[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:16.80,0:00:22.07,Default,,0000,0000,0000,,3,4-Methylenedioxymethamphetamine: MDMA.
Dialogue: 0,0:00:22.07,0:00:23.40,Default,,0000,0000,0000,,Now you've probably heard
Dialogue: 0,0:00:23.40,0:00:27.100,Default,,0000,0000,0000,,of this compound in the context\Nof the recreational drug Ecstasy.
Dialogue: 0,0:00:27.100,0:00:31.77,Default,,0000,0000,0000,,But today I want to talk about MDMA,\Nnot as a recreational drug,
Dialogue: 0,0:00:31.77,0:00:35.63,Default,,0000,0000,0000,,but as a potential\Nnew treatment in medicine,
Dialogue: 0,0:00:35.63,0:00:38.16,Default,,0000,0000,0000,,and then a very important\Ntreatment for psychiatry
Dialogue: 0,0:00:38.16,0:00:41.75,Default,,0000,0000,0000,,because MDMA could offer us,\Nin psychiatry, for the first time,
Dialogue: 0,0:00:41.75,0:00:45.08,Default,,0000,0000,0000,,the opportunity to tackle trauma.
Dialogue: 0,0:00:45.08,0:00:46.77,Default,,0000,0000,0000,,And psychological trauma,
Dialogue: 0,0:00:46.77,0:00:50.07,Default,,0000,0000,0000,,particularly that caused\Nby child abuse and maltreatment,
Dialogue: 0,0:00:50.07,0:00:57.14,Default,,0000,0000,0000,,is at the heart of all or most psychiatric\Ndisorders due to anxiety and addictions.
Dialogue: 0,0:00:58.27,0:01:02.00,Default,,0000,0000,0000,,Psychiatry is in need\Nof this innovative approach
Dialogue: 0,0:01:02.00,0:01:04.73,Default,,0000,0000,0000,,because current treatments \Nare failing patients.
Dialogue: 0,0:01:05.65,0:01:07.82,Default,,0000,0000,0000,,Hi, my name's Ben Sessa.
Dialogue: 0,0:01:07.82,0:01:09.86,Default,,0000,0000,0000,,I'm a child and adolescent psychiatrist.
Dialogue: 0,0:01:09.86,0:01:12.35,Default,,0000,0000,0000,,Now that means\NI trained as a medical doctor,
Dialogue: 0,0:01:12.35,0:01:14.44,Default,,0000,0000,0000,,then specialized in mental health,
Dialogue: 0,0:01:14.44,0:01:17.40,Default,,0000,0000,0000,,and then specialized\Nin child and adolescent mental health.
Dialogue: 0,0:01:17.40,0:01:20.22,Default,,0000,0000,0000,,But for the last five years,\NI've been working with adults
Dialogue: 0,0:01:20.22,0:01:24.48,Default,,0000,0000,0000,,with mental health disorders\Nand addictions due to misuse of drugs.
Dialogue: 0,0:01:24.48,0:01:27.51,Default,,0000,0000,0000,,And that developmental\Npathway of my own,
Dialogue: 0,0:01:27.51,0:01:31.92,Default,,0000,0000,0000,,from working with child abuse into adults\Nwith mental disorders and addictions
Dialogue: 0,0:01:31.92,0:01:34.04,Default,,0000,0000,0000,,has brought me to the door of MDMA.
Dialogue: 0,0:01:34.75,0:01:37.92,Default,,0000,0000,0000,,And I'm going to propose today \Nthat MDMA could be [as] important
Dialogue: 0,0:01:37.92,0:01:42.04,Default,,0000,0000,0000,,for the future of psychiatry\Nas the discovery of antibiotics was
Dialogue: 0,0:01:42.04,0:01:44.50,Default,,0000,0000,0000,,for general medicine a hundred years ago.
Dialogue: 0,0:01:44.100,0:01:47.77,Default,,0000,0000,0000,,So when we think about child abuse,
Dialogue: 0,0:01:47.77,0:01:53.07,Default,,0000,0000,0000,,we think about physical abuse,\Nmental abuse, emotional abuse,
Dialogue: 0,0:01:53.07,0:01:54.92,Default,,0000,0000,0000,,sexual abuse, and neglect.
Dialogue: 0,0:01:55.37,0:01:57.99,Default,,0000,0000,0000,,And we think about noxious environments.
Dialogue: 0,0:01:57.99,0:02:00.09,Default,,0000,0000,0000,,We think about parents\Nwith mental disorders,
Dialogue: 0,0:02:00.09,0:02:02.45,Default,,0000,0000,0000,,we think about parents\Nwho are addicted to drugs,
Dialogue: 0,0:02:02.45,0:02:06.71,Default,,0000,0000,0000,,and social issues like poverty and\Npoor housing, poor education.
Dialogue: 0,0:02:07.39,0:02:10.26,Default,,0000,0000,0000,,Now I'm going to illustrate\Nmy talk today with a patient,
Dialogue: 0,0:02:10.26,0:02:12.33,Default,,0000,0000,0000,,and I'm going to call her Claire.
Dialogue: 0,0:02:12.33,0:02:15.92,Default,,0000,0000,0000,,Now, Claire was no single\Nparticular patient of mine.
Dialogue: 0,0:02:15.92,0:02:18.64,Default,,0000,0000,0000,,Rather, she's an amalgamation\Nof many different people
Dialogue: 0,0:02:18.64,0:02:22.07,Default,,0000,0000,0000,,I've met in the last 18 years working\Nas a medical doctor.
Dialogue: 0,0:02:23.35,0:02:25.06,Default,,0000,0000,0000,,She's certainly not the worst.
Dialogue: 0,0:02:25.68,0:02:29.17,Default,,0000,0000,0000,,Now what was Claire's environment like \Nas she was growing up?
Dialogue: 0,0:02:29.17,0:02:31.38,Default,,0000,0000,0000,,Well, her mother was depressed.
Dialogue: 0,0:02:31.38,0:02:33.60,Default,,0000,0000,0000,,Unfortunately, the family doctor\Ndidn't have time
Dialogue: 0,0:02:33.60,0:02:36.94,Default,,0000,0000,0000,,to accurately diagnose\Nand treat depression,
Dialogue: 0,0:02:36.94,0:02:40.48,Default,,0000,0000,0000,,rather, Claire's mother was put\Nonto one antidepressant after another,
Dialogue: 0,0:02:40.48,0:02:42.63,Default,,0000,0000,0000,,never really got therapy.
