I remember watching Cinderella as a young girl and dreaming about the day that I would find my own true love. After all, who wouldn’t want a prince to save them from the mundane tasks of everyday life? But it turns out that those Disney movies, and the relationship expectations they created for future relationships, held me back from establishing healthy relationships early on. I expected that relationships would be easy and that they would fulfill me. But to have a healthy relationship takes time and commitment. Below are the most common relationship expectations that hold us back from having a healthy relationship.

Love Should Be a Fairy Tale

In the beginning of a relationship, it’s common to mistake the feelings of excitement and attraction for someone as love. But love is not a fairy tale in which things “just work out.” Each relationship has hurdles to overcome which take communication, trust, and vulnerability.

With The Right Person, The Relationship Will Be Easy

All relationships take work! Even with the right partner, relationships can be difficult, and differences of opinion are sure to arise. It is important that we communicate with each other and try to understand each other’s point of view. Even with the right person, it takes communication, commitment, and understanding to make a relationship succeed.

My Partner Should Always Make Me Happy

It’s important to feel happiness in our relationships, however your happiness should not be dependent on your partner. Each person in a relationship is responsible for their own happiness. When we expect that someone else will make us happy, this often leads to disappointment.

Sex Is The Most Important Part of a Relationship

While sex is an important part of intimacy in a relationship, it is not the only part. Emotional intimacy is equally important in a relationship. It is important that we discuss physical and emotional expectations with our partners to ensure satisfaction in our relationship.

If Someone Loves You, They Won’t be Attracted to Anyone Else

Humans are biologically wired to find others attractive. This does not end because we enter a relationship with someone. Even when our partner finds someone else attractive, it does not change the way they feel for us.

Jealousy is a Sign of Love

It is common to feel jealousy in a relationship from time to time. But overwhelming feelings of jealousy and the extreme behaviors that can accompany it (i.e., overwhelming questions, invading privacy, and controlling behavior) are a sign of a partner’s insecurity about themselves. 

Please note: Irrational jealousy is either pathological, meaning related to a perceptual, biological, or mental health related diagnosis such as borderline or narcissistic personality disorder. If you suspect that your partner has irrational and pathological jealousy, you should exercise caution as some people have even escalated to highly aggressive and dangerous level of anger over jealousy.

If you or a loved one is experiencing abuse, reach out to a therapist near you.

Love Conquers All

Love does not conquer all. There will always be differences of opinion and issues that arise, and assuming that love will fix these problems only leads to disappointment and resentment. To conquer all, a couple must have trust, respect, understanding, and healthy communication with each other. 

Written by Rayeann Milne, Counseling Intern. If you’d like to schedule an appointment with Rayeann, please call us at 412-322-2129.

Reference: 

LePera, N. (2022, December 24). 7 Expectations that hold you back from a healthy relationship. News

https://www.news18.com/news/lifestyle/7-expectations-that-hold-you-back-from-a-healthy-relationship-6683707.html.

Deciding to begin therapy is never an afterthought. Therapy requires a significant level of vulnerability. Add in the worry over choosing which therapist is the right one for you, makes the decision even more impactful. Imagine you’re reading a therapist bio on a therapy website and you see the word intern listed alongside a description of a provider. What would you think? Here’s why selecting a Counseling Intern could be the right choice for you:

Counseling Interns Are Always Learning

As interns work to complete their Master’s degree, they are active in receiving education on various techniques and theories for treatment. Interns are constantly researching the best forms of treatment for their unique and specific client needs.

Interns work alongside their educators, facilities, supervisors, and coworkers to hone their skills in providing superior client care. Interns are well informed in current treatment strategies and theories. Interns spend the majority of their time learning how to harness their understanding in theoretical work to be effective counselors for all possible client situations.

Counseling Interns are Fresh Faced

Although counseling interns have less client-facing experience than licensed therapists, they are filled with up-to-date research. With interns experiencing things for the first time, there is less room for comparison to prior cases. Interns are energized by treating their clients in comparison to being burnt out from experience. Interns are willing to apply all information learned to provide consistent and complete mental health care for their clients. The energy exuded from interns is often contagious and creates an open therapeutic relationship.

