[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:11.20,0:00:16.80,Default,,0000,0000,0000,,(applause)
Dialogue: 0,0:00:16.80,0:00:22.07,Default,,0000,0000,0000,,3,4-Methylenedioxymethamphetamine: MDMA.
Dialogue: 0,0:00:22.07,0:00:27.49,Default,,0000,0000,0000,,Now you're probably heard of this compound\Nin the context of the recreational drug Ecstasy.
Dialogue: 0,0:00:27.49,0:00:31.77,Default,,0000,0000,0000,,But today I want to talk about MDMA not \Nas a recreational drug,
Dialogue: 0,0:00:31.77,0:00:35.63,Default,,0000,0000,0000,,but as a potential new treatment in medicine.
Dialogue: 0,0:00:35.63,0:00:39.75,Default,,0000,0000,0000,,And then very important treatment \Nfor psychiatry because MDMA could offer us
Dialogue: 0,0:00:39.75,0:00:44.61,Default,,0000,0000,0000,,in psychiatry for the first time the\Nopportunity to tackle trauma.
Dialogue: 0,0:00:45.08,0:00:49.29,Default,,0000,0000,0000,,And psychological trauma particularly that\Ncaused by child abuse and maltreatment
Dialogue: 0,0:00:49.29,0:00:57.14,Default,,0000,0000,0000,,is at the heart of all or most psychiatric\Ndisorders due to anxiety and addictions.
Dialogue: 0,0:00:57.76,0:01:02.07,Default,,0000,0000,0000,,Psychiatry is in need of this \Ninnovative approach,
Dialogue: 0,0:01:00.90,0:01:04.73,Default,,0000,0000,0000,,because current treatments \Nare failing patients.
Dialogue: 0,0:01:06.05,0:01:09.86,Default,,0000,0000,0000,,Hi, my name's Ben Sessa. I'm a child and\Nadolescent psychiatrist.
Dialogue: 0,0:01:09.86,0:01:12.35,Default,,0000,0000,0000,,Now that means I 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 in child \Nand adolescent mental health.
Dialogue: 0,0:01:17.40,0:01:20.22,Default,,0000,0000,0000,,But for the last five years I've \Nbeen working with adults with
Dialogue: 0,0:01:20.22,0:01:24.48,Default,,0000,0000,0000,,mental health disorders and addictions\Ndue to misuse of drugs.
Dialogue: 0,0:01:24.48,0:01:27.51,Default,,0000,0000,0000,,And that developmental pathway \Nof my own,
Dialogue: 0,0:01:27.51,0:01:30.30,Default,,0000,0000,0000,,from working with child abuse into adults
Dialogue: 0,0:01:30.30,0:01:34.07,Default,,0000,0000,0000,,with mental disorders and addictions has\Nbrought me to the door of MDMA.
Dialogue: 0,0:01:34.83,0:01:37.30,Default,,0000,0000,0000,,And I'm gonna propose today \Nthat MDMA could be
Dialogue: 0,0:01:37.30,0:01:41.70,Default,,0000,0000,0000,,important for the future of psychiatry\Nas the discovery of antibiotics was
Dialogue: 0,0:01:41.70,0:01:44.50,Default,,0000,0000,0000,,for general medicine a hundred years ago.
Dialogue: 0,0:01:44.100,0:01:51.09,Default,,0000,0000,0000,,So when we think about child abuse we think\Nabout physical abuse, mental abuse,
Dialogue: 0,0:01:51.09,0:01:54.43,Default,,0000,0000,0000,,emotional abuse, sexual abuse and neglect.
Dialogue: 0,0:01:55.37,0:01:58.18,Default,,0000,0000,0000,,And we think about noxious environments.
Dialogue: 0,0:01:58.18,0:02:00.55,Default,,0000,0000,0000,,We think about parents with mental disorder. \N
Dialogue: 0,0:02:01.10,0:02:06.65,Default,,0000,0000,0000,,We think about parents\Nwho are addicted to drugs.
Dialogue: 0,0:02:03.57,0:02:08.88,Default,,0000,0000,0000,,And social issues like poverty and poor housing, poor education.
Dialogue: 0,0:02:06.65,0:02:10.77,Default,,0000,0000,0000,,Now I'm going to illustrate my talk
Dialogue: 0,0:02:08.88,0:02:12.33,Default,,0000,0000,0000,,today with a patient and I'm going to
Dialogue: 0,0:02:10.77,0:02:14.55,Default,,0000,0000,0000,,call her Claire.
Dialogue: 0,0:02:12.33,0:02:16.56,Default,,0000,0000,0000,,Now Claire was no single particular
Dialogue: 0,0:02:14.55,0:02:18.60,Default,,0000,0000,0000,,patient of mine. Rather she's an
Dialogue: 0,0:02:16.56,0:02:20.79,Default,,0000,0000,0000,,amalgamation of many different people
Dialogue: 0,0:02:18.60,0:02:24.27,Default,,0000,0000,0000,,I've met in the last 18 years working as
Dialogue: 0,0:02:20.79,0:02:24.90,Default,,0000,0000,0000,,a medical doctor. She's certainly not the
Dialogue: 0,0:02:24.27,0:02:27.81,Default,,0000,0000,0000,,worst.
Dialogue: 0,0:02:24.90,0:02:30.60,Default,,0000,0000,0000,,Now what was Claire's environment like
Dialogue: 0,0:02:27.81,0:02:32.49,Default,,0000,0000,0000,,she was growing up. Well, her mother was
Dialogue: 0,0:02:30.60,0:02:34.61,Default,,0000,0000,0000,,depressed. Now unfortunately the family
Dialogue: 0,0:02:32.49,0:02:37.14,Default,,0000,0000,0000,,doctor didn't have time to accurately
Dialogue: 0,0:02:34.61,0:02:38.85,Default,,0000,0000,0000,,diagnose and treat depression, rather
Dialogue: 0,0:02:37.14,0:02:40.41,Default,,0000,0000,0000,,Claire's mother was put onto one
Dialogue: 0,0:02:38.85,0:02:42.99,Default,,0000,0000,0000,,antidepressant after another,
Dialogue: 0,0:02:40.41,0:02:44.76,Default,,0000,0000,0000,,never really got therapy. Claire's mother
Dialogue: 0,0:02:42.99,0:02:46.83,Default,,0000,0000,0000,,also had a lot of aches and pains
Dialogue: 0,0:02:44.76,0:02:48.99,Default,,0000,0000,0000,,typical what we call psychosomatic
Dialogue: 0,0:02:46.83,0:02:51.69,Default,,0000,0000,0000,,symptoms in depression, and as a result
Dialogue: 0,0:02:48.99,0:02:53.43,Default,,0000,0000,0000,,the family doctor put her on to opiate
Dialogue: 0,0:02:51.69,0:02:56.58,Default,,0000,0000,0000,,based painkillers which she promptly
Dialogue: 0,0:02:53.43,0:02:59.07,Default,,0000,0000,0000,,became addicted to. Now Claire's father,
Dialogue: 0,0:02:56.58,0:03:01.62,Default,,0000,0000,0000,,now he was alcoholic and he was often
Dialogue: 0,0:02:59.07,0:03:03.12,Default,,0000,0000,0000,,not around in and out of prison. Which is
Dialogue: 0,0:03:01.62,0:03:04.95,Default,,0000,0000,0000,,just as well because when he was there
Dialogue: 0,0:03:03.12,0:03:08.13,Default,,0000,0000,0000,,he was physically abusive to Claire and
Dialogue: 0,0:03:04.95,0:03:10.92,Default,,0000,0000,0000,,her mother. Okay so what does this kind
Dialogue: 0,0:03:08.13,0:03:13.92,Default,,0000,0000,0000,,of chaotic, frightening environment do
Dialogue: 0,0:03:10.92,0:03:15.51,Default,,0000,0000,0000,,to the developing child brain. I'm going
Dialogue: 0,0:03:13.92,0:03:17.67,Default,,0000,0000,0000,,to give you a brief neurophysiology
Dialogue: 0,0:03:15.51,0:03:19.62,Default,,0000,0000,0000,,lesson if I may. There's a part of the
Dialogue: 0,0:03:17.67,0:03:22.05,Default,,0000,0000,0000,,brain called the amygdala. Now the
Dialogue: 0,0:03:19.62,0:03:23.88,Default,,0000,0000,0000,,amygdala is a very ancient part of the
Dialogue: 0,0:03:22.05,0:03:26.58,Default,,0000,0000,0000,,mammalian brain and many other animals
Dialogue: 0,0:03:23.88,0:03:29.49,Default,,0000,0000,0000,,other than humans have an amygdala. The
Dialogue: 0,0:03:26.58,0:03:31.56,Default,,0000,0000,0000,,amygdala lights up when stimulated by
Dialogue: 0,0:03:29.49,0:03:34.23,Default,,0000,0000,0000,,fear in the environment, by a frightening
Dialogue: 0,0:03:31.56,0:03:35.99,Default,,0000,0000,0000,,stimulus. It lights up and it says
Dialogue: 0,0:03:34.23,0:03:38.13,Default,,0000,0000,0000,,fight-or-flight, get out!
