WEBVTT

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This is Kirk.

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He suffered from depression
for five years.

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He tried antidepressants, talking therapy,

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and nothing helped.

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In May 2015, in Imperial College,
he was given psilocybin,

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also known as magic mushrooms.

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And since that time
he's been depression free.

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This is Ben.

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He suffered from depression for 30 years.

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And in that time he tried everything:
CBT, group therapy,

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a list of medications
prescribed to him by his doctor,

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and nothing helped.

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In June 2015, he was given psilocybin,

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and since that time
he has been depression free.

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Not only had the symptoms
of his depression gone,

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but in the last year,

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he has done an acting course,
a printing course,

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he's flown on a plane
for the first time in a decade,

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and his career and social life
are flourishing.

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I can't show you his face

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because magic mushrooms
are an illegal psychedelic drug,

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and he's asked to remain anonymous.

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Magic mushrooms -

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you might think of the '60s, dropping out,

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jumping out of windows
thinking you can fly.

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You might think of going crazy,

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quite the opposite of what magic
mushrooms did to Ben and to Kirk.

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And despite its bad reputation,
we need to ask the question:

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What does this mushroom
know that we don't?

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What does it do that we can't?

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I'm a clinical psychologist
at the psychedelic research group

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at Imperial.

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It's a vibrant group
of scientists and clinicians

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asking these very unconventional questions
in a most conventional way.

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It is led by Robin Carhart-Harris -
he's a pioneering neuroscientist,

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and also overseen by David Nutt,

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who is a world-renowned
psychopharmacologist.

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And together they cut through
ribbons and ribbons of red tape

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so that we could do the first
psilocybin for depression study last year.

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And in this study, 20 individuals
with treatment-resistant depression,

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were given a high dose of psilocybin
in a therapeutic setting.

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Now, the numbers of may seem small,
but the results were remarkable.

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We kept seeing these drops
in their depression scores

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after the psilocybin treatment
over and over again.

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Their symptoms of depression
were going right down,

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much bigger reductions
in depression scores

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than you would expect to see
in trials of conventional treatments

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like antidepressants and talking therapy.

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The depression scores
were going right down,

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and they were staying down.

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Six months after the dose,

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six of them were still in remission,
no symptoms of depression.

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Three of them didn't really
respond to the drug,

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so there were small
reductions in their depression

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but only for about a week.

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But for 11, their depression
was greatly reduced for about two months,

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and then the symptoms of depression
started to creep back again.

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Now, that might sound very disappointing,

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but with antidepressants,
you have to take them every day.

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They have some unpleasant side effects;
it takes weeks for them to work.

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And they are a palliative
treatment, not a cure.

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But with psilocybin treatment,

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we were seeing immediate reductions
in depression symptoms,

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immediate relief that last for months,
without side effects,

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and it seemed to be working
on the root causes

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rather than just suppressing symptoms.

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Depression is a relentless,
haunting affliction.

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Winston Churchill called it the black dog.

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Patients in our study called it
a concrete coat, a sack over the head,

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a locked box, a prison.

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They had tried between
three and 11 types of antidepressants

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and six types of talking therapy,

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but nothing had released them.

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They were stuck in their individual
prisons of depression.

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And they're not the odd ones out.

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We are entering an epidemic of depression.

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It's the number one cause
of disability globally,

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and it will affect everyone in this room -

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either someone you care about
or you directly.

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And we don't understand depression.

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We don't really know what causes it.

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And despite enormous scientific endeavor,
we have not yet found a conclusive cure.

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We don't really understand it.

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It's a complex mixture
of so many different factors.

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And when it hits, it can be
a wave of sadness shame and grief,

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or it can be just a shroud
that kills all feelings.

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And it's not an illness
that we can just test for and treat.

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It's different for every person.

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So how to unlock depression?

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The key is never simple,
and it will be different for each person.

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So, in our study,

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we were originally looking at the effect
of psilocybin on the patients' brains.

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So it makes the brain
go from rigid to flexible,

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hyper-connected.

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You could say that it unlocks the brain.

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So in our study, we did these brain scans,

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and we could see
this increased flexibility.

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And we also included
a symptom measure,

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so we could see that depression
symptoms were going right down.

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But that doesn't tell the full story.

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We wanted to know from patients
in their own words.

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What was happening?

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What was the psilocybin doing?

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So we interviewed them all
six months after the dose,

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and we analysed the interview transcripts
and came up with two themes

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about what psilocybin was doing.

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But before I get onto those themes,

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I think maybe I should clarify
what a psychedelic experience is.

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So psychedelics allow the unconscious
mind to become conscious.

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Important material that has
been built up over the course of life

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but that has been pushed out of sight
where you can't see it,

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emerges, like -
it's kind of crumpled clothes

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that you push to the back
of your wardrobe,

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and it emerges, it comes out;

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you don't just see it, you embody it.

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Memories, emotions, pain, love, grief -

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whatever has been hidden
emerges and demands you feel it.

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It can be incredibly painful
and incredibly beautiful.

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Patients in our study described overall
having three main types of experience.

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So firstly, visiting past traumas;

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secondly, having insights
about your life -

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negative patterns and how to change them;

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and thirdly, these experiences
of harmony and connection and unity.

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And sometimes they would have
all three experiences

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in the course of one dosing session.

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So here's our treatment room.

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And you would have the two therapists
either side of the patient.

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They'd be given eye shades and asked
to sit back and listen to the music,

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and just surrender to whatever comes up.

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And they would have had sessions
with the therapists beforehand

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so that they trusted them
and they felt safe.