Dialogue: 0,0:02:42.63,0:02:44.96,Default,,0000,0000,0000,,Claire's mother also had a lot\Nof aches and pains,
Dialogue: 0,0:02:44.96,0:02:48.11,Default,,0000,0000,0000,,typical of what we call \Npsychosomatic symptoms in depression,
Dialogue: 0,0:02:48.11,0:02:52.85,Default,,0000,0000,0000,,and, as a result, the family doctor \Nput her onto opiate based painkillers
Dialogue: 0,0:02:52.85,0:02:55.47,Default,,0000,0000,0000,,which she promptly became addicted to.
Dialogue: 0,0:02:55.95,0:02:59.10,Default,,0000,0000,0000,,Claire's father, now he was alcoholic\Nand he was often
Dialogue: 0,0:02:59.10,0:03:01.11,Default,,0000,0000,0000,,not around, in and out of prison,
Dialogue: 0,0:03:01.11,0:03:03.16,Default,,0000,0000,0000,,which is just as well\Nbecause when he was there,
Dialogue: 0,0:03:03.16,0:03:06.64,Default,,0000,0000,0000,,he was physically abusive\Nto Claire and her mother.
Dialogue: 0,0:03:06.64,0:03:08.26,Default,,0000,0000,0000,,Okay, so what does this kind
Dialogue: 0,0:03:08.26,0:03:13.64,Default,,0000,0000,0000,,of chaotic, frightening environment\Ndo to the developing child brain?
Dialogue: 0,0:03:13.72,0:03:16.71,Default,,0000,0000,0000,,I'm going to give you a brief\Nneurophysiology lesson, if I may.
Dialogue: 0,0:03:16.71,0:03:19.43,Default,,0000,0000,0000,,There's a part of the brain\Ncalled the amygdala.
Dialogue: 0,0:03:19.43,0:03:22.78,Default,,0000,0000,0000,,Now the amygdala is a very ancient part\Nof the mammalian brain,
Dialogue: 0,0:03:22.78,0:03:26.44,Default,,0000,0000,0000,,and many other animals\Nother than humans have an amygdala.
Dialogue: 0,0:03:26.44,0:03:29.30,Default,,0000,0000,0000,,The amygdala lights up when stimulated
Dialogue: 0,0:03:29.30,0:03:32.63,Default,,0000,0000,0000,,by fear in the environment,\Nby a frightening stimulus.
Dialogue: 0,0:03:32.63,0:03:36.85,Default,,0000,0000,0000,,It lights up and it says,\N"Fight or flight, get out!"
Dialogue: 0,0:03:36.85,0:03:40.17,Default,,0000,0000,0000,,Now, there's another part of the brain,\Nmuch more sophisticated part,
Dialogue: 0,0:03:40.17,0:03:41.57,Default,,0000,0000,0000,,called the prefrontal cortex,
Dialogue: 0,0:03:41.57,0:03:44.51,Default,,0000,0000,0000,,and it's right here\Nat the front above the eyes.
Dialogue: 0,0:03:44.51,0:03:47.36,Default,,0000,0000,0000,,Now the prefrontal cortex,\Nonly humans have,
Dialogue: 0,0:03:47.36,0:03:52.27,Default,,0000,0000,0000,,and it's in the prefrontal cortex\Nwhere we use logic and reasoning
Dialogue: 0,0:03:52.27,0:03:55.13,Default,,0000,0000,0000,,to rationalize the situation\Nand we can use
Dialogue: 0,0:03:55.13,0:03:57.47,Default,,0000,0000,0000,,our prefrontal cortex to overcome
Dialogue: 0,0:03:57.47,0:04:00.88,Default,,0000,0000,0000,,that instinctive fear response\Nfrom the amygdala.
Dialogue: 0,0:04:00.88,0:04:02.64,Default,,0000,0000,0000,,Now when Claire was growing up,
Dialogue: 0,0:04:02.82,0:04:04.63,Default,,0000,0000,0000,,she never knew,\None moment to the next,
Dialogue: 0,0:04:04.63,0:04:07.78,Default,,0000,0000,0000,,whether the adult coming into the room\Nwas going to give her a kiss
Dialogue: 0,0:04:07.78,0:04:09.77,Default,,0000,0000,0000,,or a cuddle or do a jigsaw with her,
Dialogue: 0,0:04:09.77,0:04:11.96,Default,,0000,0000,0000,,or were they going\Nto punch her, or kick her,
Dialogue: 0,0:04:11.96,0:04:14.31,Default,,0000,0000,0000,,or burn her with their cigarette.
Dialogue: 0,0:04:14.31,0:04:16.71,Default,,0000,0000,0000,,Or were they going to rape her.
Dialogue: 0,0:04:16.71,0:04:20.41,Default,,0000,0000,0000,,Because, throughout her childhood,\NClaire was also subjected to sexual abuse.
Dialogue: 0,0:04:21.63,0:04:25.85,Default,,0000,0000,0000,,Now, there's a group of disorders\Ncalled the anxiety disorders,
Dialogue: 0,0:04:25.85,0:04:27.95,Default,,0000,0000,0000,,and one of the most important\Nis what we call
Dialogue: 0,0:04:27.95,0:04:31.84,Default,,0000,0000,0000,,posttraumatic\Nstress disorder, or PTSD.
Dialogue: 0,0:04:31.84,0:04:34.84,Default,,0000,0000,0000,,Now PTSD, some of the core features:
Dialogue: 0,0:04:34.84,0:04:38.77,Default,,0000,0000,0000,,very low mood, anxiety,\Nhigh levels of anxiety,
Dialogue: 0,0:04:38.77,0:04:41.17,Default,,0000,0000,0000,,what we call hypervigilance -
Dialogue: 0,0:04:41.17,0:04:43.25,Default,,0000,0000,0000,,this edginess, this jumpiness.
Dialogue: 0,0:04:43.25,0:04:47.16,Default,,0000,0000,0000,,Exactly how Claire felt,\Nthroughout her childhood and adolescence.
Dialogue: 0,0:04:47.16,0:04:49.73,Default,,0000,0000,0000,,Never knowing whether\Nthe next assailant or assault
Dialogue: 0,0:04:49.73,0:04:51.85,Default,,0000,0000,0000,,was around the corner.
Dialogue: 0,0:04:51.85,0:04:56.46,Default,,0000,0000,0000,,Another core feature of PTSD,\Nwhat we call re-experiencing phenomena.
