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

Interested in Family Counseling or Child Therapy?

Call 412-322-2129 to get started or fill out the form below.

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

In more recent years, society has progressed towards a body positive mindset, inclusivity and loving your body at any size. In turn, the question surrounding food and nutrition is transitioning to “what can my body do,” instead of a detrimental focus on the number on a scale. With this shift, the focus on nutrition and a weight management mindset of restriction is also changing.

Read on for 4 Dietitian-Recommended Ways to Help You Achieve Body Positive Weight Management:

1. Utilize other measures of success. For those individuals above a healthy weight, losing weight can improve overall health, reduce risk of certain chronic diseases, and lengthen lifespan. While weight loss is a good thing for most individuals, abandoning body positivity in the process can only hinder your self-esteem and motivation. Utilizing other measures of success, such as energy levels, mindfulness and awareness, and sleep quality, can all provide a positive outlook on the journey to being the best version of yourself.
2. Focus on how foods can benefit your body. Allowing one-self to shift and focus on a more positive mindset surrounding how foods can benefit your body by providing energy, satiety, fullness, and completeness can help increase overall self-awareness. This means a focus on whole, complete foods that can create well-rounded meals. For example, think of lean proteins for satiety, high fibrous foods for fullness, and bright colored vegetables that are a good source of both fiber and vitamins/minerals. Think “how can I make my meals better?” Utilizing the foods and meals that you enjoy, think how they can be enhanced with flavorful, nutrient-dense foods that add satiety and fullness, and help your body and mind feel better.
3. Honor your hunger and fullness cues. Utilizing fullness sensations and hunger cues to guide eating versus the mindset of restriction can also help create a positive mindset. By focusing on “how do these foods make me feel,” this will help to create an emphasis on what my body can do versus the need to restrict certain foods. It can also help reduce stress eating. Prolonged stress increases cortisol levels in the body. Elevated cortisol levels can lead your body to deposit fat in the midsection. This increase in fat in the belly is shown to increase risk of type 2 diabetes and heart disease. Cortisol can also enhance cravings for high-fat and high-sugar foods by making them taste better. Practicing stress-reducing techniques, such as deep breathing, meditation, or simply allowing yourself to sit in a quiet space, can all help to calm our bodies down and reduce those cortisol levels.
4. Identify stressors to help reduce negative thoughts and improve mental health. Reducing stress, and viewing foods as beneficial additions to help your body be the best it can be for you, can improve your overall mental and physical health. Body positivity is about eating well, creating movement that you can do, and being honest about your needs in the moment.

This article was written by our Registered Dietitian, Kali Alrutz

Get Started with Body Positive Weight Management and 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.

National Recovery month is observed in September every year. It gives us the opportunity to celebrate Sober life, break down stigmas and bring awareness to addiction. The month serves as a celebration of the steps taking to improve access, information, and treatment. You can observe National Sober Month by spending it Sober. While that may seem simple enough, it may come as a challenge to some. We’re here to help! Read on for 8 Sober Activities to Do in Pittsburgh.

1. Visit a Museum. Pittsburgh has so many great museums. Visit the Heinz History Center, Phipps Conservatory & Botanical Gardens, the Carnegie Science Center, the Carnegie Museum of Natural History, the National Aviary, or the Andy Warhol Museum.
2. Physical activity. Physical activity is a great Sober activity. Get outside and enjoy a bike ride. Or if you prefer the indoors, climb the wall at Lawrenceville’s climbing gym, Iron City Boulders.
3. Enjoy the Scenery. If physical exercise isn’t your bag, but you want to enjoy the outdoors, take the Duquesne Incline up to Mount Washington and take in the views. You can capture amazing photos of the skyline, simply enjoy the view or if you’re artisticly-inclined, paint the city.
4. Bubble Tea with a Friend. Spending time with a friend is a great way to celebrate National Recovery Month. Hit up a local coffee shop, juice bar or bubble tea shop. Our favorites are: Adda for coffee; Live Fresh for juice & smoothies; and Kung Fu Tea in Squirrel Hill for bubble tea.
5. Make a Fall-Inspired Mocktail.
   Sparkling Apple Cider
   Ingredients
   2 cups apple cider
   1 cup seltzer
   fresh whole cranberries (optional)
   fresh apple slices (optional)Instructions
   Mix together the apple cider and seltzer.
   Garnish with fresh cranberries and/or fresh apple slices.
6. Spend Time with Animals. Time spent with animals is never wasted. Luckily, Pittsburgh has some great options for hanging out with our feline friends. Book an appointment at Garfield’s Black Cat Market , Edgewood’s Rescue and Relax, Pittsburgh’s Kitty Queen Cat Rescue or Wexford’s Cats N’At where you can cuddle up with adoptable kitties.
7. Pranayama. Sitali Pranayama, known as “the cooling breath,” can help calm your nervous system. Here’s how to practice:
   Curl your tongue and extend it just past the lips.
   Inhale through the tunnel of the tongue as if drinking through a straw.
   Release the tongue, close the mouth and exhale out through the nose.
   Practice for 2-5 minutes.You can still practice if you can’t curl your tongue. Just stick it out!
8. Pickleball. Pickleball is one of the fastest growing sports in the country! A racquet sport combining elements of tennis, badminton and table tennis. Lots of fun and a great workout for everyone! Check out the City of Pittsburgh Pickleball schedule. Or find one at the Global Pickleball Network.

