Psychedelic Medicine

are far more harmful than the substances themselves. In today's episode, we're going to approach related issues, but from a different angle. We're going to talk about the emergent research on the efficacy of psychedelic assisted psychotherapy and the associated question of recreational use of psychedelics. There's been an explosion of research, which we're going to hear about shortly from one of

the leading experts on the top. That's doctor David Raven, who's a neuroscientist aboard certified psychiatrist who does psychedelic assisted psychotherapy and is also the co founder and chief innovation officer at Apollo Neuroscience. He's going to talk to us about some of the new research in the field, what the mechanisms are for why and how psychedelic assisted psychotherapy seems to be working, and what it tells us about

the brain and its capacities to heal in general. Dave, thank you so much for joining me here on deep background. I want to begin with some research that's gotten a lot of attention in the last several months, and that is research that looks at new psychedelic assisted psychotherapy approach and at least so far, seems to produce some extraordinarily impressive experimental results. And this is your field, and you both study it at a scientific level and also are

a practitioner. I want to invite you to start by saying what you think of as the most impressive recent results, and then we'll talk in a little bit more depth about what those studies show. Sounds good, Yeah, I appreciate

you for again for having me. Always a pleasure to share this conversation because I think that we're at a point in mental health in particular where we're starting to identify tools to treat mental illness that are reaching a level of success in terms of management of symptoms and remission long term remission of mental illness in particular like depression and anxiety that we haven't ever seen in the field of mental health, and so I think one of

the things that's really exciting and also challenging about psychedelic assistant psychotherapy is that it is a full paradigm shift away from the current way that we treatment to illness to one in which we really focus on short courses of treatment. That for example, with MDMA, which is three four methylene dioxy methymphetamine, which I would say is beyond the experimental phase, it's well into the FDA phase through

trials demonstrating tremendous results can vary consistently. What we're seeing is that with just three doses of MDMA with two therapists present over the course of twelve weeks of psychotherapy, those three doses of MBMA in people who are completely treatment resistant with PTSD post traumatic stress disorder, having tried everything under the sun, and never having had significant symptom remission or relief that exists that lasts over the long

term without daily medication management. These people have three doses of MDMA and twelve weeks of psychotherapy. The pulsebo controlled trial in it right after the treatment is over twelve weeks and two months out something like fifty five percent of these people are completely in remission. They're no longer

meeting diagnostic criteria for PTSD. However, what's even more exciting is that one year out, because we really care about durability of response, right one year out, we see that sixty seven percent of these people are no longer meeting

diagnostic criteria for PTSD without any additional treatment. So that's what's really incredible is that these people seem to be able to be taught, using the medicine in an accelerated fashion, how to manage their own healing process more effectively, and then continue that process after the treatment is effectively finished.

Let's dive into this study that you're talking about, and this comes out of Johns Hopkins, if I'm not mistaken, although I think there's some other affiliated centers that have been doing similar research. Is that right? So this study is not explicitly at John's Opkins. This is a international trial actually, so so the trial that is centered at Hopkins, which is equally exciting, I would say, but is at a slightly earlier stage in terms of the FDA. I

believe it's in phase two, not phase three. Is a psilicided trial and that is used for predominantly for depression. It's equally exciting work. But what we're seeing and the study that I mentioned earlier, that's the furthest along is the MDMA for Treatment Resistant PTSC study. That's an international trial at i think over twenty clinical sites that are distributed throughout Canada, the US, and the EU and Israel. Thank you, so thanks for that clarification. Let's talk about

this international trial in that case. So a question that immediately came to my mind when I first read about this research is the question of placebo effect and double blinding. I think the study is billed as double blind, which means that in principle, neither the person receiving the treatment nor the psychotherapist who's doing the psychotherapy sessions is supposed to know whether the person is in the target group who has received MDMA or is not. That is correct.