Dialogue: 0,0:04:56.46,0:04:58.39,Default,,0000,0000,0000,,Flashbacks, in which the patient
Dialogue: 0,0:04:58.39,0:05:01.59,Default,,0000,0000,0000,,has sudden remembrances\Nof painful traumatic memories.
Dialogue: 0,0:05:01.59,0:05:04.52,Default,,0000,0000,0000,,They could've popped\Ninto the head, at any time,
Dialogue: 0,0:05:04.52,0:05:07.46,Default,,0000,0000,0000,,triggered by some cue\Nn the environment.
Dialogue: 0,0:05:07.46,0:05:10.77,Default,,0000,0000,0000,,And when they have those experiences,\Nthose daytime flashbacks,
Dialogue: 0,0:05:10.77,0:05:14.05,Default,,0000,0000,0000,,they relive the trauma in all the\Nsensory modalities,
Dialogue: 0,0:05:14.23,0:05:17.55,Default,,0000,0000,0000,,and this results in them\Nfreezing or dissociating
Dialogue: 0,0:05:17.55,0:05:20.00,Default,,0000,0000,0000,,to try and block out the pain.
Dialogue: 0,0:05:20.00,0:05:23.41,Default,,0000,0000,0000,,Now, Claire experienced all of this\Nas she was growing up.
Dialogue: 0,0:05:25.16,0:05:29.45,Default,,0000,0000,0000,,High levels of self-harm and suicide\Nare associated with PTSD.
Dialogue: 0,0:05:29.45,0:05:32.07,Default,,0000,0000,0000,,Claire would cut her thighs\Nand her breasts.
Dialogue: 0,0:05:32.67,0:05:37.27,Default,,0000,0000,0000,,Pretty common form of cutting\Nin children who've been sexually abused.
Dialogue: 0,0:05:37.27,0:05:40.01,Default,,0000,0000,0000,,She was being sexually abused\Nby her mother's clients
Dialogue: 0,0:05:40.01,0:05:43.60,Default,,0000,0000,0000,,because her mother had moved on\Nfrom the addiction to painkillers
Dialogue: 0,0:05:43.60,0:05:46.89,Default,,0000,0000,0000,,and was using street heroin\Nwhen Claire was a teenager.
Dialogue: 0,0:05:46.89,0:05:49.67,Default,,0000,0000,0000,,And because of the way\Nthe war on drugs has set up
Dialogue: 0,0:05:49.67,0:05:54.03,Default,,0000,0000,0000,,that reduces access to treatment\Nfor people with opiate dependence,
Dialogue: 0,0:05:54.03,0:05:56.32,Default,,0000,0000,0000,,she had to pay for her heroin\Nusing sex work,
Dialogue: 0,0:05:56.32,0:05:58.94,Default,,0000,0000,0000,,and the clients\Nwould sexually abuse Claire.
Dialogue: 0,0:06:00.41,0:06:05.29,Default,,0000,0000,0000,,It's very hard to treat PTSD\Nand it has a high treatment resistance -
Dialogue: 0,0:06:05.29,0:06:09.38,Default,,0000,0000,0000,,50% of people do not respond\Nto the traditional treatments.
Dialogue: 0,0:06:09.92,0:06:10.96,Default,,0000,0000,0000,,How do we treat it?
Dialogue: 0,0:06:10.96,0:06:12.46,Default,,0000,0000,0000,,Well, we can treat it with medications.
Dialogue: 0,0:06:12.46,0:06:14.98,Default,,0000,0000,0000,,We can treat it with psychotherapies.
Dialogue: 0,0:06:14.98,0:06:18.85,Default,,0000,0000,0000,,And the medications we use,\Nthere's a broad range of drugs.
Dialogue: 0,0:06:18.94,0:06:21.01,Default,,0000,0000,0000,,No single drug,\Nand this is very important,
Dialogue: 0,0:06:21.01,0:06:24.34,Default,,0000,0000,0000,,no single drug cures PTSD.
Dialogue: 0,0:06:24.85,0:06:27.43,Default,,0000,0000,0000,,Rather, we treat\Nthe disorder symptomatically.
Dialogue: 0,0:06:27.43,0:06:30.40,Default,,0000,0000,0000,,If the patient's depressed,\Ngive them an antidepressant.
Dialogue: 0,0:06:30.40,0:06:33.80,Default,,0000,0000,0000,,If their mood fluctuates,\Ngive them a mood stabilizer.
Dialogue: 0,0:06:33.80,0:06:36.54,Default,,0000,0000,0000,,If they can't sleep, give them a hypnotic.
Dialogue: 0,0:06:36.54,0:06:41.00,Default,,0000,0000,0000,,And if that edginess and that fear \Nspills over into paranoia and psychosis,
Dialogue: 0,0:06:41.00,0:06:43.75,Default,,0000,0000,0000,,give the patient an anti-psychotic drug.
Dialogue: 0,0:06:43.88,0:06:46.24,Default,,0000,0000,0000,,And they have to take\Nthese drugs day in, day out,
Dialogue: 0,0:06:46.27,0:06:48.24,Default,,0000,0000,0000,,for weeks, months, decades.
Dialogue: 0,0:06:48.24,0:06:53.71,Default,,0000,0000,0000,,They have to keep taking them\Nbecause the drugs we use to treat trauma,
Dialogue: 0,0:06:53.71,0:06:59.32,Default,,0000,0000,0000,,when it's due to this level of severity,\Ndo not attack the root cause of trauma.
Dialogue: 0,0:06:59.32,0:07:01.57,Default,,0000,0000,0000,,They paper over the cracks.
Dialogue: 0,0:07:01.57,0:07:07.70,Default,,0000,0000,0000,,A good analogy would be taking aspirin\Nor ibuprofen when you have a fever.
Dialogue: 0,0:07:07.70,0:07:13.10,Default,,0000,0000,0000,,A fever is caused by an infection,\Nby a microorganism.
Dialogue: 0,0:07:13.10,0:07:15.90,Default,,0000,0000,0000,,Sure, you can take\Nparacetamol or ibuprofen,
Dialogue: 0,0:07:15.90,0:07:17.77,Default,,0000,0000,0000,,and this will lower the temperature
Dialogue: 0,0:07:17.77,0:07:22.19,Default,,0000,0000,0000,,make you feel a bit better\Nbut it doesn't attack the root cause.
