Dr. Shahana Alibhai - Feel Better

I think a lot of people that listen to today's show are gonna say, I needed that. And the reason why is my guest has come through quite a journey to being somebody today who serves the lives of others in such a beautiful way. I know how much courage it takes for us to ask for help, but it is this courage that creates connection eating disorders and anxiety and how it led her to a degree in medicine and to a higher purpose helping youth, especially marginalized youth, find their path in life.

Here I was a family doctor whose job was to work with youth and encourage them to share their own struggles with me. Yet my pride held me back from sharing when the story was my own. And she offers so much for all of us in terms of what we need to focus on and prioritize and invest in to go after being content and even joy and happiness. This is chatter that matters with Tony Chapman presented by RBC. Doctor Shahana Alba is a TEDx speaker, family physician, and a mental

health advocate. She really focuses on integrating the head, heart, and hands, or mental, physical, and emotional well-being. She's a medical lead at one of British Columbia's largest youth health centers, and she invests a lot in helping others manage their mental health through preventative measures. She's also a bestselling author and speaker. Doctor. Shahana Alabai, welcome to Chatter That Matters. I'm so excited to be here. Thanks for having me. So I've given you this

glowing resume. But, you know, if you were on an elevator and that elevator pitch and somebody said, what do you actually do? How would you say that in a few sentences? You know what? That's such a great way to open up this conversation because what you've done right there is differentiated my identity versus my values. It's much easier for me to introduce myself as a dinner party and tell you I'm a doctor. I have 3 young boys, and I love to speak. Done. That

sounds pretty good. Right? But you know nothing about me. You don't know that I actually love working with marginalized populations. I love working for people who have been dealt a difficult deck of cards, especially our youth. I love cooking. I love the idea of preventative medicine. And I've also come to acknowledge something within me that I, for years years, really since the age of 4 or 5, struggled with so much shame and secrecy about my own mental health

diagnosis. Now it might take a bit of a longer of an elevator ride for me to go into that. But, at the end of the day, that's truly who I am. So I always joke that me as a doctor, mother, speaker, that resume taught me something, but me as a patient taught me everything. You're from Abbotsford, BC. I just had Nick Taylor on my show. So now now I've had two famous people from that town. What is going on with your with your little part of the world that produces these world class

thinkers, athletes? I think it's the antioxidants and the berries. We're known for our beer. I'll just go with that now. There must be something because I'm going this I gotta go out there. I might have to move there just to become a world renowned like you 2 are. So I've listened to a lot of your interviews. An incredibly passionate speaker, and I love your honesty and even how you sort of frame the TED Talks where, you know, I'm gonna I'm gonna share something with you.

One of the areas that I really paid a lot of attention to is, and maybe in many ways, it's the notes that you're playing today, is that your parents' refugee experience from Uganda. I think anybody whose parents are immigrants to this country who are refugees, and in my case, my parents were literally kicked out of their country given 72 hours notice, if that, one bag per family, $50, if that, and sent to the airport to get on any sort

of charter out of Uganda. And the the premise was all based on the color of their skin. So you can imagine one thing is being kicked out of the country you've called home. The other thing is this profound recognition that you are not enough or you are actually the wrong kind of color. So both of those things influenced my upbringing a lot because my parents would, of course, relay this story, but they always took a very optimistic positive

spin on it. But I think the foundation there was this very implicit, sometimes explicit message to, you know, don't take for granted our sacrifices, what we've come to this country to hopefully achieve. And the one thing that you can hang on to, one of the things that you know will always be yours and no one can take away from you is your education. So it wasn't even a question of if you were going for higher education as

this is what you're going to do. And, yes, that whole kind of humorous joke about immigrant parents only giving their kids several options. Yeah. That was kind of the case for me. You know, lawyer, maybe pharmacist was always the biggest thing. You're gonna be a pharmacist. My sister's a pharmacist. My dad's a pharmacist. I was going to be a pharmacist.

