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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.

An Introduction to Mindfulness Practice

Chris Frasz, BS, MSWMindfulness, an eastern meditation practice with a history of over 2,500 years, was established as a foundation for developing a clear and focused mind, allowing one to then analyze in depth various topics for self improvement.

With the gradual introduction of this practice to the west in the 60’s, interest has gradually built, supported by a great deal of research and empirical evidence, clearly showing many mental and physical benefits. Now, the practice of mindfulness is part of our culture, being incorporated extensively throughout the United States, from hospitals to businesses, from schools to professional athletic teams. Most recently, 60 Minutes aired a segment on mindfulness, touting both its efficacy and widespread use.

Mindfulness practitioners learn to better understand and regulate their thoughts, thus taking a more active role in improving their mental well-being. With developed stability and awareness, practitioner’s benefit by viewing and relating to their mental and physical states in a more objective and healthy manner. And, as the medical world builds empirical evidence relating to the connection of one’s mental and physical well-being, the mental growth and improvement has shown significant physical benefits, including:

  • Lower blood pressure
  • Lower heart rate
  • Increase in immune system
  • Stress reduction
  • Growth of grey matter in the brain (Psychiatry Research: Neuroimaging)

Within our upcoming course, Introduction to Mindfulness for Stress Reduction, we review the mindfulness practice in detail, giving participants various ways of engaging in the practice and the rationale behind why and how the practice is effective. Guided, in-class participation, combined with discussion and presentation, enables participants to learn and grow in a supportive and safe environment. Active engagement allows participants to build their own practice and create a foundation for future growth.

Chris Frasz received his B.S. from Michigan Technological University and his Masters Degree in Social Work from the University of Michigan, Ann Arbor. He has many years of experience teaching Mindfulness Meditation at a variety of levels, drawing on his exposure to various meditation techniques from both Western and Eastern meditation teachers, including Jon Kabat-Zinn, Kyabje Gehlek Rimpoche and others. His background in engineering, business, social work, and family life give him a unique perspective in understanding and working with the various stressors related to work, family, and life in general. If you are interested in learning more about the benefits of mindfulness and our Introduction to Mindfulness to Stress Reduction courses, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.


Today we finalized and published our fall Mindfulness class schedule and I am really excited about it.

What is Mindfulness?

Here is a textbook definition:  Mindfulness is the practice of paying attention to our thoughts and feelings purposely, in order to become more present within our own lives.

Need more clarification? Here is how I explain the concept of Mindfulness to my patients:  Mindfulness is a tool to create some distance between yourself and your “brain chatter”.


There will always be stress. Often in life it seems we finish dealing with one stressor, and there is another waiting around the corner. We can't change that. What we can change is our reaction to stress. We don't have control over the presence of stress in our lives, what we do have control over is our response.

When you start to think of stress in these terms, the concept of stress itself becomes external. You can put a little distance between yourself and the stress. By doing so, the effects of stress are less likely to "take over" your mind and body.

If you feel chronically “stressed”, it is likely that you have a good amount of what I like to call “brain chatter”. As a Type-A busy working mom, I am very familiar with this concept.  “Brain chatter” is all of that stuff that is spinning around in your brain.  It is the to-do lists, the thoughts about what happened at dinner last night, about where the kids need to be picked up later, about your worries about your job, about that kitchen faucet that still needs to be fixed, and everything else.  It is all of those thoughts that are spinning around in your brain while you go about your day.

With a brain so full of chatter – it’s difficult to concentrate on anything else.  You go about your day almost on “auto pilot”. You could get yourself ready in the morning, eat breakfast, and drive to work and yet be totally unaware of your actions because you are so distracted by your “brain chatter”.  If that chatter is full of worries and negativity, it can cause you to be irritable and snap at others for no apparent reason. You react quickly, perhaps in a negative way, because you are not focused and present within moment, your brain is focusing instead on negative chatter. The chatter escalates and spreads throughout your body, causing you the physical symptoms of stress (muscle tension, headaches, and heart palpitations to name a few).


It is called Mindfulness practice for a reason. You can read about the concept all day long, but it is putting it into action that gives you results. It isn't easy! It takes time to retrain your brain to become more aware and less reactive. With patients I often use the analogy of running a marathon. You wouldn't just wake up one day and run a marathon. You would spend months, oftentimes up to a year, to train. It is similar when training your brain. When learning Mindfulness meditation, you start with a few minutes here and there, and gradually work your way up to longer meditations.


"STOP" is a quick and easy way to start incorporating Mindfulness into your daily routine as a means of reducing the effects of stress. It takes about 30 seconds. I often do this routine in between seeing patients.

S = Stop what you are doing

T = Take a deep breath.  A " belly breath", Relax your abdominal muscles and breathe deep as though you are filling your belly with air.

O = Observe. How is your body feeling? Where are your thoughts right now? If your mind is spinning with "brain chatter", acknowledge this chatter and then set it aside. Put a little bit of space in between you and your "brain chatter"

P = Proceed. Go on about your day with a mind that is slightly more clear and a body that is slightly more relaxed.

Have I sparked your interest? I’ll discuss the science and research of Mindfulness in future posts, but if you are interested in getting started this fall we will offer everything from one-night workshops to a six-week course to teach the principles and practices of Mindfulness.

Chris Frasz, MSW

Back by popular demand, we will be offering our six-week introductory course "An Introduction to Mindfulness for Stress Reduction". This course is facilitated by Chris Frasz, MSW who has facilitated several courses for us in the past and gets many rave reviews and requests for additional classes. Chris recently completed a week-long Mindfulness intensive under the direction of Jon Kabat –Zinn, the founding and executive director of the Center for Mindfulness in Medicine, Healthcare, and Society at the University of Massachusetts Medical School. Learn more about this class and Chris Frasz by clicking here,

Kelly Daunter, PsyD, LLPIn addition to the six-week introductory course, clinical psychologist Dr. Kelly Daunter will be offering three one-night Mindfulness Workshops - Mindful Eating, Mindful Parenting, and Mindfulness for Stress Reduction During the Holidays. These workshops are a great way to “get your feet wet” and see what Mindfulness Practice is all about, while applying the concept to everyday life stressors. If you’ve ever mindlessly ate a bag of potato chips, snapped at your kids and regretted it, or felt run-down by Holiday stress, one of these workshops might be for you!

Workshops will be held at Integrative Medicine | Carin Nielsen, MD in Downtown Petoskey. Space is limited and advanced registration is required. Please contact us to reserve your spot (231) 638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it." target="_blank" style="color: #f05329; line-height: 1.5;">This email address is being protected from spambots. You need JavaScript enabled to view it.