Dialogue: 0,0:07:22.19,0:07:26.44,Default,,0000,0000,0000,,And that's what we do when we give\Nthese patients these daily SSRI drugs.
Dialogue: 0,0:07:26.44,0:07:27.71,Default,,0000,0000,0000,,We paper over the cracks.
Dialogue: 0,0:07:27.71,0:07:30.51,Default,,0000,0000,0000,,We maintain the symptoms\Nat a manageable level.
Dialogue: 0,0:07:32.09,0:07:37.74,Default,,0000,0000,0000,,We also use psychotherapies to treat PTSD,\Nand there's again a broad range of these:
Dialogue: 0,0:07:37.74,0:07:43.67,Default,,0000,0000,0000,,DBT, CBT, EMDR, trauma focused\Npsychotherapy, CAT, APT ...
Dialogue: 0,0:07:43.67,0:07:46.79,Default,,0000,0000,0000,,Now all of them have\Na pretty similar approach
Dialogue: 0,0:07:46.79,0:07:48.55,Default,,0000,0000,0000,,which actually is an old wives tale
Dialogue: 0,0:07:48.55,0:07:51.39,Default,,0000,0000,0000,,which is: a problem shared\Nis a problem halved.
Dialogue: 0,0:07:51.39,0:07:53.03,Default,,0000,0000,0000,,"Let's talk about your trauma.
Dialogue: 0,0:07:53.03,0:07:56.13,Default,,0000,0000,0000,,Claire, tell me about your rape."
Dialogue: 0,0:07:56.44,0:07:59.84,Default,,0000,0000,0000,,Now that's fine for 50% of patients,
Dialogue: 0,0:07:59.84,0:08:03.85,Default,,0000,0000,0000,,but for a significant half,\Nthey just cannot do that.
Dialogue: 0,0:08:03.85,0:08:07.53,Default,,0000,0000,0000,,As soon as Claire is asked to talk\Nabout her rape, she freezes,
Dialogue: 0,0:08:07.53,0:08:10.31,Default,,0000,0000,0000,,she flees, she drops out of treatment.
Dialogue: 0,0:08:10.31,0:08:11.69,Default,,0000,0000,0000,,Now, by the time she was 15,
Dialogue: 0,0:08:11.69,0:08:13.87,Default,,0000,0000,0000,,Claire had been removed\Nfrom the family home,
Dialogue: 0,0:08:14.04,0:08:18.50,Default,,0000,0000,0000,,and she was brought up in a succession\Nof foster placements and children's houses
Dialogue: 0,0:08:18.50,0:08:21.56,Default,,0000,0000,0000,,and hostels where the abuse continued.
Dialogue: 0,0:08:22.16,0:08:25.34,Default,,0000,0000,0000,,She would self-harm, cutting, and\Nshe started drinking,
Dialogue: 0,0:08:25.34,0:08:28.26,Default,,0000,0000,0000,,and, by the time she was 18,\Nshe was using heroin as well.
Dialogue: 0,0:08:29.26,0:08:32.10,Default,,0000,0000,0000,,Sometimes working in psychiatry\Ncan feel pretty desperate,
Dialogue: 0,0:08:32.10,0:08:34.41,Default,,0000,0000,0000,,can feel pretty hopeless.
Dialogue: 0,0:08:34.41,0:08:39.16,Default,,0000,0000,0000,,Sometimes it feels as if psychiatry\Nis a palliative care profession.
Dialogue: 0,0:08:39.16,0:08:41.47,Default,,0000,0000,0000,,And this is the truth\Nbecause the treatments we use
Dialogue: 0,0:08:41.47,0:08:44.56,Default,,0000,0000,0000,,do not get to the root cause\Nof the problem, the trauma,
Dialogue: 0,0:08:44.56,0:08:46.74,Default,,0000,0000,0000,,and paper over the cracks.
Dialogue: 0,0:08:46.74,0:08:49.69,Default,,0000,0000,0000,,And I think the pharma industry\Nknows this, and they queue up,
Dialogue: 0,0:08:49.69,0:08:51.80,Default,,0000,0000,0000,,and they provide us\Nwith product after product
Dialogue: 0,0:08:51.80,0:08:54.60,Default,,0000,0000,0000,,to give to our patients\Nthat doesn't quite cure them,
Dialogue: 0,0:08:54.60,0:08:58.38,Default,,0000,0000,0000,,but it gets them\Nslightly better to function.
Dialogue: 0,0:08:58.38,0:09:00.07,Default,,0000,0000,0000,,And they have to keep taking them.
Dialogue: 0,0:09:00.07,0:09:02.20,Default,,0000,0000,0000,,Indeed, would say\Nthat we're in psychiatry today
Dialogue: 0,0:09:02.20,0:09:04.66,Default,,0000,0000,0000,,where we were in general\Nmedicine 100 years ago.
Dialogue: 0,0:09:04.66,0:09:06.52,Default,,0000,0000,0000,,Now, 100 years ago in general medicine,
Dialogue: 0,0:09:06.52,0:09:10.11,Default,,0000,0000,0000,,humanity was losing the battle\Nto the infectious diseases.
Dialogue: 0,0:09:10.11,0:09:12.80,Default,,0000,0000,0000,,Oh, we were very good\Nat classifying and diagnosing them.
Dialogue: 0,0:09:12.80,0:09:14.77,Default,,0000,0000,0000,,We knew who got smallpox.
Dialogue: 0,0:09:14.77,0:09:17.32,Default,,0000,0000,0000,,We knew people died\Nof post-operative surgery.
Dialogue: 0,0:09:17.32,0:09:20.64,Default,,0000,0000,0000,,We knew there were microorganisms,\Nbut we didn't have a treatment.
Dialogue: 0,0:09:20.64,0:09:23.38,Default,,0000,0000,0000,,And then at the beginning\Nof the 20th century,
Dialogue: 0,0:09:23.38,0:09:25.85,Default,,0000,0000,0000,,we discovered the antibiotics.
Dialogue: 0,0:09:25.85,0:09:27.22,Default,,0000,0000,0000,,Not symptomatic treatment,
Dialogue: 0,0:09:27.22,0:09:29.89,Default,,0000,0000,0000,,but treatment that goes\Nto the core of the cause,
Dialogue: 0,0:09:29.89,0:09:33.46,Default,,0000,0000,0000,,and we started getting\Non top of infectious disease.