Dialogue: 0,0:03:35.99,0:03:40.44,Default,,0000,0000,0000,,Now there's another part of the brain
Dialogue: 0,0:03:38.13,0:03:42.21,Default,,0000,0000,0000,,much more sophisticated part, called the
Dialogue: 0,0:03:40.44,0:03:43.77,Default,,0000,0000,0000,,prefrontal cortex and it's right here at
Dialogue: 0,0:03:42.21,0:03:46.56,Default,,0000,0000,0000,,the front above the eyes.
Dialogue: 0,0:03:43.77,0:03:48.65,Default,,0000,0000,0000,,Now the prefrontal cortex only humans
Dialogue: 0,0:03:46.56,0:03:52.50,Default,,0000,0000,0000,,have. And it's in the prefrontal cortex
Dialogue: 0,0:03:48.65,0:03:55.05,Default,,0000,0000,0000,,where we use logic and reasoning to
Dialogue: 0,0:03:52.50,0:03:57.54,Default,,0000,0000,0000,,rationalize the situation and we can use
Dialogue: 0,0:03:55.05,0:03:59.43,Default,,0000,0000,0000,,our prefrontal cortex to overcome that
Dialogue: 0,0:03:57.54,0:04:02.19,Default,,0000,0000,0000,,instinctive fear response from the
Dialogue: 0,0:03:59.43,0:04:04.44,Default,,0000,0000,0000,,amygdala. Now when Claire was growing up
Dialogue: 0,0:04:02.19,0:04:06.06,Default,,0000,0000,0000,,she never knew from one moment to the
Dialogue: 0,0:04:04.44,0:04:07.47,Default,,0000,0000,0000,,next whether the adult coming into the
Dialogue: 0,0:04:06.06,0:04:09.87,Default,,0000,0000,0000,,room, were they going to give her a kiss
Dialogue: 0,0:04:07.47,0:04:11.64,Default,,0000,0000,0000,,or a cuddle or do a jigsaw with her, or
Dialogue: 0,0:04:09.87,0:04:14.49,Default,,0000,0000,0000,,they're going to punch her or kick her
Dialogue: 0,0:04:11.64,0:04:16.83,Default,,0000,0000,0000,,or burn her with their cigarette. Or were
Dialogue: 0,0:04:14.49,0:04:18.33,Default,,0000,0000,0000,,they going to rape her. Because
Dialogue: 0,0:04:16.83,0:04:23.59,Default,,0000,0000,0000,,throughout her childhood Claire was also
Dialogue: 0,0:04:18.33,0:04:25.60,Default,,0000,0000,0000,,subjected to sexual abuse. Now there's a
Dialogue: 0,0:04:23.59,0:04:27.10,Default,,0000,0000,0000,,group of disorders called the anxiety
Dialogue: 0,0:04:25.60,0:04:29.14,Default,,0000,0000,0000,,disorders and one of the most important
Dialogue: 0,0:04:27.10,0:04:33.76,Default,,0000,0000,0000,,is what we call post-traumatic stress
Dialogue: 0,0:04:29.14,0:04:37.15,Default,,0000,0000,0000,,disorder or PTSD. Now PTSD, some of the
Dialogue: 0,0:04:33.76,0:04:39.73,Default,,0000,0000,0000,,core features: very low mood, anxiety, high
Dialogue: 0,0:04:37.15,0:04:42.73,Default,,0000,0000,0000,,levels of anxiety, what we call hyper
Dialogue: 0,0:04:39.73,0:04:45.58,Default,,0000,0000,0000,,vigilance. This edginess this jumpiness,
Dialogue: 0,0:04:42.73,0:04:47.80,Default,,0000,0000,0000,,exactly how claire felt throughout her
Dialogue: 0,0:04:45.58,0:04:49.81,Default,,0000,0000,0000,,childhood and adolescence. Never knowing
Dialogue: 0,0:04:47.80,0:04:52.39,Default,,0000,0000,0000,,whether they next assailant or assault
Dialogue: 0,0:04:49.81,0:04:54.52,Default,,0000,0000,0000,,was around the corner. Another core
Dialogue: 0,0:04:52.39,0:04:57.28,Default,,0000,0000,0000,,feature of PTSD what we call
Dialogue: 0,0:04:54.52,0:04:59.02,Default,,0000,0000,0000,,re-experiencing phenomena. Flashbacks, in
Dialogue: 0,0:04:57.28,0:05:00.73,Default,,0000,0000,0000,,which the patient has sudden
Dialogue: 0,0:04:59.02,0:05:02.86,Default,,0000,0000,0000,,remembrances of these painful traumatic
Dialogue: 0,0:05:00.73,0:05:05.86,Default,,0000,0000,0000,,memories. They can just pop into the head
Dialogue: 0,0:05:02.86,0:05:08.59,Default,,0000,0000,0000,,at any time, triggered by some cue in the
Dialogue: 0,0:05:05.86,0:05:10.60,Default,,0000,0000,0000,,environment. And when they have those
Dialogue: 0,0:05:08.59,0:05:13.09,Default,,0000,0000,0000,,experiences those daytime flashbacks,
Dialogue: 0,0:05:10.60,0:05:15.10,Default,,0000,0000,0000,,they relive the trauma in all the
Dialogue: 0,0:05:13.09,0:05:18.16,Default,,0000,0000,0000,,sensory modalities and this results in
Dialogue: 0,0:05:15.10,0:05:20.53,Default,,0000,0000,0000,,them freezing or dissociating to try and
Dialogue: 0,0:05:18.16,0:05:22.15,Default,,0000,0000,0000,,block out the pain. Now Claire
Dialogue: 0,0:05:20.53,0:05:26.59,Default,,0000,0000,0000,,experienced all of this as she was
Dialogue: 0,0:05:22.15,0:05:29.71,Default,,0000,0000,0000,,growing up. High levels of self-harm and
Dialogue: 0,0:05:26.59,0:05:32.13,Default,,0000,0000,0000,,suicide are associated with PTSD. Claire
Dialogue: 0,0:05:29.71,0:05:34.57,Default,,0000,0000,0000,,would cut her thighs and her breasts.
