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The holiday season can be full of excitement, family, friends, and...busy-ness. Before your season becomes a blur of things to do and places to go, take some time to create intentional practices to help you slow down and appreciate the inspiration of the season. Here are five ideas to get you started.

Use a word, image, or memory to guide your holiday season. Take some time to think about what you truly want from your experience this year, then allow that idea to become a touchstone for your time and energy. For example, if your guiding word this year is gratitude, think about how you can enliven that word in your life, perhaps through journaling, writing a holiday letter of thanks to your friends and family, or finding opportunities to express gratitude within your community.

Getting outside, away from technology, is one of the best ways to slow down and appreciate the here and now. Being in nature calms the body, mind, and spirit, and beneficially affects the nervous system and immune system. Take time to walk in the woods. While you're there, stop to take notice of what you see, hear, and smell. Feel the ground beneath your feet. Plant yourself firmly and remind yourself that you, too, are part of the natural world.

When we become busy and stressed, we change our breathing patterns, taking shorter breaths out of the chest rather than the relaxed, deep breaths that help us feel calm and balanced. Breath awareness techniques can help your mind and body establish a state of relaxation in which you can operate from a state of intentional response rather than stressful reaction. Here's a quick breath awareness tool you might try when you notice yourself feeling rushed and stressed:
  • Close your eyes if you can.
  • Breathe in and feel a touch of cool air at the tip of your nose.
  • Breathe out and feel a touch of warm air.
  • Notice how in each moment of breath awareness you are just here, just now, in the present moment.


In our focus on "getting it all done," we can forget to nourish ourselves. Whole, minimally processed food can reduce our stress levels, provide the energy we need to stay balanced, and remind us of the comfort of a good, healthy meal. Choose colorful veggies and fruits, savor the smells and sights of your meal, and enjoy it mindfully, one bite at a time.

Nothing can take away from enjoying the season like sleep deprivation. Sleep is the time when our bodies rest, restore, and gather the resources necessary to wake up focused and ready for an intentional day. Especially during the busy holiday season, your body needs this time to reset. Adequate sleep helps the body to recover from stress, fight off illnesses, balance hormone levels associated with appetite and food cravings, and improve mood, just to name a few of the benefits of healthy sleep. If you are not waking up feeling rested, consider changing your bedtime routine to help you establish a calm state before bed. A few ideas include creating a consistent bedtime, turning off all technology at least one hour before bed, and avoiding substances that interfere with sleep (alcohol, sugar, caffeine, etc.). Treat yourself to a relaxing warm bath or cup of herbal tea and notice how your body can begin to relax and become calm before you get into bed.

Give yourself and those around you the gift of mindful presence this holiday season. Slow down and create a season of intention. Notice that you can find a moment of peace and joy, and take the time to absorb and extend that sensation.

Many Blessings to you all this holiday season,
Katie Winnell RN, BSN, NC-BC

b2ap3_thumbnail_katiewinnell_thumbnail.jpgKatie Winnell is a Registered Nurse and Board Certified Nurse Coach with Credentialing in Clinical Meditation and Imagery and Health Education. She helps clients reveal and activate a lifestyle of wellness though Integrative Nurse Coaching and Clinical Meditation, Mindfulness and Imagery techniques. Katie is now seeing clients through the Integrative Medicine Office of Dr. Carin Nielsen.



Spring has sprung in Northern Michigan, finally! More sun and warmer temps beckon us outdoors and inspire us to get out and move. Spring is a great time to enter into or return to your exercise routine*. But just like any other healthy habit, it can be hard to find the motivation to stay committed to moving our bodies. 

Instead of plodding through an exercise routine using highly over-rated willpower to push through motivation obstacles, how about taking a step back to look honestly at those obstacles, as well as your hopes and goals? Observing our strengths and struggles nonjudgmentally allows us to view and explore them without falling into sabotaging self-criticism. Once we are clear on where we are, strengths, struggles, and all, then we can plan the path forward with a clear vision based in reality and inspiration.