Dialogue: 0,0:09:33.76,0:09:37.09,Default,,0000,0000,0000,,Now, psychiatry, today,\Nis in a similar place.
Dialogue: 0,0:09:37.09,0:09:39.55,Default,,0000,0000,0000,,We're very good\Nat classifying and diagnosing.
Dialogue: 0,0:09:39.55,0:09:41.67,Default,,0000,0000,0000,,Our epidemiology is superb.
Dialogue: 0,0:09:41.67,0:09:44.00,Default,,0000,0000,0000,,We write these thick diagnostic manuals.
Dialogue: 0,0:09:44.00,0:09:45.53,Default,,0000,0000,0000,,We know who gets depression.
Dialogue: 0,0:09:45.53,0:09:47.07,Default,,0000,0000,0000,,We know who gets anxiety.
Dialogue: 0,0:09:47.07,0:09:48.53,Default,,0000,0000,0000,,We even know the cause:
Dialogue: 0,0:09:48.53,0:09:53.70,Default,,0000,0000,0000,,trauma, child abuse, maltreatment,\Npoor social conditions.
Dialogue: 0,0:09:53.70,0:09:56.15,Default,,0000,0000,0000,,But our treatments are lousy.
Dialogue: 0,0:09:57.81,0:10:01.71,Default,,0000,0000,0000,,And I'm quite shocked the way\Nthe empathy switch
Dialogue: 0,0:10:01.71,0:10:03.40,Default,,0000,0000,0000,,and our understanding of these patients
Dialogue: 0,0:10:03.40,0:10:05.55,Default,,0000,0000,0000,,seems to be switched off.
Dialogue: 0,0:10:05.55,0:10:09.52,Default,,0000,0000,0000,,We have lots of gushing sentimentality\Nfor the little five and six year old
Dialogue: 0,0:10:09.52,0:10:14.71,Default,,0000,0000,0000,,who's being abused, and we throw money\Nat our television sets on these campaigns
Dialogue: 0,0:10:14.71,0:10:17.93,Default,,0000,0000,0000,,to improve the lives\Nof these poor little innocent victims.
Dialogue: 0,0:10:17.93,0:10:21.00,Default,,0000,0000,0000,,But let me tell you what happens\Nto that little five or six year-old,
Dialogue: 0,0:10:21.00,0:10:23.18,Default,,0000,0000,0000,,when they're 11 or 12.
Dialogue: 0,0:10:23.18,0:10:26.83,Default,,0000,0000,0000,,On goes the hood, start smoking weed.
Dialogue: 0,0:10:26.83,0:10:29.24,Default,,0000,0000,0000,,By the time they're 16, they're\Nbuying and selling amphetamine,
Dialogue: 0,0:10:29.24,0:10:30.49,Default,,0000,0000,0000,,and, by the time they're Claire's age,
Dialogue: 0,0:10:30.49,0:10:31.49,Default,,0000,0000,0000,,in their mid 20s,
Dialogue: 0,0:10:31.49,0:10:33.67,Default,,0000,0000,0000,,they're addicted to heroin and alcohol.
Dialogue: 0,0:10:33.67,0:10:36.58,Default,,0000,0000,0000,,And, suddenly, we have lost our empathy.
Dialogue: 0,0:10:36.58,0:10:39.45,Default,,0000,0000,0000,,These people are public enemy number one.
Dialogue: 0,0:10:39.45,0:10:40.89,Default,,0000,0000,0000,,"It's your fault, Claire.
Dialogue: 0,0:10:40.89,0:10:42.77,Default,,0000,0000,0000,,You brought this upon yourself.
Dialogue: 0,0:10:42.77,0:10:45.16,Default,,0000,0000,0000,,It's your lifestyle choice."
Dialogue: 0,0:10:45.16,0:10:48.06,Default,,0000,0000,0000,,And I'm quite shocked\Nand having worked in pediatrics
Dialogue: 0,0:10:48.06,0:10:52.41,Default,,0000,0000,0000,,and seeing the developmental trajectory\Nthat is so inevitable,
Dialogue: 0,0:10:52.41,0:10:55.29,Default,,0000,0000,0000,,from early trauma into adolescent,
Dialogue: 0,0:10:55.29,0:10:57.51,Default,,0000,0000,0000,,and then adult mental\Nhealth and addictions.
Dialogue: 0,0:10:57.51,0:10:59.80,Default,,0000,0000,0000,,We have to hold on\Nto that sense of compassion
Dialogue: 0,0:10:59.80,0:11:04.47,Default,,0000,0000,0000,,and evidence-based understanding\Nabout the developmental trajectory there.
Dialogue: 0,0:11:05.72,0:11:08.72,Default,,0000,0000,0000,,So it does sound desperate,\Nbut all is not lost.
Dialogue: 0,0:11:09.74,0:11:13.96,Default,,0000,0000,0000,,MDMA. MDMA has some fascinating qualities.
Dialogue: 0,0:11:13.96,0:11:17.33,Default,,0000,0000,0000,,Indeed, I would suggest\Nthat if you were to invent\N
Dialogue: 0,0:11:17.33,0:11:19.41,Default,,0000,0000,0000,,a hypothetical drug to treat trauma,
Dialogue: 0,0:11:19.41,0:11:21.90,Default,,0000,0000,0000,,it would be MDMA.
Dialogue: 0,0:11:21.90,0:11:23.85,Default,,0000,0000,0000,,The way it works,\Nin terms of receptors
Dialogue: 0,0:11:23.85,0:11:25.61,Default,,0000,0000,0000,,and subjective psychological effects,
Dialogue: 0,0:11:25.61,0:11:27.55,Default,,0000,0000,0000,,ticks all the right boxes.
Dialogue: 0,0:11:27.55,0:11:31.42,Default,,0000,0000,0000,,At one level of receptors,it causes\Nan increased positive mood.
Dialogue: 0,0:11:31.42,0:11:34.20,Default,,0000,0000,0000,,Lowering of depression,\Nlowering of anxiety.
Dialogue: 0,0:11:34.20,0:11:37.16,Default,,0000,0000,0000,,At another group of receptors,\Nit speeds the patient up,
Dialogue: 0,0:11:37.16,0:11:41.57,Default,,0000,0000,0000,,mild stimulation which motivates\Nthem to engage in therapy.