On the day of the application, I decided not for me. And for the first time in my life, the first time in my 20 years of life, I actually did something my parents told me to not to do, basically. Right? I had never rebelled, never done anything. And I pursued, my undergraduate in kinesiology. But I remember my father looking at me and saying, you're gonna teach exercise for the rest of your life. Is this what we're actually gonna be doing? So that, of course, led

into medical school. But the foundation I trained as a fitness instructor, I put myself through medical school teaching fitness classes. That passion, that value system was thread throughout my entire life. So I always want people to listen to that inner voice because you the path might look so gloomy. It might look so shadowy. You might not be able to see clearly what you're going to make out of this. But I knew for 1 that pharmacy just wasn't for me, and I'm glad I listened to that intuition.

That must create such incredible shifting sand. 72 hours, one bag, $50 if you're lucky. Did they ever feel they were on a firm foundation once they got to Canada, or how long did it take for them to realize that wouldn't happen again? Because I have to believe when a country abandons you like that, it has to have some

lasting impact. I think to be honest, it was relief. When you saw the carnage that was happening, when you saw the volatility that was happening on the ground level, when you saw the amount of suffering, the idea that you could get out and you could save your family, and hear their first memory of Canada was arriving and the Red Cross cooking them an Indian meal and giving them warm clothes because they came from the equator line.

They didn't even know what snow was. Right? So all they were met was this beautiful love and grace and this idea that the world is your oyster. So I think in some ways, it was a lot of relief. I'm sure there was anger. I'm sure there was frustration. They relay a beautiful story to me that there was how many of them in a family, maybe 15 or 16, all packed into one small house because that's the way it was. And their blinds were open one day and

they were all holding a cup of tea, but nobody was sitting down. So some neighbors were passing by and they look in and seeing 15 people sitting sorry, standing and holding a cup of tea. They knocked on the door and they said, where's your furniture? They said, we couldn't if you can't afford furniture. So the next day, those neighbors brought in some patio furniture to be used

inside, and that was how they got their first tables and chairs. The other part of it that you talked about is sort of the parents and sort of saying, this is a fresh start, and we have high expectations in terms, as you said, education is your only path. But as I started to read about your childhood, and you even alluded to it in your beginning, even though you looked perfect on paper, you had a lot of thoughts that you were struggling with. So I want everyone to kind of

rewind 30 years ago. You know, right now, we live in a world where if I mentioned anxiety, depression, OCD, bipolar, most of the times people are gonna gonna at least listen or acknowledge the words that I'm saying. 30 years ago, especially when I was first going through these symptoms, that that really wasn't the case. Mental health was even more stigmatized than it it does eat that it does exist

today as well. So what you are mentioning is the first recognition of symptoms that I started struggling with since the age of 4 or 5. So I didn't know what these thoughts were called. I just know that they were deeply, deeply upsetting. And it wasn't until 20 years later in medical school, upsetting. And it wasn't until 20 years later in medical school, sitting in a psychiatry lecture, that the psychiatrist had put

up a slide on the various types of anxiety. And right there on the bottom was a subtype of OCD called pure O or pure obsessional OCD, which is basically where the person just has intrusive thoughts. The thoughts could be related to harm coming to themselves or their family, or if they were responsible for causing harm. And you can imagine how repugnant and awful these thoughts can

be, but you don't have the compulsions. What people portray OCD like on TV, the checking and the cleaning and the checking the lock 600 times. That's not the case with people who have pure OCD. They don't have the compulsion, so it all goes hidden. And oftentimes, they're misdiagnosed as just anxiety because, of course, they're anxious about these thoughts, but you're missing the bigger picture because nobody wants to admit what the thoughts are

really about. So this started happening to me at a very tender young age. I was lucky enough to talk to my mom about them, but of course, she didn't know what was going on. She did the best that she could. So whenever you don't have a name for something, whenever you feel like you are so unique that you were the only one in not so good of a way, all that leads is to just buckets and buckets and buckets of shame.

