If you're cutting the 3rd therapy, I would definitely go with the 4th cabal ritual. Deathrite shaman is only good if you're running unmask too. However, the card disadvantage of unmask really hurts with all of the dead cards in the deck. A second wild cantor for increased mana fixing and serve as a creature to sacrifice (for double narc hands) is a possibility too. Those would be my candidates if I cut the 3rd therapy. Hope this helps.
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