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Our blog features personal thoughts, insights and analysis written by our own therapists and counselors on diverse topics of interest and current events related to issues of life, relationships, and emotional wellness.

Providing Grace and Resilience to Trauma Survivors, How To – Help Guide.


Provide resilience to Abuse Victims.

Provide grace & resilience to trauma survivors.

                           How to Provide Grace and Resiliency to a Friend or Family Member Who Discloses Trauma.

According to the United States Veterans Administration, about 50% of women and 60% of men will experience trauma at some point in their lives. Trauma is defined as an emotional response to a distressing event. Traumatic events can include witnessing or experiencing sexual or physical assault, violence, robbery, or attack. We are not all equipped with a vast understanding of psychology, and when a friend or family member turns to us with their memories of a traumatic event, more than ever we could benefit from some information on how to respond with validation, support, and compassion. The literature on trauma widely cites how important loved ones’ responses are to survivors’ disclosures of the events that they experienced. In fact, in a 2016 study by Lischner and Hong at the University of Washington, invalidating responses of friends, family, and others are correlated with an increased likelihood that the survivor will experience psychopathology including Post Traumatic Stress Disorder (PTSD). With the number of people who have survived trauma growing each year, it becomes ever more likely that someone will turn to you with their memories of a traumatic event. Below we will highlight some invalidating responses and provide validating responses so that each of us can do our best to provide caring support to those who may approach us with their heavy burden.

Validation is defined as responding with empathy, agreement, acknowledgement that we believe what was shared and that it makes sense. We can validate many levels of expression and meaning, feelings as well as thoughts. As a couples counselor, I help couples use the tool of validation to comfort each other in conflict. Validation is powerful. Some validating responses are;

  • ‘Thank you for trusting me enough to share this.’
  • Summarize the memories that were shared, always referring to them as memories or experiences.
  • ‘That must be so (painful, scary, traumatic, other feeling word) for you.’ Summary of emotions, this is to indicate a full understanding of the feelings that the person shared.
  • ‘You were so strong and brave in sharing your experiences.’ This is a compassionate response that highlights their survival skills.  
  • ‘How can I support you further?’ Letting the person know that you are glad to discuss any of it further, that you want to be there for them in any way that they need.

Invalidating responses can cause survivors to feel anxious, depressed, panicked, overwhelmed, and called to defend themselves and their pain. Many trauma survivors cite that invalidation from family or friends of their traumatic event is at times just as distressing as the trauma itself. Invalidation can be consciously used as a tool to manipulate and coerce, and it can be unconsciously done because the recipient to the confidence doesn’t know how to respond or help. Some examples of invalidating responses are as follows:

  • ‘Why are you bringing this up right now?’ Every survivor unfolds their trauma memories to different people and in varying times, when and how they will share their trauma and with who it feels safe to share. 
  • ‘Are you sure you remember this accurately?’ The first duty of love is to listen and validate, provide understanding, care, warmth, and support. It is not a good time to put them on the witness stand for cross examination.
  • ‘The perpetrator remembers it differently.’ Attend to the survivor’s feelings first and save the fact checking for a different time and day. Even if you feel called to defend the person or event that is being discussed as the source of trauma, this survivor is sharing something very vulnerable and the immediate need for understanding and care would indicate that we should triage and be delicate.
  • ‘Try not to think about it and put it behind you.’ This response indicates that the person’s experience of grief, pain, panic, anxiety, is something that can be dismissed. Working with trauma clinically provides opportunity to experience the depth of the memories and emotions to be reprocessed. There is much evidence that the more we think we should be able to dismiss our responses to trauma, the more likely we develop PTSD.

Don’t be hard on yourself if you recognize after reading this that you may have been invalidating to someone in the past. ‘We all do our best and when we know better, we do better.’ Maya Angelou

Please pass this along. Every day another person survives and attempts to thrive in the wake of pain and anguish. Each of us has the potential power to be a safe zone, to provide support, help, and healing for those who are making sense of traumatic events, we have the ability to provide resiliency against emotional pain and we can create a buffer and reduce the development of Post Traumatic Stress Disorder.

With resiliency and hope,

Stephanie Wijkstrom, MS, LPC, NCC

Counseling and Wellness Center of Pittsburgh

*The is not a replacement for mental health support provided in a clinical setting by a licensed counselor, psychologist, or clinical social worker. If you or a loved one has experienced trauma and are working through its effects, reach out to a therapist near you.

Thank you to our editor, Dr. Stellan Wijkstrom.

For more reading;

Phan Y.Hong, David A.Lishner: General invalidation and trauma-specific invalidation as predictors of personality and subclinical psychopathology,Personality and Individual Differences. January 2016.

Posted in abuse, abuse resources, domestic violence, help for trauma victims, rape, resilience, survivors, trauma counseling, validation, victim blaming, victims Tagged with: , , , , ,

Hands off-Please Do Not Touch My Body, Yoga and Consent.

Consent, Please Do Not Touch My Body

Hands off-Please Do Not Touch My Body.

Closeness is sacred and powerful, and we should share it however we would like with a partner or partners with whom we have provided consent. Personally, I am a ‘toucher’, meaning I am a person who enjoys touch with my partner, someone who hugs family and friends and genuinely savors safe closeness. As we all know, touch can feasibly happen in many contexts. A recent trip to a local yoga studio has spurned some inspiration for considering consent and what exactly that means within the context of yoga. Consent is one of the topics of the century, the importance of asking for it, and heeding to it are championed issues with personal, psychological, and legal context. When we are on our yoga mat, we are presumably in a safe zone, we practice yoga to be well, to relax, to be inside of our bodies, to give life and expression to what our physical selves need in the moment to create our highest expression of safety, openness, and comfort. We rely upon the professionalism, understanding, and care of our yoga instructors while we are on the mat. When others take liberties with our bodies, reactions can range from uncomfortable to traumatic, yet we shouldn’t need to rely upon trauma informed yoga instructors to be the only providers who can offer a style of instruction which provides opportunity to say “No thank you, please do not touch my body.’ From chaturanga to shavasana, we find our bodies configuration of the posture as the yoga instructor cues. Without making space for hands off adjustments, one well-intentioned yoga instructor can inadvertently have a negative impact upon his or her student’s practice, day, overall wellness by taking liberties with his or her student’s bodies.