Counseling Interns Receive Close Supervision With Their Case Load

With the understanding that interns are in the process of attaining a Master’s degree, they often have at minimum one supervisor at the therapy practice. Most educational programs require student interns to receive supervision through the university in addition to site supervision. This system allows for fully licensed, credentialed, and experienced counselors to assist interns with effective therapy.

Interns review and consult with their supervisors on all cases, providing thorough assessment. Essentially, having an intern is like having two counselors strive to provide the best form of treatment for you! Interns are more receptive to feedback and open to adaptation. Feedback and openness allow for interns to become the best form of professional that they strive to be.

Counseling Interns Are Less Expensive And More Available

Due to their student status, interns are not fully licensed. At an intern level, mental health providers cannot accept insurance so interns accept self-pay clientele. Mental Health Practices have a sliding fee scale or reduced cost for interns. Thus, interns can offer financial relief at a budget friendly cost.

As interns build their clientele, they often have more room for clients than established professionals. There is no need to wait for treatment when there is an available option for you. Managing fewer clients allows interns to be more focused to your case and your needs. Interns have more time to prepare and plan between sessions, making sure that your time is well spent.

Counseling Interns Are Limitless

With today’s challenging academic nature, modern interns are well informed, well educated, and willing to do the hard work.

Interns are also:

• Always looking for the best avenue to help their clients find comfortability in life.
• Willing to ask hard questions, attempt new routes, and work with multiple professionals to provide critical care.
• Free of misconceptions nor do they feel run down from constant repetition.
• Advocating for the needs, wants, and representations of people in everyday life. Their passion is limitless and their care is expansive.

Written by Edisa Music, Counseling Intern. If you’d like to schedule an appointment with Edisa, please call us at 412-322-2129.

Ah, the New Year! A clean slate, a fresh start, a new beginning—365 days of possibilities. Are you one of those folks who sets a slew of New Year’s Resolutions, including losing weight, only to find yourself unable to live up to those very high expectations?

Back when I taught fitness classes at various gyms, my classes would be PACKED in January with those dewy-eyed resolutioners who were determined to make a plethora of changes in a very short time. By the end of February, my classes would be back to regular sizes with my tried and true students who were glad things were getting back to normal.

As a Health Coach, I am not a fan of the grandiose expectations attached to the start of a new year. And here is why—we are programmed to revert to our existing habits when life starts to get busy, complicated, or difficult. Instead, I would encourage you as I encourage my clients, to take small, actionable steps that will eventually lead you to create new and healthier habits.

Take a marathon runner for example, they don’t wake up and decide to run 26 miles the first day. Instead, they slowly build up their body’s ability to handle both the physical and the mental aspect of running for an extended period of time. This is the beauty of challenging yourself to take baby steps toward your health and life goals. Just like a house needs a solid foundation to build upon, so does your health.

Let’s be honest, most people can lose weight fairly easily. Fad diets are popular because they are relatively successful in the weight loss aspect! But when you take a deeper look at some of the most popular ones at the moment such as Keto, Paleo, or Intermittent Fasting, you’ll find the issues lie within the principles of the plan.

Take Keto, where at the beginning of the plan you may experience flu-like symptoms as your body starts to adjust to the extreme changes to your diet. Or intermittent fasting where there are basically no parameters to what you eat, only when you can eat.

When attempting these diets, ask yourself these two questions, 1. Can I sustain this for the rest of my life? and 2. What am I learning? This isn’t to say that folks don’t have success on these plans, but it is something to consider when thinking through what you are willing to sacrifice on your journey to lifelong health. If I am being honest with myself, I could never commit to a plan where I will never eat Christmas cookies or birthday cake again. And Keto fat bomb versions of these are not something I am willing to substitute.