Dialogue: 0,0:11:41.57,0:11:45.14,Default,,0000,0000,0000,,At another level, it relaxes\Nthe patient paradoxically,
Dialogue: 0,0:11:45.14,0:11:47.47,Default,,0000,0000,0000,,at the same time as the stimulation,
Dialogue: 0,0:11:47.47,0:11:51.18,Default,,0000,0000,0000,,and this puts the patient\Ninto the optimal arousal zone
Dialogue: 0,0:11:51.18,0:11:53.73,Default,,0000,0000,0000,,where they can engage in psychotherapy.
Dialogue: 0,0:11:53.73,0:11:56.07,Default,,0000,0000,0000,,But perhaps the most\Nimportant thing about MDMA,
Dialogue: 0,0:11:56.07,0:11:58.39,Default,,0000,0000,0000,,and the most important clinical tool,
Dialogue: 0,0:11:58.39,0:12:00.84,Default,,0000,0000,0000,,is its ability to provide a sense\N
Dialogue: 0,0:12:00.84,0:12:05.62,Default,,0000,0000,0000,,of empathy and understanding\Nand emotional security.
Dialogue: 0,0:12:07.17,0:12:09.40,Default,,0000,0000,0000,,It can hold the patient in a place
Dialogue: 0,0:12:09.40,0:12:12.23,Default,,0000,0000,0000,,where they can think about\Nand access their trauma
Dialogue: 0,0:12:12.23,0:12:15.31,Default,,0000,0000,0000,,like they've never been able to do before.
Dialogue: 0,0:12:15.95,0:12:17.77,Default,,0000,0000,0000,,One of the ways in which MDMA works
Dialogue: 0,0:12:17.77,0:12:21.65,Default,,0000,0000,0000,,is it increases the release\Nof a hormone called oxytocin.
Dialogue: 0,0:12:21.65,0:12:25.60,Default,,0000,0000,0000,,Oxytocin is released from the brains\Nof breastfeeding mothers.
Dialogue: 0,0:12:25.60,0:12:28.76,Default,,0000,0000,0000,,It's a hormone that engenders\Na sense of attachment and bonding,
Dialogue: 0,0:12:28.76,0:12:32.91,Default,,0000,0000,0000,,and that's what's happening\Nin the patient who takes MDMA.
Dialogue: 0,0:12:32.91,0:12:37.79,Default,,0000,0000,0000,,And, also, it acts directly on the amygdala\Nto reduce that fear response
Dialogue: 0,0:12:37.79,0:12:41.44,Default,,0000,0000,0000,,while ,at the same time,\Nboosting the prefrontal response,
Dialogue: 0,0:12:41.47,0:12:44.24,Default,,0000,0000,0000,,allowing the patient\Nto see things in a new light.
Dialogue: 0,0:12:44.24,0:12:46.13,Default,,0000,0000,0000,,A positive light.
Dialogue: 0,0:12:46.13,0:12:48.55,Default,,0000,0000,0000,,So let's go back to Claire.
Dialogue: 0,0:12:48.55,0:12:50.34,Default,,0000,0000,0000,,She's 40 now.
Dialogue: 0,0:12:50.34,0:12:52.78,Default,,0000,0000,0000,,She's been in and out\Nof psychiatric hospitals,
Dialogue: 0,0:12:52.78,0:12:55.21,Default,,0000,0000,0000,,having tried to take\Nher own life in the inception.
Dialogue: 0,0:12:55.21,0:12:58.78,Default,,0000,0000,0000,,She's been on all the antipsychotic\Nand antidepressant mood stabiliser drugs.
Dialogue: 0,0:12:58.78,0:13:01.76,Default,,0000,0000,0000,,She's tried all the psychotherapies,\Nbut she cannot engage
Dialogue: 0,0:13:01.76,0:13:05.34,Default,,0000,0000,0000,,because she will not talk about her feelings.
Dialogue: 0,0:13:06.32,0:13:11.16,Default,,0000,0000,0000,,So she comes into a course\Nof MDMA-assisted psychotherapy.
Dialogue: 0,0:13:11.86,0:13:13.53,Default,,0000,0000,0000,,What does it look like?
Dialogue: 0,0:13:13.53,0:13:17.81,Default,,0000,0000,0000,,It's weekly sessions,\Nmaybe eight, ten, twelve weeks long.
Dialogue: 0,0:13:17.81,0:13:21.08,Default,,0000,0000,0000,,There're two therapists, male-female pair.
Dialogue: 0,0:13:21.08,0:13:25.36,Default,,0000,0000,0000,,You do not take MDMA everyday,\Nyou do not take it every week.
Dialogue: 0,0:13:25.36,0:13:28.94,Default,,0000,0000,0000,,Over that course of 12 sessions,\Nyou'll take the MDMA three times,
Dialogue: 0,0:13:28.94,0:13:30.37,Default,,0000,0000,0000,,and the other sessions,
Dialogue: 0,0:13:30.37,0:13:35.01,Default,,0000,0000,0000,,you talk about the material\Nthat's released on the MDMA session.
Dialogue: 0,0:13:35.41,0:13:39.55,Default,,0000,0000,0000,,So what does Claire actually feel\Nwhen she takes this MDMA?
Dialogue: 0,0:13:40.53,0:13:42.100,Default,,0000,0000,0000,,What she feels is a sense of warmth.
Dialogue: 0,0:13:42.100,0:13:46.42,Default,,0000,0000,0000,,and understanding, and a sense of containment,\N
Dialogue: 0,0:13:46.42,0:13:50.52,Default,,0000,0000,0000,,within that relationship\Nshe's having with the therapist.
Dialogue: 0,0:13:51.10,0:13:55.55,Default,,0000,0000,0000,,MDMA is like a lifejacket,\Nlike a bulletproof vest
Dialogue: 0,0:13:55.55,0:13:58.87,Default,,0000,0000,0000,,to wear to go into battle\Nwith your trauma.
Dialogue: 0,0:13:58.87,0:14:01.17,Default,,0000,0000,0000,,This is not ecstasy!
Dialogue: 0,0:14:01.17,0:14:06.31,Default,,0000,0000,0000,,She's not enjoying some raver's euphoric\Necstasy delight.
Dialogue: 0,0:14:06.31,0:14:10.79,Default,,0000,0000,0000,,This is still trauma focused psychotherapy\Nand it's still hard and distressing for her,
Dialogue: 0,0:14:10.79,0:14:14.93,Default,,0000,0000,0000,,but she can just about do it with\NMDMA on board.
Dialogue: 0,0:14:14.93,0:14:19.91,Default,,0000,0000,0000,,So when the therapist says:\N"Claire, tell me about your rape".
