Friday, October 31, 2014

Rah rah, go team

"Well, those are some words I never thought I'd hear coming out of your mouth." — Paul Bridson

HALLOWEEN is my favorite holiday because I get to be whoever I want to be: country western star, ballerina, prom queen, 1950's rock-around-the-clock high schooler, sixties hippie chick, Cher, but I repeat myself.

Paul and I have long wanted to go as a gender-bending football player (me) and cheerleader (him). We tried to pull it off last year, but finding a football uniform in my size proved impossible.

This year, however, we have a new client pal who happens to be an assistant football coach at an area high school, and he came through for us.

We thought the hard part was done.

But nooooooo! Just try finding a cheerleading skirt for someone who's six feet tall and weighs 210 pounds. We started out last night but only got as far as determining that he wears a size 18 in women's wear. Before we switched off the light last night, I said, "Well, tomorrow we'll have to go shopping for a skirt for you." 

That's when he said, "Well, those are some words I never thought I'd hear coming out of your mouth."

It took us eight stores, but we finally put together his outfit. You gotta admit, he's a good sport. FYI: If you want to find big sizes of things, go to WalMart.

But we've been having a blast all day. We stopped at a nursing home on the way into the office and passed out candy, then surprised a couple of friends in their offices, and tonight there's a special trick-or-treat in the East Village that we're looking forward to. We never get trick-or-treaters at our home, so this is our chance to get to have kids in costumes tell us wheezer jokes. Fun!!

Thursday, October 30, 2014

Not your grandparents' Republican party

"Even when life begins in that horrible situation of rape, it is something that God intended to happen." — Richard Mourdock, 2012 Republican candidate for the US Senate from Indiana

WHEN will women in America get it? The Republican party ballyhoos puppet-women like Sarah Palin, Michele Bachmann and Joni Ernst, but it's camouflage for extremist, vicious, anti-woman ideology. 

Today someone sent me six quotes by Republican officeholders and candidates. I had verified some of them before, but I checked each one out again on the myth-busting site,, and all of the quotes are legitimate. 

If you have trouble taking this all in because you have grandparents who have always been Republicans, and your sensible, kindly pop pop and grandma would never have countenanced such awful views, you're right; this isn't what the Republican party used to be like, say, in the days of President Dwight Eisenhower and Iowa Governor Bob Ray, but it's what the party is now.

This isn't the first time — and unfortunately it's not likely to be the last — I've written on this topic. I went back through my blog history to find a chart from two years ago that, sad to say, is still relevant. I've attached it below.

I said all that to say this: if you're a woman, or are married to a woman, or are a parent of a woman or girl, or have a mother or sister, or like and care about women in general or in particular — vote BLUE.

This button says it all. 

I want this on a T-shirt!! I'm seriously thinking of making some.

"Rape is kinda like the weather. If it's inevitable, relax and enjoy it." — Clayton Williams (R–TX)

"If it's a legitimate rape, the female body has ways to try to shut that whole thing down." — Todd Akin (R–MO)

"Rape victims should make the best of a bad situation." — Rick Santorum (R–PA)

"In the emergency room they have what's called rape kits where a woman can get cleaned out." — Jodie Laubenberg (R–TX)

"If a woman has [the right to an abortion], why shouldn't a man be free to use his superior strength to force himself on a woman? At least the rapist's pursuit of sexual freedom doesn't [in most cases] result in anyone's death." — Lawrence Lockman (R–ME)

Tuesday, October 28, 2014

Michael Brown and the militarization of the police

“There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.” ― Elie Wiesel

AMONG all the hoopla and frenetic activity surrounding the midterm elections in Iowa and nationwide, I'm still thinking about the death of Michael Brown

Friday, October 24, Amnesty International released a 23-page report critical of the police department in Ferguson, MO

Below is part of a New York Times article with details. I've also attached some photographs taken in August by Robert Cohen for the St. Louis Post-Dispatch and AP and by Scott Olson for Getty Images that appeared on the ABC News website, as a reminder of what's wrong with too much of law enforcement in this country now: the militarization of the police.

Amnesty International Report Faults the Police in Ferguson, Mo.
By Julie Bosman
October 24, 2014

The police in Ferguson, Mo., violated the rights of protesters during demonstrations after the killing of 18-year-old Michael Brown in August, according to a report issued by Amnesty International on Friday.

Among the offenses police committed, according to Amnesty International, were using tear gas and curfews to quell protests, and arresting journalists who were covering demonstrations. Protesters who gathered in Ferguson were intimidated by officers who used unnecessary force to control and disperse them, the report said.

“Irrespective of whether there was some sort of physical confrontation between Michael Brown and the police officer, Michael Brown was unarmed and thus unlikely to have presented a serious threat to the life of the police officer,” the report said.

Asked to comment on the report, Brian Schellman, a spokesman for the St. Louis County police, said: “The St. Louis County Police Department and the unified command had one mission, and that was the preservation of life.”

Mr. Brown’s killing is under investigation by the St. Louis County police. A grand jury has been hearing evidence in the case since late August and is expected to return sometime in the next month.

This is NOT what our country is supposed to be.

Monday, October 27, 2014

Finding a way in

“Have a heart that never hardens, and a temper that never tires, and a touch that never hurts.” — Charles Dickens

I’VE OFTEN passed along special articles and features about the autism spectrum when I’ve come across them. Many have been about the unique ways individual parents and families have found a way to reach a child who had disappeared into the spectrum. This story from The New York Times is about a father who connected with his son through photographing him.

Son and Father Pierce Autism’s Veil
By Jane Gross  
November 5, 2010

Neighbors, friends and teachers were dropping hints — some subtle, others pointed, even cruel — that something was not right with Timothy Archibald’s first child, Elijah.

The little boy seemed hypnotized for hours by certain objects: doors, mechanical gears, the vacuum cleaner hose. He mimicked electrical sounds, knew the time schedule of the Bay Area Rapid Transit system by heart and had epic tantrums. Mr. Archibald, 43, an editorial and advertising photographer whose commercial clients include a maker of artificial limbs and Skittles candy, remembers thinking, “I can’t raise this kid; I can’t relate to him at all.’’

The tension at home was all but unbearable. Every waking hour had to do with Eli, who was 5 at the time. Why was he this way? Why was he that way? Was he mentally ill? Should he be medicated? In retrospect, the evidence seems so unambiguous, particularly once there was a second child, Wilson, to compare Eli to. But nobody in the household had yet spoken aloud the word “autism.’’

