Calendula: Healing your Wounds both Psychic and Physical by Julie Foster Family Nurse Practitioner


A sweet friend has a garden full and shared her bounty.

Apparently it grows like a weed.

I will make an remedy of
Infused Oil
Calendula Essence in an alcohol tincture

Calendula helps with wound healing, both psychic and skin wounds.

The oil applied is nice for wanting to feel more secure. Great for babies getting used to being out of the womb into the world. Sometimes us adults feel vulnerable like babies.

The tincture applied to infection prone wounds after soaking and cleaning. Apply with gauze and let air dry.

The salve to help move along a healing wound to seal and make new skin (granulation).

I am drying out for a day and then will get started making medicine.

I also was gifted seeds to propagate for my home.

Let the healing begin!

As Primary Care Providers we know how to assess and treatment your most common emotional and physical wounds……….

Schedule an appointment with us Pohala anytime (503) 572-4196

Summer Loving: Keep your Cool in Fire Season by Malia Susee Licensed Acupuncturist


3 Ways to Keep Your Cool in Fire Season——

Summer’s element is fire, according to Five Element theory used in Traditional Chinese Medicine, and fire’s associated emotion, when in balance, is joy. When fire is overabundant or unchecked, it can have far-reaching effects; Too much heat, light, and activity can damage fire’s relationship with the body’s other elements, manifesting in panic, insomnia, restlessness, mania, and even urinary discomfort, fever, and physical injury. So, how do we spark summer joy without being consumed by it? These three things can help:

Nourish yin:

Drink plenty of clear fluids. Eat watermelon; Watermelon (especially the white part) clears heat, drains dampness, cools the body, and calms the spirit. Blueberries, blackberries, and huckleberries also nourish yin, as do kidney beans, tofu, and mung beans and sprouts.

Balance activities, workouts, and commitments:

Heavy cardio or anaerobic (yang) workouts need more aerobic, slow-twitch (yin) activities for balance in summer. Swim leisurely. Walk in the woods. Meditate. Enjoy summer reading. Stick with healthy routines (including psych meds unless your prescriber is actively helping you wean off of them) and keep commitments in check: Summer is an excellent time to celebrate connect with friends, but it’s easy to overbook your commitments when the season’s light and heat are high.

Visit your acupuncturist:

Acupuncture can help calm the body’s sympathetic nervous responses during overactive times. It balances all the body’s systems, rendering us less vulnerable to summer’s excess heat, and less likely to engage in injurious excess. (Note: It also helps you heal after having broken your arm waterskiing.)

Schedule acupuncture with Malia Susee, L.Ac. by calling Pohala at (503) 572-4196.

Antidepressants: How to reduce or taper off your Medications by Tyler Mostul Psychiatric Mental Health Nurse Practitioner in Portand, Oregon

Nearly all psychiatric drugs can potentially cause mild to severe withdrawal symptoms. If you are interested in exploring reducing or coming off of your antidepressant it is important to have a prescriber who is knowledgeable about what can occur in the antidepressant withdrawal process and how to go about it in as safe a way as possible. NEVER ATTEMPT TO COME OFF YOUR PSYCHIATRIC DRUGS ALONE.

Most psychiatric drugs
cause withdrawal
reactions, which can
include life threatening
emotional and physical
reactions. Withdrawal
from psychiatric drugs
should be done carefully
under experienced clinical

Various studies suggest 50-86% of people experience withdrawal symptoms when coming off of
their antidepressant, making some people feel they are addicted or dependent on them.
Symptoms range from mild to severe, with some estimates of 25% of people that experience
withdrawal having severe withdrawal symptoms. 1,2,3,4,5,6,7,8,9,10, 11 Antidepressant withdrawal can
occur in those who have taken the drug for only one to two months, 12,13 and up to 78% of
people taking their antidepressant feel that they are addicting. 14 Some antidepressant users
who have also used opiates, cocaine, or other drugs of abuse say it was more difficult to get off
their antidepressant than these other drugs. 23 Fortunately, we know that a slow and gradual
antidepressant taper reduces the risk of distressing withdrawal symptoms occurring.
Some common symptoms of antidepressant withdrawal: worsened mood, irritability, anxiety,
agitation, crying spells, poor concentration, dizziness, electric shocks/head zaps, blurred
vision, burning sensations, tingling, nausea, vomiting, fatigue, muscle pain, chills or
temperature dysregulation, insomnia, vivid dreams, as well as suicidal and homicidal
thoughts and urges. As you can see, some of these symptoms overlap with things you may
have been experiencing when you originally started the drug. This is why withdrawal symptoms
are often wrongly interpreted as a return of your mental health condition or the emergence of
a new one. Careful assessment is crucial.