This is the beauty of working with a health coach, I am the voice of reason in the swirling vortex that is the health and wellness industry. And I will hold you accountable for the choices you are making while encouraging you along your path to whole health.

Written by Lori Misitis, Certified Heath Coach. If you’d like to talk to Lori, to see if coaching may be right for you, book a free 15 minute discovery call.

Setting Couples New Year’s Resolutions is a great way to create a stronger connection, reinforce your bond, and set expectations for the future. Having shared goals can help you both stick to your promises—the more effort you two put in, the stronger the relationship. If you’re looking for some goals to work toward with your partner, this list of 6 Relationship Resolutions for 2023 is the perfect place to start.

1.  Make a conflict management plan: this will allow you both to have your unique emotional constitutions respected, as well as forming a plan for how to manage healthy conflict in your relationship. A plan for conflict implies that disagreements are not inherently a problem but aims at tackling issues in the relationship that can cause small issues to become much bigger. It also brings awareness about how emotions play into your disagreements and what to do so that there is a smaller likelihood that trigger topics spiral out of control.

2. Make a vision board for your relationship and what you want in the next month, 6 months, 1 year, 2 years and 5 years! Once you’re done, put your vision board in a place you’ll see often because when you see something that inspires you on a daily basis, you stay on track. You can even take a picture of it and use it as your phone wallpaper.

3. Create an environment of appreciation between yourself and your partner. Catch your partner doing three things a week that you are grateful for. Share this with each other at the end of each week. 

4. It is commonplace to be consumed by work, children, and finances that we literally forget how important it is to carve out quality time with our partners. Schedule date nights every other month. Pick the day (time and place can come later). Having a planned date is a great way to maintain a sense of adventure and fun in your relationship—it ensures time to build emotional intimacy and check in with each other.

5. Make rituals that honor your birthday, anniversary, holidays, and other landmark events through time. Celebrating the passage of time is a key component of how relationship masters keep their relationship well.

6. Choose compassion over being right. So many relationships suffer because our egos become gridlocked in the pattern of trying to be correct instead of being understanding and loving towards our partners and loved ones! Keep this in mind and always remember it is our kindness and care which nurtures those that surround us!

Written by Marriage Counselor and Founder of the Counseling and Wellness Center of Pittsburgh, Stephanie Wijkstrom.

Interested in Couples Counseling?

Fill out the form below or contact us at 412-322-2129.

What is Trauma?

When you hear the word trauma or trauma counseling what comes to mind? It is common for people to hear the word trauma and think of those one-time catastrophic events (car accidents, assault, robbery, natural disasters, etc.) that result in major injuries like broken bones, head injuries, or lacerations, and symptoms of post traumatic stress disorder such as flashbacks, nightmares, hypervigilance, increased startle response, etc. This perception of trauma causes people to minimize their suffering and postpone receiving treatment that helps them heal and increase their quality of life.

So, what is trauma, and who experiences it? Trauma is anything that overwhelms the mind and body and happens too fast, too soon, or too much. It causes physiological, neurological, chemical, and hormonal changes that impact memory and cognition; often resulting in:

• Emotional dysregulation
• Hypervigilance
• Lack of trust in yourself, others, and the world
• Mental health illness
• Chronic pain
• Inflammatory disease

What Types of Trauma Are There?

“Big T” traumas, like those catastrophic events listed above, are the most obvious and lead people to seek treatment to help them learn to cope and move past the event. “Little t” traumas are the things we experienced regularly throughout our lives that we may have been conditioned to accept as part of life or growing up. Some of these experiences may include:

• Being bullied
• Witnessing violence
• Lack of constant care during childhood
• Lack of emotional validation
• Having a caregiver who struggled with mental illness and/or substance use
• Incarceration or having a loved one who was incarcerated
• Experiencing discrimination due to race, gender, age, socioeconomic status, or religious affiliation
• Lack of autonomy
• Lack of affection
• Being isolated, yelled at, or controlled by others

This does not mean that everyone who has experienced these things is traumatized. Traumatization is dependent on several biological and environmental factors that influence perception and physiological regulation.