Consent means that one has asked for permission to approach another person in any way, whether that be to touch, to enter an intimate encounter, or even to provide unsolicited verbal feedback, we should always ask before encroaching upon others. After asking for consent, we wait and pause for that person to respond with their response of approach or avoid. A key component of consent is that the other person is truly able to say ‘no,’ if we are in a position of power, or if we are asking a person who is intoxicated, a minor, or incapacitated in any way, then the other can not provide for their own consent. Under normal circumstances, then, if and after we have been given permission to ‘approach’ we take it a step further to check in to be completely sure that non-verbal permission has been granted to continue or deepen the exchange. Physical space, proximity, and closeness are very special, they are exchanges which can lead to bliss, warmth, bonding, relaxation and even orgasm in the right time. When touch is used subversively, to coerce, to control, to harm, physical connection can become shrouded in horror, it also has the potential to instill anxiety, fear, terror, panic, and pain.

Consensual sexual intimacy is the gold standard, we should always be sure that we are well within the green zone of any boundaries of any person who we are touching and to also always note that we are creating safety for others as we strive for mutual enjoyment and pleasure. There are many contexts or situations where touch happens from fitness instruction, personal training, yoga instruction, little league coaching, physical therapy, massage, and medical settings. While there are many of the medical and physical instructors listed above who do check in and ask, ‘is it ok for me to adjust you.’ The best ones who follow this question by ‘does this feel ok for you’ and to them I applaud their insight and wisdom to always, in all settings, to ask first and wait for an enthusiastic ‘yes’ or a clear non-verbal head nod which unambiguously encouraging procession. For other yoga and fitness instructors, it may be less obvious that they should ask for consent before breaking the touch barrier with students. Let us examine consent from a trauma informed perspective and look at some ways that we can be sure we are always providing supportive and caring touch.

Regardless of the setting or context, we do not have permission to touch another person until we have asked for it and they have given it. For a trauma survivor it can be very triggering and alarming to feel a person, even a coach or instructor grabbing at them, or tapping on their body, for another person to move ones legs or touch ones hands. Feeling safe and giving permission for these things to happen is vital and walking into a yoga studio to practice does not provide consent for one’s physical boundaries to be violated. Just as walking into a bar or nightclub in a low-cut blouse is not the same as providing consent for someone to touch our breasts. Being a woman out late having drinks is not an invitation to have sex, we need a society which is built upon making space for ‘Yes’, or ‘No’ by always ask first. Yoga and fitness instructors, we are here, we want to participate in a fun and fulfilling way but ask before touching please. Additionally, for some instructors who may have a style of delivering their teaching that is very directive and assertive, it may feel punitive to some students.

Recently, in an all levels class, the instructor was someone I had never practiced with before. The class was much less than an all level class, it was more of an intro in my experience, we were cued to move into postures without much attention to how we flow through the sequencing. In any event, after 15 minutes or so warming up, we were cued to do some Sun A’s. When forward folding the instructor told everyone to grab a two blocks in anticipation of their hands not hitting the ground. I have long arms, and have been doing forward folds for many, many, years, it does not tax my body to fold forward and I find it delicious and restorative. The teacher stomped back to me and said ‘No! get your blocks, do not go into your deepest fold!’ In knowing my body, and knowing that I did not need the blocks I started to reach for them to appease her as she began grabbing my leg and tapping rapidly and harshly onto the front of my quad with her pointed finger tips and squinted eyes, ‘Move! Move! Move!’ she commanded. What started as a day of wellness, mindfulness, and an attempt to let myself feel peace, quickly became a source of discomfort and anxiety.

Being a yoga instructor is a big responsibility, it is a pathway to open ones consciousness, those blissed out happy vibes and chakras can really open up and make others aware of themselves, their feelings as well as anything happening with the instructor. We should encourage yoga instructors to have a higher level of insight into their style of relating to others so that the instructor is not unconsciously projecting their own unmet needs or style onto all of those who they come into contact with. The yoga instructor should be very aware of how of tone and content of speech particularly as adjustments are being made. If an instructor is simultaneously speaking in a critical or cold tone ‘move!’ ‘faster!’ ‘in, in, in;’ in a style that feels like they are spitting commands to the students, if the instructors speak this way while grabbing at a students body, it may become even more likely that they are making others feel tense, uncomfortable for anyone, and furthermore this kind of tone and motion can even be panic inducing for some trauma survivors.

More than ever, we must seek to create safety, to speak with love, to be sure that we are providing physical touch which is tender, and warm, and supportive or not tender and warm, if that is the kind of touch which is consensual and agreed upon by those who can legally and actually provide consent. Speak and act with awareness and care for other people’s feelings, doing fitness, pilates, doing a forward fold or downward facing dog, or even having a suspicious mole removed from our bodies are things that must happen peacefully and respectfully, and always with particular attention to any person’s ability to state, ‘No thank you- please do not touch my body’.