There are many reasons a person might be interested in reducing or stopping their
antidepressant. One reason is there is a long list of potential adverse effects, some of which are
very common. Some of the most common adverse effects of antidepressants are 60% of
people report feeling emotionally numb, apathetic, or indifferent. 15 50-90% of people
experience sexual dysfunction in a variety of forms. 15,16,17,18,19,20,21 The overall effect of
antidepressants could be described as feeling an increased distance or disconnection between
antidepressant users and their worlds. 22 These effects could be useful for some at least for a
time. It is important to continually assess whether the antidepressant is having an overall
useful effect for you or not. If you are interested in reducing or coming off of your
antidepressant, this is something I specialize in and I would love to discuss options with you
including the possibilities of a slow and gradual antidepressant taper.


Schedule an appt with Tyler Mostul PMHNP if you want guidance in your process at

Pohala Clinic (503) 572-4196


1. Barr, L.C., Goodman, W.K., Price, L.H., (1994). Physical Symptoms
Associated with Paroxetine
[Paxil] Discontinuation [withdrawal], American Journal of Psychiatry, 151:289
2. Black, D.W., Wesner, R., Gabel, J. (1993). The Abrupt Discontinuation
[withdrawal] Fluvoxamine [Luvox] in Patients with Panic Disorder, Journal of Clinical Psychiatry, 54:146-49
3. Fava, M., Mulroy, R., Alpert, J., Nierenberg, A.A., Rosenbaum, J.F. (1997). Emergence of
adverse events following discontinuation [withdrawal] of treatment with extended-release venlafaxine
[Effexor], American Journal of Psychiatry, 154 (12): 1760-2.
4. Giakas, W.J., Davis, J.M. (1997). Intractable withdrawal from venlafaxine [Effexor] treated with
fluoxetine [Prozac], Psychiatric Annals, 27:85-92
5. Kasantikul, D. (1995). Reversible delirium after discontinuation of fluoxetine [Prozac], Journal of the
Medical Association of Thailand, 78:53-54
6. Kessing, L., Hansen, H.V., Demyttenaeire, K., et al. (2005), Depressive and bipolar disorders: patients’
attitudes and beliefs towards depression and antidepressants, Psychological Medicine, 35:1205-13
7. Perahia, D.G., Kajdasz, D.K, Desaiah, D., et al. (2005), Symptoms following abrupt
discontinuation of duloxetine treatment in patients with major depressive disorder, J Affect Disord,
8. Pyke, R.E. (1995). Paroxetine [Paxil] withdrawal syndrome, American Journal of Psychiatry,
9. Read, J., Cartwright, C., Gibson, K., (2014), Adverse emotional and interpersonal effects
reported by 1829 New Zealanders while taking antidepressants, Psychiatry Res, 216:67-73
10. Young, A., Haddad, P., (2000), Discontinuation symptoms and psychotropic drugs, Lancet, 355:1184
11. Coming off antidepressants. Royal College of Psychiatry.
12. Coupland, N.J., Bell, C.J., Potokar, J.P. (1996). Serotonin reuptake inhibitor withdrawal, Journal
of Clinical Psychopharmacology, 16:356-62
13. Haddad, P.M. (2001). Antidepressant Discontinuation Syndromes, Drug Safety, 24: 183
14. Raven, M., (2012), Depression and antidepressants in Australia and beyond: a critical public health
analysis (PhD thesis). University of Wollongong, Australia;
15. Read, J., Cartwright, C., Gibson, K., (2014), Adverse emotional and interpersonal effects reported by 1829
New Zealanders while taking antidepressants, Psychiatry Res, 216:67-73
16. Kirsch I. (2014). Antidepressants and the Placebo Effect. Zeitschrift fur Psychologie, 222(3), 128-134
17. Baton, R. (2006). SSRI-associated sexual dysfunction. American Journal of Psychiatry, 163:1504-1509
18. Modell, J.G., Katholi, C.R., Modell, J.D., et al. (1997). Comparative sexual side effects of bupropion,
fluoxetine, paroxetine, and sertraline, Clinical Pharmacology and Therapeutics, 61:476-87
19. Montejo-Gonzalez, A.L., Llorca, G., Izquierdo, J.A., et al. (1997), SSRI-Induced Sexual Dysfunction:
Fluoxetine [Prozac], Paroxetine [Paxil], Sertraline [Zoloft], and Fluvoxamine [Luvox] in a Prospective,
Multicenter, and Descriptive Clinical Study of 344 Patients, Journal of Sex and Marital Therapy, 23:176-94
20. Montejo, A., Llorca, G., Izquierdo, J., et al. (2001). Incidence of sexual dysfunction associated with
antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for
the study of psychotropic-related sexual dysfunction, J Clin Psychiatry, 62 (suppl 3): 10-21
21. Patterson, W.M. (1993). Fluoxetine-induced sexual dysfunction, Journal of Clinical Psychiatry, 54:71
22. Teal, Jay. (2009). Nothing Personal: An Empirical Phenomenological Study of the Experience of “Being-on-
an-SSRI”. Journal of Phenomenological Psychology. 40. 19-50. 10.1163/156916209X427972
23. Healy, D. (2016). Psychiatric Drugs Explained (6th ed., p. 261). N.p.: Elsevier.

