[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: 0,0:01:58.18,0:02:00.22,Default,,0000,0000,0000,,We think about parents with mental disorder. \N Dialogue: 0,0:02:00.22,0:02:02.45,Default,,0000,0000,0000,,We think about parents\Nwho are addicted to drugs. Dialogue: 0,0:02:00.22,0:02:06.71,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 my talk\Ntoday 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: 0,0:02:12.33,0:02:16.02,Default,,0000,0000,0000,,Now Claire was no single particular\Npatient of mine. Dialogue: 0,0:02:16.06,0:02:18.64,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: 0,0:02:25.82,0:02:29.17,Default,,0000,0000,0000,,Now what was Claire's environment like \Nwhen she was growing up? Dialogue: 0,0:02:29.17,0:02:31.38,Default,,0000,0000,0000,,Well, her mother was depressed. Dialogue: 0,0:02:31.38,0:02:34.89,Default,,0000,0000,0000,,Now unfortunately the family\Ndoctor didn't have time to accurately Dialogue: 0,0:02:34.89,0:02:37.67,Default,,0000,0000,0000,,diagnose and treat depression, rather, Dialogue: 0,0:02:37.67,0:02:40.62,Default,,0000,0000,0000,,Claire's mother was put onto one\Nantidepressant after another, Dialogue: 0,0:02:40.62,0:02:42.69,Default,,0000,0000,0000,,never really got therapy. Dialogue: 0,0:02:42.69,0:02:45.14,Default,,0000,0000,0000,,Claire's mother also had a lot of aches and pains Dialogue: 0,0:02:45.14,0:02:48.11,Default,,0000,0000,0000,,typical 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 on to opiate based painkillers Dialogue: 0,0:02:52.85,0:02:55.61,Default,,0000,0000,0000,,which she promptly became addicted to. Dialogue: 0,0:02:55.95,0:02:59.10,Default,,0000,0000,0000,,Now Claire's father, now he was alcoholic and 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 because when he was\Nthere Dialogue: 0,0:03:03.16,0:03:06.39,Default,,0000,0000,0000,,he was physically abusive to Claire\Nand her mother. Dialogue: 0,0:03:06.39,0:03:08.13,Default,,0000,0000,0000,,Okay so what does this kind Dialogue: 0,0:03:08.13,0:03:10.94,Default,,0000,0000,0000,,of chaotic, frightening environment do Dialogue: 0,0:03:10.94,0:03:13.72,Default,,0000,0000,0000,,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: 0,0:03:16.71,0:03:19.65,Default,,0000,0000,0000,,There's a part of the brain called the amygdala. Dialogue: 0,0:03:19.65,0:03:23.03,Default,,0000,0000,0000,,Now the amygdala is a very\Nancient part of the mammalian brain Dialogue: 0,0:03:23.03,0:03:26.58,Default,,0000,0000,0000,,and many other animals other than humans\Nhave an amygdala. Dialogue: 0,0:03:26.58,0:03:29.51,Default,,0000,0000,0000,,The amygdala lights up when stimulated by Dialogue: 0,0:03:29.51,0:03:32.60,Default,,0000,0000,0000,,fear in the environment,\Nby a frightening stimulus. Dialogue: 0,0:03:32.60,0:03:36.85,Default,,0000,0000,0000,,It lights up and it says:\Nfight-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: 0,0:03:40.17,0:03:44.11,Default,,0000,0000,0000,,called the prefrontal cortex and it's\Nright here at the front above the eyes. Dialogue: 0,0:03:44.11,0:03:47.36,Default,,0000,0000,0000,,Now the prefrontal cortex only humans have. Dialogue: 0,0:03:47.36,0:03:52.50,Default,,0000,0000,0000,,And it's in the prefrontal cortex\Nwhere we use logic and reasoning to Dialogue: 0,0:03:52.50,0:03:55.13,Default,,0000,0000,0000,,rationalize the situation and we can use Dialogue: 0,0:03:55.13,0:03:57.78,Default,,0000,0000,0000,,our prefrontal cortex to overcome that Dialogue: 0,0:03:57.78,0:04:00.67,Default,,0000,0000,0000,,instinctive fear response from the amygdala. Dialogue: 0,0:04:00.67,0:04:02.75,Default,,0000,0000,0000,,Now when Claire was growing up Dialogue: 0,0:04:02.75,0:04:04.71,Default,,0000,0000,0000,,she