Photo by Joan Azeka

Fall is here and our senses look toward Autumn: nutmeg & cinnamon, pumpkin patches, warm coffee, light jackets, and gorgeous sunsets. There’s nothing like evenings in the Fall. It’s just cool enough during the day that cozying up with a warm tea is the perfect medicine to wind down. Here’s a list of some of our favorite fall drinks to warm you up, boost your immune system, and help you find relaxation in this beautiful season of transition.

1. Cacao. We all know of Cacao from our favorite chocolate bars and desserts. But in its unprocessed form, Cacao is a highly medicinal and heart opening plant medicine with a rich history of ceremony and ritual. Cacao is full of antioxidants, supports heart and circulatory health, and has antidepressant properties. Prepared with just some hot water or milk, Cacao creates a rich, warming, and stimulating beverage. This drink is lovely in the company of others – be it a sweetheart or loved ones around a campfire, or in a simple ceremony on your own. Please note – Cacao does contain caffeine and can be quite stimulating. Please purchase raw Cacao or ceremonial grade Cacao from an ethical and sustainable source. Cacao Infusion
   2 C Water
   2 TBSP Raw or Ceremonial Cacao
   Sweetener of choice
   Optional: Cinnamon, Cayenne, Vanilla Extract, MilkHeat water in a pot until just before boiling. Turn off heat and add Cacao and sweetener and spices of choice. Stir until dissolved, and enjoy with a moment of reflection and contemplation.
2. Tulsi. Otherwise known as Holy Basil, Tulsi is a revered herb in India and in the ayurvedic tradition. Tulsi is considered to be sacred and the smell and taste of the tea is indeed divine. Tulsi is known to be a wonderful immune booster and restorer of the nervous system, while also supporting the lungs, stomach, and heart. The tea is initially uplifting to the spirit, and then deeply restful and restorative. My favorite way to enjoy Tulsi in the cooler seasons is with warming chai spices and a bit of milk.
    Tulsi Chai Recipe:
   1 TBSP Tulsi
   1 C Water
   ½ C Milk of choice
   Sweetener of choice
   A couple shakes of Cardamom
   Add water, Tulsi, and sweetener to a pot and bring to a simmer. Strain. Add milk & top with cardamom.
3. Roasted Dandelion Root. We often think of Dandelion flowers when we think of the spring. However, during the cooler months when the rest of the plant dies back, the roots become filled with rich nutrients and sugars and wonderful medicinal compounds. Dandelion root supports the liver and gentle detoxification, and is also full of inulin, a super important prebiotic for our gut flora. My favorite way to make Dandelion root tea is by first roasting the root in the oven which gives it a deeply rich and nutty flavor. Next, I like to simmer the roasted root gently in some water for 15 – 20 minutes to make a dark tea, and add some cinnamon and milk. A grounding and earthy fall flavor! You can buy already roasted Dandelion tea here at mountain rose herbs.Roasted Dandelion Root Decoction
   2-3 C Water
   1 TBSP Roasted Dandelion Root
   Milk of choice
   Cinnamon
   Optional: Sweetener
   Bring water to a boil and add Roasted Dandelion Root. Turn the heat down to low and simmer for 15 – 20 minutes. Turn off heat and add milk and cinnamon!
4. Elderberry. Elderberries are the deep purple fruit of the native Elder plant, most renowned in syrup form. Elderberry is also one of the most nourishing and immune boosting herbal medicines, and one with ample clinical data to support its use. Like many other colorful berries, Elderberries are full of anti-oxidants and flavanoids. Elderberries can be preserved through the fall and winter in their dried form, which makes a lovely immune boosting addition to tea, or made into a simple syrup and stored in the refrigerator.Simple Elderberry Syrup
   1 C dried elderberries or 2C fresh elderberries
   3 C water
   1 C sweetener of choice (sugar, honey, maple syrup)
   Combine berries and water with cold water in a pot and bring to a boil. Reduce heat and simmer for 45 minutes. Turn off heat and steep for 1 hour. Strain berries using cheese cloth. Add sweetener of choice and stir until combined. Bottle and Store in refrigerator.
5. Licorice Root. Our final fall herbal spotlight is on Licorice root, the flavor maker behind the love-or-hate licorice candies! Unprocessed licorice has a more earthy taste than the processed and synthetic candies that it has inspired, but the sweet and comforting anise notes are still very present. Licorice makes a wonderful fall herb specifically because of its moistening actions on all the mucous membranes of our bodies (think mouth, lungs, digestive system, reproductive system). It’s very important that these tissues stay hydrated and moist, which is why moistening herbs are such an important aspect of health (especially as we kick on the dry heating systems for our homes). Please note that Licorice root is contraindicated in those with high blood pressure.
   Simple Licorice Root Tea
   2 C water
   1 TBSP Licorice Root
   Optional: Ginger Root
   Bring water to a boil, turn off heat, add licorice root (and ginger). Cover and steep for 10 minutes. Strain and Enjoy!