We Accept the Following Insurance Companies at Pohala Clinic 

We know that insurance coverage is very important when you are making health care decisions. We accept a variety of insurance companies at Pohala including Blue Cross Blue Shield, Providence , United Health Care, First Choice Health, MODA  and Pacific Source. We are also willing to work with any other insurance company you may use.
Pohala is committed to providing the best care in functional and natural medicine in the Portland area. We have a variety of specialists including family care, nurse practitioners, naturopaths, psychiatric professionals, acupuncturists and body workers.
We will gladly answer any questions you have about insurance coverage. Feel free to contact Pohala with your questions.
Julie Foster- Nurse Practitioner, Owner

Pohala Welcomes Alexandra Gotea Naturopathic Physician and Licensed Acupuncturist


As Pohala Clinic grows we have hand selected all our Medical Providers. We admire those who have a shared vision for healing and who want to be present to patients in a changing tumultuous world. We want providers who can bridge mainstream medicine to holistic ways of healing. While being experts in traditional medicine Pohala providers are also experts in an array of modalities.   We are pleased to announce our newest provider!

Dr. Alexandra R Gotea ND, LAc is a licensed Naturopathic Physician and Acupuncturist. Her path to medical training is rooted in her nursing studies and providing nursing care in a high acuity setting in New York City.

She wholeheartedly believes in working together in a trusting relationship with her patients towards a place of health and healing. She believes in the communion between mind, emotions, body and spirit and the effect these mutually have on one another and manifest as symptoms of dysfunction. Balancing these is key to the healing process.

Her nursing experience and extensive training in Naturopathic and Classical Chinese Medicinegave her the tools to ‘read’ nuances of each persons’ body. Thru her studies, trainings and personal experiences, she learned that in many ways: our bodies are our storytellers! It is about deeply listening to the body and attuning to the expression of the impediment to health in an individual.

Dr. Alexandra R Gotea works towards creating a space where the patient can feel at home and be part of a nurturing environment to access their own healing potential.

 Areas of focus

  • primary care concerns
  • acute and chronic pain
  • chronic conditions such as chronic fatigue
  • neuro-degenerative disorders
  • auto-immune disorders such as thyroid disorders
  • depression, anxiety
  • woman’s health conditions such as infertility, PCOS
  • sleep concerns
  • urinary disorders
  • digestive complains such as IBS, IBD
  • holistic oncology
  • physical exams/screening exams/Gyn screening exams
  • MVC


  • Naturopathic Medicine and primary care allopathic approaches
  • Chinese and Western Herbal Medicine
  • Acupuncture
  • Diet
  • Homeopathy
  • Flower essence
  • Bodywork
  • Craniosacral Therapy
  • Holistic Pelvic Floor


She has an extensive Educational background:

Doctorate in Naturopathic Medicine, National University of Natural Medicine.

Doctor of Science in Oriental Medicine, National University of Natural Medicine.

Bachelor of Science in Nursing, Binghamton University, New York.

Bachelors of Arts in German Language and Literature, Binghamton University, New York.


She belongs to these Professional Organizations:

American Association of Naturopathic Physicians

Oregon Association of Naturopathic Physicians

Oncology Association of Naturopathic Physicians

The Arvigo Techniques of Maya Abdominal Training


Outside of work:

Dr.Alexandra R Gotea, ND, LAc enjoys spending time in nature, wild crafting and making her own medicines, exploring traditional medicines form around the world, traveling, assisting and supporting initiatives that nourish Naturopathic and traditional medicines.

And did you know she is multi-lingual?

English, Romanian, German. Working knowledge of Spanish and Italian.