And that's exactly what happened to me. And you can imagine me just compounding with shame and the only way out was academia. The only way out to feel like I had some sort of identity was the be the best in school, be the best in undergrad, be the best in medical school. Same same story, different setting. Right? I call it transactional identity. We all have this in a different way. If I'm pretty enough, if I'm smart enough, if I'm good at sports, then the world has to reward

me with something. And most oftentimes, all that person wants is acceptance. Within that context then of your family, because you're kind of the future now. I mean, they've lost everything they've had. They're in a new country. They're dealing with snow and patio furniture for furniture and stuff, and they're raising a family. Did that add to that, the fact that you were letting them down? Or is it was it just something you found a way to continue to internalize and

then if anything channel in terms of when you got to school? It's actually exactly the latter. It was I didn't I couldn't afford to let it leak. I couldn't afford to let the facade break up. Right? I had to be that personification of, in my own eyes, perfection. Not that my parents ever would say that you have to be it, but it was the standard that I felt like I had to keep up. Right? So there wasn't any time for it. There wasn't any space

for it. And all that happens when you start to ignore the thing that your body and mind want you to pay attention to, it just starts to I always call it Halloween. It just takes on a different costume. So the costume of OCD, the intrusive thoughts, the horrible anxiety just took on a different costume to an eating disorder, which took on a different costume to obsessional exercise, which took on a different costume to

depression. If you're not going to treat the root, it's just gonna keep changing costumes until you finally go, oh, boy. Now I have to address it. To compound all of this, your sister has a severe illness at 19. How did that impact you and your family and what you felt the world was gonna offer you? Probably the most important context to all this is knowing that my sister and I are incredibly close. You know, there's close, and then there's the type of close that we

are. You know, everyone says we look the same. We're only 19 months apart, except I'm 51, and she's 58. So, you know, I think we'd have both been better at 54. We could have even things out, but there's a big height difference there too. I'm not sure she's willing to do that trade. You likely. Exactly. Definitely. Yes. Exactly. So, my kids are gonna

outgrow me very fast. So, you know, she ended up getting a severe form of inflammatory bowel disease, IBD, this form of ulcerative colitis at 19, ended up having toxic megacolon, which basically means the colon is about to rupture. So she had to go for emergency surgery and have an ileostomy, like a bag from the outside. And imagine at 19 getting that. Right? That and this is once again 20 years ago. So even the ostomy care and where it was positioned and the propensity

for leakage, things are so much better today. It wasn't like that 20 years ago. It is an embarrassing, difficult, painful thing to reconcile with that as a 19 year old. So I I moved. I moved to UBC to be with her. I found myself kind of going not even into the position of an older sister, but the position of a mom to her. You know, cooking, cleaning, making sure that she was okay. And in a very short amount of time, she had to drop out of school because of her illness, and she fought and

came back a while later. But I think anybody who has a sibling who has has had such chronic health issues, has had such a difficult goal in life, I think any sibling often feels guilty. Like, why isn't it me? Why aren't I the one suffering? Why does it all have to be her? And that's what we talk about internalization, the shame accompanied with the guilt of what's happening with my sister, all of that fueled the need to always control everything, to always

make everything right. And that can only sustain you for so long. As you move on in life, one of the things that you talked about was a great awakening for you is to move away from needing this constant validation as you, you know, you talk about the reward of you're such a great student. You're you're such a great sister and moving and focusing on helping others. Do you think the seed was planted during that time with your sister that that grew into kind of manifest

into who you are today? Absolutely. I think my parents always, always instilled in us as well, going back to the idea that Canada was the first. Like, you know, as this country was the first person you can think of it as giving them that leg up, giving them that chance. And it was not this the message to educate yourself, but to educate yourself in order to give back, you know, to do your due diligence, to make sure that you have

rewarded this country for what did they've given us. Right? So that seed was planted very early and only flourished and grew, you know, as I took on more of a caregiver role to my sister. And then realizing too that by focusing on me, we were not going to get anywhere. I was still dealing with the shame, still dealing with the guilt. But but medicine was such a beautiful career because it was so others focused. Right? So I could channel that energy to service.

