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Season 1 Episode 6 – Melanie Badali

Dr. Melanie Badali is a Registered Psychologist and is certified in the practice of Cognitive Behaviour Therapy (CBT) by the Canadian Association of Cognitive and Behavioural Therapies. With over 15 years of experience working as a clinician, researcher, and instructor in the field of psychology, Melanie currently provides assessment and treatment services at the North Shore Stress and Anxiety Clinic. 

In this podcast, Melanie shares how she overcame her own struggles with anxiety on her way to being a therapist, and how “One of the great things about Anxiety Canada is that you can research anxiety and have access to high quality evidence-based information.”

John Bateman (JB): Melanie? How are you?

Melanie Badali (MB): I’m great. And also anxious. I know all the tools and as I was waiting on hold to speak I noticed I’m super anxious.

JB: Well it’s interesting and heartening to hear that a trained therapist like you still experiences anxiety – thank goodness!

MB: We all experience anxiety and some of us more than others. Some of us are wired that way. And some of us get some baggage along the way.

JB: For sure.

MB: Anxiety can wax and wane over time. For me, the key is not letting anxiety boss you around. We need more people talking about anxiety, talking about what tools we can use to manage anxiety, such as Anxiety Canada’s great new MindShift CBT app. But also to say ‘here I am’. And just because I’m thriving doesn’t mean I’m not also suffering with some anxiety too. There is definitely a management component involved for people with anxiety disorders. That is, people who have a symptoms that cause them distress and start interfering with their lives.

JB: Yeah. Did you experience anxiety on a critical level at any point?

MB: Yes. I’ve always been a worrier. I come from a long line of worriers.

JB: Yeah. Anxiety has had many different names over the years.

MB: For sure. And I just thought certain things were normal because everybody in my family was that way. For me anxiety started ramping up in my twenties and I’m 45 now. I was just reflecting before I was going to be talking with you about how lucky I was that I had already started some graduate training in clinical psychology because when I had my first panic attack, I knew what it was.

JB: That’s interesting.

MB: Panic attacks are quite common. But not everyone who experiences a panic attack goes on to develop panic disorder, where you start having more of them and you start doing things differently because you don’t want to have another one. Then you start to develop kind of that fear of fear. I think I was very lucky because I was able to figure out what was going on. The panic attack didn’t feel good – It was very, very uncomfortable. But I don’t think it was as scary for me. I didn’t actually feel like I was gonna die or lose control or go crazy or some of the common thoughts people have because I realized what was happening. I’m like, ‘Oh well, I’m having panic’.

JB: I guess. I mean, if I can use it in this term, I guess you’re lucky in that sense. No panic attack is never lucky, but…

MB: Oh no. But I definitely was lucky. My knowledge about anxiety helped me. One of the great things about Anxiety Canada is that you can research anxiety and have access to high quality evidence-based information. You can learn a little bit more about what’s going on. It’s really helpful even knowing it is in fact anxiety causing the panic attack: often people don’t know what’s happening end up in the ER thinking they’re having a heart attack.

JB: Yeah, yeah. So what led you down the CBT route?

MB: Well that was an easy path for me. The first course I took on any type of therapy was Cognitive Behavioural Therapy back in my undergrad at McGill University. And the instructor who taught it included not only what was the theory and what were some of the research studies, but what I thought was an overwhelming amount of evidence that this type of therapy worked really well for a lot of different problems. And so that was my taster. And then when I went into graduate school, the program that I was lucky enough to be accepted to had a strong CBT focus. So I was able to get really good training right from the get go. But that’s not everybody’s path.

JB: Yeah. And do you find that your direct experience of anxiety and panic attacks helps you with how you deal with patients?

MB: I think so. I don’t believe that you need to have personal experience with everything to help somebody. I think there are enough commonalities of the human condition and things that we share. But I think it’s an extra layer of insight into how horrible it feels in the moment. There are different types of empathy. There’s cognitive empathy – being able to see things from another person’s perspective. And then there’s emotional empathy, which is sharing the feelings with someone else. In Cognitive Behavioural Therapy, we’re often looking at that cognitive piece. We’re trying to look at things from different perspectives and also helping people look at things from different perspectives. To help anxiety, we are trying to take a view that focuses on a realistic appraisal of their ability to cope and of current threat. People often overestimate the threat or danger and also underestimate how well they’re going to be able to cope or handle the situation. So we’re often talking about different perspectives, but in terms of that little insight into what it feels like to be overwhelmed in the moment – yes, I definitely have that.

JB: Yeah. I often wonder about how, if you subject 10 people to the same kind of stressors, there’s that percentage of people, which is alarmingly high, whose anxiety goes to that next level of getting a phobia or having chronic anxiety or generalized anxiety. What causes the difference in reactions with people?

MB: That’s a great question. There are studies done for different disorders, and there are definitely more nuances in the literature. But I think the take home is, it’s usually a number of factors. There are genetic vulnerabilities. We come pre-wired with some stuff. But as a Cognitive Behavioural Therapist, my slant definitely is what are the cognitive factors or the ways you’re thinking about things that might be making things worse or maintaining things. And what things are you doing that are making things worse? So for example, you decide to do all these live interviews. Then it’s the weekend before you’re like, ‘Oh crap’.

JB: Yeah, exactly.

MB: ‘What am I getting myself into?’ It might not even be that concrete, you just have this full body reaction to the upcoming event. Now if at that time you decide to call it off and you say, ‘Oh, sorry, Anxiety Canada you’re going to have to find yourself another host’ – well, you’re never going to learn that you can actually move through that anxiety to accomplish your goal.