Why did Tyler Mostul become a Psychiatric Mental Health Nurse Practitioner: Becoming Sane in an Insane World

Tyler Mostul


Pohala now has Behavioral /Mental Services. So many people are suffering, and at least in Oregon, so many cannot find a mental health practitioner or when they do they do not align with their values.   Psychiatric Mental Health Nurse Practitioner Tyler Mostul is unlike most in that he has an unique perspective and aims to focus more on therapy, holistic approaches as opposed to pharmaceuticals. When warranted Tyler Mostul PMHNP has the expertise to prescribe pharmaceuticals and does so, thoughtfully.

His original interest in psychiatry grew out of his experience volunteering for a year with the homeless in Los Angeles, California.  After he graduated with his Bachelor’s degree in Business Administration and a minor in Theology, he developed an interest in learning how a person comes to be in a place where they did not have a house to live in.  At that time, this was not a situation that he or anyone close to him had ever had to deal with. He figured there was no better way to learn than to LISTEN  to those who found themselves experiencing homelessness directly.

During his time in L.A., he was present in the lives of those who were some of the most oppressed in our society.  He witnessed these people grossly mistreated by police, paramedics, and other social service providers.  He listened to horror stories of what people go through to survive.  He realized that mental health and substance abuse are two of the largest personal barriers to people improving their lives, and he saw firsthand that the way society at large chooses to deal with these things does not work very well.  In fact, the places people are told to go for help often cause more harm than good. This awakened a passion inside of him to attempt to help people deal with their problems in a way that causes them the least amount of distress as possible.  

This experience and others for him solidified the belief that there are always significant psychological, social, and environmental factors that contribute to a person’s mental health.  Whether a person lacks enough money to pay for their basic needs or has plenty of money, there will always be significant psychological, social, and/or environmental factors involved.  This concept heavily influences his practice today.

Psychiatry attempts to say that a person’s mental health struggles are due to there being something wrong with their brain.  First of all, this is a theory that even psychiatry acknowledges is a theory and not fact, yet many mental health providers promote this theory as fact.  The theory that mental health challenges are caused by there being something wrong with the brain never made sense to Tyler as he saw there were endless things going on in a person’s life that could easily explain why a person would be depressed, anxious, or addicted to something.  Not only is there no brain scan, blood test, genetic test, or other objective test mental health professionals use to diagnose mental health conditions,  Later he learned that the evidence does not support the brain-based theory of psychological distress either.  

Tyler Mostul PMHNP does not see depression, anxiety, mania, addiction, hearing voices, or seeing visions as some kind of brain disease or as “insane.” Instead he sees them as sane ways of relating to and coping with a person’s often insane world.  Acknowledging this has the potential to provide some relief as we open up to being more gentle and compassionate with ourselves. Discovering new ways of relating to our insane world also has this potential. He hopes to explore these possibilities with his clients.

Tyler Mostul PMHNP is accepting new patients. Call Pohala for an appointment today (503) 572-4196


Spring Cleanse with Chinese Medicine Approach by Malia Susee, Acupuncturist in Portland, Oregon

Here are some  thoughts on Spring Cleaning your Body for Better Health from a Traditional Chinese Medicine perspective.

Malia Susee Licensed Chinese Acupuncturist shares three things that can help you enliven and reboot your health for 2019:

1) Start with a clean slate. “Detox” and “cleanse” diets are popular Spring approaches to reset the body’s systems after winter’s down-time and heavy foods. Seek advice from a medical provider or at least to help understand what kind of liver cleanse, fast, or detox regimen is right for your body. Saunas, detox-tea, dry-brushing your skin, and drinking plenty of water are ways you can boost the effect of your cleanses.

2) Eat your greens! Traditional Chinese Medicine (TCM) uses blue-green foods (chlorophyll rich dark leafy greens, algae) and slightly sour flavors (i.e., plum) to support the liver, the organ/energetic system that governs the smooth movement of chi (qi). In his book Healing with Whole Foods, Paul Pitchford also recommends radishes, lettuce, cucumber, and celery to help detoxify and cool the liver. If you don’t digest salads well, eat cooked veggies. Good digestion is key to good nutrition!

3) Move it! Acupuncture, exercise, meditation, Qi Gong, Tai Chi, and yoga are helpful ways to move chi (qi) and keep your emotional and physical health in balance. The TCM liver and gall bladder (not just the organs in our bodies, but entire energetic systems in the TCM paradigm) the are of the wood element and require movement to help you manifest your hopes and plans. (Picture trees branching out and sprouting leaves.) Without movement, these energetic systems are prone to irritability and anger and take it out on your body’s other systems (think of any health complaint exacerbated by stress). With movement, Springtime turns their smoothly flowing chi (qi) into a super-booster for your health and your efforts!

Schedule your appointment with Malia Susee, L.Ac. at Pohala (503) 572-4196 to create a plan for you!