So how is that possible? I mean, is it conceivable that a patient would not know that he or she was on MDMA at the dosage level that is being used in the study, And is it conceivable that the therapist would not Yeah, it's a great question, and I think this is a question that has always been a challenging one to answer when we're looking at these kinds of studies, and also just to take a step back when we're looking at any study of a complex treatment

program or a natural treatment, natural treatment program like a complimentary or alternative medicine program, acupuncture being a great example. It's very, very difficult, notoriously difficult, to do double blind pall cebo control trials because how do you create an adequate placebo or active control group that is consistent with

the blinding process. I think MAPS Multidisciplinary Association for Psychedelic Studies that is running the MBMA trial and has run and funded most of the MBMA trials to date through the FDA, have worked very closely with the FDA to come up with a valid and clinically acceptable to cebo group, and it's evolved over time. It wasn't always the way

it is today. I think I believe that in the previous trials they were using niacin, which causes a warmth and a flushing that has a lot of the physical feelings that are similar to those that are experienced with MBMA, without the emotional component as much. And I believe that in the current trial they're using a sub threshold dose of MBMA, So they're using a dose of MDMA that's lower than what would be required to provide an active peak effect, and there's a dosing threshold that we know

of that's critical to achieve that peak effect. But I think the data speaks for itself because when you look at the Phase two data, which comes from the first one hundred plus veterans were mostly veterans that were treated with PTSD, you can look at the placebo groups data and both groups, by the way, are getting two therapists for the entire treatment course. They're getting the same therapy sessions, the same eight hour therapy sessions, with sleeping over afterwards,

with constant care and attention. And the point of the treatment is that the therapy itself is actually very potent. Right, So even in the people who received completely inactive placebo or MBMA that was below threshold, these people just with the excellent therapy alone in the trial, with these two therapists who are extremely well trained and extremely trauma oriented in their delivery of care, we're seeing a roughly twenty seven percent remission rate in terms of people having significant

reduction and symptoms after the treatment. Is completed in about two months out. However, I think the real tell is that when you go and look at one year out, the folks who received active MBMA have an increased rate of recovery, so it goes from fifty five percent to sixty seven percent symptom free. When you go back and look at the placebo group, that group actually had about

fifty percent of those people relapse into symptomatic PTSD. So are cymo therapists able to tell that a patient or a research subject has received MBMA versus a placebo It's possible. It is hard to tell. Sometimes in the therapeutic experience, it is possible that they know, but the delivery of therapy is the same either way. They're still working with the person to do the same work with the medicine

on board or not. And that's one of the things that I think is really fascinating about psychedelic assisted psychotherapy is that it's not called psychotherapy assistant psychedelic work, right, It's called psychedelic assisted psychotherapy. What we're testing is is

the medicine and catalyzing the psychotherapy experience. We would normally be offering someone and giving them or empowering them with the ability to take the healing process into their own hands and really start to work on themselves after the

process is over. And that is absolutely what the data is showing, which is extremely promising, and it's directly contradictory to which I think is important to know the existing paradigm of mental health, which is, if you stop taking your SSRIs, you stop taking your antidepressants or whatever your daily prescription medicine for mental health symptoms, that your chances of relapse are almost inevitable, which is a really depressing statistic.

In that case, let's turn to the question of mechanism. I would love to hear why you think this works. In general. When I have read about this and spoken to a few people, the magic word that is often deployed as though it solved all of our questions is the word neuroplasticity. That seems to me to be an opener rather than a closer. And I'm very curious to hear how you think about this. It's a great question, and I love the way that you look at neuroplasticity

as an opener or not a closer. You're absolutely right when we think about psychedelic medicines on the whole taking like a ten thousand foot view kind of looking down at all the whole spectrum of medicines that we call psychedelic or psychoactive. What we're really looking at is a group or a class of medicines that are most accurately

referred to as non specific amplifiers. So what this means is that if whatever you take into the experience, whether it's thoughts of self gratitude, self love, self compassion, and a therapeutic orientation towards healing yourself, or if you bring in shame and guilt and fear and a lack of safety in your environment or within yourself, whatever you bring in, that is what will be amplified by the psychedelic experience.

So that is something that I think a lot of people don't necessarily understand, which is that the psychedelic medicine is non preferential to positive feelings or negative feelings. When you induce neuroplasticity in that context, you can train the brain to think differently. But if you are not prepared adequately, and you bring in a lot of negative self referential thinking, and you're not prepared to work on and you don't have the right support systems around you to work on it.

