Episode 353: Childhood Concussion & Boundaries with Friends

Hello, friends! I hope you are all doing well.

Our first question comes from a listener who reached out to express their appreciation for the show, my course, and books. They share a childhood experience of being in a dodge car accident where they were hit from behind, resulting in a significant lump on their head and feelings of sickness and disorientation. They recently heard me speak about frontal lobe damage and its potential effects, which resonated with them. They also suspect they may be undiagnosed autistic. They are concerned about the possibility of having sustained a brain injury and whether an MRI at their current age (31) would reveal any long-term effects. This uncertainty has brought up feelings of betrayal and neglect. I provide insight into the likelihood of detecting an old brain injury on an MRI and offer guidance on the next steps to gain clarity and peace of mind.

Moving on to our second question, a listener in their late twenties shares their struggle with assessing whether to judge people based on how they treat others or solely on how they treat them. They describe ending relationships with men who exhibited disrespectful behavior towards other women, as well as navigating concerns about a close platonic female friend who has made questionable moral choices. They ponder whether to judge people based on their life choices or patterns, and if it’s necessary to align values with others or accept them as they are. I delve into the complexities of these situations, emphasizing the importance of personal boundaries, unconditional positive regard, and self-reflection in determining how to approach relationships.


Question 1:

Hi Robert,

Thanks so much for all you do with the show, your course, and your books (I have both on audible and repeat listen to them).

When I was less than 10-years-old I was on dodge cars and I was hit from behind. I don’t remember much but I remember I had a really, REALLY big lump on my head afterwards and I was thrown back and forth by the impact of being hit. I remember the father and son that did it came over to check in with us (my dad and me) after the ride, and I know my dad did not take me to the hospital. I did not lose consciousness, but I vaguely remember feeling sick and very disorientated. On a recent episode you spoke about frontal lobe damage and the possible effects. It resonated with me a lot and I actually had to sit down when you spoke about it because I was hit with severe emotional overwhelm. I think I may also be undiagnosed autistic – and have done a number of online diagnostic questionnaires that also put me in the high likelihood of autism range.

I would like to ask if there are any things that might indicate I did sustain a brain injury? If I got an MRI now (I am 31, I am also female if this is relevant) would it show whether I had an injury that long ago? This has really frightened me, as I am worried I have gone my whole life with this impairment and not even known. I feel betrayed and neglected by my father too. There were no obvious developmental issues, but I was a social outcast in primary and secondary school and have issues with lots of things – emotional overwhelm, irritability, self-esteem, having a sense of self.

Thanks so much for reading.


Hi there! Thank you so much for your kind words and for being a listener of the show, as well as for your support through my course and books. I truly appreciate it. Now, let’s dive into your question about the potential brain injury you sustained when you were less than 10 years old.

First of all, I want to acknowledge the mix of emotions you’re experiencing in wanting to find answers while also feeling fearful of discovering a long-standing impairment. It’s completely understandable to have these conflicting emotions.

To address your specific concerns, an MRI at this point would not likely show evidence of a brain injury from such a long time ago. MRIs are effective at detecting recent traumatic damage, vascular issues, strokes, or brain atrophy, but they are not as sensitive to detecting old mild traumatic brain injuries. Based on the information you provided, it sounds like you may have experienced a concussion, which is considered a mild traumatic brain injury. Most individuals who experience concussions, even with post-concussive symptoms, fully recover without permanent effects.

Furthermore, your age at the time of the incident is in your favor. Young brains have higher plasticity, which means they are more adaptable and capable of recovering from injuries. While adults can still recover from brain injuries, the level of plasticity is reduced compared to childhood.

Considering your circumstances, it is unlikely that you had a significant brain injury that went unnoticed. If there had been a noticeable change in your functioning, it would have been evident to those around you. However, it might be worth discussing your childhood experiences with family members or others who knew you well at that time to gain additional insights.

In relation to the issues you mentioned with social interactions, emotional overwhelm, irritability, self-esteem, and a suspicion of being on the autism spectrum, it’s important to note that online questionnaires are not sufficient for a diagnosis. They can provide a general idea, but a formal evaluation is necessary.

My recommendation would be to seek an evaluation from a neuropsychologist who can assess for any potential lasting impacts from a traumatic brain injury and also explore the possibility of autism. A neuropsychologist can assess cognitive functioning, executive dysfunction, behavioral concerns, and provide you with a better understanding of your experiences.

Finally, I want to emphasize that it’s never too late to seek an evaluation or diagnosis. Many individuals have received diagnoses in their 30s and beyond, and it has been a validating and empowering experience for them.

I hope this response takes your concerns seriously while also offering reassurance that you likely don’t need to worry about a brain injury. Pursuing an evaluation for your peace of mind and gaining important insights into your experiences is a valid and worthwhile step. Take care and best of luck on your journey of self-discovery.

Question 2:

Thank you for the podcast! It is super helpful in my life journey!

I am in my late twenties (26) and moved to a new city last year where I knew no one as part of my bucket list. As I’ve been developing relationships I find myself struggling with the same question: do I judge a person based on how they treat me or other people?