And now I tell the adolescents that I work with, I mainly work with adolescents, that no matter what you choose, even if you are a custodian staff, you are in a job of service. Every occupation must be a service based profession in order to bring some sort of joy, and it's your job to retrofit your your occupation for service. How difficult is that to get that message across? I call it, by the way, the Yoda mentality that I'm here to help you get to where you wanna go.

How difficult is that when we're in a world where we're constantly fed these social media bits and bytes, and it seems to be less about transformation and much more about proclamation? Yeah. I love that question. I think the dust settles in the examining room. When I can see that patient in front of me and when we're finally clear on what's going on, when there's no noise, when there's no distractions, when there's no need to impress anymore, you finally look at that adolescent and

go, okay, like the jig is up. Now we're here. We need to figure this out. Because the way that you've been doing it is not working. I think whether you're 13 years old or whether you're 24 or whether you're 38, you can admit somewhere along the way, this idea of proclamation isn't working for me. So I need to actually

do something different. Right? So I think that's where the message of service because when you start to put your focus and put your energy into that, the only outcome you can possibly have is more happiness. There was a great quote by doctor Lori Santos, who's very well known for the Happiness Lab Podcast. And she said, I dare you to find me a study that shows acts of service do not cause increased happiness. They just don't exist. Like, that study does

not exist because that is the one thing that does. So that's where we need to put more of our focus and attention, but it's not sexy. You know, sometimes service bait is just not a sexy thing. So that's why the 1 on 1 conversations are so much better to dive deeper. So if you're not a patient who's dealing with, I just wanna find a way out, you're just an average kid out there, youth, how do you instill that very simple philosophy

of that serving others is where you'll find your purpose and happiness? How do you get them to buy into that? So you start to allow them to reflect. Right? You know, however old these this this youth might be. Let's say that they're 19 you know, 18, 19. Perhaps they worked at a summer camp. Perhaps they volunteered because they had to as part of their, high school hours. Then you start to take that experience and go, well, how did that make you feel when such and such happened?

How did that act when that 6 year old boy came up to you and wanted some help with their arts and crafts, what was going on there for you too? So you just start to tie in the emotion to the experience that they've had. And I think we have the misnomer that every service based profession, doctor being aside, it has to be completely selfless. It doesn't it doesn't have to be. Selfless and service don't always have to go together. Right? You can be very monetarily focused and still serve a

lot of people. I think that is the connection that adolescents need to make. Because we do live in a very in a society where they can call the shots and that's amazing. But if the more people that you impact, the more successful you likely are going to be. And if I start to create that narrative, I know that they'll start to buy in. So you team up with New York Times bestselling author, Adrienne Gostick, and you write this book called Feeling Better.

Is it fair to say that part of this book is your memoir of personal struggles with OCD and other mental health challenges as much as it is your experiences helping others? I wouldn't have written the book if I didn't have the struggles that I continue to do and did have at the age of 4. I just wouldn't. Because the problem is that until it affects you, until the bee actually stings you, then you can empathize and support and advocate all you want, but it pinched me. I felt it. I know what

that feels like. So I can speak a common language, and that need for me to come out the other end of what feel better is prescribing was bred and thought out from years years of pain. So I think that's what makes it so real and authentic. And the joke is that you always write the first book for you, for for the author. And so this book

was written for me, for everyone else. And when you talk about everyone else, if you could wave a magic wand and saying, after reading my book, not just glancing at it, not just opening a page, but reading it, what do you hope happens in terms of what I call head, heart, and hands, how people think, feel, and behave? Most importantly, I want people to understand that self acknowledgment, understanding your inner worth, understanding that achievement is much less weighty than progress precedes