Dialogue: 0,0:05:32.13,0:05:37.39,Default,,0000,0000,0000,,Pretty common form of cutting in
Dialogue: 0,0:05:34.57,0:05:39.25,Default,,0000,0000,0000,,children who've been sexually abused.
Dialogue: 0,0:05:37.39,0:05:41.14,Default,,0000,0000,0000,,She was being sexually abused by clients of
Dialogue: 0,0:05:39.25,0:05:43.63,Default,,0000,0000,0000,,her mother, because her mother had moved
Dialogue: 0,0:05:41.14,0:05:45.37,Default,,0000,0000,0000,,on from the addiction to painkillers and
Dialogue: 0,0:05:43.63,0:05:47.80,Default,,0000,0000,0000,,was using street heroin when Claire was
Dialogue: 0,0:05:45.37,0:05:50.38,Default,,0000,0000,0000,,a teenager. And because of the way the
Dialogue: 0,0:05:47.80,0:05:52.03,Default,,0000,0000,0000,,war on drugs has set up that reduces
Dialogue: 0,0:05:50.38,0:05:54.85,Default,,0000,0000,0000,,access to treatment for people with
Dialogue: 0,0:05:52.03,0:05:57.04,Default,,0000,0000,0000,,opiate dependence she had to pay for her
Dialogue: 0,0:05:54.85,0:06:00.85,Default,,0000,0000,0000,,heroin using sex work and the clients
Dialogue: 0,0:05:57.04,0:06:03.85,Default,,0000,0000,0000,,would sexually abuse Claire. Now it's
Dialogue: 0,0:06:00.85,0:06:06.67,Default,,0000,0000,0000,,very hard to treat PTSD and it has a
Dialogue: 0,0:06:03.85,0:06:08.44,Default,,0000,0000,0000,,high treatment resistance, 50% of people
Dialogue: 0,0:06:06.67,0:06:11.38,Default,,0000,0000,0000,,do not respond to the traditional
Dialogue: 0,0:06:08.44,0:06:12.70,Default,,0000,0000,0000,,treatments. How do we treat it? Well, we
Dialogue: 0,0:06:11.38,0:06:15.64,Default,,0000,0000,0000,,can treat it with medications. We can
Dialogue: 0,0:06:12.70,0:06:17.86,Default,,0000,0000,0000,,treat it with psychotherapies. And the
Dialogue: 0,0:06:15.64,0:06:20.62,Default,,0000,0000,0000,,medications we use: there's a broad range
Dialogue: 0,0:06:17.86,0:06:24.12,Default,,0000,0000,0000,,of drugs. No single drug, and this is very
Dialogue: 0,0:06:20.62,0:06:26.29,Default,,0000,0000,0000,,important, no single drug cures PTSD.
Dialogue: 0,0:06:24.12,0:06:28.21,Default,,0000,0000,0000,,Rather we treat the disorder
Dialogue: 0,0:06:26.29,0:06:30.25,Default,,0000,0000,0000,,symptomatically: if the patient's
Dialogue: 0,0:06:28.21,0:06:32.80,Default,,0000,0000,0000,,depressed give them an antidepressant. If
Dialogue: 0,0:06:30.25,0:06:34.60,Default,,0000,0000,0000,,their mood fluctuates give them a mood
Dialogue: 0,0:06:32.80,0:06:36.25,Default,,0000,0000,0000,,stabilizer. If they can't sleep
Dialogue: 0,0:06:34.60,0:06:38.35,Default,,0000,0000,0000,,give them a hypnotic.
Dialogue: 0,0:06:36.25,0:06:40.66,Default,,0000,0000,0000,,And if that edginess and that fear
Dialogue: 0,0:06:38.35,0:06:43.24,Default,,0000,0000,0000,,spills over into paranoia and psychosis,
Dialogue: 0,0:06:40.66,0:06:45.82,Default,,0000,0000,0000,,give the patient an anti-psychotic drug.
Dialogue: 0,0:06:43.24,0:06:48.34,Default,,0000,0000,0000,,And they have to take these drugs day in
Dialogue: 0,0:06:45.82,0:06:50.98,Default,,0000,0000,0000,,day out for weeks, months, decades. They
Dialogue: 0,0:06:48.34,0:06:53.71,Default,,0000,0000,0000,,have to keep taking them because the
Dialogue: 0,0:06:50.98,0:06:56.35,Default,,0000,0000,0000,,drugs we use to treat trauma when it's
Dialogue: 0,0:06:53.71,0:06:59.44,Default,,0000,0000,0000,,due to this level of severity do not
Dialogue: 0,0:06:56.35,0:07:02.17,Default,,0000,0000,0000,,attack the root cause of trauma. They
Dialogue: 0,0:06:59.44,0:07:05.58,Default,,0000,0000,0000,,paper over the cracks. A good analogy
Dialogue: 0,0:07:02.17,0:07:08.62,Default,,0000,0000,0000,,would be taking aspirin or ibuprofen
Dialogue: 0,0:07:05.58,0:07:11.22,Default,,0000,0000,0000,,when you have a fever. Now a fever is
Dialogue: 0,0:07:08.62,0:07:14.32,Default,,0000,0000,0000,,caused by an infection, by a
Dialogue: 0,0:07:11.22,0:07:17.05,Default,,0000,0000,0000,,microorganism. Sure you can take paracetamol
Dialogue: 0,0:07:14.32,0:07:18.49,Default,,0000,0000,0000,,or ibuprofen and this will lower
Dialogue: 0,0:07:17.05,0:07:20.56,Default,,0000,0000,0000,,the temperature and make you feel a bit
Dialogue: 0,0:07:18.49,0:07:23.47,Default,,0000,0000,0000,,better but it doesn't attack the root
Dialogue: 0,0:07:20.56,0:07:26.56,Default,,0000,0000,0000,,cause. And that's what we do when we give
Dialogue: 0,0:07:23.47,0:07:28.54,Default,,0000,0000,0000,,these patients these daily SSRI drugs. We
Dialogue: 0,0:07:26.56,0:07:32.41,Default,,0000,0000,0000,,paper over the cracks. We maintain the
Dialogue: 0,0:07:28.54,0:07:34.66,Default,,0000,0000,0000,,symptoms at a manageable level. We also
Dialogue: 0,0:07:32.41,0:07:38.29,Default,,0000,0000,0000,,use psychotherapies to treat PTSD, and there's
Dialogue: 0,0:07:34.66,0:07:41.80,Default,,0000,0000,0000,,again a broad range of these: DBT
Dialogue: 0,0:07:38.29,0:07:45.01,Default,,0000,0000,0000,,CBT, EMDR, trauma focused psychotherapy,
Dialogue: 0,0:07:41.80,0:07:47.59,Default,,0000,0000,0000,,CAT, APT... Now all of them have a pretty
Dialogue: 0,0:07:45.01,0:07:49.57,Default,,0000,0000,0000,,similar approach which actually is an
Dialogue: 0,0:07:47.59,0:07:52.03,Default,,0000,0000,0000,,old wives tales which is: a problem
