WEBVTT

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Good afternoon. How was the Venlo burger?

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Good?

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Let me ask you some personal questions:

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which one of you
is in a romantic relationship?

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Please, raise your hand.

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(Laughter)

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I'm not hitting on you, guys.
Trust me, no.

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Which one of you is lucky enough
to have a couple of friends around?

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Again, a lot of people.

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So, I should conclude you all
have a lot of people around you.

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So, which one of you knows someone
who suffers from mental distress,

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or even a mental disorder?

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It's a lot harder to raise
your hand now, isn't it?

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One out of four people in the Netherlands
suffers from mental distress

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and one out of ten people
suffers from a condition

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that we could diagnose 
as a mental disease.

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Please, look around you.

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My talk is about you
and the people in your lives.

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I want to show you how our relatively
non-severe mental problems

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can go from bad to worse very quickly,

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and how often we create
these situations ourselves.

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I also want to show you

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how our healthcare system
fails to address complex problems

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and how we can use the power
of suffering in order to evolve.

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I want you to meet Jane.

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Now, we all know Jane.

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She could be your neighbor,
your relative, your average colleague.

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Jane is a 40-year-old woman,

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and she's married, has two children,
a son and a daughter,

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and she works as a secretary
in a large company.

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One day, Jane doesn't show up for work.

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She was feeling tired for a while,

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and she reports to her family doctor
and he advises her to take a good rest.

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So, that's what she does: she goes home
and she takes a good rest,

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and this rest takes up to four weeks.

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After four weeks, she gets back to work.

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Six months later, she drops out again:
same symptoms, but worse.

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Again, she reports to her family doctor
and he diagnoses her with burnout.

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He prescribes her 
antidepressant medication

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and, again, advises her
to take a good rest.

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This time, this rest
takes up to four months.

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After these four months,

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she goes back to work, 
still on medication.

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Two months later, she drops out again,
third time within a year.

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Severe depression.

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She's referred to specialized
mental healthcare

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for a very intensive treatment,

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and, after one year 
of intensive treatment,

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she ends up at home,
losing her job permanently,

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still depressed.

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So, what's going on?

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Why isn't her medication working?

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Why isn't the therapy working?

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The real problem that Jane is facing
is that she has an addicted son

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stealing from her every day,

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manipulating her every single day,

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lying to her, threatening her.

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So, every time she was sent home
by her family doctor to take a rest,

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she was sent straight into hell.

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The question that comes to mind is:

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why didn't Jane tell her family doctor
about her addicted son?

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She only asked him
to help her with her depression.

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But, on the other hand,
the family doctor knows her son.

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In fact, he knows the whole family,
and he also knows her son is addicted.

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How come he's only focusing
on the symptoms Jane is presenting?

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And how come the specialized
mental healthcare

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is doing exactly the same thing?

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That's because they're doing their job.

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The family doctor is doing his job well,

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focusing on the symptoms his patient
is presenting, and treating them.

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scaling up, as does the specialized
mental healthcare,

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following protocol

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and treating her with so-called
evidence-based treatment.

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It is however the system
that doesn't allow them

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to focus on the main 
source of the problem.

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The system is broken.

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It is the system that does not address
complex situations like Jane's adequately.

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It is this system failure that made me
as a mental professional healthcare worker

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think about a drastic change
in the way we help people like Jane.

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And so, I want to introduce you
to the M.A.D. approach.

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"M.A.D." stands for
motivation analysis diagram,

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and M.A.D. is based on the principle
that the level of suffering

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influences our motivation to take
responsibility for our own recovery,

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and taking this responsibility

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is a fundamental element
in any effective treatment.

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In order to show you
that it is a real diagram,

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this is how it looks like.

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It tries too far to fully explain
the model in full detail,

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but I will show you its main principles.

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And the first principle
of the M.A.D. approach

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is that the degree of suffering
influences motivation.

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As you can probably imagine,
if my level of suffering is too low,

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then I probably won't be motivated
to change my behavior

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or make other choices.

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On the other hand, 
if my level of suffering is too high,

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chances are that I'm not able to change,

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due to too much pain or pressure.

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So, if I can influence
your level of suffering,

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then I can also influence your behavior.

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In Jane's case,

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the family doctor and the
specialized mental healthcare

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decreased the level of suffering
by treating her symptoms,

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but therefore, they also
decreased her motivation

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to address the main source of the problem.

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So, influencing the level of suffering
is a key element in the M.A.D approach.

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The second main principle

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is that M.A.D. focuses
on the main source of the problem,

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instead of the symptoms 
that are presented.

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Again, in Jane's case,
we stopped her treatment,

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we also stopped her medication,
and all we did was follow up.

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We only monitored the level
of suffering rising again.

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Eventually, she opened up,
she told us about her addicted son.

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So, that's what we did:
we treated her son's addiction,

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we gave him the attention
and care that he needed,

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and we also provided him
with another place to live.

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Within four months,

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Jane's symptoms cleared,
without any additional treatment.

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The M.A.D. approach has been proven
successful in the past three years

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within my company,

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and as a comparison,

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up to 85% of the people who are treated
in regular addiction healthcare

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will fall back in their former habits
within the first year.

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Eighty-five percent will fall back.

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Using the M.A.D. approach,

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we are able to reduce
this fallback to only 10%,

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and just imagine the personal
benefits for our patients.

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Imagine the social benefits,
or even the financial benefits.

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It is my personal mission
for the upcoming years

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to make this M.A.D. approach trainable
and therefore accesible

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to every professional healthcare worker.

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But you also can start using
the M.A.D. approach today,

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helping your relatives,
helping your loved ones or colleagues.

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And in order to do so,
I have three recommendations for you.

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First one is: recognize suffering.

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In order to do so,
keep asking questions.

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Again, it's no rocket science,

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but try to figure out
what is really going on here,

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instead of jumping to conclusions.

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Try to detect the main source
of the problem.

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The second one is: stop focusing
on what people want.

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Start focusing on what they really need.

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These two things are not the same.

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The third one is that nobody
likes to suffer, it hurts,

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but instead of reducing the pressure,

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you can use it as a powerful tool
for you to evolve.

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So, next time, tomorrow,
on Monday, back at work,

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next time you meet your Jane,

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I want you to remember
these recommendations.

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Thank you for listening.

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(Applause)