Dialogue: 0,0:14:19.91,0:14:22.32,Default,,0000,0000,0000,,In the past just the word rape\Nand she'd be out the door,
Dialogue: 0,0:14:22.32,0:14:25.89,Default,,0000,0000,0000,,but on MDMA she says:\N"yeah, I can talk about that!
Dialogue: 0,0:14:25.89,0:14:31.90,Default,,0000,0000,0000,,I can see him now coming into the room.\NI can smell the whiskey on his breath and
Dialogue: 0,0:14:31.90,0:14:35.83,Default,,0000,0000,0000,,I can feel the stubble on his face\Nas he's raping me".
Dialogue: 0,0:14:35.83,0:14:40.28,Default,,0000,0000,0000,,And she talks about it and she explores it\Nand she reflects upon it
Dialogue: 0,0:14:40.28,0:14:42.99,Default,,0000,0000,0000,,and she can begin the process of healing.
Dialogue: 0,0:14:42.99,0:14:45.64,Default,,0000,0000,0000,,And from here she can start her journey.
Dialogue: 0,0:14:45.64,0:14:48.89,Default,,0000,0000,0000,,She can attack the root cause of her problems.
Dialogue: 0,0:14:48.89,0:14:52.73,Default,,0000,0000,0000,,Not just maintain the symptoms at a level.
Dialogue: 0,0:14:54.99,0:14:56.83,Default,,0000,0000,0000,,So, does it work?
Dialogue: 0,0:14:56.83,0:14:59.44,Default,,0000,0000,0000,,Well, we've known about MDMA\Nfor a very long time
Dialogue: 0,0:14:59.44,0:15:04.53,Default,,0000,0000,0000,,and indeed we've used MDMA in\Nunderground therapy for 30 or 40 years.
Dialogue: 0,0:15:04.53,0:15:07.41,Default,,0000,0000,0000,,And there are thousands of\Npositive anecdotal cases.
Dialogue: 0,0:15:07.41,0:15:12.73,Default,,0000,0000,0000,,I get five emails a week from all over the\Nworld: "Dr. Sessa, I've had PTSD for years.
Dialogue: 0,0:15:12.73,0:15:17.39,Default,,0000,0000,0000,,I've tried everything and now I tried MDMA\Nand I'm starting to make a breakthrough!"\N
Dialogue: 0,0:15:17.47,0:15:21.27,Default,,0000,0000,0000,,Now, anecdotal reports like that are\Ninteresting but they're not science so
Dialogue: 0,0:15:21.27,0:15:23.15,Default,,0000,0000,0000,,we've done the science.
Dialogue: 0,0:15:23.15,0:15:26.12,Default,,0000,0000,0000,,And some important studies in recent years.
Dialogue: 0,0:15:26.12,0:15:32.61,Default,,0000,0000,0000,,Big study in the States showed that a single\Ncourse of MDMA therapy, 16-week course,
Dialogue: 0,0:15:32.61,0:15:36.46,Default,,0000,0000,0000,,patient takes MDMA three times\Ntested against a placebo.
Dialogue: 0,0:15:36.46,0:15:44.13,Default,,0000,0000,0000,,At the end of that course 85% of the people no\Nlonger met the diagnostic criteria for PTSD.
Dialogue: 0,0:15:44.13,0:15:48.82,Default,,0000,0000,0000,,Not just a relief of symptoms,\Nthey didn't have PTSD!
Dialogue: 0,0:15:48.82,0:15:54.01,Default,,0000,0000,0000,,Now that cohort were then followed up\Nthree years later, the same no PTSD.
Dialogue: 0,0:15:54.01,0:15:57.95,Default,,0000,0000,0000,,Many of those people had come of\Ntheir daily medications.
Dialogue: 0,0:15:57.95,0:16:03.19,Default,,0000,0000,0000,,They were cured! We don't use\Nthe "cure" word in psychiatry.
Dialogue: 0,0:16:03.19,0:16:08.35,Default,,0000,0000,0000,,We've become learned helplessness\Nposition of--This is the truth!
Dialogue: 0,0:16:08.35,0:16:11.100,Default,,0000,0000,0000,,If you're diagnosed with a severe\Nmental disorder like anxiety or depression
Dialogue: 0,0:16:11.100,0:16:16.58,Default,,0000,0000,0000,,in your 20s, and the developmental route\Nof that disorder is severe child abuse,
Dialogue: 0,0:16:16.58,0:16:19.43,Default,,0000,0000,0000,,there's a pretty good chance--\Nand I'm sorry to say this--
Dialogue: 0,0:16:19.43,0:16:21.77,Default,,0000,0000,0000,,there's a pretty good chance you\Nwill still be going to
Dialogue: 0,0:16:21.77,0:16:24.59,Default,,0000,0000,0000,,psychiatric clinics in your 60s and 70s.
Dialogue: 0,0:16:24.59,0:16:30.75,Default,,0000,0000,0000,,Now that is not good enough and we're in this\Nposition because we're not tackling trauma.
Dialogue: 0,0:16:31.75,0:16:35.13,Default,,0000,0000,0000,,So, it works but is it safe?
Dialogue: 0,0:16:35.13,0:16:39.60,Default,,0000,0000,0000,,When we talk about safety of\Nclinical MDMA, what we must not do is
Dialogue: 0,0:16:39.60,0:16:43.66,Default,,0000,0000,0000,,look at the risks of recreational ecstasy.
Dialogue: 0,0:16:44.18,0:16:47.00,Default,,0000,0000,0000,,I don't even know what ecstasy is anymore!
Dialogue: 0,0:16:47.00,0:16:49.37,Default,,0000,0000,0000,,Ecstasy is over here, what is ecstasy?
Dialogue: 0,0:16:49.37,0:16:53.05,Default,,0000,0000,0000,,Some dodgy pill bought in some\Ndodgy club of some dodgy geezer,
Dialogue: 0,0:16:53.05,0:16:59.93,Default,,0000,0000,0000,,that may or may not contain MDMA plus or\Nminus whatever far more toxic substance.
Dialogue: 0,0:17:01.24,0:17:05.97,Default,,0000,0000,0000,,And indeed, when you hear about the very high-profile\Ndeaths of people who take ecstasy,
Dialogue: 0,0:17:05.97,0:17:10.02,Default,,0000,0000,0000,,it invariably is not MDMA.