You're not in a safe environment or all of the above, then you can actually increase the strength of wiring and neural connections in your brain to favor thinking about yourself in a negative way. You can actually this is completely fascinating and also a little scary. Scary, So, if I'm hearing you correctly, you know, in theory no one would

think to do this. But if one ran this experiment, as it were, the opposite way, and you gave people psychedelics and put them in a connectly controlled setting and then made them feel terrible about themselves, you're suggesting that the drugs would have an amplifying effect such that you could maybe make people much much, much worse soft than they would have been without that, right, So you could amplify a PTSD experience perhaps, or a traumatic experience for example,

or you could drive lack of self esteem or various other antisocial outcomes. Am I Am I hearing that correctly? And is there any experimental evidence for that? Mk Ultra as one example, right, I think that you know, we see that in some of the studies that the CIA conducted on unsuspecting folks who were given psychedelic medicine and an unsafe or an experimental environment that was not soothing or therapeutic, we saw very very negative outcomes, some of

which resulted in suicide. So I naively say, no one would do this, But but you're telling me the CIA did in fact do this in the fifties and sixties and even into the early seventies when mkalto was going on, Right, there is evidence that this did occur, and that there were very substantial negative consequences from these kinds of conditions that even resulted in self harm. And I think that we be But the best example of this in a non experimental setting is the real world. Right. We see

that people all the time. You know, there's estimated to be over a million new users of MDMA every year in the United States. Right, there's probably an almost equal amount, it's not more of psilocybin mushrooms. That is a huge number of people. These are people who are using this medicine recreationally in an generally unguided environment, and they're new

to it. And so those are the people where we often see, like in my practice, where I'm one of the few psychiatrists that actually not only does psychotherapy, but I'm trained to help people navigate challenging psychedelic experiences, and I a big part of my practice is helping people recover from feeling retraumatized as a result of an unsafe or unpleasant psychedelic experience. So this is a very real

thing that we see happen. Part of the reason why we actually started the Psychedelic News Hour on Clubhouse is to help educate the general community about how to avoid these very specific and unpleasant experiences that are easily avoidable, but are also easy to step into by accident if you're not paying attention to don't know what to look out for, but you're describing as something with very significant

risks if administered in the wrong setting. And if people are using MDMA, for example, or psilocybin recreationally in the numbers that you're marking, you know, a million new users a year, that means almost everybody is using it in an unsupervised way, and presumably a lot of those people

are going to have bad experiences. If that's right. It's a very different narrative than sometimes one hears while there is risk, and I appreciate you bringing off the point that we need to make sure we understand that there is risk from using any of these medicines to augment or alter our stated consciousness, as they are nonspecific amplifiers.

We also should acknowledge that from an objective perspective, a scientific perspective, the risk of these medicines is substantially lower for most, probably ninety five ninety nine percent of people, even than it is with things like cocaine, opiates, benzodiazepines, and many other prescription medicines that are scheduled by the DA at a level that is lower and more accessible than psychedelic medicines. THC, for instance, is still Schedule one drug,

so as MBMA and soil side. I think the question is that if these medicines are accessible to everyone through the legalization process that is happening for example in Massachusetts, it's happened into Denver and Oregon, in certain places in California, then are we doing a disservice to folks if we don't take the time to properly educate them about what

the risks are and how to do it safely. Right, it almost seems to follow less of a cannabis path and more of I mean it's following the cannabis path to some extent, but it seems to be following at a larger level the absence only education path with sex. Right, It's like we know people from thousands of years of research of looking back into history, we know people used drugs to access altered states of consciousness, whether they came

from plants or we're synthesized. We know people have sex to feel good, to bond with each other, to alter states of consciousness. We know that both of these types of experiences are very powerful for people, and they're going to seek them out no matter what. If we do not teach people how to have safe sex and what the potential consequences are of not having safe sex, then people are going to do what they're going to do unsafely, right, and it's going to cause a lot of problems. And

we've seen that. And at the same time, if we teach people how to have safe sexual relations with people, how to use drugs safely, we see the positive outcomes there. So I think that what we ultimately the responsibility is not to disseminate these medicines as quickly as possible, regardless of how people use them, and let them just choose

without having any guidance. I think the responsible thing to do that a lot of us agree on a clinical world, the medical world, and I believe also in the indigenous cultures that have been using this for a long time, is to combine our efforts and our wisdom from all

sides and say, okay, here's your guidebook. Right here is the basics that you need to know, the few points coming in that you need to know to prepare adequately to have the best possible experience that you can have, because it really, you know, like you said, there is risk.