Be well,

Stephanie Wijkstrom, MS, LPC, NBCC

Counseling and Wellness Center of Pittsburgh

830 Western Avenue Pittsburgh Pa


Counseling and Wellness Center of Pittsburgh – In Monroeville 

4108 Monroeville Blvd Monroeville Pa 15146

For more reading on the ethics of touch in yoga;

Posted in counseling for anxiety, counseling for PTSD, psychotherapist, touch, yoga for trauma Tagged with: , , , , , , , , , , , , , , , , , , , , , ,

What are the benefits of a high fat diet?

What are the benefits of a high fat diet?

Liz Mckinney, CNS, LDN continues to examine the big fat myth and share some more information and sample mean plan to incorporate the dietary changes of a high fat diet into your busy lifestyle. Our last blog post caused quite a stir and we want to be sure that our readers understand the differences between ‘good fats’ and ‘bad fats.’ One big take home point is that not all dietary fats are created equally. So, what does the science tell us about a high fat diet? To recap our last blog article, research is showing that a high fat made up of healthy fats coupled with a low carbohydrate diet can be beneficial for:

  • Heart health
  • Boosting the immune system
  • Brain function (and reduced risk of Alzheimer’s, cognitive impairment and dementia)
  • Blood sugar control
  • Weight management

High fat diets, and even ketogenic diets are being studied for their efficacy in treating Parkinson’s, Alzheimer’s, ALS, Epilepsy and even ADHD. More and more, we understand there is a significant effect on our physical and emotional health exerted by our food consumption, even anxiety and depression can be effected by our diet. In particular, of the vital and nourishing micro nutrients, cholesterol is especially protective of brain function. One famous study called the Framingham Heart Study found that those with low serum cholesterol performed less well on cognitive function tests than their counterparts with borderline or high cholesterol levels. We can infer from this correlation that cholesterol does seem to have a protective effect on the brain. Additionally, when we note that their are ramifications for those who take statin drugs to lower their cholesterol. One known side effect of statin drugs are problems with memory and cognition.

Adding more fat to your diet the healthy way

Adding more fat to your diet the healthy way.

What should I eat?

The good news is that it’s easy to start enjoying the benefits of a high fat, low carbohydrate diet. It’s important to limit grains and legumes to maintain the benefits. It is best to try to aim for only about 60 grams of carbohydrates a day. Along with unlimited non-starchy vegetables (think asparagus, cauliflower, broccoli, kale, swiss chard and spinach) and low sugar fruits (grapefruits, oranges, apples, berries, melon, pears, cherries, grapes, kiwis, plums, peaches and nectarines), enjoy ample amounts of these ‘good or healthy fats’ which are foods which will accelerate health and allow you to experience the benefits of a high fat diet:

  • Grass fed beef and lamb
  • Free range chicken
  • Cage free eggs
  • Cold pressed oils (walnut, olive, avocado, coconut, and palm)
  • Grass fed butter
  • Cold water fish (salmon, shrimp, sardines and tuna)
  • Nuts (walnut, cashews, macadamia and almonds)
  • Avocados
  • Cheese (Gruyere, goat cheese, feta cheese, and mozzarella)

Sample One Day Meal Plan*


2 scrambled eggs with 1 oz. goat cheese cheese and stir fried veggies (onions, mushrooms, spinach and red bell pepper)


4 oz. baked chicken or canned tuna with a side of leafy greens dressed in balsamic and olive oil


3 oz. grass fed steak with a side of roasted broccoli and mashed cauliflower


3 squares of 70% dark chocolate

*Adapted from Dr. David Perlmutter’s book Grain Brain

So go ahead and give it a try, of course one should always consult either your PCP or a dietitian or nutritionist before making any changes to your diet, this is especially true if you have preexisting health conditions.

In good health and wellness,

Liz Mckinney, CNS, LDN

Certified Nutritionist, Licensed Dietary Nutritionist for The Counseling and Wellness Center of Pittsburgh

Providing good health and wellness to Western Pennsylvania.

Liz provides nutrition counseling in both our Pittsburgh and Monroeville Locations

Accepting Self paying clients, Out of Network, and Highmark Blue Cross Blue Shield.


Posted in benefits of high fat diet, blue cross blue shield, counseling wellness, dietician Tagged with: , , , , , , , , , , , , , , , , ,

The Big Fat Myth

Big Fat Myth

Big Fat Myth, High Fat Diet and how it affects health.

Open a women’s magazine or examine the back of a food label, you will find the ‘evidence’ there. It’s easy to find ready sources that say dietary fat is bad news for your waist line, cholesterol, skin, mood, you name it. Many clinicians still hold that saturated fats like coconut oil, butter and beef cause weight gain, clogged arteries, high cholesterol and heart disease. But, according to Certified Nutritionist Liz Mckinney, there is much to learn when it comes to the Big Fat Myth, read on to re-evaluate fat’s bad reputation. This blog will fill you in on the facts and research in order to assist your physical health, emotional health, and wellness goals by consuming fat and nourishing yourself with this well known macro-nutrient.

Myth: Saturated Fat and Cholesterol Increases Risk of Heart Disease

Today, a common scenario occurs when a patient walks in for a checkup or health screening and they learn that  their cholesterol is high. The patient is then told to limit saturated fat and cholesterol intake. Cut down on foods such as red meats, butter, eggs, and oils like palm and coconut) and often a prescription for a statin drug  follows when their cholesterol is over 200 mg/dL. This is probably due in part to misleading evidence that suggested that cholesterol levels are directly correlated to risk of heart disease. One such study was performed by a researcher by the name of Ancel Keys in the 1980’s that looked at 22 countries and found that dietary fat intake was related to increased risk of heart disease. However, data on only 7 of those 22 countries was published – those that fit his hypothesis. Since then, many researchers and physicians have refuted this study, and yet, the recommendations that come down the pipe from the American Heart Association and the USDA continue to perpetuate that dietary fat and cholesterol are bad for us.