That was the moment when Mr. Archibald decided to look for his son, in the most literal sense of the word — through the lens of his camera.

“My feeling of utter frustration and powerless started this project,’’ he said recently about “Echolilia,” a limited-edition volume with 43 photographs, mostly of Eli. (It was published in June by Echo Press.) The title is derived from echolalia, a technical term for the copying of sounds and sentences common in children who suffer from some form of autism, who include verbal children like Eli who attend regular public schools. “I knew he was tuned differently,” Mr. Archibald said, “and I needed to build a bridge, get inside his head, learn what made him tick.’’

This would not be a standard documentary project in which he turned his camera on the boy at any and every opportunity, to chronicle his life. Nor would he stage and shoot standard portraits.

Instead, man and boy, father and son, would collaborate, in formal shooting sessions that rarely lasted more than 5 or 10 minutes but were regularly scheduled and initiated by an object or notion that interested Eli. It was Eli’s idea to see if a very large manila envelope would fit over his head; Eli’s idea to blow into one end of a vacuum cleaner hose and hold the other end to his ear to hear the whoosh. It was Eli’s idea to see if he could curl up his body until it fit inside a clear plastic toy box, to flatten his features with a wide rubber band, to look through the wide end of a funnel that happened to be the same circumference as his face. “He has always fetishized objects,’’ Mr. Archibald said. “They are iconic to him.’’

With a digital camera, photographer and subject could examine each image immediately. Sometimes Eli would have an idea for a more interesting pose or setting. Mostly that was Mr. Archibald’s job. He might suggest that they try the shot again at a different time of day or in a place with different light. The collaboration “satisfied something deep inside both of us,” Mr. Archibald said. “We shared — I don’t know what — mutual respect?’’

Light mattered. And simple settings. And contrast. And composition. Take, for instance, the photo of Eli and the vacuum cleaner hose. It was on the living room floor when he came home from school one day because his mother had been cleaning. It riveted the boy. “This is cool,” he told his father. “Let’s make some photos.” First, they went outside, where the light would be better. But Mr. Archibald didn’t like the image of the boy seated, tube to his mouth and ear, amid the chalk scrawling on the driveway. They moved to the backyard. Mr. Archibald noted the dark expanse of dirt and wanted to see Eli’s pale skin against that background. On an impulse, he said, he asked his son to take off his shirt.

One photograph juxtaposes a page of notes Mr. Archibald took when Eli’s ailment was diagnosed with a child’s bandage. It’s meant to capture the specialness of this child, which exists side by side with the fact that he is a normal little boy who skins his knees. “I was looking for that push and pull,’’ Mr. Archibald said, “the flux between the two.’’

All the pictures are set at home, in El Sobrante, Calif., a working-class community in the East Bay, quite charmless with its unlandscaped lawns and commercial strips lined with muffler repair shops and the like. Why only at home? “That’s where the tension was; that’s where I was trying to be a parent and feeling I was doing such a bad job of it,’’ Mr. Archibald said. “This is not about Eli in the world.’’

The world will soon enough impinge, Mr. Archibald fears, when Eli, now 8 and in the third grade, hits middle school. For the moment, “quirkiness is accepted by the other kids,’’ he said. “There is no social big boot to crush him yet.’’ Mr. Archibald said Eli finds nothing embarrassing about the book, despite what he acknowledged might look like “feral” images to some viewers, including a number in which the boy is unclothed. “There is no adolescent body consciousness yet,” Mr. Archibald said.

His wife, Cheri Stalmann, objected to the project at first. She worried that Eli was being exploited to serve her husband’s need to make sense of his own suffering. Eventually, however, Mr. Archibald said she grew enthusiastic as she saw Eli’s pleasure in the work and the results.

When the book was published, the rest of the family celebrated. Eli seemed uninterested at first. Then he asked for his own copy, to keep in his room. There, happily thumbing through it with his father these days, Eli will come upon photos taken as long as three years ago. “Oh, I forgot about that one,’’ he says to his father. “Look how cool it is!”

Sunday, October 26, 2014

The family dynamic of a national disaster

“Some folks look at me and see a certain swagger, which in Texas is called walking.” — George W. Bush

I WON'T attempt to deny it. I thought (and continue to think) that George W. Bush was quite possibly the worst president in our nation's history. 

The reasons are many, but I'll toss out a couple.

1) During President Bill Clinton's administration, the federal deficit was eliminated and the federal budget was balanced. Clinton left us a $280 billion surplus that George Bush succeeded in replacing with a $6 trillion deficit.

2) George Bush and his minions (or puppeteers) lied and obfuscated about nonexistent weapons of mass destruction in order to justify the invasion of Iraq and two deficit-financed wars.

Here's how the above two truths intersect, explained simply and clearly by the Center of Budget and Policy Priorities:

"If not for the Bush tax cuts, the deficit-financed wars in Iraq and Afghanistan, and the effects of the worst recession since the Great Depression (including the cost of policymakers’ actions to combat it), we would not be facing these huge deficits in the near term. By themselves, in fact, the Bush tax cuts and the wars in Iraq and Afghanistan will account for almost half of the $20 trillion in debt that, under current policies, the nation will owe by 2019."

What I've never been able to grasp, though, is how we ended up with this frat boy failure.

In the October 25 addition of The New York Times, the brilliant Frank Bruni peers into the family dynamic that created George W. It's fascinating.

Fathers, Sons and the Presidency
By Frank Bruni
October 25, 2014

I’M always thinking back to that lunch in Kennebunkport, because I saw it all there: what drove George W. Bush toward the presidency; what shaped so many of his decisions in office.

I was interviewing his parents at the family’s compound on the Maine coast. The 2000 Republican National Convention was just weeks away, and Bush by then was a well-established political phenomenon. Even so, his father said that he remained amazed that George had made it so far. Never had George’s parents seen such a grand future for him.

Perhaps an hour into our conversation, George’s brother Jeb, the Bush boy who had been tagged for greatness, happened to join us. From that moment on, when I asked his father a question, he’d sometimes say that Jeb should answer it, because Jeb knew best.

And as he gazed at Jeb, I noticed in his eyes what George must have spotted, craved and inwardly raged about for so much of his life: an admiration that he had been hard pressed to elicit. Running for the presidency was his way of demanding it. Winning the White House was his way of finally getting it.

And he went on to govern in defiance of the father who had cast such a long shadow over him and nursed such doubts about him. He went on to show him who was boss. No matter the cost, he invaded Iraq and toppled Saddam Hussein, whom Dad had spared. No matter the tactics, he secured a second term, which Dad hadn’t.