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But the therapist doesn't structure
the sessions at all

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or direct the content in any way.

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But there was a structure to sessions.

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There was a beginning,
a middle, and an end,

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and a flow of ideas and symbols
that built on each other

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in the most sophisticated way,

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as if it had been planned
by a most excellent therapist.

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Now, in my previous work
as a non-psychedelic psychologist,

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providing talking therapies in the NHS,

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I would plan my sessions for my patients

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and think, how can I help them
talk about traumatic experiences

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or how could I help them
get a different perspective

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or develop some self-compassion
or some motivation for change.

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And I'd try and instill all these things.

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But it's all coming from the therapist;

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the patient experiences it
as somehow outside of themselves,

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and it sometimes just misses the mark.

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But with the psilocybin sessions,

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I was witnessing patients
go on their own journeys of healing,

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the ideas all came from inside themselves,

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and they were powerful and transformative.

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Because the lessons were planned
by the most accurate therapist there is:

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themselves.

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So, the themes:

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What did the patients say
the psilocybin did?

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The clicker is broken.

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Can I have another clicker?

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(Laughter)

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Okay.

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The next slide isn't coming up,
but I'll tell you what it says.

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It says that the first theme
was of an inner unlocking.

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So patients described going
from being emotionally locked up inside

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to being emotionally liberated.

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They described going
from being avoidant of emotion

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to accepting emotion.

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So, they talked about how in depression,

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when stressful or painful things happened,

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emotions were distanced or suppressed.

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They - our society
doesn't really value suffering.

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It's seen as a weakness.

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So they'd learned to put
their feelings in boxes.

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Sam remembered growing up
and being told 'Boys don't cry',

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so he learnt to suffer in silence.

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And many of the patients just -
they couldn't deal with their feelings

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because so much
had happened in their lives,

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they had so many years of hurt,

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they just didn't have
the resources to face it all.

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And they had many different
ways of avoiding their pain,

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self-medicating through food,
through television, through painkillers

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and then often through antidepressants,

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which didn't really work
on the root causes of their suffering,

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just numb the worst of the pain.

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But they also numbed other emotions too.

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And so many of the patients described
feeling numb and unable to feel.

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Many of them had described

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experiencing trauma in their life,
often in early childhood.

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And they've never been able to process it
or think about what had happened.

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And in their psilocybin experiences,
they were able to process these things.

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John -

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Where's John?

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John here -

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He had suffered from abuse in childhood,

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and in his psilocybin dose,
he saw a great big cask,

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and he knew that in that cask
with all of his pain and shame

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that he'd never been
able to think or talk about.

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And he grappled with it.
It was extremely painful.

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But in the course of the session,

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he was able to unlock that box
and accept his past.

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And it was so powerful.

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Many of them cried
for the first time in years.

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This cathartic experience
of accepting emotion

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and just being able to live it.

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We saw in six hours what you would
often see in six years of therapy.

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And now the second theme
is of an outer unlocking.

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So, they described going
from disconnection to connection.

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So, they talked about depression
as a gradual turning inward,

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slowly becoming disconnected
from the people you love,

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from your identity

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and becoming just kind of
trapped in their minds,

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trapped in a small corner of their minds,

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locked there with constant negative
thinking attacking them all the time,

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and the psilocybin
started a process of reconnection.

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So Ben described it this way.

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He said, 'It was like when you defrag
the hard drive on your computer.

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I experienced things
being rearranged in my mind,

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I witnessed it
as it was all put into order,

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and I thought my brain is being defragged!

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How brilliant is that?

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And since that time my thoughts
make sense, and I ruminate less.'

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And other patients
described the same process

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but in a different way.

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Some described it as the fog lifting
or being able to see clearly.

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John said it was like turning
on the lights in a dark house.

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And after that mental reboot,

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they were able to connect to their senses,

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they would connect
to their self, their identity.

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Kirk said he felt like
he was gliding through life,

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and they could connect to other people.

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John went for dinner with his wife
for the first time in seven years,

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said that they were like teenagers again.

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Many of them felt a connection to nature.

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They didn't just see nature
as a thing like a television or a picture,

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but they felt part of it.

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And they connected to a spiritual
principle for the first time -

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some of them.

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Overall, they went from being trapped
to being unlocked, expanded and free.

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So, altered states of consciousness
have been held in high esteem

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for thousands of years around the world.

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But the scientific research
is in its infancy,

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and we're excited to be doing
a bigger study this year.

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But we're still treading carefully.

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We don't know so much about it yet.

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And it won't be right for everyone.

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So, we're treading carefully,

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and we're going to learn
so much over next five years

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about how and when
psilocybin can help us.

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But I believe that it could
revolutionize mental healthcare.

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Patience in our study described
all these superficial treatments,

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short-term therapies,
sticking plasters that didn't help.

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Nothing had ever helped

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because nothing had ever
got to the heart of their pain.

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And in this epidemic of depression,
there are so many people in need,

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so many people need help,

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and the NHS can't afford
to provide long-term treatments,

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years and years
of psychotherapy for everyone.

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But I believe that
if we incorporate psilocybin

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into existing short-term therapies
like the therapies I used to work in,

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that we can make them so much
more effective, so much more powerful.

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It's supplementing therapy with a medicine

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that lets you find a way
out of your suffering

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rather than just padding the cage.

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So, can magic mushrooms
unlock depression?

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The answer is 'no'.

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It's not the mushroom
that unlocks depression,

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it's the patient.

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The mushroom just shows them the key.

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Thank you.

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(Applause)