What Kinds of Trauma Counseling Can Help?

What kind of help is there? Trauma is a multifaceted and complex phenomenon that traps itself in the body and the brain keeping you in survival mode at a physiological level. Trauma treatment is an evidence-based technique that walks you through specific stages of treatment to ensure a felt-sense of safety, agency, and autonomy, empowering the client to take control of their lives leaving the past in the past. Certified trauma specialists and professionals can help unlock the trauma trapped in your brain, muscles, nervous system, and adrenal/endocrine system so that you can feel safe in your body and the world. Some of the effective treatments include but are not limited to:

EMDR (Eye Movement Desensitization and Reprocessing) targets upsetting life experiences that have not been stored properly in memory areas of the brain and are triggered more easily by similar events or negative personal beliefs. Unprocessed or blocked traumatic memories need help from therapies such as EMDR to become processed or unblocked.

IFS (Internal Family Systems) is an approach to psychotherapy that identifies and addresses multiple sub-personalities or families within each person’s mental system. 

Sensorimotor psychotherapy (SP) integrates the body and movement into traditional talk therapy to address and heal ongoing psychological and physical difficulties.

Narrative Exposure Therapy: With the guidance of the therapist, a patient establishes a chronological narrative of their life, concentrating mainly on their traumatic experiences, but also incorporating some positive events. It is believed that this contextualizes the network of cognitive, affective and sensory memories of a patient’s trauma. By expressing the narrative, the patient fills in details of fragmentary memories and develops a coherent autobiographical story. In so doing, the memory of a traumatic episode is refined and understood.

Cognitive Processing Therapy (CPT) is a short term evidence-based treatment for PTSD and other related disorders. CPT is based in cognitive theory and helps individuals to recognize the impact that the traumatic event has had on their thoughts and beliefs, feelings and behaviors.

How Do I Know if I Should Seek Trauma Therapy?

If you experience any of the following it may be beneficial for you to see a professional who can help you sort through your experiences and move forward in life:

• You are easily startled
• Flashbacks or nightmares of the event
• Feeling afraid but not knowing why
• A generalized distrust in yourself, others, and the world
• Hypervigilance
• You notice a pattern of unhealthy relationships throughout your life
• Feelings of restment
• Unmanaged anger
• Avoidance of certain people, places, or things
• Unexplainable body aches and pains
• Chronic pain, inflammation, or fatigue
• Easily triggered
• Persistent feelings of sadness 

If you are experiencing any of these symptoms, reaching out to a professional can help you determine if trauma therapy is right for you.

Written by Autumn Walsh, MSW. Autumn is accepting patients at our Pittsburgh location as well as online.

Interested in Starting Trauma Therapy?

Fill out the form below or contact us at 412-322-2129 to begin trauma counseling.

References:
Centers for Disease Control and Prevention. (2020, September 17). Infographic: 6 guiding principles to a trauma-informed approach. https://www.cdc.gov/cpr/infographics/6_principles_trauma_info.htm
Levine, P. A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. North Atlantic Books.
American Psychological Association (2017, July 31). https://www.apa.org/ptsd-guideline/treatments/narrative-exposure-therapy
Psychology Today (2022, May 20). https://www.psychologytoday.com/us/therapy-types/internal-family-systems-therapy
Bartella, A. (2011, October). Sensorimotor psychotherapy: A somatic path to treat trauma. The Trauma & Mental Health Report. Retrieved from https://trauma.blog.yorku.ca/2011/10/sensorimotor-psychotherapy-a-somatic-path-to-trauma-treatment/

In more recent years, studies have been emerging that focus on the possible connection between gut health and mental health disorders, including anxiety and depression. The microbiome makes up all microorganisms in the human body. The microbiota encompasses all the microorganisms in a particular location, such as the GI tract. These together are developed while in the womb. During this time, early nutrition can play a role in shaping the developing gut microbiota. This helps with the development of various healthy bacteria.

