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    The Sunday Read: ‘How I Learned That the Problem in My Marriage Was Me’

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    Listen and follow ‘The Daily’Apple Podcasts | Spotify | Amazon Music | YouTube | iHeartRadioOne thing I’ve learned from being married to my wife, Jess, who is a couples therapist, is how vast the distance is between the masks people show to the world and the messy realities that live behind them. Every couple knows its own drama, but we still fall prey to the illusion that all other couples have seamlessly satisfying relationships. The truth about marriage — including my own — is that even the most functional couples are merely doing the best they can with the lives that have been bestowed on them.This past spring, Jess and I had the first of eight sessions of couples therapy with Terry Real, a best-selling author and by far the most famous of the therapists we’ve seen during our marriage. Real, whose admirers include Gwyneth Paltrow and Bruce Springsteen, is one of a small number of thinkers who are actively shaping how the couples-therapy field is received by the public and practiced by other therapists. He is also the bluntest and most charismatic of the therapists I’ve seen, the New Jersey Jewish version of Robin Williams’s irascible Boston character in “Good Will Hunting” — profane, charismatic, open about his own life, forged in his own story of pain.There are a lot of ways to listen to ‘The Daily.’ Here’s how.We want to hear from you. Tune in, and tell us what you think. Email us at thedaily@nytimes.com. Follow Michael Barbaro on X: @mikiebarb. And if you’re interested in advertising with The Daily, write to us at thedaily-ads@nytimes.com.Additional production for The Sunday Read was contributed by Isabella Anderson, Anna Diamond, Frannie Carr Toth, Elena Hecht, Emma Kehlbeck, Tanya Pérez, and Krish Seenivasan. More

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      What to Know About Buprenorphine, Which Could Help Fight Opioid Crisis?

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      When President Trump announced plans to impose tariffs on Mexico and Canada, one of his stated rationales was to force those countries to curb the flow of fentanyl into the United States. In fiscal year 2024, United States Customs and Border Protection seized nearly 22,000 pounds of pills, powders and other products containing fentanyl, down from 27,000 pounds in the previous fiscal year. More than 105,000 people died from overdoses, three-quarters of them from fentanyl and other opioids, in 2023. It doesn’t take much illicit fentanyl — said to be about 50 times as powerful as heroin and 100 times as powerful as morphine — to cause a fatal overdose.In my article for the magazine, I note that one of the many tragedies of the opioid epidemic is that a proven treatment for opioid addiction, a drug called buprenorphine, has been available in the United States for more than two decades yet has been drastically underprescribed. Tens of thousands of lives might have been saved if it had been more widely used earlier. In his actions and rhetoric, Trump seems to emphasize the reduction of supply as the answer to the fentanyl crisis. But Mexico’s president, Claudia Sheinbaum, has pointed to American demand as a driver of the problem. Indeed, if enough opioid users in the United States ended up receiving buprenorphine and other effective medication-based treatments, perhaps that demand for illicit opioids like fentanyl could be reduced.Comparing buprenorphine and abstinence-based treatments for opioid-use disorder.A wealth of evidence suggests that a medication-based approach using buprenorphine — itself a type of opioid — is much more effective at preventing overdose deaths than abstinence-based approaches. (Methadone, a slightly more powerful opioid, is also effective as treatment.) That greater success stems in part from the fact that by engaging the same receptors stimulated by fentanyl and other illicit opioids, buprenorphine (and methadone) can greatly blunt cravings and withdrawal symptoms. Several studies indicate that people exiting abstinence-based programs actually face a greater danger of overdosing than they did when chronically using illicit opioids. After abstaining for a long period, former users lose their tolerance to opioids; doses that were previously fine can become deadly. This is one reason many addiction experts think that a medication like buprenorphine is more effective as a treatment for opioid-use disorder than stopping cold turkey. It greatly reduces the cravings and misery that could provoke a relapse.Where buprenorphine has reduced deaths.Although the United States government partly funded buprenorphine’s development as a treatment for opioid addiction, France was one of the first countries to most fully exploit its potential. In the 1990s, French health authorities began allowing all doctors to prescribe buprenorphine. By the early 2000s, overdose deaths there from heroin and other opioids had declined by nearly 80 percent. Other European countries, like Switzerland, that have made medication to treat opioid-use disorder easily accessible also have much lower overdose death rates than those seen in the United States.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Long Island Therapist Charged With Distributing Child Sex Abuse Imagery