Dialogue: 0,0:07:49.57,0:07:54.94,Default,,0000,0000,0000,,shared is a problem halved. "Let's talk
Dialogue: 0,0:07:52.03,0:07:58.57,Default,,0000,0000,0000,,about your trauma. Claire tell me about
Dialogue: 0,0:07:54.94,0:08:01.69,Default,,0000,0000,0000,,your rape." Now that's fine for 50% of
Dialogue: 0,0:07:58.57,0:08:04.69,Default,,0000,0000,0000,,patients but for a significant half they
Dialogue: 0,0:08:01.69,0:08:06.82,Default,,0000,0000,0000,,just cannot do that. As soon as Claire is
Dialogue: 0,0:08:04.69,0:08:10.36,Default,,0000,0000,0000,,asked to talk about her rape she freezes,
Dialogue: 0,0:08:06.82,0:08:12.10,Default,,0000,0000,0000,,she flees, she drops out of treatment. Now
Dialogue: 0,0:08:10.36,0:08:14.41,Default,,0000,0000,0000,,by the time she was 15 Claire had been
Dialogue: 0,0:08:12.10,0:08:16.00,Default,,0000,0000,0000,,removed from the family home and she was
Dialogue: 0,0:08:14.41,0:08:18.79,Default,,0000,0000,0000,,brought up in a succession of foster
Dialogue: 0,0:08:16.00,0:08:21.48,Default,,0000,0000,0000,,placements and children's houses and
Dialogue: 0,0:08:18.79,0:08:23.92,Default,,0000,0000,0000,,hostels where the abuse continued. And
Dialogue: 0,0:08:21.48,0:08:26.11,Default,,0000,0000,0000,,she was self-harm cutting and she
Dialogue: 0,0:08:23.92,0:08:28.74,Default,,0000,0000,0000,,started drinking and by the time she was
Dialogue: 0,0:08:26.11,0:08:31.21,Default,,0000,0000,0000,,18 she was using heroin as well.
Dialogue: 0,0:08:28.74,0:08:32.53,Default,,0000,0000,0000,,Sometimes working in psychiatry can feel
Dialogue: 0,0:08:31.21,0:08:35.47,Default,,0000,0000,0000,,pretty desperate, can feel pretty
Dialogue: 0,0:08:32.53,0:08:37.26,Default,,0000,0000,0000,,hopeless. Sometimes it feels as if
Dialogue: 0,0:08:35.47,0:08:40.09,Default,,0000,0000,0000,,psychiatry is a palliative care
Dialogue: 0,0:08:37.26,0:08:42.16,Default,,0000,0000,0000,,profession. And this is the truth because
Dialogue: 0,0:08:40.09,0:08:44.32,Default,,0000,0000,0000,,the treatments we use do not get to the
Dialogue: 0,0:08:42.16,0:08:47.26,Default,,0000,0000,0000,,root cause of the problem, the trauma.
Dialogue: 0,0:08:44.32,0:08:48.79,Default,,0000,0000,0000,,They paper over the cracks. And I think
Dialogue: 0,0:08:47.26,0:08:49.93,Default,,0000,0000,0000,,the pharma industry know this and they
Dialogue: 0,0:08:48.79,0:08:51.97,Default,,0000,0000,0000,,queue up and they
Dialogue: 0,0:08:49.93,0:08:53.56,Default,,0000,0000,0000,,provide us with product after product to
Dialogue: 0,0:08:51.97,0:08:55.72,Default,,0000,0000,0000,,give to our patients that doesn't quite
Dialogue: 0,0:08:53.56,0:08:59.11,Default,,0000,0000,0000,,cure them but it gets them slightly
Dialogue: 0,0:08:55.72,0:09:01.00,Default,,0000,0000,0000,,better to function. And they have to keep
Dialogue: 0,0:08:59.11,0:09:02.92,Default,,0000,0000,0000,,taking them. Indeed I would say that we
Dialogue: 0,0:09:01.00,0:09:05.20,Default,,0000,0000,0000,,are in psychiatry today where we were in
Dialogue: 0,0:09:02.92,0:09:06.97,Default,,0000,0000,0000,,general medicine 100 years ago. Now 100
Dialogue: 0,0:09:05.20,0:09:08.92,Default,,0000,0000,0000,,years ago in general medicine, humanity
Dialogue: 0,0:09:06.97,0:09:11.14,Default,,0000,0000,0000,,was losing the battle to the infectious
Dialogue: 0,0:09:08.92,0:09:13.24,Default,,0000,0000,0000,,diseases. Oh we were very good at
Dialogue: 0,0:09:11.14,0:09:15.85,Default,,0000,0000,0000,,classifying and diagnosing them. We knew
Dialogue: 0,0:09:13.24,0:09:18.04,Default,,0000,0000,0000,,who got smallpox. We knew people died of
Dialogue: 0,0:09:15.85,0:09:20.02,Default,,0000,0000,0000,,post-operative surgery. We knew there
Dialogue: 0,0:09:18.04,0:09:22.36,Default,,0000,0000,0000,,were microorganisms but we didn't have a
Dialogue: 0,0:09:20.02,0:09:24.07,Default,,0000,0000,0000,,treatment. And then at the beginning of
Dialogue: 0,0:09:22.36,0:09:27.07,Default,,0000,0000,0000,,the 20th century we discovered the
Dialogue: 0,0:09:24.07,0:09:28.81,Default,,0000,0000,0000,,antibiotics. Not symptomatic treatment
Dialogue: 0,0:09:27.07,0:09:31.54,Default,,0000,0000,0000,,but treatment that goes to the core of
Dialogue: 0,0:09:28.81,0:09:34.87,Default,,0000,0000,0000,,the cause and we started getting on top
Dialogue: 0,0:09:31.54,0:09:37.69,Default,,0000,0000,0000,,of infectious disease. Now psychiatry
Dialogue: 0,0:09:34.87,0:09:39.67,Default,,0000,0000,0000,,today is in a similar place. We're very
Dialogue: 0,0:09:37.69,0:09:42.22,Default,,0000,0000,0000,,good at classifying and diagnosing. Our
Dialogue: 0,0:09:39.67,0:09:44.71,Default,,0000,0000,0000,,epidemiology is superb. We write these
Dialogue: 0,0:09:42.22,0:09:46.51,Default,,0000,0000,0000,,thick diagnostic manuals. We know who
Dialogue: 0,0:09:44.71,0:09:49.57,Default,,0000,0000,0000,,gets depression. We know who gets anxiety.
Dialogue: 0,0:09:46.51,0:09:52.60,Default,,0000,0000,0000,,We even know the cause: trauma, child
Dialogue: 0,0:09:49.57,0:09:55.23,Default,,0000,0000,0000,,abuse, maltreatment, poor social
Dialogue: 0,0:09:52.60,0:10:00.94,Default,,0000,0000,0000,,conditions. But our treatments are lousy.