Research continues to show that high quality animal fats and eggs aren’t the real culprit in heart disease. One of the most notable studies that shows this was called the Women’s Health Initiative, which studied over 48,000 postmenopausal women and the connection between a low fat diet and the risk of heart disease. Participants were followed for an average of 8 years and then assessed for heart disease. The group that reduced overall fat intake and increased intake of whole grains, fruits, and vegetables did not experience reduced risk of Coronary Heart Disease (CDC), stroke or CVD, over the control group. There are other studies that have found similar results, indicating that low fat diets don’t really have much impact on heart disease risk. A report published in 2010 by the American Journal of Clinical Nutrition stated that there was no substantiated link between saturated fat intake and outcomes of obesity, CVD, cancer or osteoporosis. And, if you need even more proof, a meta-analysis of 21 medical reports and studies also published in 2010 in the American Journal of Clinical Nutrition concluded that, “the intake of saturated fat was not associated with an increased risk of coronary heart disease, stroke, or CVD.”

If not fat, then what?

So, if saturated fats aren’t the culprit in CVD and atherosclerosis, then what is? Enter carbohydrates. Most grains and sugars are highly inflammatory. As a society, our diets are high in processed and packaged foods like pastries, fast food, crackers, cookies and cakes. Eating these foods causes surges in blood sugar and taxes the pancreas, whose job it is to produce insulin to shuttle the sugar into our cells to be used for energy or stored for later. Over time, the cells become resistant to insulin and sugar remains in the bloodstream instead of being transported into the cells. Sugar in the blood stream sticks to protein molecules like LDL cholesterol (called “bad cholesterol”). This changes the structure of the LDL and causes an inflammatory cascade which leads to plaques in the arteries and the inability of LDL to carry cholesterol where it’s needed,especially to the brain. So, now we have a simple equation. Too many carbohydrates cause inflammation, which leads to oxidized or damaged LDL and atherosclerosis. This is what leads to heart disease, not eating too much dietary saturated fat and cholesterol.

Read on and look for next weeks post, Liz will share more details about how your health and wellness can be bolstered with fat as she shares all of the well researched benefits to Fat. She will also share a sample meal plan to help you take advantage of the most nourishing food options available.

Certified Licensed Nutritionist

Certified Licensed Nutritionist, Nutrition and Wellness Counseling

Be Well!

Liz Mckinney, LDN, CNS

Counseling and Wellness Center of Pittsburgh

830 Western Avenue Pittsburgh, PA 15233

4108 Monroeville Blvd Monroeville PA 15146

Providing Individual, Marriage and Family Counseling, as well as wellness solutions to Western Pennsylvania.





Edited By, Stephanie Wijkstrom, MS, LPC, NCC

Posted in blue cross blue shield, high fat diet, highmark nutrition counseling, insulin, integrative medicine, Nutrition Counseling, upmc, Wijkstrom Tagged with: , , , , , , , , , , , , , , , , , , , ,

Ketogenic Diet

What is the Ketogenic Diet?

By: Liz Mckinney, CNS, LDN

The Ketogenic or Keto diet for short is a buzzword now, but it’s not new! Decades ago, it was used primarily to treat epilepsy in children whose seizures were uncontrolled. Research found that those with epilepsy had fewer seizures when in a state of ketosis vs. being glucose dependent. Today, there are many more applications for this diet that show promise to continue researching for more potential benefits. But, let’s take a deeper dive into what being in ketosis really means!

Being in ketosis means that the primary fuel source in the diet is fat, instead of carbohydrates. When you become fat adapted and burn fat over glucose, the body makes byproducts called ketones which the brain used for fuel. This spares glucose, the primary fuel source for the red blood cells, endocrine system and muscles. Traditionally, carbs make up 45-65% of our daily intake, protein makes up 10-35% and fat makes up 20-35%. On the keto diet, one might be consuming as much as 70% fat, 20% protein with a mere 10% coming from carbohydrates. One a standard 2,000 calorie diet that is only 50 grams coming from carbohydrates. A very strict approach to this diet might allow only 20 grams of carbohydrates, while a more moderate approach may allow between 40-60 grams depending on goals and taking into account each individuals therapeutic need.

So, what are some reasons to pursue a very low carbohydrate diet like this? Evidence is suggesting that the ketogenic diet is a great way to spark weight loss. Since it’s very low carbohydrate, this keeps insulin (our fat storage hormone) low. This means that fat stores can be unlocked and used for fuel. Additionally, prevention and improvement of neurodegenerative diseases like Alzheimer’s and Parkinson’s Disease have been seen with high fat diets. The brain seems to do very well when using ketones for fuel instead of glucose. These applications are very relevant for Americans today, as neurodegenerative diseases and obesity are on the rise. Maybe even more important, are the applications for cancer. Cancer cells love sugar (glucose). Starving the cancer cells on a ketogenic diet shows promise in slowing cancer progression.

One drawback to the keto diet is that it is usually low in fiber since fiber is found in carbohydrate rich foods. GI issues like constipation, cramping or acid reflux may occur. One way around this is to count only net carbohydrates. That is, total carbohydrates minus the total fiber. This is usually a more moderate approach, but still confers the benefits of a traditional diet and keeps carbohydrate intake low.

The long term effects of the ketogenic diet are still being studied, but it shows much promise for short term use. Pregnant or nursing women, those with gallbladder disease or insulin dependent diabetics should use caution and discuss with their health care or dietary professional before implementing and keto changes into their diet.

If you want to learn more about this diet, book an appointment with Liz or check out “The Keto Diet”, a great comprehensive read on those curious about whether a high fat diet might be right for them. Remember that every body is different and diets should be tailored to what works best for your health and wellness goals.