JB: Yeah. And it’s interesting because that’s been one of my go-to things, coming up to this and talking to my friends. It’s always been a matter of being presented with something, having anxiety about it, and then often taking the plunge and then being glad I did it afterwards. That’s the faith that I’m running with today. My big concern about today is being triggered. It’s like I’m going to be talking to all these people who have anxiety, who you know, all about anxiety, anxiety, anxiety. It’s, it’s ruled my life. How’s this going to be? How’s this going to affect me the next hour, the next day, you know, the next month after this happens.

MB: And you might be more vulnerable, right? I think sometimes if we open ourselves up to the painful emotions, they don’t boss us around quite so much. If we fight them, sometimes they get worse. And sometimes doing things that are worth it will involve an escalation in some symptoms. Marathon runners don’t generally feel super energetic the next day.

JB: No, no they don’t. What I’ve found in my experience with anxiety is that it does go. I’ve had really bad anxiety and then I’ve had long periods of time where I felt “normal” and good. So that’s another one of the things that I go to when I start thinking, ‘Oh, I’m going to be triggered’, I start telling myself, maybe I will get triggered. But there’s smooth sailing ahead still. Or it’s worth it. 

MB: What you bring up reminded me of one thing that a lot of people with anxiety share: we don’t like uncertainty.

JB: Yeah. Oh yeah. No,

MB: We like to have a sense of control. There are definitely times when I think, okay, well I could say no to that media interview or talking with John and I will have less anxiety. But then I also don’t get to help people, or I don’t get to help bust up some stigma and share my story and be part of something. And so one of the things that happens for people who have an “allergy” to uncertainty is that we will often fill in the blanks with something negative rather than just to have uncertainty hanging there.

JB: Yeah. Yeah. For sure.

MB: Being aware that that might be one of your tendencies and then being strategic in your actions can be helpful. Trying to balance out those anxiety promoting thoughts with some more realistic thoughts can also be helpful. These are some of the things that you can do with Cognitive Behavioural Therapy and also that you can do on your own. Anxiety Canada’s MindShift CBT app helps you work on balancing your thinking, trying to figure out if you’re falling into any thinking traps, and setting behavioural challenges for yourself.

JB: Definitely. In your experience as a therapist, is talking to people about previous experiences a relevant pursuit for you?

MB: Yes. My primary orientation is Cognitive Behavioural Therapy (CBT), which is mostly focused on the present. If someone can’t leave their house due to anxiety, we start with helping them leave their house. The focus is on helping people to be doing the things that they want to be doing – to lead a valued life and exploring current thought patterns that are holding them back. But I definitely think it’s worth exploring previous experiences. In CBT we look for “core beliefs” or schemas – organizing principles through which we filter the world and that give rise to the moment by moment chatter that we have going on in our brain. So I think it can be very useful.

JB: Yeah. One thing I do find interesting about CBT is this is the concept of thought patterns that are established from a young age. Because I had sort of a traumatic thing happen when my parents split up when I was young. I was like five, and it came out of nowhere. I wasn’t expecting it and that was really hard and I think that led my thought patterns to get entrenched the wrong way. So I, I’m wondering in a circumstance like that, how do you utilize that in CBT?

MB: I think that’s a good example. It’s hard to go back and be in the mind of a five-year-old. It’s common in situations like that that people may pick up beliefs. Like, ‘I’m not going to have any warning when bad things happen’. ‘Something bad could be around any corner’. And so let’s just say that that was something you didn’t realize your five year old self had learned. Those kinds of things can stick with you. There are common underlying beliefs that definitely drive some anxiety disorders. And there’s a technique in CBT called “the downward arrow technique”. So I won’t use you, but I’ll use myself. So Melanie, you’re anxious that you’re going to be doing this live interview with, with John Bateman, who knows what you’re gonna say? You’re on the Board of Directors and you may make a fool of yourself. And then you would ask yourself, ‘okay, so what would be so bad about that’? The worst that can happen. Yeah. So you do make a fool of yourself. You say something stupid in front of John and whoever else listening. So what? It’s a moment in time that will pass.  If you keep asking “what would be so bad about that?” you can sometimes get down to the core belief – “I am a failure”, “I will be rejected”.

JB: I’m curious about the brain. Within our thought processes and our thought patterns, do some get entrenched and can they be re programmed?

MB: Donald Hebb was a Canadian Psychologist known for saying “neurons that fire together, wire together”. Pathways in the brain are formed and reinforced through repetition. The more you have similar thought patterns, the more they’re going to form a neural network. There’s also some research that shows that attention density, so how much attention you’re paying to something, can make those pathways stronger. So if anybody has ever studied for a test or learned a new instrument, you know that you need to practice. If you read something once, you’re probably not going to remember that as easily as if you read it and write notes or if you read it, write notes and do flashcards and then are tested on it. So the idea is that we have neuro-plasticity, which is basically means that our brains can change over time.

MB: If you’ve ever learned something new, you’ve changed your brain. It’s super cool. So while you’re learning the new things, it’s like if you are building a new pathway through the woods in a forest. If there’s already one pathway that’s well worn, that one’s going to be easier to walk down. The new pathway that you’re building, even though it is going to be a better route with a nicer view and faster, while you’re still building that and before the other one grows over it is going to be less automatic. And that’s why if you can get some tools, and CBT is one of them, it can help you make the new path. You can change your thought patterns.

JB: I really appreciate you talking to me, Melanie. It’s been incredibly informative and very important that people out there watching and listening understand that there’s many people like you out there to help. And then there’s people out there like me who sometimes seem like I’m silently suffering, but I’m here and I’m open and there’s a whole community waiting to help people. I appreciate you.

MB: Take care. Bye.