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      Renee Hoberman, a licensed social worker on Long Island, used messaging platforms to share graphic videos of infants being abused, prosecutors said.A child therapist on Long Island has been charged with distributing sexual abuse imagery of children as young as infants on social media, according to a federal complaint.The therapist, identified as Renee Hoberman, 36, of Plainview, N.Y., appeared in court in Central Islip on Wednesday before Magistrate Judge Arlene R. Lindsay, according to the U.S. attorney’s office for the Eastern District of New York. The judge ordered that Ms. Hoberman be held without bail at the Metropolitan Detention Center in Brooklyn, the U.S. attorney’s office said.Federal prosecutors said that over several months this year, Ms. Hoberman, a licensed social worker who also goes by Rina, used messaging apps to upload sexually abusive images of minors, including videos of a man raping infants a year old or younger.As recently as Oct. 16, the complaint said, she uploaded the images to several “chats” on the messaging app Kik, claiming to be a man with several young children. She described punishing the children with sexual assaults, the complaint said, and shared two videos depicting the abuse of children whom she said belonged to the man she claimed to be. She also invited another person in the chat to visit and “spank the children,” the complaint said.Ms. Hoberman has not been charged with producing child sexual abuse imagery, and the complaint does not indicate that she was involved in the abuse.Ms. Hoberman’s public defender, Evan Sugar, did not immediately respond to a request for comment. Her brother and father, reached by phone on Wednesday evening, both declined to comment.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      First Sickle Cell Gene Therapy Patient, 12, Leaves Hospital

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      After 44 days, Kendric Cromer, 12, left the hospital. While his family feels fortunate that he was the first to receive a treatment, their difficult experiences hint at what others will be up against.Kendric Cromer, 12, left Children’s National Hospital in a wheelchair on Wednesday, wearing a T-shirt and cap printed with designs from the anime series “Naruto” and a black face mask. Staff lined the hallway, cheering and waving noisemakers. He had just become the first patient to receive a gene therapy for sickle cell since it was approved — a therapy that is expected to free him from the ravages of the disease.After 44 days in the hospital, he was a bit dazed.“I thought I would have sickle cell for the rest of my life,” he said. The disease had deprived him of his childhood, making everyday activities, like playing basketball or riding a bike, impossible because they could bring on searing pain, often resulting in hospitalizations.But despite the celebratory atmosphere, Kendric and his parents are still shuddering over what they endured during his hospital stay.Nothing, absolutely nothing — not all the discussions with doctors, not all of their reading and highlighting of texts, not the 13-page consent form that included organ damage and even death as possible outcomes — prepared them for what he would go through.About 100,000 people in the United States have sickle cell disease. For the 20,000 or so with the most severe disease, gene therapy may be their only hope of living a normal life. The disease is caused by a mutation in hemoglobin genes that leads to crescent-shaped red blood cells, which tend to get stuck in blood vessels, causing episodes of excruciating pain. The blockages can damage organs, cause strokes and shorten lives.Until recently, most saw no way out.Then, last December, the Food and Drug Administration approved a $3.1 million sickle cell gene therapy by Bluebird Bio of Somerville, Mass., and a $2.2 million treatment by Vertex Pharmaceuticals of Boston. That potentially gives patients like Kendric, if their insurance will pay for the therapy, a path to a life that is not shadowed by the ravages of the disease.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      First Day of a ‘New Life’ for a Boy With Sickle Cell

