In this instructional video, David Brimacombe—who has experienced seven concussions over two decades—explains how the common strategy of constantly monitoring and immediately avoiding symptoms creates a self‑reinforcing cycle that entrenches post‑concussion syndrome (PCS). He argues that the brain, as a pattern‑recognition system, learns to associate any symptom with escape, which strengthens maladaptive neural pathways. Using a child‑tantrum analogy, he shows that giving in to symptoms provides short‑term relief but long‑term reinforcement of avoidance. Brimacombe proposes a graded exposure approach: deliberately entering mildly symptom‑provoking situations for short, sub‑threshold durations (e.g., 5–7 minutes in a store) and gradually extending exposure as tolerance builds. This method retrains the nervous system to recognize these contexts as safe, lowers over‑reactivity, and restores confidence. He emphasizes incremental, weekly or bi‑weekly steps, warns against over‑loading the system, and acknowledges setbacks as part of the rewiring process, which may take months or years. The video ends with encouragement to take small, consistent actions to reshape identity and recovery trajectory.
Chapters
There's a pattern you're repeating and it's keeping you stuck. Every time you feel symptoms, you react the same way. You stop, you overthink, and then avoid. Now, your brain is learning from this, but the best part here is that once you can see it, you can break the cycle. Hi and welcome to the PCS Resilience Collective. My name is David. And after 7 concussions over 20 years, I learned a lot about how we need to be consciously aware of what we're doing and what we're thinking in order to improve our recovery trajectory. Here's the crazy part about this, is that you are doing intrinsically what you think is right. When your symptoms start to escalate, you avoid it. When you start to feel uneasy, you get out of the situation. You're constantly checking how you feel from minute to minute, thinking about, what if I do that? Now, what if I do this? Now, in, in theory, this might seem like the right thing to do. And in a lot of ways, people are saying this online, that you need to stay in touch with who you are and constantly symptom check. But okay, there is a problem with this, because your brain understands what you repeat. So by repeating this, there is a pattern recognition your brain is understanding that anytime I feel something, a symptom, I start to think, I start to overthink. Now, this is true for a lot of parts of recovery. You're doing what you think you're supposed to do. Now, I've never met someone who's purposely trying to do things that would hurt their recovery trajectory, but sometimes what we think isn't what we really need. So in this case, anytime your symptoms start to escalate, you avoid the situation. You're constantly checking in. How do I feel? What if I do this? What if I do that? What is it going to— what's going to happen? Now, on the surface, this seems like the right thing to do. Symptoms escalate, I leave. Okay, but here's the problem. Your brain is a pattern recognition machine. Every time you do that, it makes note of it. It says, okay, this happens, I feel symptoms. Therefore, this is the pattern that's going to continue in perpetuity unless you stop it. Now, think of the analogy for those who have had kids, or you're an uncle and aunt, or you have younger siblings. I think this is a great connection. When a child is misbehaving or they really want something, they're having a temper tantrum, They're swinging their hands, they're yelling, they're crying. Okay, you can go about this 2 ways. Okay, the first way to go about it is to give in. Here's the iPad, here's a chocolate bar. Okay, in the moment, guess what happens? The crying stops, their screaming downregulates. Okay, and that's great in the moment, but what happens over time is those fits become more regular and they become louder. Okay, the same is true for your symptoms. If you give in to your symptoms— so I'm going out to go shopping, okay? I start to feel a little uneasy. The anxiety is picking up. The light sensitivity is kicking in, okay? And I go out. I leave. I go to my car, shut the door, and sit, okay? What am I telling my system? I'm giving in to my system, much like I'm giving in to that child who wants that chocolate bar, okay? In the short term, I feel great. I sit down in the car. You know what, I feel pretty good now. Okay, I can downregulate. But what you've just reinforced in the system is that anytime I feel any kind of symptom, okay, I leave, I run, I hide. Okay, and that is what I do. I'm reinforcing that in the system, and therefore that is how I'm always going to feel. Now, the longer you've done this, the deeper those neural connections are. Okay, when in reality it could just be that you're a hype— you have a hypersensitive nervous system. Okay, so again, when you reinforce that cycle, you're making things worse. Now, this might seem like doom and gloom, like, oh, I'm just destined for this for life. But understand, what has been already wired can be rewired. The goal is not to do more. The goal is not to actually make yourself constantly symptomatic. That would be crazy. Okay, but The goal is actually to go into those situations, okay, for 2 reasons. First off, when you go into a situation, okay, and maybe you have some slight provocation of symptoms, you feel a little bit worse, okay, guess what? Your system now knows that, you know what, it's okay. It's a safe environment. You can