Here is an example of the satiating kinds of meal plan a person can enjoy on the Keto Diet!

For breakfast you might have scrambled eggs and add in heavy cream, chives, and up to 4 slices of your favorite nitrate free bacon. With so much dense nourishment, you will hardly notice that you skipped the bread!

For lunch, put your favorite protein on a bed of baby salad greens, add a vinegar or cream based dressing.

For dinner: Go all out with a generously cut Ribeye that can be enjoyed with mushroom cream sauce and several ounces of broccoli.

Health and Wellness,

Liz Mckinney, CNS, LDN

Posted in keto diet, ketogenic diet Tagged with: , , , , , , , ,

Anti-Inflammatory Diet – Including Meal Plan by Licensed Nutrition Counselor, Liz Mckinney, CNS, LDN.

Anti-Inflammatory Diet, food as therapy.

Anti-Inflammatory Diet for wellness, food as therapy.

Anti-Inflammatory Diet, What it is, What it Does and Including a Meal Plan by Licensed Nutrition Counselor, Liz Mckinney, CNS, LDN.  

Every standard anatomy course covers a section on inflammation, health circles and modern medicine studies how this physiological process effects our bodies. Modern science has uncovered much evidence related to how our dietary consumption fuels our internal inflammation. To understand inflammation, let’s talk what about what inflammation really is. Inflammation is a normal part of our body’s healing process.  Think of the redness, pain and swelling that comes along with an acute injury. These are bio-markers that our white blood cells are migrating to the origin of a wound, when the white blood cells arrive they will unfold to facilitate the healing process. This mechanism is a normal and necessary indication that our immune response is hard at work. But what happens when our immune systems are working over time in a way we can’t see? This is a part of what is termed ‘chronic inflammation’, and our diet definitely plays a large role in both calming it down or conversely, throwing fuel on the flames.

Chronic inflammation is a contributing factor to many common diseases in the U.S today. Obesity, heart disease, and Type 2 Diabetes are some common diseases to which inflammation contributes to the onset and progression (Lopez-Condelez 2017). Additionally, according to a 2018 study Dr. Billmore et, al, which was published in Nature, there is also evidence that inflammation may contribute to certain forms of depression as well as aiding in the development and progression of this mental health disease, inflammation is also being study as a contributing factor in the development of other mood disorders. Of course diet alone can not provide total therapy for depression or disease but it is an important pathway to providing our best course to become well.

The fact is when our immune system becomes chronically activated, low-grade, systemic inflammation occurs. Even if you aren’t suffering from an overt disease, things like stress, leaky gut, food sensitivities and even an imbalance in our gut micro-biome all are capable of pushing our bodies into an inflammatory state. The consequences of chronic inflammation are serious. Increased risk of neuro-degenerative and cardiovascular disease, trouble losing weight, digestive problems, hormonal imbalances, and cellular damage may all occur as a result.

Our food choices can either promote or calm inflammation.  Many of the diseases and problems listed above may be prevented or mitigated with an anti-inflammatory diet. The top foods that commonly contribute to chronic inflammation in the standard American diet are:

  • Refined grains (bread, crackers, cookies, cakes, snack foods)
  • Dairy (all cow dairy products including milk, ice cream, and yogurt
  • Sugar (table sugar, high fructose corn syrup, sugar alcohols or artificial sweeteners)
  • Vegetable oils (Canola, Corn, Safflower, Sunflower and Rapeseed oils)
  • Trans fat (Margarine, peanut butter, mayonnaise, packaged snacks)
  • Conventional/commercially raised meat
  • Alcohol (More than 1 drink per day for women and 2 for men)
  • Food additives (MSG, artificial flavors and food dyes)

On the flip side, nourishing foods can also accelerate healing in the body and prevent the inflammatory cascade from becoming chronic. For whole body health and wellness, add these anti-inflammatory foods into your daily diet:

  • Fatty fish (Halibut, salmon, sardines, trout)
  • Coconut oil
  • Olive oil
  • Vegetables (Any and all kinds!)
  • Berries
  • Pineapple
  • Ginger
  • Chia seeds
  • Flax seeds
  • Turmeric
  • Grass-fed animal meats

We know that one of the barriers to incorporating dietary changes is that we simply don’t know where to begin. As an added bonus, we will share an example one-day meal plan, made by a certified and licensed Nutrition Counselor, Liz Mckinney, by using this plan, you can jump start your anti-inflammatory diet today!

  • Breakfast
    • 2 scrambled eggs with sautéed spinach, mushrooms and garlic
    • ½ avocado
  • Lunch
    • 2 cups mixed greens with 4 oz. salmon or chicken and walnuts with a turmeric ginger dressing (Juice from 2 large organic lemons, approximately 1/4 cup of fresh juice, 1″ fresh ginger, skin removed, 1 garlic clove, 2 teaspoon ground turmeric, 3 tablespoons extra virgin olive oil, 1 tablespoon apple cider vinegar, 1/4 teaspoon black pepper, Salt to taste – Blend in food processor)
  • Dinner
    • Sautéed lemon pepper shrimp over zucchini “noodles” sautéed in olive oil with salt and pepper
  • Snacks
    • 70% or greater dark chocolate, almonds/walnuts, rice cake with mashed avocado, hard boiled egg with spicy mustard, cut up veggies with hummus or another home made veggie dip

Additionally, by working with a licensed nutritionist or dietitian to identify food sensitivities, heal leaky gut, balance your gut micro-biome, eradicating bacterial overgrowth, and implementing a stress reduction plan into your daily life, your wellness, emotional, and physical health can be optimized. As always, wellness routines that include yoga, meditation, mindfulness, progressive muscle relaxation, spending time in nature, or deep breathing are all proven techniques to increase resilience to stress.