And at the same time, if we take the time to say, spend you know, focus on three to five points that we can do to make sure that our environment is safe, we're feeling emotionally safe and comfortable and of course physically safe, spiritually safe, and we can have that for the course of our psychedelic experience, which is altering our state of consciousness and making us vulnerable for lack of a better term to shifting meaning about ourselves, than we can actually have a lot more control over

that environment than we think. And thankfully, I would say, looking at the recreational use cases, thankfully we do not see as many harms being done by people misusing these medicines as we thought we might. However, I think the concern is that we might see more if recreationalization across the US spreads without the accompanying education is required. We'll be right back if I want to turn back for the last segment of our conversation to some of the

scientific underpinnings of how this amplification and process works. And I guess what I'd like to do is ask you about this from two angles. The first is from your clinicians angle, to ask you what it's like when you are doing psychotherapy with a patient who is on a dose of psychedelics compared to what it's like to do the identical form of talk therapy with someone who isn't. And then after you've talked a little bit about that, maybe people talk about some of the underlying chemistry and

how the brain chemistry might be facilitating those differences. So the first question is really what's it like for you in the room when you're doing the treatment. Does the patient feel different? That's a great question. So it's really just about tools when we think about the psychotherapy approach. My approach is the same, relatively the same, regardless of who I'm working with or what their condition is. It's empathy first, non judgment, radical acceptance, leaving my own baggage

at the door. Whatever has been going on in my life that day or that week that might be stressful for me, I do not bring it into the session. I'm entirely focused on the individual I'm working with, listening to them and making sure that they know they're heard

in the experience. And sometimes it involves holding hands, but it definitely involves direct eye to eye contact and practice of empathic listening where the client clearly is aware and acknowledges that they are being heard non judgmentally by me. That is the foundation of all psychotherapy, no matter what kind of therapy you do, whether it's psychedelic assisted or not.

So in people who have had very mild to moderate trump for instance, or mild to moderate issues of depression, where I can engage with them enough and me letting them know that they're heard makes them feel safe enough that they can really dive into the experience and make

positive change the results of that experience because they feel safe. However, when people have had very severe trauma or very severe episodes of depression, it's sometimes very difficult for those people to feel safe, and sometimes they haven't felt safe in the years, and they can't remember when the last time

was that they did feel safe. And no matter what I do emotionally, empathetically, even holding hands or giving them something like Apollo or other tools that work to help settle the body and boost the vagel parasympathetic nervous system activity to help facilitate recovery and bonding and engagement in the session, it just doesn't quite cut it, and they

can't lean into the experience. So for those people, when we give them a psychedelic medicine like ketamine as an example, which is I want to bring up because it's the only currently legal psychedelic medicine that we have access to, and it's very short acting and very powerful and is safe for clients to actually use at home, we can see that the medicine number one is catalyzing the safety

response for these people. So more importantly than anything else, what we hear from our clients is that when they they do therapy with us without the medicine and then they add the medicine, they often say, I haven't felt this safe in my recent memory, I don't remember feeling this way about myself without judging myself since childhood. I haven't felt my constant ruminative negative and thoughts stop or

pause for as long as I can remember. And as soon as they have that experience, it's like a wake up call because they remember a feeling, they remember a state of being that they had before. It's familiar, but it's something that they forgot how to access because of a bunch of other stuff that happened in the meantime

that interfere. And now once they're reconnecting with that part of themselves and they realize that something they can access, then we use the medicine as a tool to teach them, not that they require the medicine to access that state every time they want to get there, but that the medicine is a teacher and a tool to show them experientially that they can feel safe and that they let me ask you about that's totally fascinating, and let me

ask you about what you think is happening. So when the person then says, oh, I remember what it was like to feel safe, and now I can get back to that again. Is it your view that there was a kind of neural pathway that was it was always it always existed, It still existed, but it was difficult to access it, and you are helping the person to access it and then learn to access it without your presence or is that too literal? On that account, You're

not necessarily creating a new pathway. You're just opening an access point to a pathway that already existed at an earlier life stage, but that was kind of thwarted. That's exactly right. And going back as far as Hippocrates is thought to be the founder of Western medicine, Hippocrates said that healing comes from I'm on a butcher's quote, but the healing comes from within us and within the individual. That it is not for us as clinicians to be the to identify as the source of a patient or

client's healing experience. It is for us to use the tools we have access to and use our own healing abilities to facilitate that person. It's empowerment to learn that they can heal themselves and that is the source of

their healing. Is it possible for that small number of patients whose trauma was introduced already in the earliest stages of childhood that for such a person, the approach might be less effective because that person might never have managed to create the sense of safety or security that you're describing that you're trying to access. But that might not be the same as building that from scratch if you