never knew from one moment to the next Dialogue: 0,0:04:04.71,0:04:07.52,Default,,0000,0000,0000,,whether the adult coming into the room,\Nwere they going to give her a kiss Dialogue: 0,0:04:07.52,0:04:09.77,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 to punch her or kick her Dialogue: 0,0:04:11.96,0:04:14.33,Default,,0000,0000,0000,,or burn her with their cigarette. Dialogue: 0,0:04:14.33,0:04:16.71,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: 0,0:04:21.63,0:04:25.80,Default,,0000,0000,0000,,Now, there's a group of disorders\Ncalled the anxiety disorders, Dialogue: 0,0:04:25.80,0:04:27.16,Default,,0000,0000,0000,,and one of the most important Dialogue: 0,0:04:27.16,0:04:31.84,Default,,0000,0000,0000,,is what we call\Npost-traumatic stress 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: 0,0:04:34.84,0:04:38.61,Default,,0000,0000,0000,,very low mood, anxiety,\Nhigh levels of anxiety, Dialogue: 0,0:04:38.61,0:04:40.83,Default,,0000,0000,0000,,what we call hyper vigilance: Dialogue: 0,0:04:40.83,0:04:43.25,Default,,0000,0000,0000,,this edginess, this jumpiness. Dialogue: 0,0:04:43.25,0:04:46.86,Default,,0000,0000,0000,,Exactly how Claire felt \Nthroughout her childhood and adolescence. Dialogue: 0,0:04:46.86,0:04:49.65,Default,,0000,0000,0000,,Never knowing whether\Nthe next assailant or assault Dialogue: 0,0:04:49.65,0:04:51.85,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: 0,0:04:56.46,0:05:01.52,Default,,0000,0000,0000,,Flashbacks, when the patient has sudden\Nremembrances of painful traumatic memories. Dialogue: 0,0:05:01.52,0:05:02.94,Default,,0000,0000,0000,,They can just pop into the head Dialogue: 0,0:05:02.94,0:05:07.32,Default,,0000,0000,0000,,at any time, triggered by\Nsome cue in the environment. Dialogue: 0,0:05:07.32,0:05:10.77,Default,,0000,0000,0000,,And when they have those experiences,\Nthose daytime flashbacks, Dialogue: 0,0:05:10.77,0:05:15.05,Default,,0000,0000,0000,,they relive the trauma in all the\Nsensory modalities and this results in Dialogue: 0,0:05:15.05,0:05:19.22,Default,,0000,0000,0000,,them freezing or dissociating\Nto try and block out the pain. Dialogue: 0,0:05:19.85,0:05:23.41,Default,,0000,0000,0000,,Claire experienced all of this\Nas she was growing up. Dialogue: 0,0:05:24.45,0:05:29.45,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 and her breasts. Dialogue: 0,0:05:32.67,0:05:37.27,Default,,0000,0000,0000,,Pretty common form of cutting in\Nchildren 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 and Dialogue: 0,0:05:43.60,0:05:46.89,Default,,0000,0000,0000,,was using street heroin\Nwhen Claire was a teenager. Dialogue: 0,0:05:46.89,0:05:51.31,Default,,0000,0000,0000,,Because of the way the war on drugs has\Nset up that reduces access to treatment Dialogue: 0,0:05:51.31,0:05:54.79,Default,,0000,0000,0000,,for people with opiate dependence,\Nshe had to pay for her Dialogue: 0,0:05:54.79,0:05:58.94,Default,,0000,0000,0000,,heroin using sex work and the clients\Nwould sexually abuse Claire. Dialogue: 0,0:06:00.32,0:06:05.17,Default,,0000,0000,0000,,It's very hard to treat PTSD and it has a high treatment resistance, Dialogue: 0,0:06:05.17,0:06:09.38,Default,,0000,0000,0000,,50% of people do not respond to the traditional treatments. Dialogue: 0,0:06:09.92,0:06:11.32,Default,,0000,0000,0000,,How do we treat it? Dialogue: 0,0:06:11.32,0:06:14.98,Default,,0000,0000,0000,,We can treat it with medications. We can treat it with psychotherapies. Dialogue: 0,0:06:14.98,0:06:18.90,Default,,0000,0000,0000,,And the medications we use:\Nthere's a broad range of drugs. Dialogue: 0,0:06:18.90,0:06:24.52,Default,,0000,0000,0000,,No single drug, and this is very important,\Nno