Certified Licensed Nutritionist

Certified Licensed Nutritionist, Nutrition and Wellness Counseling

Blog article is written by Liz Mckinney, CNS, Liz is the licensed and certified nutritionist for the Counseling and Wellness Center of Pittsburgh, Liz can provide nutrition counseling near you, now accepting new patients in Western Pennsylvania. 



edited, by Stephanie Wijkstrom, MS, LPC, NCC

Posted in anti-inflammatory diet, chronic inflammation, diabetes, medicine, nutrition, Uncategorized, Wijkstrom Tagged with: , , , , , , , , , , , , , , , , ,

28 Foods to Decrease Anxiety and Depression & Enhance Positive Moods

Food For Depression

                         Food For Depression

28 Foods to Decrease Anxiety and Depression and Enhance Positive Moods

Food & Mood Series by Liz Mckinney, CNS, Board Certified Nutritionist

“It is both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders. There are exciting implications for clinical care, public health, and research” – editorial in the American Journal of Psychiatry

Mood imbalances like depression and anxiety are on the rise in the U.S. In 2016, the National Institute for Mental Health estimated that 16.2 million Americans have experienced at least one major depressive episode and 42 million have an anxiety disorder of some kind. Additionally, depression is the leading cause of disability globally. Traditionally, depression and anxiety are viewed as being caused by chemical imbalances, due to under production of our feel good neurotransmitters like dopamine, GABA, and serotonin. Lets explore how food is related to emotional health and how we can put ourselves at risk for developing anxiety or depression with our diet, as well as the good news of how diet can increase of mood, energy, and all around wellness. 

So what factors contribute to a drop in the production of neurotransmitters? Biologically, this question has a multi-tiered answer. First, genetics and epigenetics (namely, how our environmental exposures affect which of our genes become activated) certainly play a role in a person’s proclivity towards depression and anxiety. For example, a common genetic mutation called MTHFR has a big impact in how we activate the B vitamin folate in our cells. Those with this genetic mutation are more prone to depression because of folate’s role in making serotonin. But, we know that our genetics don’t tell the whole story. The second factor influencing the expression of our genes, are our mental and emotional stressors or triggers, this is the part that can be effected by our social supports and reduced with therapy. Social factors and cognitive perceptions contribute significantly to the onset of these common mood disorders. 

The Standard American Diet, which is low in fiber, healthy fats and protein and packed full of cheap, convenient sugar laden foods means we have less of the amino acid building blocks we need to make GABA, serotonin, and dopamine. A second issue to consider is that poor gut health is directly linked to worsened mood disorders thanks to the two-way gut-brain connection. Intake of processed snack foods packed with sugar, flour, and trans fat are like pouring gasoline on the fire and promote overgrowth of pathogenic bacteria and yeast in our gut where up to 80% of our body’s serotonin is produced. Eating poor quality proteins or simply not enough further compound the issue because proteins are the building blocks for these important compounds that keep our moods stable. Grain fed, factory farmed eggs and meats and genetically modified crops are not only loaded with toxins and pesticides that alter our microbiomes, they serve to ramp up that low grade chronic inflammation. Finally, fiber intake has never been lower thanks to the standard American diet. Fiber rich foods serve as probiotics that feed the beneficial bacteria in our large intestine. Without fuel, the good “bugs” are more likely to die off, leaving room for the pathogenic species to flourish. Our bacteria send signals to our brains, so we want our good bacteria to dominate and send signals that promote brain health, not cause further chemical imbalances and inflammation.

Now time for the empowering news! The food we eat can also improve mood, and decrease symptoms of depression and anxiety. Food can be a kind of internal therapy, by nourishing organs, healing of stomach linings and then increasing energy and brain health, they have a huge impact on decreasing ones susceptibility to relapsing from mental health disorders.


  • High quality proteins
  • Cage-free Eggs
  • Grass-fed Beef and
  • Chicken raised without growth hormones or antibiotics.

Vegan or vegetarian

  • Non-GMO soy 
  • Vegetable proteins like legumes, pea chia, or hemp.
  • Fermented foods like kefir, kombucha, or sauerkraut which contain live organisms that populate the microbiome with beneficial bacteria.

The above mentioned foods promote emotional and physical health by keeping the gut happy and healthy. As a word of caution, avoid processed, packaged snack foods at all costs and focus on whole, unprocessed foods like promote a good mood. Here are some more delicious options to add to your daily diet that calm inflammation and support mood:

  • Dark Chocolate (70% or darker)
  • Vitamin B rich foods – eggs, raw dairy, grass fed beef, and organic chicken and turkey, leafy greens like kale or Swiss chard, and bananas
  • Turmeric
  • Red, Purple, and Blue Berries – Contain Vitamin C and other antioxidants
  • Omega 3s – wild caught fatty fish (2 servings weekly), walnuts and flax seed
  • Coconut oil

As a final note, understanding mood disorders is complex and the underlying factors multi-tiered. Everyone is unique and requires and individualized approach that takes into account genetics and epigenetics, mental and emotional health and diet and lifestyle. When all three are addressed, we are better able to address mood disorders and provide the best outcomes. If you want to learn more about health enhancing diets and what foods can support emotional and physical  health, meet with a board certified and licensed nutritionist, our nutritionist, Liz Mckinney, CNS accepts Aetna and Blue Cross Blue Shield insurance as well as self paying clients. 

Certified Licensed Nutritionist

Certified Licensed Nutritionist


Posted in food for anxiety, food for depression, food for mood Tagged with: , , , , , , , , , , , , , , , , ,

Anxiety and Depression During Pregnancy, ‘Wellness for People Like Me.’