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      There was supposed to be a special party for Kendric Cromer, 12, last Wednesday, but it had to be postponed because he was too groggy to celebrate.It was meant to mark the first day of his new life — the day he became one of the first children ever to be treated with a newly approved gene therapy that will free him from the sickle cell disease that has stolen his childhood.On Sept. 11, despite the excitement of the moment, Kendric was unable to keep his eyes open as he lay in his hospital bed at Children’s National Hospital in Washington because of the drugs he had been given in preparation for his treatment.His life with the disease has been punctuated by episodes of excruciating pain, requiring days in the hospital as doctors tried to control it. Sickle cell eroded his hip bones. It prevented him from riding a bike or playing soccer or even going outside when the temperature was below 55 degrees Fahrenheit because cold often brought on intense pain.Now he could see a future — in a month or so — without pain from sickle cell.“I can’t wait to start my new life,” he told his mother, Deborah Cromer.His disease is caused by an inherited genetic mutation that leads to blood cells that form crescent shapes — sickles — instead of discs. Trapped in blood vessels and organs, the cells cause damage and pain. Gene therapy fixes that problem by giving the patient a new, normal hemoglobin gene.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Three MDMA Studies Are Retracted by Scientific Journal

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      The journal Psychopharmacology has retracted three papers about MDMA-assisted therapy based on what the publication said was unethical conduct at one of the study sites where the research took place.Several of the papers’ authors are affiliated with Lykos Therapeutics, the drug company whose application for MDMA-assisted therapy to treat post-traumatic stress disorder was rejected last week by the Food and Drug Administration. The company said the research in the retracted papers was not part of its application to the F.D.A. In declining to approve Lykos’s application, the agency cited concerns about missing data and problems with the way the company’s study was designed, according to a statement released by Lykos on Friday.The F.D.A. has asked Lykos to conduct an additional clinical trial of its MDMA-assisted therapy, which would have been the first psychedelic medicine to win approval by federal regulators. Lykos has said it would appeal the decision.The journal retraction was first reported by Stat, the health and medical news website.On Sunday, Lykos said that it disagreed with Psychopharmacology’s decision and that it would file an official complaint with the Committee on Publication Ethics, a nonprofit that sets guidelines for academic publications.“The articles remain scientifically sound and present important contributions to the study of potential treatments for PTSD,” the company said in the statement.The incident cited by Psychopharmacology has been well documented. In 2015, an unlicensed Canadian therapist who took part in the trial engaged in a sexual relationship with a participant after the conclusion of the trial’s dosing sessionsIn civil court documents, the patient, Meaghan Buisson, said she was sexually assaulted by the therapist, Richard Yensen, who at the time was working alongside his wife, a licensed therapist. Mr. Yensen has said the relationship was consensual and initiated by Ms. Buisson. Six months after the final session, she moved from Vancouver to Cortes Island, in British Columbia, where the couple lived, according to court documents. The relationship between patient and practitioner continued for more than a year, the documents said. Professional associations in both Canada and the United States prohibit sexual relationships between psychologists and patients for at least two years after their final session. The incident helped highlight some of the challenges associated with psychedelic medicine, which can render patients especially vulnerable during dosing sessions. For that reason, most clinical trials involving psychedelic compounds require the presence of two mental health professionals. (Lykos’s trials with MDMA require only one of the practitioners to be licensed.)The Multidisciplinary Association for Psychedelic Studies, or MAPS, is the nonprofit that carried out the research and later created Lykos to market its proprietary MDMA-assisted therapy. The association publicly acknowledged the incident in 2019, adding that it had been reported to the F.D.A. and to Canadian health authorities.The company acknowledged on Sunday that it had failed to notify Psychopharmacology about the violations, but it said that the oversight should have been addressed through a correction, not a retraction. More

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      FDA Declines to Approve MDMA Therapy, and Seeks Further Study