I have been dating men on and off, and find myself ending relationships based on how they treat other women. For example, the last man I dated did not speak to some women well, and I spoke to him about it but ultimately I ended the dynamic in part because of the way he treated other people. He said it was just a habit and would never treat me the way he treated other women, which to be fair he didn’t for the 6 months we dated, but still. He could be callous and outright sexists towards other women. And I made a close platonic female friend this last year, but I really question her moral compass sometimes. She had sex with her friends’ fiance the day before their wedding and continues to hold a relationship with this woman without her knowing of the on and off affair. To be fair, both these people treat me relatively well, they also have amazing redeeming qualities, and I get along with them! And when I do not agree with their life choices, I respectfully speak up and sometimes it makes a difference in the situation. I am not here to judge people’s choices and I am NO angel. But sometimes their choices make me worry about how they will treat me. For example, the close platonic female friend recently told me she wanted to date some men I previously dated and I said I wouldn’t be uncomfortable with that (she acquiesced and said she wouldn’t if I disliked it). But the question comes up… do you judge people on their life choices/patterns because it’s indicative of their character? Or take them as they are and just love them anyway?  I want to be clear, I am not passing judgement on other values. I just recognize they are different and find myself nervous about how these people will act towards me in the relationship. Or am I to find people who have similar values? What are your thoughts?

Thank you again for the podcast! It’s been a great help as I unlearn certain patterns!


Thank you for this question. It’s definitely a complex one and I think that a lot of people have been in situations like this. I know that I have had the experience of caring about someone, but not feeling good about their decisions, and there is definitely no clear guidebook about what to do about that.

Let’s start with the first part of your question, which is about guys that treat other women poorly. You are 10000% allowed to feel iffy about that. Behavior being “just a habit” is not an excuse. Even that rationalization indicates that he is not even taking the fact that you are uncomfortable into account. I wouldn’t exactly call it a “green flag”, but it would certainly be less of a red flag if he were to say something like, “I know what you’re talking about. It probably seemed harsh and sexist for me to say those things. I am trying to be better about that. It has a lot to do with how I was raised, but I realize that it’s not right. Thank you for pointing it out to me. I will try to be more aware and I promise that I will not treat you that way either.” It doesn’t sound like you got anything like that. Just excuses, which to me is indeed bullshit. You are allowed to be both satisfied with how he treated you and disappointed or concerned about the way he treated other women. And you are allowed to make decisions about relationships based on your values and personal boundaries.

This is to say that I think the situation with the dude you were dating is pretty straightforward, and it sounds like you did the right thing. The situation with your platonic woman friend is more nuanced. As you mentioned, you’re not here to judge people’s decisions and you’re not trying to throw stones from your glass house. I appreciate that. However, your concern about the implications of your friend’s behaviors is reasonable. I think that a lot of this comes down to the why behind her behaviors. If you know that she is intentionally sleeping with people to cause them issues in their relationship or as a form of revenge or aggression, that is going to probably be way more concerning to you as someone in her orbit than if she simply had a naturally occurring relationship with this person that wasn’t within the bounds of his marriage, but it wasn’t intended to be malicious. I would also look at the broader patterns. Is there any evidence that your friend tends to treat her friends in ways that are concerning or is this more specific to the situation at hand? We all have our own sets of values, morals, and beliefs. You may not share the same set of guiding values as your friend, and I think it’s great that you would like that to be okay. You want to give her the benefit of the doubt and you recognize that she’s not one-dimensional. You get along and there are a lot of redeeming qualities, as you mentioned.

If your primary concern is whether someone will treat you well, then I think you need to give them the chance to show you. As I said, the situation is much more clear-cut with the guy you were talking about because there is a much closer parallel. I feel like a similar situation for this friend would be if your concern was because she tends to be vindictive and backstabbing toward her female friends. That would be totally give you good reason to worry about your own potential mistreatment by her. But that’s not what we are talking about here. We are talking about someone that makes some choices that you probably wouldn’t, but there don’t seem to be indications that there is anything she would do to you. It’s important not to be all-or-nothing/black and white about these types of issues.

There is also something called unconditional positive regard, which is what we try to have as therapists and ideally what your parents have toward you. It means that you are on someone’s side and you want them to grow and be well. You may disagree with some of their actions or attitudes, and you don’t have to pretend like you are okay with them. You can tell them that you care and you are also disappointed or concerned. If you prefer to have people with similar values, you are also allowed to seek them out. I think that we all have a range of what we are comfortable with. I don’t mind hanging out with people that are pretty different from me, but there are some types of behaviors or beliefs that I simply can’t be okay with, which, in turn, leads to boundaries that may limit relationship or friendship potential.

I’ll give a hypothetical personal example. If you’ve listened for a while, you probably know that I am pretty liberal/progressive, especially when it comes to social issues. Does this mean it’s impossible for me to be friends with someone who is more conservative or moderate? Not necessarily. But if they hold views that are diametrically opposed to my own on issues like gender identity or sexual orientation, I don’t want to have anything to do with them unless they are very open to the idea of learning more and re-evaluating.

So, overall, I think you need to reflect a bit and be clear with yourself. What is the reason that you are concerned about being friends? Is it because you dislike the way they act due to some opposing values or beliefs? Is it because you want to make sure that you don’t need to worry about being treated poorly in the future? Each of these answers suggests a different course of action. If you are primarily concerned about your own future treatment by this friend, then you will want to look at the evidence that helps you understand how they treat friends and women in their life. If it’s the other possibility, you are allowed to express concerns and establish boundaries over what is okay with you. That’s a bit of a non-answer, but I hope that it gets you thinking and looking at the situation in a slightly different way.

As always, I appreciate your support and engagement with the show. You can send your questions to duffthepsych@gmail.com, and find the show notes for this episode at http://duffthepsych.com/episode353.

This episode is sponsored by Mindbloom, the leader in at-home ketamine treatment. If you are struggling with depression and anxiety, try ketamine treatment from the safety and comfort of your own home and get $100 off at http://mindbloom.com/duff with the code duff at checkout.

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