So, try taking a step inward to notice the story you may be telling yourself about exercising, a story which may color and shape your motivation and commitment to this healthy habit.  Journaling is a great way to begin this practice. Here are 3 journaling prompts to help you get started:

1) Get clear on where you are right now. Why do you want to exercise? It seems like an easy question, but we exercise for different reasons, some for specific health-related outcomes, some to meet athletic goals, and others to get out and feel better emotionally. Knowing why you want to exercise can help you choose a routine and set goals that will be effective and enjoyable. It can also help you remain realistic about your exercise routine, which helps you to set specific, achievable goals that honor your motivation and path, not someone else's. 

2) Take a peek at your future self. Close your eyes, take a deep breath, imagine walking a path. Ahead you see yourself 3 months from now. What do you see from a whole, integrated perspective? Not just your physical self, but what do hope for in terms of your emotional, spiritual, and relational self? Now, what strengths do you hold that can get you further along your path? Perseverance? Positive attitude? Enjoyment of the outdoors? And what obstacles might get in your way? Lack of social support? Time limitations? Self-criticism? How can you problem solve those obstacles now, so when they pop up, you have a plan to overcome them? Keep this picture (make sure it is realistic!) close, and revisit and revise when it's helpful. 

3) Maximize the benefits. Take a moment at the end of each exercise session to journal about how you feel, physically, emotionally, and spiritually. Our human brains spend lots of time ruminating on the negative aspects of new habits (no, it’s not just you, we all do it!), and it is more difficult to hard-wire in the positive. So take a minute to revel in your accomplishment and the state you are in after you exercise. What do you feel? Name how your body feels. Name the emotions you experienced while exercising and, positivity, pride? Revisit this positive physical and emotional state when you are low in motivation, remind yourself of what is to come (no worries if you aren't feeling those good vibes, journal about the obstacles you noticed and spend a minute problem solving those struggles).  

Journaling can be an effective awareness practice to help you uncover the stories that either limit you or motivate you. Give it a try, you might surprise and inspire yourself! Most of all, use exercise journaling as a method to explore, not critique. Everything you uncover is more information, neither good nor bad, just more self-knowledge to work with to fine tune your motivation. 

So, explore, journal, and MOVE!

*As always, if you have a specific health condition or are new to exercise, have a conversation with your health care provider regarding your exercise routine. 

Katie Winnell, Board Certified Nurse Coach, Health Educator, and Clinical Mediation and Imagery Specialist, can help you with your wellness plan using coaching, behavioral change, and self-awareness tools. You can make an appointment by calling 231.638.5585.

b2ap3_thumbnail_katiewinnell_thumbnail.jpgKatie Winnell, Board Certified Nurse Coach, Health Educator, and Clinical Mediation and Imagery Specialist, can help you with your wellness plan using coaching, behavioral change, and self-awareness tools. You can make an appointment by calling 231.638.5585.This email address is being protected from spambots. You need JavaScript enabled to view it.">



In our fast-paced, on-the-go culture, a meditation practice can offer moments of calm amidst the chaos, moments which can grow into a lifestyle of greater attention, awareness, and peacefulness. As stressful lives have led to an increase in stress-related illness, the healthcare industry has gravitated toward integrating contemplative practices such as meditation into care plans for those with new or chronic illness. This occurrence is supported by years of research into the effectiveness of using meditation as a tool for stress reduction, chronic illness risk reduction, and for balanced emotional and spiritual health. As western medicine becomes better at understanding the gifts of meditation, it is clear that meditation is an effective adjunct therapy for many physical, emotional, and spiritual illness states. 

In using meditation as an aspect of integrated medical care, however, we must be careful to match the meditation style to both the personality and the symptom set of the client. Though meditation skills, in general, are appropriate for almost all populations, using meditation clinically involves more than a one-size-fits-all approach. Using an evidence-based scientific approach to meditation has taught us that meditation changes the neurophysiology of the brain, changes the parts of the brain that are "on-line" and functioning, and changes brain wave activity in the brain. These changes, of course, are reflected in the body. So, how these practices are taught and applied, among other factors, can determine the outcome. This is important in setting where a particular outcome is desired, where others may not be. Different goals require different techniques. 

Fortunately, we know a lot about how different meditation techniques affect the body and the brain. And we know a lot about how different symptoms and illnesses present in the body and the brain. With the combination of clinician experience, medical history, and the client's own wisdom, specific meditation techniques can be matched to best meet the needs and goals of the client. Mindfulness Meditation may be the right fit for one client, Focused Awareness Meditation more effective for another, while Open Heart Meditation best matches the needs of yet a different client.

