During the day, the diet also permits two selections containing a bit more protein. These selections are from the foods made of grains: breads, crackers, cereals, pastas, popcorn, and rice; and from all the vegetables except legumes and nuts. Legumes, which include peas, lentils, soybeans, and dry beans (such as baked beans, kidney beans, and chickpeas), cannot be eaten during the day because they contain most of the amino acid building blocks of protein. Together, the two selections should contain no more than 4 or 5 grams of protein.

The 7 grams of permitted daytime protein enable the dieter to eat a serving of cereal with breakfast, such as a cup of corn flakes or puffed wheat or three quarters of a cup of bran flakes or rice squares, containing about 2 grams of protein. (Cereal boxes can be checked; they usually show grams of protein per 1 ounce portion of cereal.) Cereal can be eaten with nondairy liquid creamer or apple juice, but not with milk. The daytime protein allowance also permits the dieter to take three quarters of a cup of cooked vegetables or white rice with lunch (containing about grams of protein). Of course, the dieter may not eat any meat, fish, egg white, milk, cheese, or other milk products for breakfast or lunch.

With such a list of restrictions, what can the dieter eat for breakfast? Actually, breakfast is fairly easy. A glass of fruit juice, an orange, or half a grapefruit can be followed by a portion of cereal (described earlier) in nondairy liquid creamer or apple juice and

served with raisins, half a banana, or other fruit, and a cup of coffee or tea. For variety, half of an English muffin with butter and jam or a cup of popped corn (prepared with oil, butter, or margarine) could be substituted for the cereal. Other substitutes for cereal might include a slice of buttered toast or matzo, a small plain muffin with jelly, or a small doughnut. (To aid those of you who are not familiar with the U.S. system of measurement, here are the metric equivalents of American measurements used in the recipes in this chapter: 1 cup [8 fluid ounces] is approximately one fourth of a liter; 1 fluid ounce is approximately 30 milliliters; 1 solid ounce is approximately 30 grams; 1 teaspoon is approximately 5 milliliters; 1 tablespoon is approximately 15 milliliters.

Some critics have said that I get such good results because I only accept patients who believe in my concepts. But I can only work with patients who are reasonably receptive to the idea that their emotions are responsible for their pain. Even so, most of my patients are still skeptical when I first see them. It is my job to convince them of the logic of the diagnosis, because only by acknowledging the role of emotions can we get the brain to stop doing what it is doing. That is not believing?it is learning.

Would a surgeon operate on a patient who was not a good surgical risk? Should I be less selective than a surgeon? Another common criticism by my peers, since we are talking about critics, is that I go too far in claiming that the majority of pain syndromes of the neck, shoulders and back are due to TMS. ?He may be right in 30 percent to 40 percent of the cases,? they say.

If 30 percent to 40 percent of back pain patients have TMS, why then do these critics never make the diagnosis themselves? The sad fact is that they cannot because it means repudiating long held diagnostic biases and acknowledging the role of the emotions in these pain syndromes?something for which they have a ?visceral incapacity,? to borrow a phrase from Senator Byrd of West Virginia.