The Science Behind Gut Health and Mental Health

As solid foods are introduced to infants, the microbiome is exposed to many different energy substrates, creating and developing our metabolism along with new variations of bacteria that make up the gut. It is difficult to determine what a normal microbiome consists of given the environmental, seasonal, and health status of an individual. Although, what we eat can determine what type of bacteria are predominantly present. This can also be directly linked to inflammation of the GI tract, placing stress on the microbiome. This can result in the release of cytokines and neurotransmitters. Elevated blood levels of these pro-inflammatory markers increase the permeability of the blood-brain barrier. Their release influences brain function, leading to anxiety and depression.

Pro-inflammatory cytokines are also important stimulators of the hypothalamic-pituitary-adrenal axis (HPA). The hypothalamus releases various hormones, one in which stimulates the adrenal release of cortisol, a known stress hormone. Cortisol stimulates a pro-inflammatory response, leading to a dysregulation of the HPA axis, resulting in symptoms of depression and anxiety.

When the human microbiome is challenged with dietary changes, coupled by stress, or maybe a course of antibiotics, the physiology of the normal microbiome changes. When there is a loss of beneficial bacteria, this can trigger a pro-inflammatory response and weaken the intestine. This can lead to increased intestinal permeability and allow bacteria to leak through, leading to detrimental effects on our bodies, which can be demonstrated in diseases such as irritable bowel syndrome (IBS), and mental health disorders such as anxiety and depression.

Probiotics, living microorganisms of yeast and bacteria, have been utilized as supplements for aiding in reducing symptoms of anxiety and depression. Primarily, they have been studied in the suppression of cytokines, noting improved intestinal barrier integrity. This promotes a decrease in inflammatory response. As a result, adding a probiotic to your daily regimen could help reduce pro-inflammatory hormones, especially in individuals suffering from chronic inflammation.

Although, there is no FDA regulation pertaining specifically to probiotics, and ultimately, no dosage recommendations. Until more research behind the use of probiotics as therapy for anxiety and depressive disorders is available, probiotics cannot be considered a reliable treatment method as compared to psychiatric medications.

Anti-Inflammatory Foods

When it comes to diet, various components in food can help reduce inflammation. Consider foods that are high in fiber, omega-3s found in fish, oils, and leafy greens, polyphenols (plant chemicals) found in fruits such as berries, and unsaturated fats found in almonds and flaxseeds. All of these foods can be incorporated into your daily diet to help reduce inflammation and promote a healthy gut and microbiota!

1. Yogurt: containing live bacteria cultures, yogurt can help support a healthy gut by keeping the microbiome healthy. The probiotics in yogurt can help reduce inflammation and symptoms of bloating, gas, constipation or diarrhea. Many yogurt varieties contain added sugar, so look for plain options and add your own flavoring with fruit, nuts, and seeds to avoid excess sugar intake.
2. Fermented foods like Kombucha, kimchi, sauerkraut, kefir and miso are rich in probiotics. The good bacteria grow during the fermentation process. Add fermented foods to your diet for a healthy dose of probiotics.
3. Dark Green Leafy Vegetables: Packed full of vitamins like A, K and magnesium, dark green leafy vegetables, such as spinach, kale, bok choy, mustard greens, and collards, are crucial for brain function and gut health. Swiss chard is a great example of a food that is loaded with fiber, feeding the healthy bacteria in your gut, preventing inflammation.
4. Omega-3s: Omega-3 fatty acids also support brain health. Fatty fish such as salmon and tuna, are great sources of omega-3 fatty acids. Foods containing fatty acids can help reduce inflammation, and support healthy digestion. This can help you feel less bloated and sluggish.
5. Healthy Grains: Whole grain foods, such as oatmeal and bulgar wheat, are high in fiber, which plays an important role in stabilizing blood sugar levels. This helps restore a potential imbalance to the gut that can happen when blood sugar levels are challenged. Most whole grain products contain beneficial prebiotics that help increase healthy bacteria in the gut microbiome.
6. Berries: Berries are rich in antioxidants, which can help keep your gut healthy by reducing inflammation. They are also a great source of prebiotics, which promotes healthy gut motility. One of the highest vitamin C foods, which can improve the gut barrier and enhance nutrient absorption.