self awareness. You can talk self awareness all day long, but no one is gonna wanna introspect if they hate themselves. And that was all born from a phrase that 1 17 year old told me when I finally looked at him and said, what are we doing here? Said, do you even like yourself? And he said, no, Doctor. Alabai. I, expletive, expletive, expletive, hate myself. That's where we need to start. Right? So that is one extreme example, but self acknowledgment

precedes self awareness. And only when you have those two things can you actually be kind and compassionate towards yourself. And the and the action pieces, I want everybody to understand that your emotions are not just cumbersome, but they leave you clues. There's 3 amazing clues that every emotion leads you. And if we start to pay attention to those clues, we can start to get more curious. I was asked on another podcast, what is the one single most

important emotion everyone can have? And that was one answer I knew right away, curiosity. We've lost our sense of curiosity because we're so scared. We don't suffer from an epidemic of anxiety or depression. We suffer from an epidemic of not being willing to feel anything at all. We've all become numb. And that's what this book is helping to change. And what are the other clues? So one is sensation, how it feels in your body. The second

is a story in your head. Many people out there might be like me and I loved Matlock growing up. I'm that's a long time ago, but there was always a lady in the back of the courtroom when Matlock would be delivering his debrief, and she was typing. Right? Typing, typing, typing. That's what your brain is doing. It's an inner typographer typing out everything. Right? You have that in your brain and that's normal. And the last one is significance. Why are you having this emotion in the

first place? If the bee didn't sting you, if you didn't pinch that shoe, it's only because it matters to you in some way. If I go to a birthday party and see so much wastage of food and people not recycling and all the rest of it, if I didn't have a climate conscience, I'd go, I don't care. I'm walking out of that party. But if I really was conscious about the climate, I might look at that and go, oh, I feel that in my gut. Like,

that really bothers me. So it all depends on the tug of war between your values and your fears. And when I read about the pyramid of optimal health, I first went, oh, here I she's gonna lose me because everybody has this sort of, 40 seconds to curing this or that. But I really took away that this less about the magic wand and more about a mythology in terms of how you get literally your head and your heart and your hands together. It really it was this sense

of optimal health. So tell us a little bit about it. How did you come up with it? Is it easy for people to embrace, or is one of your great frustrations, like, as you said, the environmentalist, so upset there's waste. Does it make you upset that something so simple is so often ignored? So this was actually bred on the back of a paper napkin one day when I think my son must have been 5 or 6 months, and I was at, you know, a version of my rock bottom.

And I had to ask myself after studying kinesiology and nutrition and teaching fitness and going to medical school and all of this stuff that promises to teach you about feeling better and keeping better and making making yourself more healthy, how did I get here? Like, how did I literally end up on my knees? So, I drew out a simple triangle. On the bottom, I put the 2 things that I had been completely neglecting. 1 is called think better. The idea that your brain's job is not to

keep you happy. Many of us have heard this phrase, but the brain just craves what's familiar. I had no clue that I had an inner narrative. I had no clue that my emotions were trying to teach me something. I had no clue, Right? Your emotional health is as much biology as it is biography. It's the way that your parents sorted out a disagreement.

It's the way that your teacher approached you when you were struggling. It's the way that your coach came up to you and taught you how to approach or avoid a particular technique issue that you might be having with your sports. It's all of that. So emotional health is not about learning, it's about unlearning. Unlearning so many of these coping mechanism and defense styles that we all have. And the second thing on the foundation was connect deeply.