Dialogue: 0,0:09:55.23,0:10:02.83,Default,,0000,0000,0000,,And I'm quite shocked the way the empathy
Dialogue: 0,0:10:00.94,0:10:05.65,Default,,0000,0000,0000,,switch and our understanding of these
Dialogue: 0,0:10:02.83,0:10:08.20,Default,,0000,0000,0000,,patients seems to be switched off. We
Dialogue: 0,0:10:05.65,0:10:09.58,Default,,0000,0000,0000,,have lots of gushing sentimentality for
Dialogue: 0,0:10:08.20,0:10:12.19,Default,,0000,0000,0000,,the little five and six year old who's
Dialogue: 0,0:10:09.58,0:10:14.74,Default,,0000,0000,0000,,being abused and we throw money at our
Dialogue: 0,0:10:12.19,0:10:16.81,Default,,0000,0000,0000,,television sets on these campaigns to
Dialogue: 0,0:10:14.74,0:10:18.58,Default,,0000,0000,0000,,improve the lives of these poor little
Dialogue: 0,0:10:16.81,0:10:20.50,Default,,0000,0000,0000,,innocent victims. Well, let me tell you
Dialogue: 0,0:10:18.58,0:10:24.10,Default,,0000,0000,0000,,what happens to that little five or six
Dialogue: 0,0:10:20.50,0:10:27.31,Default,,0000,0000,0000,,year old when they're 11 or 12. On goes
Dialogue: 0,0:10:24.10,0:10:28.54,Default,,0000,0000,0000,,the hood, start smoking weed. By the time
Dialogue: 0,0:10:27.31,0:10:29.98,Default,,0000,0000,0000,,they're 16 they're buying and selling
Dialogue: 0,0:10:28.54,0:10:32.05,Default,,0000,0000,0000,,amphetamine and by the time they're
Dialogue: 0,0:10:29.98,0:10:33.64,Default,,0000,0000,0000,,Claire's age in their mid-20s, they're
Dialogue: 0,0:10:32.05,0:10:36.73,Default,,0000,0000,0000,,addicted to heroin and alcohol. And
Dialogue: 0,0:10:33.64,0:10:39.67,Default,,0000,0000,0000,,suddenly we have lost our empathy. These
Dialogue: 0,0:10:36.73,0:10:41.56,Default,,0000,0000,0000,,people are public enemy number one. "It's
Dialogue: 0,0:10:39.67,0:10:45.01,Default,,0000,0000,0000,,your fault Claire. You brought this upon
Dialogue: 0,0:10:41.56,0:10:47.04,Default,,0000,0000,0000,,yourself. It's your lifestyle choice." And
Dialogue: 0,0:10:45.01,0:10:50.56,Default,,0000,0000,0000,,I'm quite shocked and having worked in
Dialogue: 0,0:10:47.04,0:10:52.72,Default,,0000,0000,0000,,pediatrics and seen the developmental
Dialogue: 0,0:10:50.56,0:10:55.60,Default,,0000,0000,0000,,trajectory that is so inevitable from
Dialogue: 0,0:10:52.72,0:10:57.67,Default,,0000,0000,0000,,early trauma into adolescent and then
Dialogue: 0,0:10:55.60,0:10:59.08,Default,,0000,0000,0000,,adult mental health and addictions, we
Dialogue: 0,0:10:57.67,0:11:00.57,Default,,0000,0000,0000,,have to hold on to that sense of
Dialogue: 0,0:10:59.08,0:11:01.83,Default,,0000,0000,0000,,compassion and evidence-based
Dialogue: 0,0:11:00.57,0:11:04.94,Default,,0000,0000,0000,,understanding
Dialogue: 0,0:11:01.83,0:11:07.50,Default,,0000,0000,0000,,about the developmental trajectory there.
Dialogue: 0,0:11:04.94,0:11:09.77,Default,,0000,0000,0000,,So it does sound desperate, but all is
Dialogue: 0,0:11:07.50,0:11:09.77,Default,,0000,0000,0000,,not lost.
Dialogue: 0,0:11:09.98,0:11:16.59,Default,,0000,0000,0000,,MDMA. MDMA has some fascinating qualities.
Dialogue: 0,0:11:13.62,0:11:18.78,Default,,0000,0000,0000,,Indeed I would suggest that if you were
Dialogue: 0,0:11:16.59,0:11:22.41,Default,,0000,0000,0000,,to invent a hypothetical drug to treat
Dialogue: 0,0:11:18.78,0:11:24.09,Default,,0000,0000,0000,,trauma, it would be MDMA. The way it works
Dialogue: 0,0:11:22.41,0:11:25.77,Default,,0000,0000,0000,,in terms of its receptors and its
Dialogue: 0,0:11:24.09,0:11:28.26,Default,,0000,0000,0000,,subjective psychological effects ticks
Dialogue: 0,0:11:25.77,0:11:30.54,Default,,0000,0000,0000,,all the right boxes. At one level of
Dialogue: 0,0:11:28.26,0:11:32.94,Default,,0000,0000,0000,,receptors it causes a increased positive
Dialogue: 0,0:11:30.54,0:11:35.55,Default,,0000,0000,0000,,mood. Lowering of depression, lowering of
Dialogue: 0,0:11:32.94,0:11:38.28,Default,,0000,0000,0000,,anxiety. At another group of receptors it
Dialogue: 0,0:11:35.55,0:11:40.11,Default,,0000,0000,0000,,speeds the patient up, mild stimulation
Dialogue: 0,0:11:38.28,0:11:43.92,Default,,0000,0000,0000,,which motivates them to engage in
Dialogue: 0,0:11:40.11,0:11:45.75,Default,,0000,0000,0000,,therapy. At another level it relaxes
Dialogue: 0,0:11:43.92,0:11:48.12,Default,,0000,0000,0000,,the patient paradoxically at the same
Dialogue: 0,0:11:45.75,0:11:49.80,Default,,0000,0000,0000,,time as the stimulation and this puts
Dialogue: 0,0:11:48.12,0:11:52.23,Default,,0000,0000,0000,,the patient into the optimal arousal
Dialogue: 0,0:11:49.80,0:11:54.30,Default,,0000,0000,0000,,zone where they can engage in
Dialogue: 0,0:11:52.23,0:11:56.55,Default,,0000,0000,0000,,psychotherapy. But perhaps the most
Dialogue: 0,0:11:54.30,0:11:59.40,Default,,0000,0000,0000,,important thing about MDMA and the most
Dialogue: 0,0:11:56.55,0:12:02.46,Default,,0000,0000,0000,,important clinical tool is its ability
Dialogue: 0,0:11:59.40,0:12:07.35,Default,,0000,0000,0000,,to provide a sense of empathy and
Dialogue: 0,0:12:02.46,0:12:09.63,Default,,0000,0000,0000,,understanding and emotional security. It
Dialogue: 0,0:12:07.35,0:12:11.67,Default,,0000,0000,0000,,can hold the patient in a place where
Dialogue: 0,0:12:09.63,0:12:13.59,Default,,0000,0000,0000,,they can think about and access their
Dialogue: 0,0:12:11.67,0:12:17.37,Default,,0000,0000,0000,,trauma like they've never been able to
Dialogue: 0,0:12:13.59,0:12:19.77,Default,,0000,0000,0000,,do before. One of the ways in which MDMA
Dialogue: 0,0:12:17.37,0:12:22.74,Default,,0000,0000,0000,,works is it increases the release of a
Dialogue: 0,0:12:19.77,0:12:23.94,Default,,0000,0000,0000,,hormone called oxytocin. Now oxytocin is
Dialogue: 0,0:12:22.74,0:12:26.19,Default,,0000,0000,0000,,released from the brains of
