Trysa Shulman & Associates

09/03/2025

Please join us! Register today by emailing Leahincleveland@gmail.com for Psychology Grand Rounds: Dr. Ashley Gabelman will present how she uses ACT and ERP to effectively treat OCD. You don't want to miss this!

06/29/2025

There is so much in this person's story that speaks to the ideas I've been wanting to explore around the underlying causes of depression and debunking the idea that any mental illness is a static "thing" rather than a process of physiological and psychic interruption that needs to be uncovered to be healed.

Can you safely taper off psychiatric medications? And what are the potential harms of long-term psychiatric care?Laura Delano spent years as a professional p...

06/11/2025

The first episode of The Rehearsal definitely has therapeutic value. I'm not sure if I can say that about the rest of the show (I'm about 4 episodes in). But there's a DBT skill called Cope Ahead this is built on a lot of the same principles as the basis of that first episode, which was brilliant!

06/11/2025

06/09/2025

So glad to see the promising research being done to develop a knowledge base in the field of metabolic psychiatry. Came across this editorial article in _Frontiers in Psychiatry_ listing the state of the field

Insulin resistance, pre-diabetes, type 2 diabetes, obesity, and other metabolic disorders are becoming increasingly commonplace around the world, and are str...

05/21/2025

Self-abandonment as defined here can lead to "Logjam Depression"

05/21/2025

This is an underused resource! Crisis text line is wonderful for people who need to talk things through, who could use a good listener, and who don't want to feel alone with whatever they are carrying.

05/20/2025

All 6 videos are live!
My framework for categorizing depression by its underlying causes, rather than by symptom presentation. Not all types of therapy address every type of depression effectively! We need to match our treatments to the underlying causes so that folks can truly heal. Depression is not a disease with a single cause - it's more like a fever, telling you something is wrong and needs to be addressed. Figuring out whether the underlying issues are "meaning based vs non-meaning based" is a good place to start. People can suffer with more than one type of depression. Each one needs to be tended to for health and thriving.

My framework for categorizing depression by its underlying causes, rather than by symptom presentation, helps you know what type of therapy or interventions ...

04/25/2025

DEPRESSION as a collection of symptoms is sort of like a fever, in that when you get a fever, it tells you that something is wrong. But it doesn’t tell you what is wrong. It could be a bacterial infection. It could be a virus. It could be from heat exhaustion, etc. All the various types of depression can manifest in the same outward symptoms of low mood, loss of interest, sleep disturbances, feelings of hopelessness, guilt, irritability, changes in appetite, trouble concentrating, etc. – which is why they are mistaken for the same thing. Once the body learns to use depression/shutdown symptoms to deal with distress – those same symptoms can manifest for any number of reasons, but the underlying reasons do matter. Learning which type of depression you have (by underlying cause, not by DSM diagnostic category) can point you toward the treatments and interventions that are most effective towards healing.

04/25/2025

When it comes to biomarkers and medication as the first line of treatment, we are certain of less than what we thought we knew 20 years ago. But that doesn't mean we know nothing. Sometimes knowing less can allow us to have _more humility and flexibility in the way we’re thinking about a complicated problem_ and even though that might not feel satisfying, and uncertainty can make us anxious, it can ultimately give us more clarity in being able to listen to the individual experiences of the people who are struggling and let those experiences inform the treatment and supports that we provide.
Any time someone says that medication is not always the answer, or not as good as we thought, they draw a lot of blowback. So Paul Tough will get some of that pushback for his recent important piece in the NYT Magazine (link in comments to full magazine article). Pushback comes especially from people and groups who are scared of the dangers of the groups like Scientology who fall on the extreme end - saying that children shouldn't be medicated at all. That's not what Tough is saying.
Some folks personally won't like this article because they’re scared that if medication is not always the answer that might mean they are not making the best decision for their kid if they are forcing their kid to take stimulants for ADHD, or it might not have been worth the sacrifices that they made to take the medication (lost appetite, battles in the home, poor mood reactions for some, rebound effects when the drug wears off, effects on sleep). But the truth is, it’s always more complicated when it comes to mental health and mental struggles. As Tough says, these meds can be very helpful for some and many teens and adults develop complicated relationships with their meds and when and how they decide to take them. We know that all mental health struggles are multi-factorial, multi-determined and none of them have one solution alone that always works for everybody, or that works same for everybody. I welcome Paul Tough's complicating of this problem and bringing to light the updated science for a general audience.

04/01/2025

Crying during intimacy can be a sign of healing and of feeling safe.

03/30/2025

After watching the Netflix series, Adolescence, I have many thoughts. There is so much to process.
I'm sure many parents are watching this and wondering what to do about limiting access to social media and the like. That's important, but it misses the underlying social-emotional causes that make so many children susceptible to the toxic messages being peddled on the internet.
I highly recommend "I don't want to talk about it - Overcoming the Secret Legacy of Male Depression" by Terrence Real on the topic. What Terry Real calls Covert Depression is what I might call the combination of Attachment Wound depressions and Logjam depressions: an inability to own and healthily feel/express all parts of oneself, and the shame that results from living in a society or a family that gives the message that some of your feelings or some aspect of you is unacceptable.
Schools and society needs to take bullying seriously. Families need to learn how to teach relational and emotional skills. There is so much work for us all to do. We cannot throw up our hands.
https://www.goodreads.com/book/show/236765.I_Don_t_Want_to_Talk_About_It