Anxiety and Depression During Pregnancy, ‘Wellness For People Like Me.’

Depression and Anxiety in Pregnancy

Writer, blogger, and art therapy graduate Angela Grace Wilt shares some of her experiences in recovering positive coping and mental health including ways to manage anxiety and depression during pregnancy. This is a part of the ‘People Like Me’ Series of our wellness blog, real people, real stories, real ways to incorporate wellness into stages and experiences of everyday normal life.

Being a woman comes with a lot of ups and downs.  Women are prone to anxiety and it can be very hard to to admit.  For example, women are closely tied to the monthly cycles that their body experiences.  Things such as menstruation cause anxiety, depression, mood swings, and intense bodily urges with cravings.  Men never will get us or grasp what we go through.  We are just that unique. For as long as I could remember, I have felt that as a woman I am special and cursed all at once.

Then of course recently, as I have taken this jump into parenthood with the amazing biological potential of my body, quickly I have learned that while things like premenstrual dysphoria, and the normal anxieties and depression of menstruation are challenging, pregnancy holds a whole long list of unique and larger fears and physical difficulties. In fact, this is true for all women, and according to The American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with some symptoms of anxiety or depression during pregnancy. The shift in mental health have multiple sources, think about it, there is insomnia because our body is changing so fast that some women can be prone to rapid heartbeat, which makes it harder to fall asleep.  There is also the whole list of ‘what ifs.’ Will my baby and I make it to full term?  Will my baby be healthy?  I can no longer drink alcohol, ride adrenaline driven roller coasters, lift heavy weights, or really take any chances of too adventurous tasks.  With each decision I make, I consider the question ‘what will makes my little bump, a healthy or not so healthy baby.’

Physical and emotional changes are also thread within social fears and adjustments, I sometimes wonder, have I planned enough for this pregnancy that has in many ways, just happened. The truth is, I am not some 30 something who has been charting my cycle for 6 months to achieve conception, I didn’t plan to get pregnant just yet.  I thought about it sure, but just like most couples we wanted to walk down the aisle with a white dress of lace and flowers all  the scenery of our closest friends and family shouting us on, it was always my dream of being that princess and marrying my soul mate!  We still will have that for our future, but it will be after we get through the current stresses. In addition to the changes in my timeline, I also care about what our parents think about our having a baby right now. Having a baby out before marriage can be shocking for some religious and cultural values. We were lucky because my family is just fine with it, and with a little time to adjust, my better half’s is now happy about the news.

The list of anxieties and real practical matters which accelerate my concerns are aplenty, even small things have caused me stress, I have had to shop for insurance as a pregnant women, because I am twenty-six, pregnant, and didn’t have any. Finally, babies are expensive, health insurance is also expensive, we have stresses of finding better jobs, I have to go on insurance yet because I am twenty-six and don’t have any.  We are cleaning house and making a baby room. When all of these real life stresses start to mount very high, I can feel my heart beating faster, I try to stop and think of the things that we do have, I try to re-frame my anxieties and depressed thoughts in a positive light, I pause and I say to myself, ‘I have my boyfriend, our love together, and I have a supportive family. I have myself and my strengths, and I am strong and able.’That always seems to calm me down and help me to remember that there is much to be excited about as we move forward together as a young family.

With all of these anxious and depressed thoughts swirling in my mind, I have taken the time to put together a small list of ways that I manage and support my emotional health during my pregnancy. Of course if you are struggling with mental health during or after your pregnancy, talk to you PCP or Mental Health provider, get a screening for Postpartum or Baby Blues, every year women die or don’t bond with their babies due to maternal mental health factors. If you are like me and relatively healthy but feeling a little anxious or blue, then read on because these tips may help you as much as they helped me.

Use positive self talk, be your own biggest fan and encourage yourself like you would a friend

I say nice things to myself, I write little notes and post them through out the house, simple thoughts like,’ Rome was built in a day’ ‘We will get everything done in time.’ We’re already almost half way there at twelve weeks.  It’s just a wild ride.  My body is going through so many beautiful changes. Tune in, all of my emotions are heightened.  Hunger is giving me nourishment now.  Sleep is always appreciated.  Sex is fierce and always wanted.  Sadness and anger are intense.  I have energy that comes out of nowhere.  Its ok if sometimes I can’t stop crying.  I love my baby and baby’s daddy and not want anything more than to be with just them and them alone.  I want the best by our new child.  I want to give it proper nutrition and a good home life.  I want to be a good parent and my baby to grow in a family where love is the answer and anger is dealt with in a healthy supportive manner. I will protect this baby with all that I have.  This child’s needs and wants are now first.  I am ready to teach this baby proper education, morals, respect, and spirituality.

Its normal to be overwhelmed, life is now changing! 

Anxiety,stress, and fear are the norm when we are overcoming big changes. ways just important to remember that having a baby is a life changing experience. Normalizing the emotions that I am experiencing helps me by making me not feel the guilty, ashamed, or odd for having these dips and emotional shifts.

Reach for your Tribe!

Please remember, you are not alone.  You are a powerhouse and you have many people who will listen and talk. Make a list of 5, if you can not list at least 5 people who will pick up the phone for you, see a therapist and talk about the feelings of isolation and loneliness. Mom, dad, best friends, siblings, make a list and think about who is the best person to talk with through the things that come up. It will likely be a different person for each of situations that one may encounter on the pregnancy journey.

Use your breath

The body and its breathing are powerful, breathing can be used to energize and manage our response to stress. Take some deeps breaths every day.

Make a Wellness Routine

Do calming relaxing type activities like yoga, walking in nature or just walking, stretch, journal, and keep time for yourself  to collect your thought and consider the daily experiences that you are managing.  Essential oils can help ease the mind and emotions and of course be sure to choose blends that are safe to use during pregnancy.