Dialogue: 0,0:12:23.94,0:12:28.32,Default,,0000,0000,0000,,breastfeeding mothers. It's a hormone
Dialogue: 0,0:12:26.19,0:12:29.91,Default,,0000,0000,0000,,that engenders a sense of attachment and
Dialogue: 0,0:12:28.32,0:12:33.69,Default,,0000,0000,0000,,bonding. And that's what's happening in
Dialogue: 0,0:12:29.91,0:12:36.45,Default,,0000,0000,0000,,the patient who takes MDMA. And also it
Dialogue: 0,0:12:33.69,0:12:38.58,Default,,0000,0000,0000,,acts directly on the amygdala to reduce
Dialogue: 0,0:12:36.45,0:12:41.07,Default,,0000,0000,0000,,that fear response whilst at the same
Dialogue: 0,0:12:38.58,0:12:43.08,Default,,0000,0000,0000,,time boosting the prefrontal response,
Dialogue: 0,0:12:41.07,0:12:46.59,Default,,0000,0000,0000,,allowing the patient to see things in a
Dialogue: 0,0:12:43.08,0:12:50.64,Default,,0000,0000,0000,,new light. A positive light. So let's go
Dialogue: 0,0:12:46.59,0:12:52.32,Default,,0000,0000,0000,,back to Claire. She's 40 now. She's been
Dialogue: 0,0:12:50.64,0:12:54.39,Default,,0000,0000,0000,,in and out of psychiatric hospitals,
Dialogue: 0,0:12:52.32,0:12:56.04,Default,,0000,0000,0000,,having tried to take her own life and
Dialogue: 0,0:12:54.39,0:12:57.78,Default,,0000,0000,0000,,the inception. She's been on all the
Dialogue: 0,0:12:56.04,0:12:59.76,Default,,0000,0000,0000,,antipsychotic and antidepressant mood
Dialogue: 0,0:12:57.78,0:13:01.56,Default,,0000,0000,0000,,stabiliser drugs. She's tried all the
Dialogue: 0,0:12:59.76,0:13:04.29,Default,,0000,0000,0000,,psychotherapies but she cannot engage
Dialogue: 0,0:13:01.56,0:13:08.75,Default,,0000,0000,0000,,because she will not talk about her
Dialogue: 0,0:13:04.29,0:13:11.16,Default,,0000,0000,0000,,feelings. So she comes into a course of
Dialogue: 0,0:13:08.75,0:13:13.78,Default,,0000,0000,0000,,MDMA-assisted psychotherapy.
Dialogue: 0,0:13:11.16,0:13:16.39,Default,,0000,0000,0000,,Wwhat does it look like? Well,
Dialogue: 0,0:13:13.78,0:13:18.70,Default,,0000,0000,0000,,it's weekly sessions, maybe eight, ten,
Dialogue: 0,0:13:16.39,0:13:22.57,Default,,0000,0000,0000,,twelve weeks long. The two therapists,
Dialogue: 0,0:13:18.70,0:13:24.76,Default,,0000,0000,0000,,male-female pair. You do not take MDMA
Dialogue: 0,0:13:22.57,0:13:26.59,Default,,0000,0000,0000,,everyday, you do not take it every
Dialogue: 0,0:13:24.76,0:13:29.26,Default,,0000,0000,0000,,week. Over that course of 12 sessions
Dialogue: 0,0:13:26.59,0:13:31.33,Default,,0000,0000,0000,,you'll take the MDMA three times and the
Dialogue: 0,0:13:29.26,0:13:33.73,Default,,0000,0000,0000,,other sessions you talk about the
Dialogue: 0,0:13:31.33,0:13:37.09,Default,,0000,0000,0000,,material that's released on the MDMA
Dialogue: 0,0:13:33.73,0:13:40.84,Default,,0000,0000,0000,,session. So what does Claire actually
Dialogue: 0,0:13:37.09,0:13:43.03,Default,,0000,0000,0000,,feel when she takes this MDMA? What she
Dialogue: 0,0:13:40.84,0:13:45.84,Default,,0000,0000,0000,,feels is a sense of warmth and
Dialogue: 0,0:13:43.03,0:13:48.52,Default,,0000,0000,0000,,understanding and a sense of containment
Dialogue: 0,0:13:45.84,0:13:52.27,Default,,0000,0000,0000,,within that relationship she's having
Dialogue: 0,0:13:48.52,0:13:54.55,Default,,0000,0000,0000,,with the therapist. MDMA is like it's
Dialogue: 0,0:13:52.27,0:13:57.73,Default,,0000,0000,0000,,like a lifejacket like a bulletproof
Dialogue: 0,0:13:54.55,0:14:01.83,Default,,0000,0000,0000,,vest to wear to go into battle with your
Dialogue: 0,0:13:57.73,0:14:05.47,Default,,0000,0000,0000,,trauma. This is not ecstasy! She's not
Dialogue: 0,0:14:01.83,0:14:07.39,Default,,0000,0000,0000,,enjoying some raver's euphoric ecstasy
Dialogue: 0,0:14:05.47,0:14:09.79,Default,,0000,0000,0000,,delight. This is still trauma focused
Dialogue: 0,0:14:07.39,0:14:11.95,Default,,0000,0000,0000,,psychotherapy and it is still hard and
Dialogue: 0,0:14:09.79,0:14:15.34,Default,,0000,0000,0000,,distressing for her, but she can just
Dialogue: 0,0:14:11.95,0:14:18.01,Default,,0000,0000,0000,,about do it with MDMA on board. So when
Dialogue: 0,0:14:15.34,0:14:20.92,Default,,0000,0000,0000,,the therapist says: "Claire, tell me about
Dialogue: 0,0:14:18.01,0:14:22.63,Default,,0000,0000,0000,,your rape". Now in the past just the word
Dialogue: 0,0:14:20.92,0:14:25.69,Default,,0000,0000,0000,,rape and she'd be out the door, but on
Dialogue: 0,0:14:22.63,0:14:28.90,Default,,0000,0000,0000,,MDMA she says: "yeah, I can talk about that!
Dialogue: 0,0:14:25.69,0:14:31.99,Default,,0000,0000,0000,,I can see him now coming into the room. I
Dialogue: 0,0:14:28.90,0:14:34.33,Default,,0000,0000,0000,,can smell the whiskey on his breath and
Dialogue: 0,0:14:31.99,0:14:37.09,Default,,0000,0000,0000,,I can feel the stubble on his face as
Dialogue: 0,0:14:34.33,0:14:39.04,Default,,0000,0000,0000,,he's raping me". And she talks about it
Dialogue: 0,0:14:37.09,0:14:42.07,Default,,0000,0000,0000,,and she explores it and she reflects
Dialogue: 0,0:14:39.04,0:14:44.56,Default,,0000,0000,0000,,upon it and she can begin the process of
Dialogue: 0,0:14:42.07,0:14:47.65,Default,,0000,0000,0000,,healing. And from here she can start her
Dialogue: 0,0:14:44.56,0:14:50.71,Default,,0000,0000,0000,,journey. She can attack the root cause of
Dialogue: 0,0:14:47.65,0:14:56.77,Default,,0000,0000,0000,,her problems. Not just maintain the
Dialogue: 0,0:14:50.71,0:14:58.96,Default,,0000,0000,0000,,symptoms at a level. So, does it work? Well
Dialogue: 0,0:14:56.77,0:15:00.97,Default,,0000,0000,0000,,we've known about MDMA for very long
Dialogue: 0,0:14:58.96,0:15:03.91,Default,,0000,0000,0000,,time and indeed we've used MDMA in
Dialogue: 0,0:15:00.97,0:15:06.19,Default,,0000,0000,0000,,underground therapy for 30 or 40 years.