This article was written by our Registered Dietitian, Kali Alrutz

Get Started with Gut Health Nutrition Counseling

Call us at 412-322-2129 or fill out the form below to get started with Nutrition Counseling. Nutrition Counseling is covered by Insurance.

Sexual intimacy plays an important role in our lives. The benefits of a healthy sex life have been linked to stress reduction, improved sleep, immune health, pain reduction, increased self-esteem, and increased closeness to a sexual partner; all-important aspects in living our happiest best lives! Sounds easy enough, have sex and be happy, right? Unfortunately for many, it is not that easy! Myths and misconceptions surrounding sexual intimacy have caused great personal and interpersonal suffering among us for hundreds of years; while stigma, shame, and socialization have created barriers to seeking professional guidance. This detrimental cycle can repeat itself causing conflict in relationships, increased stress, resentment, shame, mental health illness, and poor self-esteem in those who wish for sexual connection with others. Sex therapy can help.

What is Sex Therapy and How Can It Help?

But what is sex therapy and how can it help? Sex therapy provides a compassionate safe space to explore and address medical, psychological, personal, interpersonal, and systemic factors impacting sexual satisfaction. It is a type of talk therapy that helps individuals and/or couples move past physical and psychological challenges and develop fulfilling and pleasurable sexual relationships. Sex therapy addresses your beliefs, experiences, feelings, and concerns using evidence-based techniques in collaboration with the client to help you reach your goals and decrease stress. Some of the sexual concerns addressed in sex therapy include erectile dysfunction, premature ejaculation, delayed ejaculation, paraphilias, desire/interest/arousal concerns, and pelvic pain disorders. Sex and porn addiction are other concerns often addressed by sex therapists. Sexual preferences, kink, and poly communities and those with ‘non-traditional’ relationships can find a safe space to share with sex-positive, compassionate and accepting practitioners. 

While disagreements about sex are common and normal phenomena, the following may indicate the need to seek professional help from a sex therapist:

• Escalating and recurring conflicts about sexual frequency or preferences. 
• Feelings of not being a priority to your partner. 
• Distress, or a decrease in the quality of your life and relationship due to your sexual concerns or dysfunction. 
• If you are experiencing a lack of communication, arguments that seem to go in circles, and a loss of connection with your partner. 
• Feelings of guilt and shame surrounding sexual preferences or activity. 
• Performance anxiety.

Tips to decrease sexual anxiety: 

• Make an appointment with your PCP to discuss possible physiological causes. Also, talk to your doctor about any medications you are currently taking and possible side effects that may impact sexual function.
• Be open with your partner. Having an open honest conversation with your partner can help decrease anxiety and increase support and connection. 
• Learn to be intimate without sexual intercourse. Give and receive sensual massages, warm baths together, and cuddling without the expectation of intercourse can help reduce anxiety and build connection.
• Progressive muscle relaxation and mindful meditation can help relax the body and mind.
• A sex therapist can help you learn the differences between male and female sexual responses which can help greatly reduce anxiety.
• Most importantly, practice self-compassion. Don’t beat yourself up!  NO ONE has the sexual prowess being pushed by the media and in porn, and these expectations are unrealistic! 

Interested in Sex Therapy?

If you are interested in Sex Therapy, please fill out the form below or call us at 412-322-2129.

Written by: Autumn Walsh (she/her), MSW

References: 

Center for Women’s Health. (2021). Center for Women’s Health. OHSU. https://www.ohsu.edu/womens-health/benefits-healthy-sex-life#:~:text=Better%20immune%20system,Decreased%20depression%20and%20anxiety 

Hertlein, K. M., Gambescia, N., & Weeks, G. R. (2020). Systemic sex therapy. Routledge. 