Will he whitewash all of this in the tribute that he has written to his father, “41,” which is scheduled for publication right after the midterms? I’m guessing yes, but whatever the evasions or revisionism of “41,” it will be more than just a book. It will be the latest chapter in a father-son psychodrama that altered the country’s course.

And it will be a reminder of how many other father-son psychodramas did likewise.

While Bush is only the second child of a president to duplicate his dad’s ascent, he’s hardly the first occupant of the Oval Office whose career can be read as a response to his father’s dominance or disappearance, an answer to his father’s example. The history of American politics is a history of daddy issues, of sons who felt compelled to impress, outdo, usurp, avenge or redeem their fathers.

There are striking leitmotifs. Neither Barack Obama nor Bill Clinton ever really knew his father, and it’s impossible to divorce either’s ambition from that absence. The two men have said as much themselves.

Clinton’s father died in an accident just three months before he was born, leaving the future president with “the feeling that I had to live for two people” and “make up for the life he should have had,” he wrote in his autobiography, “My Life.”

“And his memory infused me, at a younger age than most, with a sense of my own mortality,” he continued. “The knowledge that I, too, could die young drove me both to try to drain the most out of every moment of life and to get on with the next big challenge.”

Shortly after Obama’s birth, his parents separated. Obama saw his father only once subsequently, when he was 10 years old and his father traveled from Kenya to Hawaii for a monthlong visit. The brevity of that contact — the distance between father and son — informed the narrative and title of his memoir, “Dreams From My Father,” and was a principal engine of his accomplishments.

“If you have somebody that is absent, maybe you feel like you’ve got something to prove when you’re young, and that pattern sets itself up over time,” he said in an interview with Newsweek in 2008. It’s a pattern detectable in many presidents.

In a 2012 story for Slate titled “Why Do So Many Politicians Have Daddy Issues?” Barron YoungSmith wrote, “American politics is overflowing with stories of absent fathers, alcoholic fathers, neglectful fathers.”

To look back through the years is to see presidents in rebellion against their fathers and presidents in thrall to them, presidents trying to be bigger and better than the fathers who let them down (Abraham Lincoln, Ronald Reagan) as well as presidents living out the destinies that their fathers scripted for them (John F. Kennedy, William Howard Taft). It’s to behold the inevitably fraught father-son dynamic playing out on the gaudiest stages, with the most profound consequences.

Did Clinton’s unappeasable needs come from the enormous hole that his father left? Did Obama develop his aloofness early, as a shield against the kind of disappointment that his father caused him?

The particular imprints of fathers on sons have been conspicuous in the leading characters from the most recent presidential elections. Paul Ryan was just 16 when he discovered his father dead of a heart attack. He grew up fast, and became zealous about physical fitness. Mitt Romney was trying to complete his own father’s failed quest for the presidency, and at the start of debates where he was allowed notepaper, he’d scrawl “Dad” on the blank sheet.

Al Gore, too, was attending to the unfinished business of his father, who had made it to the Senate but never the White House. And John McCain, the son and grandson of four-star admirals in the Navy, was trying to do those generations of men proud.

The country’s presidents and presidential aspirants were of course also trying to please and honor mothers, and the presidency is perhaps just as much a history of mommy issues. But there’s something singular about the father-son face-off, as there is about the mother-daughter pas de deux. In the parent whose gender we share, we’re more likely to find our yardstick, our template, our rival.

And with fathers and sons, there’s a special potential for misunderstanding, for the kind of chasm in which resentments and compulsions flourish. Men aren’t socialized to express their feelings, to speak their hearts, to talk it out.

So sons and fathers often stand at the greatest remove, neither able to read the other. From what I’ve witnessed, from what I personally know, many men spend the early part of our lives misjudging our fathers, and acting out accordingly, and then the latter part finally coming to know them. It’s one of our longest journeys.

And maybe George W. Bush — who styled himself as the kind of folksy Texan that his father wasn’t — is at last completing his. Maybe he’s reached a point of uncomplicated appreciation. How different things might have been if he’d arrived there earlier.

Saturday, October 25, 2014

Hog (and education) castration in Iowa

"I grew up castrating hogs on an Iowa farm. So when I get to Washington, I'll know how to cut pork. Washington's full of big spenders. Let's make 'em squeal." — Joni Ernst

PAUL AND I spent three and half hours today knocking on doors in support of Democratic candidates in Iowa, in particular Senate candidate Bruce Braley. Hog castrator Joni Ernst is running against him, and she is, in my opinion, desperately wrong for Iowa and the nation. 

Here's one of many reasons: she wants to close the US Department of Education because she finds the department unnecessary and believes states shouldn't have the federal government bothering them about education.

Unfortunately, Ms. Ernst misunderstands the roles of the federal government and states in education.

At a Republican primary debate Ms. Ernst revealed her goal of shutting down the federal Department of Education. Here's part of a June 27, 2014 article from the Pulitzer Prize-winning Tampa Bay Times written by Molly O'Connor:

(Ernst) called for "closing the doors to the Department of Education at the federal level. And not just because it would save taxpayer dollars, but because I do believe our children are better educated when it’s coming from the state."

We ran those comments by Ernst spokeswoman Gretchen Hamel, who said that Ernst wants to see power taken from Washington and put back in the hands of Iowans. 

According to the Education Department’s website the "federal role in education is (already) limited." States handle almost all education policy and issues. But, at the federal level, the Education Department takes on many tasks such as conducting research and overseeing state policy to prevent discrimination. It also awards and distributes federal financial aid in the form of loans and grants.

An ad for Bruce Braley says that if Ernst is elected, 213,000 Iowa students would lose their federal Pell Grants. According to federal numbers, that is the number of Iowans who received Pell Grants in 2011-12. We asked the Ernst campaign what her plan for Pell Grants is, but we didn’t get a response.

What would the ramifications of losing Pell Grants be? New York Times columnist Nicholas Kristof explains the current state of higher education in the United States better than I can.

The American Dream Is Leaving America
By Nicholas Kristof
October 25, 2014

THE best escalator to opportunity in America is education. But a new study underscores that the escalator is broken.

We expect each generation to do better, but, currently, more young American men have less education (29 percent) than their parents than have more education (20 percent).

Among young Americans whose parents didn’t graduate from high school, only 5 percent make it through college themselves. In other rich countries, the figure is 23 percent.