Research does indeed suggest that even relatively brief and general meditation training can have an impact, but this same research indicates that the popular impression that "meditation" or "mindfulness" is good for everything or everyone is a bit of a fallacy, especially when used in clinical settings. Clinically, meditation should not be guesswork. Rather, it should be used with specificity regarding the client's own goals, their physiology, and how different meditative techniques impact the brain and body. When meditation training is matched to the individual client, it has the potential to reduce stress, reduce chronic illness symptoms, and open the door to experiences of joy, wonder, curiosity, and peace.

b2ap3_thumbnail_katiewinnell_thumbnail.jpgIf you are interested in learning about how meditation can be effective for your life and health goals, you can make an appointment to begin your journey with Katie Winnell RN, BSN, NC. Katie is a licensed RN, Nurse-Coach and Health Educator with credentials in Clinical Meditation and Imagery. The upcoming Spring 2018 Foundations of Meditation Session, an introductory 4-week class which sets the foundations for your meditation practice, begins April 17th at 6:30 pm at Dr. Nielsen’s office, 413 Waukazoo Ave., in Petoskey. Call 231.638.5585 to pre-register or schedule an appointment.This email address is being protected from spambots. You need JavaScript enabled to view it.">


b2ap3_thumbnail_lotus-2436937_1920.jpgRegardless of who you are, where you live, or what you do, chances are you’ve experienced the stress and anxiety life can bring. The fact of the matter is, we live in uncertain times. As a human species, we always have. Intellectually we know there are no guarantees that come with being alive. Our evolutionary development demands that we stay alert to threats and potential danger so that we can stay alive. While we no longer find ourselves on the look-out for the proverbial lion outside the cave door, potential threats and turmoil abound, for some of us more than others. This can leave us feeling stressed, anxious, uncertain, and vulnerable.

Every day we absorb, integrate, and react to countless stressful stimuli from our external environment as well as the emotions and thoughts that these stimuli bring up within ourselves. Our brains have literally been designed to scan for these stimuli and attach emotion and memory to them (termed the negativity bias) (1). In this sometimes constant state of vigilance, we may find ourselves further and further away from a state of calm, a state of peace. This distancing from inner peace can lead to increased chronic stress and multiple stress related illnesses (2). Now we have added another layer of dis-ease to our uncertain lives.

And yet, amidst all of this turmoil, we live, we trust, we love, we look forward to tomorrow. How is it that we hold these two dichotomies within the same brain, the same heart, the same spirit? This is the essence of being human. It is in human vulnerability that we often locate both our desire for and our capacity to experience the state of peace which allows us to trust, to love, to find the meaning and purpose that see us through to tomorrow. And these potentials exist within each and every one of us. They are not mysterious or magical, they are the result of the intermingling and reorganization of the myriad functions of the human brain (3). This physiological fact, however, does not diminish the beauty and freedom experienced with unlocking these potentials. We all have access to these resources, sometimes we just need the guidance and support of others to nudge open the door within ourselves behind which they are waiting.

So how do we nudge this door within ourselves open? One inch at a time. The field of neuroplasticity has shown us we can “turn down” the negativity bias wired into our brains through evolution and “turn up” our capacity to scan and experience beauty, contentment, and peace (1). Doing this, however, takes a dedicated practice which guides us to a state of inner awareness, then gently turns this inner awareness to a more active state of focused attention to the experience of peace. This quite literally changes the activity of the brain biochemically and energetically, priming us to absorb and experience calm peacefulness. From this state we can access our own wisdom, our purpose in life, softening the vulnerability of uncertainty (4).

We can exist in peace, even in the tumultuous world in which we live. But this is a practice. And as in any practice, we need guidance and support. Join me at Dr. Nielsen’s office for one or both of these offerings as we explore the human potentials of peace, wisdom, purpose, and oneness through the practice of Clinical Meditation and Imagery.

Four-week session: When: Monday evenings November 6th, 13th, 20th, 27th, 2017, 6:30pm.
$140. Pre-registration required.