Holland, K. (2018, June 27). Sex therapy: Couples, techniques, and what does a sex therapist do? Healthline. https://www.healthline.com/health/sex-therapy#how-to-know-if-youneed-it 

Stritof, S. (2022). How important is sex in a relationship? Verywell Mind. https://www.verywellmind.com/why-should-you-have-sex-more-often-2300937#:~:text=Sex%20can%20have%20a%20variety,immunity%2C%20and%20better%20cardiac%20health.

If you have recently answered ‘yes’ to a marriage proposal, then along with the rush of planning your version of the perfect wedding you also may also be considering whether you should be going to premarital counseling. Premarital counseling is a form of couples therapy that emphasizes wellness. Our counselors have put together a list of questions to ask before marriage to determine if it makes the wellness grade for relationship health, this will help you and your partner to understand some parts of your relationship in a deeper way.

Don’t be afraid to feel a little uncomfortable, these are questions for couples that you wouldn’t normally think about but that also is what makes them especially powerful— to assess the strengths and various qualities of your unique partnership. This does not replace premarital counseling but it does help you each to examine your relationship in a mindful and healthy way.

Questions to Ask Before Marriage

1. Why do you want to get married?
2. What roles do you see for yourself in your marriage?
3. What do you imagine might be your biggest challenge in being married?
4. What makes your relationship unique?
5. How do your friends and family view your relationship with your partner?
6. What is your idea of the perfect wedding?
7. Are there others who are close to you who have different ideas for how your wedding should go?
8. How do you each talk about your thoughts and needs?
9. How do you manage conflict?
10. What are each of your conflict resolutions styles?
11. What has been a challenge for your conflict resolution?
12. How you repair conflict?
13. When you feel stress how can you partner help you?
14. How would you describe your communication style?
15. Is it generally easy for you to talk about your needs?
16. Do you find you over communicate your needs?
17. Do you have an attacking communication style?
18. Do you become very emotional when you communicate?
19. How similar or different are each of your sexual libidos?
20. Describe the amount of foreplay that you have with your partner on average?
21. Do you feel able to initiate lovemaking?
22. Do you feel able to decline sex with your partner?
23. Are you able to orgasm?
24. Do you have sex that is non-penetrative?
25. What are some of your financial concerns about your future together?
26. What is your ritual around managing the finances?
27. How do you handle household maintenance like cooking and cleaning?
28. Do you plan to have children together?
29. What trait do you most admire in your partner?
30. What is one mutual goal between the two of you?
31. What do you see yourselves doing in 10 years?
32. What do you see yourselves doing in 20 years?

With the help of questions like these, you and your partner can begin the lifelong process of deepening your understanding of yourselves and each other, keeping in mind, your answers to these questions will likely change over time. That is normal and to keep your marriage healthy, you should continually check in with each other and have hard conversations about things that matter to you. Wellness means that we manage and care for ourselves and our relationships in a way that keeps them strong and happy and that we strategically plan for success by growing our relationship to be stronger. Great marriages are created intentionally by addressing individual and relationship needs, prioritizing connection, listening and compromising.  None of which are easy, but all of which are well worth it to live happily, in love, for the rest of your life.

Interested in Premarital Counseling?

If you’re interested in pre-marital counseling or couples therapy please contact us at 412-322-2129 or fill out the form below.

If you’re here, congratulations on taking the first step and beginning therapy! Deciding to go to therapy is a major step in overcoming issues like anxiety or depression, healing trauma, getting support to cope with difficult life transitions, managing stress or working on developing healthier relationships. We asked the therapists at the Counseling and Wellness Center of Pittsburgh to share their suggestions for how to get the most out of therapy.