reinforce to yourself, remind yourself, tell yourself in that moment, I'm okay. Calm your system down, downregulate. Try to lower that heart rate. Okay? You're reinforcing that this is a safe situation. Okay? The second thing you're doing is that you're training that system, whatever it is, okay? Whether it's the vestibular system, the ocular system, that you are okay, that you can withstand a little bit of bright light or a little bit of noise. Okay? Your system is okay. And again, it's not to go ahead and blast yourself, not going to a concert or running a marathon. But what you are doing is you're going slightly below your symptom threshold. If I know that if I go to a store for 10 minutes, I become symptomatic, I'm not going to go for 12 minutes. Okay? The goal is to go for 7 or 8 minutes and slowly build up that threshold over time. Because by building that threshold, you're telling your system every single time you go, this is safe. I am safe. I am okay. Okay, and you're building that up. It's a slow incremental change. You're not going to do this overnight, but what you are going to do is you're going to reinforce the safety in the system. Okay, and by doing so, you're convincing yourself that I am the person who is going to go ahead and go to those places that used to cause me harm, used to cause those symptoms and that fear, and I'm going to be okay. Okay, and this will bleed into other parts of your life and other parts of your recovery. Because safety in the system is one of the most important barriers to break first. Okay, your nervous system is simply there to keep you safe, but it doesn't understand what truly is a danger and what is safe. It is simply based upon your thought patterns, your previous interactions. But we know, okay, these things change. So by going into those situations where you're only going to maybe have a slight increase in symptoms. Okay, you're increasing that safety in the system, that safety in the self. You're increasing your confidence, which will therefore allow for greater introduction of more stimuluses later on. So how can we apply this? I always like to start with one thing a week or one thing every 2 weeks. Okay, again, you don't need to overburden the system because what you're going to do— if I start to do too many things at once, okay, I'm going to fail. The system's going to fail. I'm not going to have the capacity And the whole thing's going to fall apart. So let's start small and then we're going to layer things up week by week or biweekly. Okay. That you struggle with. One environment. So maybe I'm going to go grocery shopping. Okay. 5 minutes. Maybe I'm going to go early in the morning or late at night. That way I know it's going to have fewer people there, probably less noise, less distractions. And I'm going to go in for 5 minutes. I'm going to go in for 7 minutes. Okay. Then I'm going to come out. What have I done? I proved to myself that this is possible. I proved to my nervous system that that is not a dangerous place. That is a place that can be safe. I can feel safe. Okay. That breeds confidence, that confidence in the self. Okay. Well then translate into confidence in other parts of your life. Okay. Maybe now you want to go ahead after a couple of weeks, you want to increase that. Maybe it's now 10 minutes. Going into that store. Now 15, 20. And now maybe I'm going to the mall or I'm going to my kids' school, whatever it is. But that confidence in the self, that safety in the self needs a starting phase. It needs a starting point. You need to start small and understand this. You may have those setbacks. You may have those days where you're already tired, already fatigued, already stressed, and you go to that mall and maybe 5 minutes was okay last week and now 5 minutes is causing your symptoms to stir. Those symptoms are not a sign your brain is broken. Okay, I mentioned this before, it is an overreactive nervous system. It's a nervous system that has been miscalibrated after your concussion. Okay, it thinks everything is a danger. Okay, and okay, now you're retraining it so that one day it's okay because you can go back to your car, you can go back home and say, you know what, that's okay. I know that that was an off day and I can go back and try again. Okay, because you have a history of being okay in that environment. So if you're at that stage of your recovery where everything seems to be causing you symptoms, just think it might not be that environment, it might not be that situation, okay? It might be up here, it might be the thought patterns, okay? It might be the stress that is elicited from that situation, but That can all change. Anything that has been wired can be rewired. It just might take time. If you've been struggling down this path for months, for years, it might take months or years to fully recover. But I can tell you this, you take that first step and you see, whoa, wait a minute, I can actually go into that store. Wait a minute, I can have that conversation. Wait a minute, I can be the person I want to be. Even if it's in a small, small dose. But that breeds confidence, okay? That breeds belief. That belief makes you want to do a bit more, okay? And over time— weeks, months, even years maybe— you're a completely different person with a completely different identity. You've become the person who's taking charge of your recovery, who knows that those tiny steps that you've made Have now made huge strides in your recovery. I appreciate you, and thank you for staying to the end. I hope you have yourself a great day.