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      The agency said there was insufficient data to allow the use of a treatment for PTSD that involves the drug known as Ecstasy.The Food and Drug Administration on Friday declined to approve MDMA-assisted therapy for the treatment of post-traumatic stress disorder, dealing a serious blow to the nascent field of psychedelic medicine and dashing the hopes of many Americans who are desperate for new treatments.The F.D.A. said there was insufficient data to allow its use, and it asked the company seeking approval for the treatment, Lykos Therapeutics, to conduct an additional clinical trial to assess whether the drug, commonly known as Ecstasy or molly, would be safe and effective.An additional clinical trial could add years, and millions of dollars, to the approval process.If approved, MDMA would have become the first psychedelic compound to be regulated by federal health authorities. Supporters of psychedelic medicine were deeply disappointed, and some said they were stunned, having assumed the therapy’s promising data would overcome flaws in the company’s clinical trials, which had been designed in consultation with F.D.A. scientists.“This is an earthquake for those in the field who thought F.D.A. approval would be a cinch,” said Michael Pollan, the best-selling author and co-founder of the UC Berkeley Center for the Science of Psychedelics. His book, “How to Change Your Mind,” helped catalyze public interest in the therapeutic potential of psychoactive compounds, demonized during the nation’s long war on drugs.But the agency’s decision had not been entirely unexpected, after a group of independent experts convened by the F.D.A. to evaluate Lykos’s data met in June and did not recommend the treatment. On two central questions, the experts voted overwhelmingly that the company had not proven the treatment was effective, and that the drug therapy’s benefits did not outweigh the risks.The agency generally follows the recommendations of its outside panels. Critics, however, have questioned the panel’s expertise, noting that only one of its 11 members had experience in psychedelic medicine.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      ‘Eldest Daughter Syndrome’ and Sibling Birth Order: Does it Matter?

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      “Eldest daughter syndrome” assumes that birth order shapes who we are and how we interact. Does it?In a TikTok video that has been watched more than 6 million times, Kati Morton, a licensed marriage and family therapist in Santa Monica, Calif., lists signs that she says can be indicative of “eldest daughter syndrome.”Among them: an intense feeling of familial responsibility, people-pleasing tendencies and resentment toward your siblings and parents.On X, a viral post asks: “are u happy or are u the oldest sibling and also a girl”?Firstborn daughters are having a moment in the spotlight, at least online, with memes and think pieces offering a sense of gratification to responsible, put-upon big sisters everywhere. But even mental health professionals like Ms. Morton — herself the youngest in her family — caution against putting too much stock in the psychology of sibling birth order, and the idea that it shapes personality or long term outcomes.“People will say, ‘It means everything!’ Other people will say, ‘There’s no proof,’” she said, noting that eldest daughter syndrome (which isn’t an actual mental health diagnosis) may have as much to do with gender norms as it does with birth order. “Everybody’s seeking to understand themselves, and to feel understood. And this is just another page in that book.”What the research says about birth orderThe stereotypes are familiar to many of us: Firstborn children are reliable and high-achieving; middle children are sociable and rebellious (and overlooked); and youngest children are charming and manipulative.Studies have indeed found ties between a person’s role in the family lineup and various outcomes, including educational attainment and I.Q. (though those scores are not necessarily reliable measures of intelligence), financial risk tolerance and even participation in dangerous sports. But many studies have focused on a single point in time, cautioned Rodica Damian, a social-personality psychologist at the University of Houston. That means older siblings may have appeared more responsible or even more intelligent simply because they were more mature than their siblings, she said, adding that the sample sizes in most birth order studies have also been relatively small.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Traumatic Brain Injury Found in Maine Gunman Could Have Wide Ramifications

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      Exposure to blasts, even at low levels, may play a much greater role in veterans’ mental health struggles than has been known, with implications for treatment strategies and for criminal justice.Shredded connections deep in the brain. Battered and scarred blood vessels that are no longer able to support neurons. Clumps of dead cell debris marking a long pattern of injury.The results of the autopsy of Robert R. Card II, the Army Reservist who killed 18 people, then himself, in the deadliest shooting in Maine’s history, left little question that his brain was profoundly damaged. But the finding raises other questions that have broad implications for the military and for the nation’s millions of veterans.Mr. Card was a grenade range instructor who never deployed to combat. He is not known to have ever hit his head in a serious car crash, he never played football, and he does not appear to have had any other accidents that might account for the damage to his brain.His only exposure came from routine training blasts on the training range — at a level that is supposed to be safe.If those blasts were still strong enough to profoundly damage his brain, as it appears happened, then how many other troops are being exposed to the same risk? How many veterans may be struggling with similar injuries that have gone unseen or been misunderstood? How should those veterans be treated if they seek mental health care, or are accused of crimes?“The implications are just so large,” said Frank Larkin, a former Navy SEAL and sergeant-at-arms of the U.S. Senate, whose son, Ryan, also a Navy SEAL, died by suicide and was found to have extensive brain damage from blasts.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More