Bond with your baby 

Talk to your baby while its in the womb, there will likely be a time after your baby is born that you are longing to be so closely connected to him or her again, try to cherish these moments and zoom out towards the big picture where you are nurturing a sacred bond right now in your womb. Being a woman is very special, and this connection, with baby snugly centered in my sacral area, right as my mother and my mothers mother have always done, this is something that men can not understand, but I am ok with that.

We are powerful, we are able to make changes that influence the outcomes of our life. Pregnancy like all things, is what you make of it.  Do your best to stay positive by thinking of the new exciting things that can be done all in great fun with your new family together.  Your love of baby and yourself will take you far. Be gentle with yourself when you notice the stress, anxiety, and fear of the 9 months ahead. This is a special time that can be used to get really healthy and in tune with your bodies needs. As always, seek medical help from a PCP, Gynecologist, or Licensed Professional Counselor if you have concerns about your mental health.



Posted in anxiety during pregnancy, depression in pregnancy, postpartum, stress pregnancy Tagged with: , , , , , , , , , , , , , , , , , , , ,

Trauma Informed Care; We Have Evolved to be at risk for Trauma; Here is Why

Trauma Informed Care

Trauma Informed Care

We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as post traumatic stress disorder, acute stress disorder, anxiety, depression, and addiction.

There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.

People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma  can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.

We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.

Cognitive behavioral therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.

Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.


Posted in counseling for PTSD, psychology, psychotherapy, ptsd, trauma, trauma informed care, trauma therapy Tagged with: , , , , , , , , , , , , , , , ,

Suicide Prevention

Suicide prevention awareness
Suicide prevention awareness

Suicide Prevention Awareness

                                                                                   Suicide Prevention

With the suicide of two Hollywood Stars this week, both Kate Spade fashion designer, and beloved Anthony Bourdain, American chef and champion of human rights, we at the Counseling and Wellness Center of Pittsburgh wish to express our condolences to the families, friends, and all of those effected by these tragic losses. According to the National Institute of Health, suicide rates are rising, 40,000 people will die by suicide each year. As a nation, and as people who want to help, we should think about the signs, symptoms, and behaviors of the people around us so that we can do our best in having awareness to prevent suicide. Suicide is a topic which holds personal importance to me, many years ago, when I was an undergraduate student studying psychology, my boyfriend attempted suicide in my bed by placing a bullet into his brain, after months in a coma, he was lucky enough to survive. Yet the act was one which was shocking for all of his friends, his family, and something that impacted me to this day. As a woman who has devoted herself to studying and working in the mental health field, at the time, I did not see the signs that my boyfriend was suicidal.

Suicide is a taboo topic and product of dismal and ill mental health; major depression, bipolar disorder, borderline personality disorder, psychosis, and schizophrenia, are a few of the disorders which are typically associated with an increased risk for suicide. For those who are closest to someone suffering from mental health disorders, the symptoms are very difficult to see for what they are. The thoughts, behaviors, and feelings of a depressed person are a set of treatable symptoms which are a produced by mental illness. Our science and psychology hold diagnostic labels but for the human beings who act out suicide, these symptoms are a daily life experience, they are much more than a label. Mental illness is an often invisible disease causing people to suffer immensely, those who are in the depths of depression or other mental illness, often have not sought treatment with a therapist or mental health professional. A person may walk through life for many years, hollow and bleak, no longer able to experience the hope or purpose to continue living. They may become so overwhelmed that they can no longer imagine the purpose of surviving more days while struggling with their feelings of despair, sadness, conflict, and internal pain. Often the person who commits suicide is one whose self-esteem and thoughts have entered a place of such distortion that they imagine the people who survive them will be better off without them in their lives. Again, this kind of thinking is a product of the illness. Please spend a few moments looking over the suicide warning signs according to the American Foundation for Suicide Prevention.


  • Isolating themselves.
  • Not returning phone calls.
  • Not showing up for family or friends invitations.
  • Being withdrawn.
  • Giving away possessions.
  • Sleeping too much.
  • Sleeping too little.
  • Using substances to excess.


  • Talking about suicide. *Especially sharing that they have a plan and a way to carry it out.
  • Saying that friends and family would be better off without them.
  • Feeling like a burden.
  • Feeling hopeless.
  • Feeling that there is no reason to live.
  • Talking about deep feelings of depression or anxiety.


  • Depressed
  • Anxious
  • Angry
  • Confused
  • Tearful
  • Sudden increase in mood or energy

Environmental Risk Factors

  • Relationship problems.
  • Financial problems.
  • Having access to lethal means such as pills or guns.
  • Prolonged stress.

If this sounds like someone you know, or if you have been feeling these things recently, please seek help. Call your local crisis center, here is a number for a national suicide hotline 1-800-273-TALK. Remember that the emotions are temporary and life’s situations which overwhelm us are solvable. Mental health help is around the corner. If your loved one has expressed these things to you, or is exhibiting some of the warning signs, stay with them, ask questions and let them talk about their worries and problems, your presence will help, listen with patience and compassion and be with them while calling the suicide prevention hotline or getting them to a local hospital.

In love and life,

Stephanie Wijkstrom, MS, LPC, NCC

Counseling and Wellness Center of Pittsburgh

830 Western Avenue

Pittsburgh Pa, 15233

4108 Monroeville BLVD

Monroeville Pa, 15146.


Serving Western Pennsylvania with Individual, Marriage, Family, Counseling and Wellness Services.

Posted in Anthony Bourdain suicide, kate spade suicide, mental health awareness, suicide, suicide prevention, suicide warning signs Tagged with: , , , , , , , , , , ,

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