The United States is devoting billions of dollars to compete with Russia militarily, but maybe we should try to compete educationally. Russia now has the largest percentage of adults with a university education of any industrialized country — a position once held by the United States, although we’re plunging in that roster.

These figures come from the annual survey of education from the Organization for Economic Cooperation and Development, or O.E.C.D., and it should be a shock to Americans.

A basic element of the American dream is equal access to education as the lubricant of social and economic mobility. But the American dream seems to have emigrated because many countries do better than the United States in educational mobility, according to the O.E.C.D. study.

As recently as 2000, the United States still ranked second in the share of the population with a college degree. Now we have dropped to fifth. Among 25-to-34-year-olds — a glimpse of how we will rank in the future — we rank 12th, while once-impoverished South Korea tops the list.

A new Pew survey finds that Americans consider the greatest threat to our country to be the growing gap between the rich and poor. Yet we have constructed an education system, dependent on local property taxes, that provides great schools for the rich kids in the suburbs who need the least help, and broken, dangerous schools for inner-city children who desperately need a helping hand. Too often, America’s education system amplifies not opportunity but inequality.

My dad was a World War II refugee who fled Ukraine and Romania and eventually made his way to France. He spoke perfect French, and Paris would have been a natural place to settle. But he felt that France was stratified and would offer little opportunity to a penniless Eastern European refugee, or even to his children a generation later, so he set out for the United States. He didn’t speak English, but, on arrival in 1951, he bought a copy of the Sunday edition of The New York Times and began to teach himself — and then he worked his way through Reed College and the University of Chicago, earning a Ph.D. and becoming a university professor.

He rode the American dream to success; so did his only child. But while he was right in 1951 to bet on opportunity in America rather than Europe, these days he would perhaps be wrong. Researchers find economic and educational mobility are now greater in Europe than in America.

That’s particularly sad because, as my Times colleague Eduardo Porter noted last month, egalitarian education used to be America’s strong suit. European countries excelled at first-rate education for the elites, but the United States led the way in mass education.

By the mid-1800s, most American states provided a free elementary education to the great majority of white children. In contrast, as late as 1870, only 2 percent of British 14-year-olds were in school.

Then the United States was the first major country, in the 1930s, in which a majority of children attended high school. By contrast, as late as 1957, only 9 percent of 17-year-olds in Britain were in school.

Until the 1970s, we were pre-eminent in mass education, and Claudia Goldin and Lawrence Katz of Harvard University argue powerfully that this was the secret to America’s economic rise. Then we blew it, and the latest O.E.C.D. report underscores how the rest of the world is eclipsing us.

In effect, the United States has become 19th-century Britain: We provide superb education for elites, but we falter at mass education.

In particular, we fail at early education. Across the O.E.C.D., an average of 70 percent of 3-year-olds are enrolled in education programs. In the United States, it’s 38 percent.

In some quarters, there’s a perception that American teachers are lazy. But the O.E.C.D. report indicates that American teachers work far longer hours than their counterparts abroad. Yet American teachers earn 68 percent as much as the average American college-educated worker, while the O.E.C.D. average is 88 percent.

Fixing the education system is the civil rights challenge of our era. A starting point is to embrace an ethos that was born in America but is now an expatriate: that we owe all children a fair start in life in the form of access to an education escalator.

Let’s fix the escalator.

Friday, October 24, 2014

When being positive is actually a negative

"Yesterday is not ours to recover, but tomorrow is ours to win or lose. — Lyndon B. Johnson, 36th President of the United States of America

WOW. This New York Times article by Gabriele Oettingen, professor of psychology at New York University and the University of Hamburg, might just spin your can-do head around as many times as it did mine. 

According to several studies, positive thinking can actually be a hinderance to achieving the wishes and goals you were thinking positively about! I'm going to have to ponder and process this for awhile before I can take it in enough to actually do me any good. 

The Problem With Positive Thinking
By Gabriele Oettingen
October 24, 2014

MANY people think that the key to success is to cultivate and doggedly maintain an optimistic outlook. This belief in the power of positive thinking, expressed with varying degrees of sophistication, informs everything from affirmative pop anthems like Katy Perry’s “Roar” to the Mayo Clinic’s suggestion that you may be able to improve your health by eliminating “negative self-talk.”

But the truth is that positive thinking often hinders us. More than two decades ago, I conducted a study in which I presented women enrolled in a weight-reduction program with several short, open-ended scenarios about future events — and asked them to imagine how they would fare in each one. Some of these scenarios asked the women to imagine that they had successfully completed the program; others asked them to imagine situations in which they were tempted to cheat on their diets. I then asked the women to rate how positive or negative their resulting thoughts and images were.

A year later, I checked in on these women. The results were striking: The more positively women had imagined themselves in these scenarios, the fewer pounds they had lost.

My colleagues and I have since performed many follow-up studies, observing a range of people, including children and adults; residents of different countries (the United States and Germany); and people with various kinds of wishes — college students wanting a date, hip-replacement patients hoping to get back on their feet, graduate students looking for a job, schoolchildren wishing to get good grades. In each of these studies, the results have been clear: Fantasizing about happy outcomes — about smoothly attaining your wishes — didn’t help. Indeed, it hindered people from realizing their dreams.

Why doesn’t positive thinking work the way you might assume? As my colleagues and I have discovered, dreaming about the future calms you down, measurably reducing systolic blood pressure, but it also can drain you of the energy you need to take action in pursuit of your goals.

In a 2011 study published in the Journal of Experimental Social Psychology, we asked two groups of college students to write about what lay in store for the coming week. One group was asked to imagine that the week would be great. The other group was just asked to write down any thoughts about the week that came to mind. The students who had positively fantasized reported feeling less energized than those in the control group. As we later documented, they also went on to accomplish less during that week.

Positive thinking fools our minds into perceiving that we’ve already attained our goal, slackening our readiness to pursue it.

Some critics of positive thinking have advised people to discard all happy talk and “get real” by dwelling on the challenges or obstacles. But this is too extreme a correction. Studies have shown that this strategy doesn’t work any better than entertaining positive fantasies.

What does work better is a hybrid approach that combines positive thinking with “realism.” Here’s how it works. Think of a wish. For a few minutes,imagine the wish coming true, letting your mind wander and drift where it will. Then shift gears. Spend a few more minutes imagining the obstacles that stand in the way of realizing your wish.

This simple process, which my colleagues and I call “mental contrasting,” has produced powerful results in laboratory experiments. When participants have performed mental contrasting with reasonable, potentially attainable wishes, they have come away more energized and achieved better results compared with participants who either positively fantasized or dwelt on the obstacles.

