The power of suffering | Patrick Leenen | TEDxVenlo

Patrick Leenen developed a revolutionary new way of no-nonsense treatment of mentally ill people. He shows amazing results with his treatment method. What those results are, you’ll hear in his talk.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

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)