1. Be consistent with your appointments. When we go to physical therapy after an injury, it is only by being consistent in our treatment that we get better in a timely way. Mental Health Therapy is the same.
2. Have an accurate perspective on the role your counselor has. They are a facilitator, helping you identify goals, steps for reaching these goals, and barriers that may get in the way. The therapist is not there to ‘fix’ you, the work is on your part.
3. Timing is important and change happens over time. We may not be ready to address every concern or goal at the same time. As long as we keep working on what is important at the time, we are making progress and moving forward. To get an accurate perspective on your growth, don’t just look ahead at where you are not, look back at where you were and how far you’ve come.
4. Put in the work. The therapy hour is once per week. While therapy offers skills, opportunities for discovery and ways to challenge your thought patterns and beliefs, it works best when these tools are applied outside of the therapy office and in between sessions.
5. Keep a therapy journal to take notes during your therapy session as well as notes throughout the week to be addressed during your next session. This helps keep treatment productive and makes sure that clients are reminded of things important from their sessions during the week.
6. Therapy is about change. Be eager for change in your life. Be willing to challenge yourself.
7. Don’t give up if you don’t see results right away. Therapy is a process, and mental health is an ongoing journey.

Ready to Get Started With Therapy?

Call 412-322-2129 to get scheduled with a therapist or fill out the form below.

Cover Photo by Leah Kelley

Journal Photo by Alina Vilchenko

White Woman in Van in Nature Photo and Bike Photo by Alex Azabache

Black Woman Working at Desk Photo by Anna Krasnikova

Every good parent knows that providing an enriching environment lays the foundation for future success. Or does it? From summer camp, to instrument lessons, and afterschool programs, how many extracurricular activities are too many and where do parents’ good intentions bleed into something less helpful and even have the unintentional consequence of creating a stressful and anxiety ridden environment for children?

Warning Signs Your Child Is Involved in Too Many Extracurricular Activities

1. Listen to your kids and teach your kids to listen to themselves, helping your child to understand and respond to their emotional cues might be more impactful for their future wellbeing than mastering their tennis swing or perfecting their smooth violin strokes.
2. Does your child have a lot of tummy aches, headaches, or have excuses when it is time to practice? According to the Centers for Disease Control, these things can be related to Anxiety. If you notice these patterns in your child, it might be time to have a discussion with your child about whether they want to continue to participate in this activity. any longer or a different variation that doesn’t stress outcome or skill.
3. Does the child have time to just be? Just be means having free time that is not structured. Overscheduled children also have overscheduled families, this a form of performance based obsessiveness being passed between generations. Does your child have time to themselves everyday? Do you have time together to be a family? Eat meals together? Have conversations or are your moments spent shuffling from one activity to another, eating in the car then heading to bed when you’re home?
4. Has your child verbalized that they don’t want to participate in a certain activity? Has this been a source of conflict between you? Many parents who want what’s best for their child insist that they should stick it out and encourage them to continue with the sport, activity, or instrument. The fine art of parenting is to know what is healthy stick-to-itiveness versus what is pushing past a child’s boundaries or neglecting their emotional needs.

What Parents Can Do When Extracurricular Activities Cause Your Child Anxiety?

1. Free play as opposed to goal oriented play activities. While goal oriented activities can help a child develop certain skills, when those skills are scrutinized by parents, coaches or teachers, it can lead to self esteem issues, stress, and anxiety. This is especially true around the age of 12 when kids start to compare themselves to their peers in the formation of identity and self concept.
2. Children should not have activities everyday or the week. Many people agree 3 is a maximum, if they want to add one activity then ensure that they drop one.
3. If you are going to be organized around a schedule, ensure that the schedule includes, downtime, family time (at least 20 minutes everyday) to play a game, sit and talk, draw or paint together.
4. When you are enjoying downtime, don’t make it another journey to a destination, don’t ask what they need to do today or tomorrow and pull your children back into planning and coordinating, instead, ask creative questions. Ie. If you were any animal which would you be? What do you think will make you happy in 5 years? Who is your favorite friend right now? What do you dream about at night?

Good behavior starts from the top down. Let your kids see you practicing the art of doing nothing and enjoying it!

Written by: Stephanie Wijkstrom, MS, LPC Founder of Counseling and Wellness Center of Pittsburgh

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News Feature: Signs Your Child Is Involved in Too Many Extracurricular Activities