When participants have performed mental contrasting with wishes that are not reasonable or attainable, they have disengaged more from these wishes. Mental contrasting spurs us on when it makes sense to pursue a wish, and lets us abandon wishes more readily when it doesn’t, so that we can go after other, more reasonable ambitions.

In a recent study on healthy eating and exercise, we divided participants into two groups. Members of one group engaged in mental contrasting and then performed a planning exercise designed to help them overcome whatever obstacles stood in their way. Four months later, members of this group were working out twice as long each week as the control group and eating considerably more vegetables. In other studies, we found that people who engaged in mental contrasting recovered from chronic back pain better, behaved more constructively in relationships, got better grades in school and even managed stress better in the workplace.

Positive thinking is pleasurable, but that doesn’t mean it’s good for us. Like so much in life, attaining goals requires a balanced and moderate approach, neither dwelling on the downsides nor a forced jumping for joy.

Thursday, October 23, 2014

New potential autism symptom relief

"I do not like broccoli. And I haven't liked it since I was a little kid and my mother made me eat it. And I'm President of the United States and I'm not going to eat any more broccoli." — George H. W. Bush

I'M ALWAYS fascinated about the ways that our brains work — the commonalities we all share and the differences, so from time to time I share interesting studies and stories about the autism spectrum. 

This ABC News article discusses a potentially new beneficial discovery to help those who struggle with autism.

Broccoli Sprout Extract May Help Curb Autism Symptoms

ABC News
By Dr. Crystal Agi  
Oct 13, 2014

A chemical derived from broccoli sprout could help treat symptoms of autism, according to a new study from Johns Hopkins and Harvard hospitals.

The study authors say it is an “intriguing” first step that could lead to a better life for those with autism spectrum disorders, which affect one in 68 children in the United States and currently have no cure or medical treatment.

“If you tell people that you’ve treated autism with broccoli, they would say that that is a very far-fetched idea,” said study author Dr. Paul Talalay, a professor of pharmacology and molecular sciences at Johns Hopkins Hospital.

Talalay and his team treated 40 autistic boys and men with autism over 18 weeks.  Twenty-six of them took pills with sulforaphane, a broccoli sprout extract, and the rest received a placebo.

Study authors found that patients who took sulforaphane improved. Almost half of the patients treated with sulforaphane had “much improved” or “very much improved” social interaction and verbal communication, and more than half exhibited less aberrant behavior. When the patients stopped taking the extract, they returned to baseline levels for these symptoms within four weeks.

Those who took the placebo did not show any improvement, according to the study.

Talalay said the way in which this extract might work in autistic patients has yet to be fully understood, but past research suggests that sulforaphane can cause the body to react as it would to a fever. Since fevers have been associated with a temporary improvement of symptoms in about a third of autism patients, sulforaphane may work in a similar way, according to the study authors.

The findings appear in the October issue of Proceedings of the National Academy of Sciences.

Autism experts not involved with the research said the findings are encouraging, but cautioned that there are still many unanswered questions.

“The trial needs to be replicated and evaluated in larger and more age-diverse samples,” Dr. Susan Hyman, chief of neurodevelopmental and behavioral pediatrics at the University of Rochester Medical Center, said in an email to ABC News. “But the data is certainly worth pursuing.”

Dr. Max Wiznitzer, a pediatric neurologist at UH Rainbow Babies & Children’s Hospital in Cleveland, Ohio, agreed.

“The results are intriguing because there is an improvement in some of the subjects,” Wiznitzer said. “However, [the authors] have not shown that they have treated the core essence of autism.”

Still, Wiznitzer said these findings would be “fascinating if true.”

“It might give us a whole new group of treatments to use in these individuals,” he said.

Doctor’s Take

Given the lack of effective treatment options available for people with autism, the results of this study deserve a closer look. The good news is that sulforaphane is associated with very few side effects and is generally regarded as a safe chemical given its natural origins, according to Talalay.

But Hyman said she would not encourage families to administer sulforaphane without guidance from their doctor because it’s unclear whether there are potential drug interactions and long-term side effects.

So should parents force their kids to eat more broccoli? Not so fast.

“It’s very difficult to get this amount of broccoli in your diet,” Talalay said. “You have to know which broccoli you’re eating because the variability of [sulforaphane] is enormous.”

Instead, he said he believes that the study provides “insight” into the mechanism of autism.

Friday, October 17, 2014

Depression in new mothers

“The message that a lot of moms hear from families and friends and even professionals who may not know much about perinatal depression is ‘be tough and fight your way through it’ — and they don’t seek help.” — Robert Ammerman, Cincinnati Children’s Hospital Medical Center

IN JULY I published a Hey Look post called Not All Unicorns and Rainbows sharing The New York Times article The Trauma of Parenthood which discussed the elevated rate of depression among new mothers — as high as 42%, according to a 2010 Journal of the American Medical Association, and I received some surprising push-back.

One respondent seemed to feel that the person who wrote the article was whiny, and my sharing of the piece was enabling and indulgent. I felt chastised. 

Yesterday, however, one of my favorite authors, David Bornstein, of one of my favorite regular NYT periodic features called Fixes, weighed in on the same subject in a much longer and detailed form, and I feel validated. 

It's a long read, but really interesting especially if you have a daughter or granddaughter or niece or friend — or you are expecting.

Treating Depression Before It Becomes Postpartum

By David Bornstein
October 16, 2014 

Shortly after the birth of her daughter, Andrea became severely depressed. She was 17 at the time and she didn’t fully understand what she was going through; she just felt like a failure. “I felt like I didn’t want to be alive,” she recalls. “I felt like I didn’t deserve to be alive. I felt like a bad person and a bad mother, and I was never going to get any better.”

When her baby persisted in crying, she felt her frustration mount quickly. “I was hitting a boiling point,” she says. “I was at a point where I didn’t want to deal with anything. Sometimes I would just let her cry — but then I would feel very bad afterwards.”

Depression is the most common health problem women face. In the United States, outside of obstetrics, it is the leading cause of hospitalizations among women ages 15 to 44. It’s estimated that 20 percent to 25 percent of women will experience depression during their lifetimes, and about one in seven will experience postpartum depression. For low-income women, the rates are about twice as high. As my colleague Tina Rosenberg has reported, the World Health Organization ranks depression as the most burdensome of all health conditions affecting women (as measured by lost years of productive life).