Equally as important and related to service is the idea of having people that you can truly be authentically yourself with. Right? This is why we talk about loneliness as an epidemic. This is why in the Harvard Longitudinal Study, when they looked at all of the metrics, the authors of the study said, I don't need to know your glycemic index. I didn't need to know your cholesterol levels. All I need to know is how well connected you are for me to know whether you are gonna live a long

and happy life. Like, that is a profound statement. And truth be told, I had let a lot of my friendships go. I didn't know how it sounds embarrassing to admit this, but I didn't know how to be a friend. I didn't know that you needed to invest in other people. I was so invested in myself, in my education, in my family, in my career that I wasn't really invested in other people and all the friends that I had made had slowly, of course, drifted away. That's why those two things

are at the bottom. I spent all my time focusing on the meat of the pyramid, Exercising, like I talked about. Exercising a lot. Fine. Not a bad idea, but not so great when you're not connected and you're not training your brain. And eating smart. Right? So are you making better decisions about how you're eating every day? The 3rd piece that we now are learning more about is I call it rest smart. So it's not about meditating.

It's not about wearing an Oura ring so you optimize your sleep. It's are you quiet in your day, full stop, period. I can't even be quiet for 5 minutes at a time. I struggle with that. I always need something on and that's what I'm working towards. At the top is why are we having this conversation in the first place? Are you fulfilling a message that's beyond an I to a we? Are you actually do you have a sense of purpose? Do you have a sense of

fulfillment? Right? So that optimal health pyramid, I always joke with my patients as well is that even if you scored 7 out of 10 in each of those categories, you might not be happy, but you darn well should be content. Because what I had was a 10 out of 10 in my nutrition, a 10 out of 10 in exercise, but I was failing in social connection, failing in resting well, failing in training my brain. And I didn't really understand what my purpose was or why I was

doing the work I was doing. This incredible book comes out. You must be very delighted even though as you said it's often the first book is for you and others. Mel Robbins provides an endorsement on many notable figures. How did that make you feel that other people saw themselves in the book, not just the author who wrote the book? That little 4 year old girl is is smiling right now because I lived so many years feeling so alone. And now

it's so much easier to share with strangers. But can I be like, I I'm I was terrified of giving the book to other extended family members? I was terrified of giving the book to friends of people who knew me as this facade of me and actually being real and authentic. So to know that people who are in higher echelons or who are in higher celebrity status also see themselves in that just makes us all human. Right? I think that's the thing. And I'm so happy to turn this shame that

I've held on for so long. It's still hard. I'm not saying it's not hard, but into a tenant of this superpower. And how would you score yourself today on that pyramid? Are you content? I am content. Yeah. Do I still have pure obsessional OCD? Yes. Does it still terrify me at times? Yes. Is it hard to talk about? Yes. But is but I'm so much further along than I was. I love the work that I'm doing. And you know what the best part is? Me as a physician fulfilled part of me, but it didn't

allow me to be creative. As a physician, you're so scared I'll just be blunt of killing somebody. You're so scared of making an error. At least that's how I feel. You feel like you're walking around with a cloud constantly. It's like, don't miss this and don't miss that. It makes you ask about this. This? Having conversation, using words as art pictures, creating presentations, creating concepts, that's allowed me a creativity

that I didn't know I so needed and wanted. So I just want to say, even if you've spent 10, 12 years in school, it's okay to color outside the lines. Whatever your profession that you've done and invested in, you can form it to make it something that you truly go, Oh my word, Like, this is what I love to do. And there's so much of this that's still hard, but when I do get a chance to talk and share these ideas, I know

it's all worth it. When we return, more with doctor Shahana Alabai, and then I offer my 3 takeaways that I hope I apply to my life for the rest of my life. Hi. This is Tony Chapman, host of the radio show and podcast Chatter That Matters. Did you know that only 1 in 5 youth with a mental health illness can get access to the care they need? Well, a big shout out to the RBC Foundation and RBC Future Launch for supporting over 150 youth mental health organizations.

And in doing so, they help youth and their families get the care they need and deserve. We cannot fool ourselves into thinking that what we teach our kids in the classroom will not directly affect the conditions we see in our clinics. It is this kind of collaboration that we need