Hello Ben,

I could have written your post myself without changing any word, as I am struggling with the same issues. I don't have any magical solution to all this (I wish I had one) but let me share a couple of ideas. If you happen to find some things that work for you (which I really hope), please reciprocate!

1. Have you sought professional help with your anxiety? I recently started a psychotherapy, and although it is too early to see any tangible benefit, I am quite confident that the therapist will help me. She specializes in post-traumatic stress disorders, and she plans to combine standard psychotherapy (which will probably focus on the same issues that you mentioned, i.e. high aspirations, problems with self-image) with other methods (relaxation techniques, etc.).

2. Practicing meditation regularly would probably help a lot in our situation. That said, I must say that I have been unable to do it consistently, as I often find myself obssessing over my problems during 20 minutes instead of letting the thoughts go. To use the standard metaphor, the dark clouds stay in my sky instead of passing by. Finding a task that distracts me works better. But given the alleged fantastic potential of meditation for cases like ours, you might want to give it a try, perhaps again with a professional.

3. Whatever technique we learn or whatever professional help we get, I think we also need to strenghten our willpower to deal with these situations. Some scientists like to think of willpower as a muscle that can be trained. In that spirit, I do the following "exercise" sometimes, and it helps me. Perhaps you could try it as well.

When an innocuous event triggers you, and you feel a need to ask for immediate reassurance, refrain from doing so during 24 or 48 hours. Tell yourself something along the following lines: "I am not sure what just happened. It might have been a real bump, or most likely that was nothing at all. But I will try to live normally without thinking about it, and see what happens. This is just an experiment, and an exercise to challenge my willpower. I have nothing to lose by doing so: if I still feel lousy in 24/48 hours I will come to the board, ask my question and get a quick answer as always."

When I do it, I force myself not to talk about the triggering event to anyone, not even to my partner when she asks how I am feeling. In 99% of the cases my symptoms have disappeared by the deadline, and I am no longer thinking about why I was worried. This happened to you already with the hairdresser, and probably at many other occasions.

4. Another argument that I sometimes find reassuring is the following. There are hundreds of threads started on this board by anxious people like you and me following a minor trigger (a kiss, a haircut, etc.). These threads usually end with the OP writing something like "thank you for the reassuring words; you are right, it was nothing to worry about, and I am already feeling better". This happens all the time. My understanding of this situation is that these events recreate symptoms, for some physical cause. Perhaps because they create some inflammation. But they don't do any damage. And whether the symptoms persist or not depends upon our psychological reaction.

Regarding your final question, I am not an expert at all, but let me tell you what two neurologists answered when I asked that precise question. The neurologists told me that the injured brain is indeed believed by some scientists to be more sensitive to concussions and sub-concussive impacts, although they also said that the evidence is not unequivocal on that. But they also told me that, for an event to have serious long-term consequences for a PCS sufferer, it must still be the case that a significant force has been transmitted to the brain, and this force would also be a problem (i.e., it would create symptoms) for most healthy people.

Kissing does not enter this category. Think of all the teenagers who just discovered this pleasure and kiss their boyfriend/girlfriend with enthusiasm 100 times per day. If they were suffering from a subconcussive impact each time, all these people would suffer from significant brain damage.

Lastly, I think we need to accept that we will never have all the answers that we want. To me this is still a vain wish because I am unfortunately making little progress on that front. Nobody knows the causal effect of all our minor decisions on our health in 10, 20, or 40 years. Nobody knows what will happen in all the counterfactual scenarios ("what will happen to me because of this haircut/kiss/ride, etc.? what would have happened without it?"). But the big picture is clear, and we have some useful general guidelines to make our decisions: avoid hitting our heads, relieve stress, sleep well, eat healthy, etc.. This applies more generally than brain health, and in domains where we accept our lack of knowledge more easily: nobody knows the exact optimal proportion of proteins, carbs, and vegetables in our meals to prevent cancer; nobody knows by how many percentage points we increase our risk of lung cancer if we smoke 10 cigarettes per day during 10 years. But when we focus on the big picture, we have some useful guidelines in mind: we know that eating little sugar and lots of vegetables is good for us, and that smoking is bad. I think that we should strive to adopt a similar attitude regarding our brain injuries.

I hope this helps. Take care.