Postpartum depressions are often assumed to be associated with hormonal changes in women. In fact, only a small fraction of them are hormonally based, said Cindy-Lee Dennis, a professor at the University of Toronto and a senior scientist at Women’s College Research Institute, who holds a Canada Research Chair in Perinatal Community Health.

The misconception is itself a major obstacle, she adds. Postpartum depression is often not an isolated form of depression; nor is it typical. “We now consider depression to be a chronic condition,” Dennis says. “It reoccurs in approximately 30 to 50 percent of individuals. And a significant proportion of postpartum depression starts during the pregnancy but is not detected or treated to remission. We need to identify symptoms as early as possible, ideally long before birth.”

The major predictors include previous incidents of depression, as well as a woman’s past and current life stresses, like childhood trauma or abuse, conflicts with a partner or family members, lack of social support or coping skills, and poverty.

Only about 20 percent to 30 percent of women who experience postpartum depression in the United States get proper treatment, and for low-income mothers, the rate is considerably lower, says Robert T. Ammerman, a professor of pediatrics at Cincinnati Children’s Hospital Medical Center who is the scientific director of Every Child Succeeds, a home visiting program for vulnerable first-time mothers.

The consequences for both mother and child can be devastating. If left untreated, postpartum depression can develop into severe clinical depression. In addition to feeling listless, anxious, guilty, lonely and frequently suicidal, mothers who are clinically depressed in pregnancy are three to four times more likely to have a premature delivery or deliver a low-birth-weight baby (both predictors of serious developmental and medical problems for the child) and, just as urgent, less likely to form healthy attachments with their children. Their children are more likely to have attention deficits, difficulties controlling their emotions and behavior, language delays and lower I.Q.s — and they are themselves at increased risk of becoming depressed later in life.

“We have this idea that during motherhood struggling with emotional issues is normal,” Ammerman says. “The message that a lot of moms hear from families and friends and even professionals who may not know much about perinatal depression is ‘be tough and fight your way through it’ — and they don’t seek help.”

Ammerman says that while it’s true that many mothers have or develop depression, it’s not a normal or typical response to the challenges of parenting. There are effective treatments. They include medication as well as a range of therapies – like cognitive behavioral therapy (C.B.T.), which helps people learn how to counter negative thoughts and their associated emotions, and interpersonal psychotherapy (I.P.T.), which focuses on improving the quality of personal relationships and the satisfaction that is gained from them. About a third of women who get treated for chronic or recurrent depression achieve remission, and more than half see an improvement in their symptoms.

Today, several states, including Illinois, New Jersey, West Virginia and Washington, have initiated mandatory screening for perinatal depression (something that is done nationally in Australia). But inadequate screening is only part of the problem. Cost and access barriers and stigmatization – and an overall lack of awareness among health professionals – are what prevent most mothers who need help from getting it. Many primary care doctors fail to recognize when their patients are depressed. And when they do, they often don’t know how to provide the most effective treatments. They also can’t ensure that patients will follow up with mental health professionals (many of whom do not accept Medicaid). And communication between doctors is notoriously problematic.

“When people are referred to mental health professionals from primary care settings, the vast majority of the referral slips go into the garbage,” says Katherine L. Wisner, director of the Asher Center for the Study and Treatment of Depressive Disorders at Northwestern University.

Given the scope of the problem, new outreach and treatment models are urgently needed. The three that I’m highlighting today are in early stages of development, but they are noteworthy because they demonstrate promise and illustrate pathways for potentially broader system changes.

The first is a collaborative care model called DAWN being pioneered at two urban obstetrics and gynecology (ob-gyn) clinics that are part of the University of Washington system. The innovation here is that mental health care is being integrated directly into ob-gyn care. Why is this such an important idea? About a third of women in the country see their ob-gyn physicians for their primary care, explains Wayne Katon, vice chair of the department of psychiatry and behavioral sciences at the University of Washington School of Medicine. When depression screening and treatment are handled in the same place as primary care, it’s more likely that women will get effective help.

Through the DAWN program, when a woman comes in for care, she is screened for depression using a standard questionnaire known as PHQ-9. If her score indicates a likelihood of major depression, she is assigned a care manager who is trained to educate her about depression, explore real or perceived barriers in her life and motivate her to pursue treatment.

It’s important that treatments are designed to fit with a patient’s preferences. “They’re given the choice to start with a form of therapy or an antidepressant,” Katon says. “Some say, ‘I’m pregnant, I’d rather not be on medication.’ Some want to take medication.” They can also choose in-person visits or telephone consultations. Physician-supervised care managers follow up regularly for a year, tracking patients’ progress. If their symptoms persist, they adjust or increase the intensity of treatment.

In two studies published this year, women experienced significant improvements in depressive symptoms. The gains were particularly notable among women who were uninsured or received public insurance, such as Medicaid. “The women were more satisfied with the care they got and the ob-gyn doctors were more satisfied because their patients got better,” Katon adds.

The second model was developed by Every Child Succeeds, a home visiting program for vulnerable first-time mothers based out of the Cincinnati Children’s Hospital Medical Center. In recent years, as I have reported in this column, home visiting programs have spread across the country as a result of a $1.5 billion appropriation in the Affordable Care Act. This summer, a study of families served by the Nurse-Family Partnership found, remarkably, that the mothers and children assisted by the program had significantly lower death rates over a 20-year period.

But home visiting programs have one notable limitation. As recent research indicates, when mothers are clinically depressed, they don’t benefit as much from the visits. “A mother who is depressed has very little to give her child,” said Judith B. Van Ginkel, the founder of Every Child Succeeds, which has worked with 22,000 families. “We found that half of the mothers we were working with were depressed, and three-quarters had witnessed or been victims of violence.”

With the leadership of Robert Ammerman and others, Every Child Succeeds has developed a program called Moving Beyond Depression, to train therapists to deliver C.B.T. in conjunction with home visitation.

This is how Andrea was able to receive treatment. Shortly after her home visits started, Andrea, who lives just north of Cincinnati and works in a call center, was asked to fill out a questionnaire. (I have changed her name.) She learned that she was depressed. “I had been in denial,” she said. For months, conflicts with her mother had been getting worse. Her mother suffered from mental illness and depression, had used drugs, and had long counted on, and expected, Andrea to take care of her.

But now Andrea needed every ounce of her strength to care for her baby, and her mother reacted angrily. Over 15 sessions, the therapist helped Andrea develop strategies to manage her feelings and interact with her mother — rather than being thrown repeatedly to anger, negative thoughts and guilt.