single drug cures PTSD. Dialogue: 0,0:06:24.52,0:06:27.21,Default,,0000,0000,0000,,Rather we treat the disorder symptomatically: Dialogue: 0,0:06:27.22,0:06:30.25,Default,,0000,0000,0000,,If the patient's depressed\Ngive them an antidepressant. Dialogue: 0,0:06:30.25,0:06:33.80,Default,,0000,0000,0000,,If their mood fluctuates give them a mood stabilizer. Dialogue: 0,0:06:33.80,0:06:36.67,Default,,0000,0000,0000,,If they can't sleep give them a hypnotic. Dialogue: 0,0:06:36.67,0:06:40.80,Default,,0000,0000,0000,,And if that edginess and that fear \Nspills over into paranoia and psychosis, Dialogue: 0,0:06:40.80,0:06:43.88,Default,,0000,0000,0000,,give the patient an anti-psychotic drug. Dialogue: 0,0:06:43.88,0:06:48.24,Default,,0000,0000,0000,,And they have to take these drugs\Nday in day out for weeks, months, decades. Dialogue: 0,0:06:48.24,0:06:53.71,Default,,0000,0000,0000,,They have to keep taking them because\Nthe drugs we use to treat trauma when it's Dialogue: 0,0:06:53.71,0:06:59.32,Default,,0000,0000,0000,,due to this level of severity do 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, by a microorganism. Dialogue: 0,0:07:13.10,0:07:17.68,Default,,0000,0000,0000,,Sure, you can take paracetamol or ibuprofen\Nand this will lower the temperature Dialogue: 0,0:07:17.68,0:07:22.19,Default,,0000,0000,0000,,and make you feel a bit better but it doesn't attack the root cause. Dialogue: 0,0:07:22.19,0:07:26.56,Default,,0000,0000,0000,,And that's what we do when we give these patients these daily SSRI drugs. Dialogue: 0,0:07:26.56,0:07:27.86,Default,,0000,0000,0000,,We paper over the cracks. Dialogue: 0,0:07:27.86,0:07:32.09,Default,,0000,0000,0000,,We maintain the symptoms at a manageable level. Dialogue: 0,0:07:32.09,0:07:35.64,Default,,0000,0000,0000,,We also use psychotherapies to treat PTSD, and there's Dialogue: 0,0:07:35.64,0:07:41.79,Default,,0000,0000,0000,,again a broad range of these: DBT, CBT,\NEMDR, trauma focused psychotherapy, Dialogue: 0,0:07:41.79,0:07:45.01,Default,,0000,0000,0000,,CAT, APT... Now all of them have a pretty Dialogue: 0,0:07:45.01,0:07:48.81,Default,,0000,0000,0000,,similar approach which actually is an old wives tales which is: Dialogue: 0,0:07:48.81,0:07:51.21,Default,,0000,0000,0000,,a problem shared is a problem halved. Dialogue: 0,0:07:51.21,0:07:56.32,Default,,0000,0000,0000,,"Let's talk about your trauma.\NClaire tell me about your rape." Dialogue: 0,0:07:56.32,0:08:03.85,Default,,0000,0000,0000,,Now that's fine for 50% of patients but for\Na significant half they just cannot do that. Dialogue: 0,0:08:03.85,0:08:07.44,Default,,0000,0000,0000,,As soon as Claire is asked to talk about her rape she freezes, Dialogue: 0,0:08:07.44,0:08:12.10,Default,,0000,0000,0000,,she flees, she drops out of treatment. Dialogue: 0,0:08:10.36,0:08:14.41,Default,,0000,0000,0000,,By the time she was 15 Claire had been\Nremoved from the family home and she was Dialogue: 0,0:08:12.10,0:08:16.00,Default,,0000,0000,0000,,brought up in a succession of foster\Nplacements and children's houses and Dialogue: 0,0:08:18.79,0:08:23.92,Default,,0000,0000,0000,,hostels where the abuse continued. Dialogue: 0,0:08:21.48,0:08:26.11,Default,,0000,0000,0000,,She was self-harm cutting and\Nshe started drinking and Dialogue: 0,0:08:23.92,0:08:28.74,Default,,0000,0000,0000,,by the time she was 18,\Nshe 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\Npretty desperate, can feel pretty hopeless. Dialogue: 0,0:08:32.53,0:08:37.26,Default,,0000,0000,0000,,Sometimes it feels as if psychiatry is a palliative care profession. Dialogue: 0,0:08:37.26,0:08:42.16,Default,,0000,0000,0000,,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)