didn't have it. That's a great point. I'm sure there is a subset of people that has a much more difficult time finding that familiar feeling of safety from the past and reconnecting with that. There are also people who connect with it very easily, and then there's everyone in between. I think that, interestingly enough, it doesn't necessarily matter when

the trauma has happened. And the reason why I say that is because of the work of Rachel Yehuda from Mount Sinai over the last thirty or four years showed that these changes that trauma induces to our bodies are actually store not just in the way that our neurons talk to each other, like Eric Candell found, but they're actually stored all the way down into the epigenetic code, which is the code that's on top of our DNA that tells every cell in our body to either increase

or decrease expression of certain proteins like CORSO, which we're all familiar with. This one of the most important stress response proteins. And so if you've experienced trauma in a certain way, that trauma does not even have to be

from your own lifetime. It can be trauma from your parents, it can be trauma from your grandparents that they experienced that caused changes to their geniue expression patterns as what was likely an evolutionary coping mechanism to help them adapt stress in their environment, but they never actually processed it or sorted it out when they were restored to an environment of safety, and so they ended up passing on the epigenetic changes or these expression pattern gene expression pattern

changes to their offspring that they were born with, and that results now we know, thanks to Rachel's work, in a predisposition to developing PTSD and other mental health disorders and potentially even metabolic disorder. But whether or not psychedelic medicine assisted psychotherapy is less equipped to be able to treat something like that, I think it's still up for debate.

I think what we see is that it actually works fairly well on all of these folks, whether or not they remember a traumatic event specifically or not, whether or not they can recall an event in their specific lifetime

or not. I think, going back to your original question, what we're about the mechanism, what we're seeing happen neural biologically, is that these medicines are facilitating activation of the five HT two, a serotonin receptor that is highly localized in the emotional cortex, but it's in our cortex as a whole of our brains, which is where all our memories are stored, all our memories about how we know ourselves in the world are stored, or turns out from a

lot of other work with antidepressant medications like SSRIs which also increase serotonin at those receptors, and psychedelic work from Franz Voldwire in Switzerland with LSD and silcybin, that it's verily clear at this point that the activating that receptor in a burst manner with a burst of serotonin, not constant serotonin, but a burst which psychedelic medicine facilitate and meaningful experiences facilitate, induces a state of perceptual shift in meaning,

or an opportunity to change the way we perceive meaning

from our environment and from ourselves. So if you think about the nonspecific amplifier idea, when you take a psychedelic medicine, you can change your meaning of the world to be potentially more positive or more negative or stay the same based on the environment that you go into, your inside set and your outside environment setting that you bring into that experience, and you have a setting of safety, what happens is we can become aware of things that have

happened in the past, things that possibly have been buried beneath our memory, or things that have even happened in past generational trauma that we did not know about or

to not know much about. And then people have the opportunity, a very unique, time limited opportunity to re experience and go back through their lives the most salient and critical events that were most meaningful to them, that to them made them who they were, and reevaluate those from a standpoint of radical safety and non judgment, so that we can understand that these events or experiences that we thought and made us who we are are just experiences that

we make who we are out of. One last question about this, Dave, because what you're saying is very, very rich and fascinating and probably deserves its own a further conversation. It's interesting to me that one of the things that happened, you know, sort of roughly speaking, in the eighties and nineties, with the rise of interest in the underlying neurochemistry as a determinant of mental wellbeing, is that there was a simultaneous reduction in respect for talk therapy as an effective

means of improving people's mental wellbeing. In what you're saying, where you describe the serotonin burst creating the possibility of a perceptual shift, you set a perceptual shift in meaning, and then you described the psychotherapeutic process in terms that would have been extremely attractive to classic talk therapy addict. It's really going all the way back to Freud, in which the human being with God and conversation and with

another human being is achieving shifts in meaning. And on that account, the non specific amplification of psychedelics works because talk therapy works. It works, not because it's in any way independent of and that's what makes it go. And so I guess I'm wondering if you would maybe close with just some reflection on you know, has this science gone a pretty far distance towards rehabilitating the idea of

talk therapy as meaning making. But through this mechanism of amplification preacing the probability that that shift in meaning making could take place more reliably, more rapidly, and for a larger number of patients. Absolutely, And I think that since you brought it up just to jtapose what was happening in the Freudian era of psychotherapy versus the current era, I think what is really interesting is that the original Freudian approach in large part was about the therapist making