Drop-In sessions: When: first and third Tuesdays of each month** starting September 5th 2017, 6:30pm.
$15 drop-in fee. No registration required.
**please note: October 2017 offerings will be the first and fourth Tuesday, Oct. 3rd and 24th, 2017**

1. Hanson, Rick. Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence. Harmony Books, NY, New York.
2. Sapolsky, R. (2004). Why Zebras Don’t Get Ulcers. Sapolosky, NY, New York.
3. Schaub, Bonnie, and Schaub, Richard. (2014). Dante’s Path: Vulnerability and the Spiritual Journey. Florence Press, NY, New York.
4. Austin, James. (2000). Zen and the Brain. First MIT Press, Cambridge, Massachusetts.

b2ap3_thumbnail_katiewinnell_thumbnail.jpgIf you are interested in learning how I can help you manage chronic illness risk factors and access your own unique lifestyle of wellness through wellness management, health education, health coaching, workshops, and clinical meditation instruction or if you would like to schedule a consultation, please contact the office of Integrative Medicine - Carin Nielsen, MD at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.


In the busy-ness of our everyday lives, we often forget one of the most powerful tools we have to create physical, emotional, and spiritual wellness. Breathing. It seems so simple, yet so many of us breathe in ways that actually cause an increase in physiologic and emotional stress. The adage “breath is life” is finding ground in the medical community, with an increasing number of evidence-based studies showing the link between breath awareness practices and improved health. Indeed, these practices have the ability to positively impact multiple symptomologies, from test anxiety to high blood pressure, the common cold to chronic pain. Further, because breath awareness techniques have the ability to alter brain functions such as brain wave patterns and how parts of the brain “talk” to each other, breathing techniques can set the stage for new understandings, emotional integration, and spiritual development.

The link between specific breathing techniques and health outcomes lies in our innate ability to affect our nervous system function by simply breathing. Just taking a moment to be aware of the sensation of your breath as it moves in and out begins to switch your body out of stress and into relaxation. This happens because calm, focused breathing both mechanically and biochemically stimulates the parasympathetic nervous system. This is the branch of your autonomic nervous system sometimes called the “rest and digest,” or “tend and befriend” nervous system. Its activation has been linked to positive health benefits such as decreased heart rate, lower blood pressure, decreased pain, and increased immune response.

The polar opposite of this state of relaxation occurs with the activation of the other branch of the autonomic nervous system, the sympathetic or “fight or flight” nervous system. Chronic activation of this part of the nervous system can contribute to multiple health problems such as cardiovascular disease, GERD, weight gain, and anxiety. Given the hectic, busy nature of our lives, we spend a large amount of time in “fight or flight,” and not nearly enough in “rest and digest.” Subsequently, our culture is seeing a precipitous rise in stress related chronic illness. Many of these states of illness, however, can be positively affected by practicing breath awareness as a stress management tool, effectively altering the nervous system balance between “rest and digest” and “fight or flight.”

In the upcoming workshop, Breath Awareness for Stress Reduction, we will explore and experience three powerful breath awareness techniques: Simple Breath Awareness, Diaphragmatic Breathing, and Extended Exhalation. These evidence-based techniques, when practiced over time, can truly lower your physiologic stress levels, allow you to access your “rest and digest” nervous system, and decrease chronic illness indicators. Moreover, they set the stage for more in depth explorations of meditation as a tool for health and wellness. Whether used independently or as an introduction to meditative practices, breath awareness can be an effective tool to reach your wellness goals. So, go ahead, Just Breathe.

1. Bergland, C. (2013 Feb.). The Neurobiology of Grace Under Pressure. Retrieved from:, accessed 03/22/17.
2. Med Sci Monit. 2013; 19: 61–66. Published online 2013 Jan 21. doi:  10.12659/MSM.883743
3. N.A., (n.d.), Stress. Retrieved from:, accessed 03/22/17
4. Neurol Sci. 2017 Mar;38(3):451-458. doi: 10.1007/s10072-016-2790-8. Epub 2016 Dec 19
5. Pain Med. 2012 Feb;13(2):215-28. doi: 10.1111/j.1526-4637.2011.01243.x. Epub 2011 Sep 21

Carin Nielsen, MD Integrative MedicineIf you are interested in learning how I can help you manage chronic illness risk factors and access your own unique lifestyle of wellness through wellness management, health education, health coaching, workshops, and clinical meditation instruction or if you would like to schedule a consultation, please contact the office of Integrative Medicine - Carin Nielsen, MD at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.