Dialogue: 0,0:15:03.91,0:15:09.31,Default,,0000,0000,0000,,And there are thousands of positive
Dialogue: 0,0:15:06.19,0:15:11.68,Default,,0000,0000,0000,,anecdotal cases. I get five emails a week
Dialogue: 0,0:15:09.31,0:15:13.51,Default,,0000,0000,0000,,from all over the world: "Dr. Sessa, I've
Dialogue: 0,0:15:11.68,0:15:16.21,Default,,0000,0000,0000,,had PTSD for years. I've tried everything
Dialogue: 0,0:15:13.51,0:15:16.93,Default,,0000,0000,0000,,and now I tried MDMA and I'm starting to
Dialogue: 0,0:15:16.21,0:15:19.69,Default,,0000,0000,0000,,make a breakthrough!"
Dialogue: 0,0:15:16.93,0:15:21.85,Default,,0000,0000,0000,,Now, anecdotal reports like that are
Dialogue: 0,0:15:19.69,0:15:23.23,Default,,0000,0000,0000,,interesting but they're not science so
Dialogue: 0,0:15:21.85,0:15:26.44,Default,,0000,0000,0000,,we've done the science. And some
Dialogue: 0,0:15:23.23,0:15:27.31,Default,,0000,0000,0000,,important studies in recent years.
Dialogue: 0,0:15:26.44,0:15:29.95,Default,,0000,0000,0000,,Big study in the States
Dialogue: 0,0:15:27.31,0:15:33.10,Default,,0000,0000,0000,,showed that a single course of MDMA
Dialogue: 0,0:15:29.95,0:15:35.44,Default,,0000,0000,0000,,therapy, 16-week course, patient takes
Dialogue: 0,0:15:33.10,0:15:39.13,Default,,0000,0000,0000,,MDMA three times tested against a
Dialogue: 0,0:15:35.44,0:15:41.95,Default,,0000,0000,0000,,placebo. At the end of that course 85% of
Dialogue: 0,0:15:39.13,0:15:45.13,Default,,0000,0000,0000,,the people no longer met the diagnostic
Dialogue: 0,0:15:41.95,0:15:47.98,Default,,0000,0000,0000,,criteria for PTSD. Not just a relief of
Dialogue: 0,0:15:45.13,0:15:50.41,Default,,0000,0000,0000,,symptoms, they didn't have PTSD!
Dialogue: 0,0:15:47.98,0:15:54.34,Default,,0000,0000,0000,,Now that cohort were then followed up
Dialogue: 0,0:15:50.41,0:15:56.71,Default,,0000,0000,0000,,three years later, the same no PTSD. Many
Dialogue: 0,0:15:50.44,0:15:56.71,Default,,0000,0000,0000,,of those people had come off their daily
Dialogue: 0,0:15:56.71,0:16:03.79,Default,,0000,0000,0000,,medications. They were cured! We don't use
Dialogue: 0,0:16:00.61,0:16:07.93,Default,,0000,0000,0000,,the word "cure" in psychiatry. We've become
Dialogue: 0,0:16:03.79,0:16:09.58,Default,,0000,0000,0000,,learned helplessness position of-- This is
Dialogue: 0,0:16:07.93,0:16:11.56,Default,,0000,0000,0000,,the truth! If you're diagnosed with a
Dialogue: 0,0:16:09.58,0:16:13.30,Default,,0000,0000,0000,,severe mental disorder like anxiety or
Dialogue: 0,0:16:11.56,0:16:15.22,Default,,0000,0000,0000,,depression in your 20s and the
Dialogue: 0,0:16:13.30,0:16:17.74,Default,,0000,0000,0000,,developmental route of that disorder is
Dialogue: 0,0:16:15.22,0:16:19.57,Default,,0000,0000,0000,,severe child abuse, there's a pretty good
Dialogue: 0,0:16:17.74,0:16:21.64,Default,,0000,0000,0000,,chance, and I'm sorry to say this, there's
Dialogue: 0,0:16:19.57,0:16:23.59,Default,,0000,0000,0000,,a pretty good chance you will still be
Dialogue: 0,0:16:21.64,0:16:26.59,Default,,0000,0000,0000,,going to psychiatric clinics in your 60s
Dialogue: 0,0:16:23.59,0:16:28.81,Default,,0000,0000,0000,,and 70s. Now that is not good enough and
Dialogue: 0,0:16:26.59,0:16:33.37,Default,,0000,0000,0000,,we're in this position because we're not
Dialogue: 0,0:16:28.81,0:16:36.82,Default,,0000,0000,0000,,tackling trauma. So, it works but is it
Dialogue: 0,0:16:33.37,0:16:39.61,Default,,0000,0000,0000,,safe? Well, when we talk about safety of
Dialogue: 0,0:16:36.82,0:16:42.64,Default,,0000,0000,0000,,clinical MDMA, what we must not do is
Dialogue: 0,0:16:39.61,0:16:45.79,Default,,0000,0000,0000,,look at the risks of recreational
Dialogue: 0,0:16:42.64,0:16:46.72,Default,,0000,0000,0000,,ecstasy. I don't even know what ecstasy
Dialogue: 0,0:16:45.79,0:16:48.79,Default,,0000,0000,0000,,is anymore!
Dialogue: 0,0:16:46.72,0:16:51.55,Default,,0000,0000,0000,,Ecstasy is over here, what is ecstasy?
Dialogue: 0,0:16:48.79,0:16:54.10,Default,,0000,0000,0000,,Some dodgy pill bought in some dodgy
Dialogue: 0,0:16:51.55,0:16:56.89,Default,,0000,0000,0000,,club of some dodgy geezer, that may or
Dialogue: 0,0:16:54.10,0:17:00.48,Default,,0000,0000,0000,,may not contain MDMA plus or minus
Dialogue: 0,0:16:56.89,0:17:03.04,Default,,0000,0000,0000,,whatever far more toxic substance. And
Dialogue: 0,0:17:00.48,0:17:05.11,Default,,0000,0000,0000,,indeed when you hear about the very
Dialogue: 0,0:17:03.04,0:17:10.36,Default,,0000,0000,0000,,high-profile deaths of people who take
Dialogue: 0,0:17:05.11,0:17:12.22,Default,,0000,0000,0000,,ecstasy, it invariably is not MDMA. So,
Dialogue: 0,0:17:10.36,0:17:15.22,Default,,0000,0000,0000,,let's not look at ecstasy as a measure
Dialogue: 0,0:17:12.22,0:17:18.40,Default,,0000,0000,0000,,of MDMA. Let's look at clinical MDMA. Now,
Dialogue: 0,0:17:15.22,0:17:20.71,Default,,0000,0000,0000,,when you use clinical MDMA, you take
Dialogue: 0,0:17:18.40,0:17:23.28,Default,,0000,0000,0000,,it under medical supervision. It is pure.