Ready to try them at home? If you’re local to Pittsburgh you can find many of these herbs at the East End Food Coop or at Cutting Root Apothecary. You can also order online at Mountain Rose Herbs.

Written by: Clinical Herbalist Annie Fox Derek.

If you’re interested in working with Annie you can reach us at 412-322-2129 or contact us here.

The term quiet quitting is a wave that sparked from the great resignation, and the apathy that some workers have experienced in dead end and toxic workplaces. Quiet quitting happens in many places including our romantic relationships. Any time that we are in a relationship and we notice that we stop caring and stop connecting with our partner, we are quiet quitting.

To use Gottman Method Marriage Therapy terms, we are all making ‘bids’ for connection in our relationships. A bid is any attempt from one partner to another for attention, affirmation, affection, or any other positive connection. Bids show up in simple ways, “How was dinner?” or they can be very complex, ‘I really wish we were having more sex!’ There are three basic ways that a partner can respond to a bid—they can turn toward, they can turn away, and they can turn against. The way that our partner responds to a bid has an impact.

In fact, researchers can predict divorce based on the number of bids that a person turns against. When a partner turns against a relationship, it is painful and creates a very toxic pattern. For example, one partner trying to connect says, ‘I would love to come with you to the store.’ Turning against says, ‘Why are you always trying to go with me, can’t you just leave me alone?’ whereas Turning Toward, might say, ‘That would be great, I will wait in the car!’ Turning away might be remaining neutral or not saying anything. Gottman Method states that happy partners in a relationship accept 86% of the bids that are made to them. Bids represent needs such as connection, attachment, understanding, intimacy, and excitement.

When we don’t have our needs met in a relationship, there is an awareness that things aren’t like we wish or had expected they would be. A person starts to wonder about the relationship and can even start to imagine that they could have their needs met with a different partner. Unmet needs create a slow landslide toward dissatisfaction and quiet quitting. A partner may first talk about the unhappiness, feelings of aloneness, or lack of appreciation that they feel. Even bids to create greater understanding and connection, if unacknowledged or not responded to, will also cease to happen, creating the cascade of distance and aloneness that hallmarks the most unhappy relationships, the relationships that very well may be headed for divorce.

Here are 5 Ways to Prevent Your Partner From Quiet Quitting You.

1. Tune in and accept the bids your partner is sending your way. Notice it when your partner does something nice, thoughtful and loving and respond to it with gratitude and attention.
2. Find ways to give back. Your partner’s relationship needs may be different from yours but it is each partners responsibility to become fluent in their partner’s love language and to speak the language of love frequently.
3. A healthy relationship needs to be a priority. We must give time, attention and care for ourselves and our partner in a way that allows for a positive, receptive and loving mindset to evolve from it.
4. If you notice that your partner is checking out, talk about it, don’t avoid the topic. Having those difficult conversations early on will allow you both the time and space to start to get the relationship back on track.
5. Get professional help. Marriage counseling or Couples Therapy can be the best method to talk about what is happening between the two of you, especially if there is defensiveness and argument when you both try to talk about the issues that are happening.

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

Interested in Couples Therapy?

Call 412-322-2129 or fill out the form below to get started with Couples Therapy.