meeting for the patient. Right, So it was a very what we call now a directive approach and in the current paradigm, but I think that what psychedelic medicine assisted psychotherapy has taught us in the therapy world is really emphasizing the importance of safety to an autonomy. In an autonomy, and by atony, I mean like agency in the individual clients experience, The client that seeks to be healed has

to be the person where the ideas about healing come from. Right, then we as particularly in the psychedelic space, to a non directive approach where we guide the individual insight to discover from themselves, what they want out of their healing process and what their inner voice for their intuition is telling them they want to and then we work with

them to sort out what that means. And so instead of meaning making for them, which is the old way of thinking about it from the FRONTI perspective, we are teaching them how to make meaning for themselves with the medicine as a facilitator and tool. And that is really the transformation that I think mental health is going to take in the future. That's a very rich, attractive vision. I think it deserves greater exploration and thought beyond what

we can do here. But I really want to thank you for an exemplary clarity in your description, Dave, in helping us see both the practical side and the scientific side, and the underlying theories of mechanism that are emerging, and helping us understand some of the research. It was a really fantastic conversation. I learned a huge amount and I'm really grateful to you. Thank you, No problem, my pleasure.

We'll be back in a moment. Listening to doctor Dave Rabin, I was genuinely fascinated and in certain ways really surprised by some of the conclusions of his analysis. First, very helpfully, he defines psychedelics as non specific amplifiers, that is, substances that amplify a series of psychological processes, either to encourage and amplify good results such as empathy, connection, and safety, and thereby to help us overcome bad trauma, but also

neutrally as capable of amplifying negative experiences. And as he pointed out, that's not just pure abstract theory. There actually is some evidence from unsanctioned CIA experiments with psychedelics from the nineteen fifties to the nineteen seventies that suggests some very bad results when the amplification was negative. From this analysis of psychedelics as non specific amplifiers, lots of fascinating

things emerge. One is the tremendous importance of anyone who's going to use psychedelics doing it in a context and a setting that will amplify in a positive way and

not in a negative way. That's a topic that deserves much more conversation in the course of the policy discussion about the potential legalization of psychedelics that's going on right now, And it suggests that the paradigm that many of us have been expecting, where gradual legalization in a handful of symbolic venues leads to a broad societal reconsideration may have to be rethought through the lens of the question of what harm can be done using psychedelics alongside the question

of the benefits. Now, doctor Abin was very clear that in his view, the positive capacities of psychedelics vastly outweigh their negative capabilities. At the same time, he was open to the idea that we ought to think carefully about context and setting in order to assure that all of

that happens. Then, on the question of the fundamental underlying science, I was truly fascinated to hear that the goal of the non specific amplification is actually to facilitate, through bursts of serotonin, a change in perception that counts as in his view, meaning making. Those shifts in meaning making, according to the theory that doctor Abin is expanding, are shifts that can fundamentally alter in positive ways the way we experience the world, not just during those experiences, but more

broadly and in the follow on. This mechanism is still at the stage of being a hypothesis, but It's fascinating hypothesis and one very much worth exploring in months and

years ahead. Broadly speaking, I think it's fair to say that the United States is undergoing the beginnings of a substantial shift in public attitudes and understanding towards psychedelics, and this conversation helped me tremendously to begin to understand some of the working theories and some of the practices that are being used by practitioners in the field to try to make sense of how our mental health might be

improved and engaged through psychedelic assisted psychotherapy. Until the next time I speak to you, breathe deep, think deep thoughts, and have a little fun. Deep Background is brought to you by Pushkin Industries. Our producer is Mola Board, our engineer is ben Toalliday, and our showrunner is Sophie Crane mckibbon. Editorial support from noahm Osband. Theme music by Luis Gara

at Pushkin. Thanks to Mia Lobell, Julia Barton, Lydia Jeancott, Heather Fain, Carlie Migliori, Maggie Taylor, Eric Sandler, and Jacob Weissberg. You can find me on Twitter at Noah R Feldman. I also write a column for Bloomberg Opinion, which you can find at bloomberg dot com slash Feldman. To discover Bloomberg's original slate of podcasts, go to bloomberg dot com slash podcasts, and if you like what you heard today, please write a review or tell a friend. This is deep background