specialized mental healthcare
is doing exactly the same thing?
That's because they're doing their job.
The family doctor is doing his job well,
focusing on the symptoms his patient is presenting, and treating them.
scaling up, as does the specialized mental healthcare,
following protocol
and treating her with so-called evidence-based treatment.
It is however the system that doesn't allow them
to focus on the main source of the problem.
The system is broken.
It is the system that does not address complex situations like Jane's adequately.
It is this system failure that made me as a mental professional healthcare worker
think about a drastic change in the way we help people like Jane.
And so, I want to introduce you to the M.A.D. approach.
"M.A.D." stands for motivation analysis diagram,
and M.A.D. is based on the principle that the level of suffering
influences our motivation to take responsibility for our own recovery,
and taking this responsibility
is a fundamental element in any effective treatment.
In order to show you that it is a real diagram,
this is how it looks like.
It tries too far to fully explain the model in full detail,
but I will show you its main principles.
And the first principle of the M.A.D. approach
is that the degree of suffering influences motivation.
As you can probably imagine, if my level of suffering is too low,
then I probably won't be motivated to change my behavior
or make other choices.
On the other hand, if my level of suffering is too high,
chances are that I'm not able to change,
due to too much pain or pressure.
So, if I can influence your level of suffering,
then I can also influence your behavior.
In Jane's case,
the family doctor and the specialized mental healthcare
decreased the level of suffering by treating her symptoms,
but therefore, they also decreased her motivation
to address the main source of the problem.
So, influencing the level of suffering is a key element in the M.A.D approach.
The second main principle
is that M.A.D. focuses on the main source of the problem,
instead of the symptoms that are presented.
Again, in Jane's case, we stopped her treatment,
we also stopped her medication, and all we did was follow up.
We only monitored the level of suffering rising again.
Eventually, she opened up, she told us about her addicted son.
So, that's what we did: we treated her son's addiction,
we gave him the attention and care that he needed,
and we also provided him with another place to live.
Within four months,
Jane's symptoms cleared, without any additional treatment.
The M.A.D. approach has been proven successful in the past three years
within my company,
and as a comparison,
up to 85% of the people who are treated in regular addiction healthcare
will fall back in their former habits within the first year.
Eighty-five percent will fall back.
Using the M.A.D. approach,
we are able to reduce this fallback to only 10%,
and just imagine the personal benefits for our patients.
Imagine the social benefits, or even the financial benefits.
It is my personal mission for the upcoming years
to make this M.A.D. approach trainable and therefore accesible
to every professional healthcare worker.
But you also can start using the M.A.D. approach today,
helping your relatives, helping your loved ones or colleagues.
And in order to do so, I have three recommendations for you.
First one is: recognize suffering.
In order to do so, keep asking questions.
Again, it's no rocket science,
but try to figure out what is really going on here,
instead of jumping to conclusions.
Try to detect the main source of the problem.
The second one is: stop focusing on what people want.
Start focusing on what they really need.
These two things are not the same.
The third one is that nobody likes to suffer, it hurts,
but instead of reducing the pressure,
you can use it as a powerful tool for you to evolve.
So, next time, tomorrow, on Monday, back at work,
next time you meet your Jane,
I want you to remember these recommendations.
Thank you for listening.
(Applause)