Dialogue: 0,0:17:20.71,0:17:30.29,Default,,0000,0000,0000,,The MDMA that I'm using in my studies is
Dialogue: 0,0:17:23.28,0:17:32.85,Default,,0000,0000,0000,,99.98% pure! Very expensive! \N(laughter)
Dialogue: 0,0:17:30.29,0:17:34.47,Default,,0000,0000,0000,,We do it under medical supervision with
Dialogue: 0,0:17:32.85,0:17:37.95,Default,,0000,0000,0000,,a doctor and a nurse and a psychologist.
Dialogue: 0,0:17:34.47,0:17:40.74,Default,,0000,0000,0000,,And under those conditions the risks are
Dialogue: 0,0:17:37.95,0:17:42.99,Default,,0000,0000,0000,,reduced to a absolute minimum. Indeed
Dialogue: 0,0:17:40.74,0:17:45.69,Default,,0000,0000,0000,,after 40 years of MDMA research, there
Dialogue: 0,0:17:42.99,0:17:48.63,Default,,0000,0000,0000,,has not been a single serious adverse
Dialogue: 0,0:17:45.69,0:17:53.58,Default,,0000,0000,0000,,drug reaction, not one! And certainly no
Dialogue: 0,0:17:48.63,0:17:55.50,Default,,0000,0000,0000,,deaths. So, we need to do this research
Dialogue: 0,0:17:53.58,0:17:59.88,Default,,0000,0000,0000,,and we need to do this research in an
Dialogue: 0,0:17:55.50,0:18:02.97,Default,,0000,0000,0000,,evidence-based, compassionate way. Looking
Dialogue: 0,0:17:59.88,0:18:05.16,Default,,0000,0000,0000,,at the data. We need to ignore the
Dialogue: 0,0:18:02.97,0:18:06.63,Default,,0000,0000,0000,,socio-political agenda that says any
Dialogue: 0,0:18:05.16,0:18:11.61,Default,,0000,0000,0000,,drug that's being used recreationally
Dialogue: 0,0:18:06.63,0:18:15.78,Default,,0000,0000,0000,,must also be very bad and dangerous. That
Dialogue: 0,0:18:11.61,0:18:19.32,Default,,0000,0000,0000,,sort of attitude hampers research. And we
Dialogue: 0,0:18:15.78,0:18:21.72,Default,,0000,0000,0000,,need scientists to drive this. It works,
Dialogue: 0,0:18:19.32,0:18:23.76,Default,,0000,0000,0000,,it's safe. And it offers patients like
Dialogue: 0,0:18:21.72,0:18:25.59,Default,,0000,0000,0000,,Claire for the first time in their life
Dialogue: 0,0:18:23.76,0:18:27.84,Default,,0000,0000,0000,,an opportunity to break through from
Dialogue: 0,0:18:25.59,0:18:31.11,Default,,0000,0000,0000,,that trauma and not become a lifelong
Dialogue: 0,0:18:27.84,0:18:33.18,Default,,0000,0000,0000,,chronic PTSD sufferer. So where were we
Dialogue: 0,0:18:31.11,0:18:35.19,Default,,0000,0000,0000,,going with MDMA research? Well, we've had
Dialogue: 0,0:18:33.18,0:18:37.05,Default,,0000,0000,0000,,some studies, we've got more coming here.
Dialogue: 0,0:18:35.19,0:18:38.67,Default,,0000,0000,0000,,I'm doing a study in Cardiff with
Dialogue: 0,0:18:37.05,0:18:41.94,Default,,0000,0000,0000,,neuroimaging in which we're going to
Dialogue: 0,0:18:38.67,0:18:43.32,Default,,0000,0000,0000,,give patients with PTSD MDMA and placebo
Dialogue: 0,0:18:41.94,0:18:44.70,Default,,0000,0000,0000,,and we're going to look at
Dialogue: 0,0:18:43.32,0:18:47.73,Default,,0000,0000,0000,,that relationship between the
Dialogue: 0,0:18:44.70,0:18:49.16,Default,,0000,0000,0000,,amygdala and the prefrontal cortex. We're
Dialogue: 0,0:18:47.73,0:18:51.42,Default,,0000,0000,0000,,also doing a study here in Bristol
Dialogue: 0,0:18:49.16,0:18:54.84,Default,,0000,0000,0000,,giving patients with alcohol use
Dialogue: 0,0:18:51.42,0:18:58.23,Default,,0000,0000,0000,,disorder MDMA, because underlying the
Dialogue: 0,0:18:54.84,0:19:00.81,Default,,0000,0000,0000,,root of this addiction is trauma. So this
Dialogue: 0,0:18:58.23,0:19:02.46,Default,,0000,0000,0000,,is an exciting time. Now people say: "This
Dialogue: 0,0:19:00.81,0:19:04.32,Default,,0000,0000,0000,,is controversial!" And indeed, I was
Dialogue: 0,0:19:02.46,0:19:06.27,Default,,0000,0000,0000,,introduced as a controversial speaker.
Dialogue: 0,0:19:04.32,0:19:08.88,Default,,0000,0000,0000,,I'm not controversial, I'm a very boring
Dialogue: 0,0:19:06.27,0:19:11.88,Default,,0000,0000,0000,,conservative doctor. I like data.
Dialogue: 0,0:19:08.88,0:19:14.43,Default,,0000,0000,0000,,I like evidence-based data that helps my
Dialogue: 0,0:19:11.88,0:19:16.86,Default,,0000,0000,0000,,patients. I'll tell you what's
Dialogue: 0,0:19:14.43,0:19:19.11,Default,,0000,0000,0000,,controversial! What's controversial is
Dialogue: 0,0:19:16.86,0:19:21.18,Default,,0000,0000,0000,,that more people have died returning
Dialogue: 0,0:19:19.11,0:19:22.59,Default,,0000,0000,0000,,from Afghanistan and Iraq because
Dialogue: 0,0:19:21.18,0:19:25.50,Default,,0000,0000,0000,,they've committed suicide because of
Dialogue: 0,0:19:22.59,0:19:27.51,Default,,0000,0000,0000,,their untreated PTSD then ever died in
Dialogue: 0,0:19:25.50,0:19:32.76,Default,,0000,0000,0000,,the conflict out there. That is
Dialogue: 0,0:19:27.51,0:19:35.15,Default,,0000,0000,0000,,controversial and that is unethical! So
Dialogue: 0,0:19:32.76,0:19:38.34,Default,,0000,0000,0000,,this is a important time for science.
Dialogue: 0,0:19:35.15,0:19:40.62,Default,,0000,0000,0000,,MDMA could be the antibiotic that
Dialogue: 0,0:19:38.34,0:19:42.42,Default,,0000,0000,0000,,psychiatry has been waiting for. We owe
Dialogue: 0,0:19:40.62,0:19:43.63,Default,,0000,0000,0000,,that population of patients who are
Dialogue: 0,0:19:42.42,0:19:46.69,Default,,0000,0000,0000,,being failed,
Dialogue: 0,0:19:43.63,0:19:50.22,Default,,0000,0000,0000,,we owe them this research! We owe this
Dialogue: 0,0:19:50.22,0:19:53.75,Default,,0000,0000,0000,,Claire! Thank you.\N(applause)