Last year, results from a clinical trial funded by the National Institute of Mental Health showed that mothers receiving Moving Beyond Depression’s in-home C.B.T. model experienced subtantial improvements in depressive symptoms and decreased diagnosis of major depressive disorder following treatment relative to a control group. The model has spread to several states, including Connecticut, Massachusetts, Kentucky and Kansas, and has been used to assist 600 mothers.

The third model grows out of Cindy-Lee Dennis’s research in Canada, and is important because it illustrates the potential of treating women through interventions over the phone. It thus reduces one of the biggest barriers low-income or rural women face in accessing treatment: transportation to and from treatment and scheduling appointments.

In one clinical trial, 700 women in the first two weeks after giving birth, who had been identified as being at a high risk of postpartum depression, were given telephone-based peer support from other mothers — volunteers from the community who had previously experienced and recovered from self-reported postpartum depression (and received four hours of training).

“We created a support network for the mothers early in the postpartum period,” Dennis explains. “It cut the risk of depression by 50 percent.” On average, each mother received just eight contacts — calls or messages, and the calls averaged 14 minutes. Over 80 percent of the mothers said they would recommend this support to a friend.

In another clinical trial conducted by Dennis, trained nurses provided interpersonal psychotherapy (I.P.T.) over the phone to 240 clinically depressed mothers across Canada. The calls were scheduled at the mothers’ convenience. The results have not been published yet, but Dennis says the treatment was highly effective. Treatment compliance rates were greater than 85 percent. Dennis is currently working with health officials to pilot test the model in New York City.

“We underestimate very simple interventions,” she says. “We have this huge bias that face to face is the most effective way to provide care. But we have to be innovative about how we offer help to women.”

Andrea, who is now 19, remains grateful for the help she received. “I can actually focus on my daughter and be with her the way I want to be with her, and teach her things,” she says. “I feel like now that I’ve been through the program — and distanced myself from people I needed to — I can focus on what I need to focus on rather than ever

Wednesday, October 15, 2014

Letting the cat out of the hat

“Women and cats will do as they please, and men and dogs should relax and get used to the idea.” ― Robert A. Heinlein

ORIGINALLY, this post had a short video of a cat putting on a hat — supposedly. But an astute reader pointed out that it wasn't legit; it was actually a video of a cat removing a hat played backwards — which makes way more sense. A cat would for sure figure out how to get that silly thing off her or his head in a nonce.

So in deference to being as truthful, here's a replacement video of Nora, the famous piano-playing cat, being accompanied by The Klaipeda Chamber Orchestra, conducted by Mindaugas Piecaitis. Enjoy. 

Monday, October 13, 2014

Why indeed

“I believe that it is better to tell the truth than a lie. I believe it is better to be free than to be a slave. And I believe it is better to know than to be ignorant.” — H. L. Mencken

LAST YEAR one of my Hey Look readers was miffed at me for suggesting that we ditch Columbus Day and replace it with International Nelson Mandela Day. My friend said, "Why insult all those of Italian descent in our country?" 

Okay. I like Italians. One of my most favorite people in all the world was first generation 100% Italian. So I amend my suggestion thusly: change the designation from Columbus Day to Italian Heritage Day (it would have to be downgraded from being a national holiday of course, but then neither is Saint Patrick's Day, and I don't grouse about that) and add International Nelson Mandela Day to the calendar as a national holiday.

There. Problem solved. We no longer celebrate the decimation of the original inhabitants of the Americas, we have the same number of days off (well, the banks, post offices and governmental workers do; the rest of us don't), and we have one additional day to drink to excess: beer on St. Patty's Day and vino on Italian Heritage Day. I expect my call from the State Department with an ambassadorial offer at any moment.

PS: This video is courtesy of my pal, Dale Bert. We don't get whatever channel John Oliver is on (more's the pity), so thanks, Dale, for sharing it with me.

Sunday, October 12, 2014

Non-celiac gluten sensitivity

“Diets, like clothes, should be tailored to you.” — Joan Rivers

I'VE ALLUDED a few times to Paul's gluten intolerance and mentioned that I'd say more about it in the future. I've just come across an excellent explanatory article in The New York Times that has finally prompted me to fulfill my promise.

The morning of what was to be our first day back at work eight years ago after the Christmas and New Year's holiday break, Paul was giving little indication of willingness to get out of bed. When I made sympathetic noises about how hard it always is to go back to work after a nice break, he almost burst into tears and said, "That's not it. I'm just tired of being in pain every day."

I knew that the joints in Paul's feet hurt with increasing frequency, but we both believed it was his genetic legacy since both his mom and sister have had to have joint surgery on their big toes, and Paul had already been to a foot specialist who told him that yes, he'd have to have the same surgery at some point. But the fact that all of his joints hurt so much came as a shock. 

I adore my husband, and I like to at least imagine that I'm attentive to his well-being. How could I not know this? 

Because Paul is not a complainer, he tends to ignore aches and pains and soldier on, but that can be a very double-edged sword. For Paul to reach a point where he was almost in tears meant that he was in a great deal of pain. 

For a couple of years I'd been suggesting that he visit a particular clinic in Las Vegas that had been highly recommended by a trusted friend who'd had his health rescued there, but Paul demurred. On this morning, however, he volunteered, "I think I want to go to that clinic you've been telling me about."

And a couple of weeks later he was there. It was the start of a somewhat circuitous process of getting Paul on a path to recovery.

The clinic ran lots of tests and concluded that Paul was allergic to wheat among other things. Although now that we know more, we don't believe he has a wheat allergy, it was a clue that, although seemingly so unrelated, his diet might be the cause of his joint pain.

The next piece of the puzzle came by accident. I was chatting with a friend who mentioned celiac disease in passing. I'd never heard of it, but based on Paul's symptoms — in addition to severe joint pain, he'd also had ongoing diarrhea for about two years — it sounded like CD might be the explanation.

After reading up on the disease, I convinced Paul to go on a gluten-free diet, and his joint pain and diarrhea eased up, but we wanted to make sure we were doing the right thing, so Paul went in for the celiac disease blood test. 

It came back negative; now we were really confused. 

A more definitive test would have been a biopsy, but in order for it to be accurate, he would have had to start eating wheat and gluten again and continue for at least two weeks, and he didn't want to put his body through the process of eating what would be harmful to him. Instead he continued on his more or less gluten-free diet.