Nettle Tea with Julie Foster

A rainy, walk last week in Oregon. I was able to collect Nettles. 🌿🌱Additionally, Horsetail, Ferns, Trillium and endless medicine surrounded me in the Forest.

1. Tea for Iron Deficiency and Blood Building.
2. Nettle vinegar for base of salad dressings and drinking vinegar eases digestion.
3. Add to soups
4. Saute with veggies.

My sweet rescue dog🐕 Shasta was curious about them too.

Just finished a cup🍵 of Nettle Tea. Yum!!!!

– Julie Foster

The Courage to Heal with Nurse Practitioner Julie Foster

Last night met by my endearing Anthroposophic colleagues 🙋‍♀️🙋‍♀️🙋‍♀️ who travelled to stay with me, then to wake up at 4am and travel to New York for a week of training.

One theme is to discuss the Courage 🦁 to Heal. I think it relates to…

1. What does it mean as a Healer to show up for a person to invite a space for healing to happen?

2. How can patients too have the Courage to stand in the face of anything and be brave enough to Heal?

What healing means to one person can mean something else to another. 🌸

We will cover topics for women’s health, chronic illness, and one of my favorite teachings on the Alchemy of the 7 Sacred Metals for healing. All of this in the context of holistic medicine.

Did you know that the word Anthroposophy means Human in Divine Wisdom? And furthermore the Divine Sophia (Feminine) Wisdom. Why does that matter? When we can know ourselves and be guided in such a higher force of Divine Wisdom then we may become or see our full human potential.

Anthroposophy gives me a lens to view the cosmos and all its facets for healing. We focus on what makes us healthy (salutogenesis). Out of this true healing is possible. My practice is guided in part by these approaches.


– Julie Foster


New Mental Health Practitioner at Pohala helps with Depression, Anxiety, Psychosis, Schizophrenia in Portland, Oregon

Tyler Mostul

Pohala would like to introduce Tyler Mostul, Psychiatric Mental Health Nurse Practitioner.  This allows him to address various mental health challenges through medication management as well as therapy.  He graduated from Yale School of Nursing, and completed a residency at the San Francisco Veteran’s Hospital.  He is an unique psychiatric prescriber in that he is openly critical of psychiatry and psychiatric medications.  This does not mean that he does not support the usage of medications, it means that he is intricately aware of the risks involved in doing so. He feels it is his job to thoroughly discuss the risks and benefits of using psychiatric medications in order to help you feel fully informed of the options you have in addressing your concerns.  


He has particular interests in helping people be on the least amount of psychiatric medications as possible in order to reduce the risk of potential negative impacts they can have, and he has an understanding of the potential challenges with psychiatric drug withdrawal and medication tapering.  He also has interests in working with people in therapy who have experiences that have been labeled as psychosis or schizophrenia. He values and enjoys taking sufficient time in connecting with his clients and working together to figure out how to best achieve your goals.


There are several guiding principles he uses in his practice:

– People are inherently good

– We do the best we can under the conditions we are given

– Often the conditions we find ourselves in are extremely stressful, and this significantly affects our experience in the world.  

– Under extreme stress, we often do things we would not normally do.  These behaviors may seem irrational, but when seen in the larger context, they are understandable and reasonable.   

– Mental health symptoms are often a message to us, which if understood and learned from, have the potential to liberate us from our suffering.  


He acknowledges that we live in a society where racism, sexism, income inequality, homophobia, and transphobia are powerful forces that often negatively impact our lives in significant ways.  He acknowledges that various traumatic experiences including and not limited to those just listed, influence the way that we live, and can be the main reason we are experiencing the types of distress we find ourselves in.


In his therapy practice, he is heavily influenced by feminism, radical therapy, mindfulness, and psychodynamic therapy.  This means that he has an understanding of how various forms of oppression may be impacting you, and am sensitive to the complexity of the dynamics involved in your life.  He also believes there can be meaning discovered in the distress you are experiencing.  His goal is to work with you in a way that you find useful, and not to rigidly fit you into any particular modality.  He uses principles from CBT (Cognitive Behavioral Therapy), CBT for psychosis, and DBT (Dialectical Behavioral Therapy).  I also use EFT (Emotional Freedom Technique), also known as “Tapping.”  This modality is very useful in helping people release emotional distress and trauma from our body in a way that cognitive and behavioral methods cannot.  


He enjoys kundalini yoga, hiking, cycling, reading, chilling by any body of water, and disconnecting from technology.

Please Call Pohala (503) 572-4196 to schedule an appointment today with Tyler Mostul PMHNP