Dialogue: 0,0:17:10.02,0:17:13.42,Default,,0000,0000,0000,,So, let's not look at ecstasy as a\Nmeasure of MDMA.
Dialogue: 0,0:17:13.42,0:17:15.60,Default,,0000,0000,0000,,Let's look at clinical MDMA.
Dialogue: 0,0:17:15.60,0:17:21.23,Default,,0000,0000,0000,,When you use clinical MDMA, you take it\Nunder medical supervision. It is pure.
Dialogue: 0,0:17:21.23,0:17:25.72,Default,,0000,0000,0000,,The MDMA that I'm using in\Nmy studies is 99.98% pure!
Dialogue: 0,0:17:27.28,0:17:31.03,Default,,0000,0000,0000,,Very expensive! \N(laughter)
Dialogue: 0,0:17:31.03,0:17:34.93,Default,,0000,0000,0000,,We do it under medical supervision with\Na doctor and a nurse and a psychologist.
Dialogue: 0,0:17:34.93,0:17:40.18,Default,,0000,0000,0000,,And under those conditions the risks are \Nreduced to an absolute minimum.
Dialogue: 0,0:17:40.18,0:17:42.85,Default,,0000,0000,0000,,Indeed, after 40 years of MDMA research,
Dialogue: 0,0:17:42.85,0:17:47.61,Default,,0000,0000,0000,,there has not been a single serious\Nadverse drug reaction, not one!
Dialogue: 0,0:17:47.61,0:17:51.09,Default,,0000,0000,0000,,And certainly no deaths.
Dialogue: 0,0:17:51.09,0:17:53.58,Default,,0000,0000,0000,,So, we need to do this research and
Dialogue: 0,0:17:53.58,0:17:59.58,Default,,0000,0000,0000,,we need to do this research in\Nan evidence-based, compassionate way.
Dialogue: 0,0:17:59.58,0:18:02.07,Default,,0000,0000,0000,,Looking at the data.
Dialogue: 0,0:18:02.07,0:18:05.04,Default,,0000,0000,0000,,We need to ignore the socio-political\Nagenda that says any drug
Dialogue: 0,0:18:05.04,0:18:11.11,Default,,0000,0000,0000,,that's being used recreationally must\Nalso be very bad and dangerous.
Dialogue: 0,0:18:11.11,0:18:14.27,Default,,0000,0000,0000,,That sort of attitude hampers research.
Dialogue: 0,0:18:15.49,0:18:18.34,Default,,0000,0000,0000,,And we need scientists to drive this.
Dialogue: 0,0:18:18.90,0:18:20.86,Default,,0000,0000,0000,,It works, it's safe.
Dialogue: 0,0:18:20.86,0:18:24.64,Default,,0000,0000,0000,,And it offers patients like Claire for the\Nfirst time in their life an opportunity
Dialogue: 0,0:18:24.64,0:18:30.22,Default,,0000,0000,0000,,to break through from that trauma and not\Nbecome a lifelong chronic PTSD sufferer.
Dialogue: 0,0:18:30.22,0:18:32.79,Default,,0000,0000,0000,,So, where were we going with MDMA research?
Dialogue: 0,0:18:32.79,0:18:35.63,Default,,0000,0000,0000,,Well, we've had some studies,\Nwe've got more coming here.
Dialogue: 0,0:18:35.63,0:18:39.51,Default,,0000,0000,0000,,I'm doing a study in Cardiff with neuroimaging\Nin which we're going to give patients
Dialogue: 0,0:18:39.51,0:18:43.98,Default,,0000,0000,0000,,with PTSD, MDMA and placebo and\Nwe're going to look at that relationship
Dialogue: 0,0:18:43.98,0:18:47.42,Default,,0000,0000,0000,,between the amygdala and the\Nprefrontal cortex.
Dialogue: 0,0:18:47.42,0:18:53.74,Default,,0000,0000,0000,,We're also doing a study here in Bristol giving\NMDMA to patients with alcohol use disorder
Dialogue: 0,0:18:53.74,0:18:58.04,Default,,0000,0000,0000,,because underlying the root\Nof this addiction is trauma.
Dialogue: 0,0:18:58.04,0:18:59.95,Default,,0000,0000,0000,,This is an exciting time.
Dialogue: 0,0:18:59.95,0:19:01.85,Default,,0000,0000,0000,,Now people say: "This is controversial!"
Dialogue: 0,0:19:01.85,0:19:04.32,Default,,0000,0000,0000,,And indeed, I was introduced\Nas a controversial speaker.
Dialogue: 0,0:19:04.32,0:19:07.53,Default,,0000,0000,0000,,I'm not controversial, I'm a very boring\Nconservative doctor.
Dialogue: 0,0:19:07.53,0:19:10.04,Default,,0000,0000,0000,,I like data.
Dialogue: 0,0:19:10.04,0:19:13.62,Default,,0000,0000,0000,,I like evidence-based data that\Nhelps my patients.
Dialogue: 0,0:19:13.62,0:19:15.67,Default,,0000,0000,0000,,I'll tell you what's controversial!
Dialogue: 0,0:19:15.67,0:19:20.58,Default,,0000,0000,0000,,What's controversial is that more people\Nhave died returning from Afghanistan and Iraq
Dialogue: 0,0:19:20.58,0:19:24.19,Default,,0000,0000,0000,,because they've committed suicide\Nbecause of their untreated PTSD
Dialogue: 0,0:19:24.19,0:19:26.98,Default,,0000,0000,0000,,then ever died in the conflict out there.
Dialogue: 0,0:19:26.98,0:19:30.59,Default,,0000,0000,0000,,That is controversial and that is unethical!
Dialogue: 0,0:19:32.37,0:19:35.33,Default,,0000,0000,0000,,So, this is an important time for science.
Dialogue: 0,0:19:35.33,0:19:40.14,Default,,0000,0000,0000,,MDMA could be the antibiotic that\Npsychiatry has been waiting for.
Dialogue: 0,0:19:40.14,0:19:43.62,Default,,0000,0000,0000,,We owe that population of patients\Nwho are being failed,
Dialogue: 0,0:19:43.63,0:19:46.04,Default,,0000,0000,0000,,we owe them this research!
Dialogue: 0,0:19:46.04,0:19:47.75,Default,,0000,0000,0000,,We owe this to Claire!
Dialogue: 0,0:19:47.75,0:19:55.33,Default,,0000,0000,0000,,Thank you.\N(applause)