After awhile, though, Paul fell off the wagon for an extended period of time. After all, the blood test had come back negative, and maintaining an entirely gluten-free diet involves a lot of discipline, not to mention considerable inconvenience. 

His body had something to say about that, however. The joint pain and the diarrhea were back. 

Paul wisely decided to listen to his body instead of the blood test, and we adopted a rigid gluten-free diet which he continues to maintain.

The reward is that the surgery he thought he was doomed to have on his big toes, now seems unnecessary, the intestinal distress is gone and so are the nosebleeds he used to get on a regular basis, and after adhering to a strict diet for some years now, the restless legs problem that used to cause him so much misery has also disappeared.

Despite our success, because our methodology was trial and error, from time to time we've both wondered if we'd cobbled together the right answer. Recent research, however, has proven that there's much more to the whole gluten issue than a simple yes or no to celiac disease.

This article from The New York Times has clarified much to us and validated our decisions. It's the second of two articles. I'll share the first one in a few days and yet another article I've found a few days after that because I believe understanding celiac disease and non-celiac gluten sensitivity may help many people be healthier. Maybe you.

When Gluten Sensitivity Isn’t Celiac Disease
By Jane E. Brody  
OctoberR 6, 2014

My nephew, sister-in-law and several others I know are on gluten-free diets, helping to support a market for these foods that is expected to reach $15 billion in annual sales by 2016.

Supermarket shelves are now packed with foods labeled gluten-free (including some, like peanut and almond butter, that naturally lack gluten). Chefs, too, have joined the cause: Many high-end restaurants and even pizza parlors now offer gluten-free dishes.

Those who say they react to gluten, a protein in wheat and other grains, report symptoms like abdominal pain; bloating; gas; diarrhea; headache; fatigue; joint pain; foggy mind; numbness in the legs, arms or fingers; and balance problems after eating a gluten-rich food.

I suspected at first that the gluten-free craze was an attempt by some to find a physical explanation for emotional problems, similar to the “epidemic” of hypoglycemia in decades past. But a growing body of research indicates that many may be suffering a real condition called non-celiac gluten sensitivity, or NCGS.

It is not celiac disease, a far less common autoimmune condition that can destroy the small intestine. Indeed, no one has conclusively identified a physical explanation for gluten sensitivity and its array of symptoms.

Recent studies have strongly suggested that many, and possibly most, people who react badly to gluten may have a more challenging problem: sensitivity to a long list of foods containing certain carbohydrates.

In 2011, Dr. Peter Gibson, a gastroenterologist at Monash University in Victoria, Australia, and his colleagues studied 34 people with irritable bowel syndrome who did not have celiac disease but reacted badly to wheat, a gluten-rich grain. The researchers concluded that non-celiac gluten sensitivity “may exist.”

Many of their subjects still had symptoms on a gluten-free diet, however, which prompted a second study of 37 patients with irritable bowel syndrome and non-celiac gluten sensitivity who were randomly assigned to a two-week diet low in certain carbohydrates, collectively called Fodmaps.

All patients on the special diet improved, but got significantly worse when fed gluten or whey protein. Only 8 percent of the participants reacted specifically to gluten, prompting the researchers to conclude that Fodmaps, not gluten, accounted for most of the distress.

Fodmaps is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, sugars that draw water into the intestinal tract. They may be poorly digested or absorbed, and become fodder for colonic bacteria that produce gas and can cause abdominal distress. They are:

■ Fructose: A sugar prominent in apples, pears, watermelon, mangoes, grapes, blueberries, tomatoes and tomato concentrate, and all dried fruits; vegetables like sugar-snap peas, sweet peppers and pickles; honey; agave; and jams, dressings and drinks made with high-fructose corn syrup.

■ Lactose: The sugar in milk from cows, goats and sheep, present in ice cream, soft cheeses, sour cream and custard.

■ Fructans: Soluble fiber found in bananas, garlic, onions, leeks, artichokes, asparagus, beets, wheat and rye.

■ Galactans: Complex sugars prominent in dried peas and beans, soybeans, soy milk, broccoli, cabbage and brussels sprouts.

■ Polyols: The sugar alcohols (sweeteners) isomalt, mannitol, sorbitol and xylitol, present in stone fruits like avocado, cherries, peaches, plums and apricots.

People with irritable bowel syndrome often find that their symptoms lessen or disappear when avoiding foods rich in Fodmaps; however, it can take six to eight weeks on a low-Fodmap diet to see a significant improvement.

Experts advise those patients to eliminate all foods rich in Fodmaps at the start. (You can find a list of foods low in these carbohydrates at Once symptoms resolve, individual foods are returned to the diet one by one to identify those to which patients react.

So what about patients who think they are sensitive only to gluten?

Dr. Joseph A. Murray, gastroenterologist at the Mayo Clinic and an expert on celiac disease, urges that they first be tested for celiac disease, a condition that has become dramatically more prevalent in recent decades. The signs of gluten sensitivity often mimic those of celiac disease, as well as irritable bowel syndrome.

Tests for celiac disease are less accurate if the diet does not currently include gluten. “Test first, test right,” Dr. Murray said in an interview. “We’re seeing people with symptoms who go on a gluten-free diet, and then we can’t make a correct diagnosis.”

With non-celiac gluten sensitivity, there is no damage to the small intestine, meaning many people may consume small amounts of gluten without incident. A forthcoming book edited by Dr. Murray, “Mayo Clinic Going Gluten Free,” lists the essential requirements for diagnosis of non-celiac gluten sensitivity:

■ Negative blood tests for celiac disease and no sign of damage on an intestinal biopsy.

■ Symptom improvement when gluten is removed from the diet.

■ Recurrence of symptoms when gluten is reintroduced.

■ No other explanation for the symptoms.

It is not yet known if the condition results from an immunological reaction similar to that seen in celiac disease, or whether gluten exerts a chemical or other negative effect on digestion.

Gluten sensitivity is not the same as a wheat allergy, a far less common problem with symptoms like swelling, itching, skin rash, tingling or burning of the mouth, and nasal congestion.

The best way to test for non-celiac gluten sensitivity (after ruling out celiac disease) is to remove all sources of gluten from one’s diet for several weeks. If the symptoms disappear, reintroduce gluten to see if they recur. Another option is to keep a food diary for a few weeks, recording everything you eat and drink and any symptoms that follow.

In addition to the inconvenience and added expense, a gluten-free diet can result in a poor intake of fiber and certain essential nutrients. It may be wise to consult a registered dietitian if you plan to go gluten-free.