Perhaps you’ve had the experience whereby everything in the moment is seemingly going well — the sun is shining, the children are playing happily — and you should not, by all reasonable measures, have a care in the world. Except that you do. And despite the objectively positive surroundings, your subjective experience is routinely polluted by a looming sense of dread. 

Maybe you notice a familiar thought as it infiltrates the scene, “Don’t get too comfortable; this won’t last forever.” Or perhaps the moment is shattered by a catastrophic fantasy, one in which you not only think about the ways in which the current situation could end badly, but actually experience what it might look and feel like to have things fall apart in the most tragic of ways. 

For clients with PTSD, this experience of a catastrophic fantasy polluting the present is as common as it is confusing. Clients don’t understand why they can’t simply ‘relax and enjoy the moment’; their logical mind knows that they’re safe, but their sympathetic nervous system simply won’t relent. 


When a client shares a catastrophic fantasy, I listen with interest and empathy, and then I gently explain that, while painful, their experience is not unique. Rather, it is a common response of individuals who have suffered adverse life experiences and whose nervous systems have learned to be constantly vigilant in an effort to keep them safe. The more trauma a person has experienced, the more their limbic system is fine tuned to detect potential threats. 

Researcher Brené Brown describes this situation as akin to waiting for the other shoe to drop. Meaning, despite the potential for joy in the moment, we await a seemingly inevitable, negative outcome. And let’s be clear, this is not an outcome we desire or actively invoke; it is an automatic response that begins in our brains and, often, ends in our bodies. 

The expression “waiting for the other shoe to drop” first surfaced in the late 1900s, and was coined by folks who lived in tenement housing in New York City. In these cheaply constructed apartments, where bedrooms were built one atop the other, it was common to hear one’s upstairs neighbor take off a shoe, drop it to the floor, and then repeat the action. The phrase became shorthand for awaiting the inevitable. 

From a neurological perspective, our brains are wired to fill-in the gaps and to repeat familiar patterns. We are wired to wait for the sound of the second shoe dropping.


When teaching my clients a way to disrupt these unwanted, involuntary responses, I use the analogy of the brain as a field of tall grass, and neural pathways as walking-paths through that field. I go on to explain that, for people with PTSD, there is often a well-defined, well-worn path that leads to the automatic conclusion that bad things will happen when they least expect it. 

Why is this the default assumption for so many of our clients? Because anticipating the inevitable, and expecting the proverbial shoe to drop, is the surest way to keep a person safe. The problem with this way of being, however, is that it becomes the only path available, and essentials robs a person of any possible moments of peace and joy. 

So, by this logic, if the well-worn path toward catastrophe is the problem, then the solution involves actively and intentionally forging a new path and, in doing so, weakening the old one. 

Easier said than done, I realize, but well worth the effort.


Step #1: stop in your tracks

Before we can begin to teach our sympathetic nervous system that, in this very moment, we are reasonably safe and sound, we first need to realize that we have, yet again, started down the well known path toward catastrophe. Once we become aware of this fact, we can pause in our tracks and take a moment to gently recognize the familiar pattern, and to thank our limbic system for trying to keep us safe. “Thank you, but no thank you” we say with love.

Step #2: forge a new path

Forging a new path is not easy, nor is it comfortable at first; think of how many cuts and scrapes we have to endure as we cut a new path through the tall grass. However, with practice and patience, the new pathway will one day become the default setting. In the meantime, convincing our nervous system that “it’s okay to feel okay” takes time and effort. “Patience young grasshopper” is the name of the game.

To forge a new path, we need to provide solid evidence to our limbic system that we are not only out in danger but that, in fact, things are presently pretty good. This confirmation of our well-being does not come in the form of an impersonal affirmation found on Instagram, nor is it comprised of things that we ‘should’ be thinking or feeling. “Serenity now!” will simply not work.

Instead, the best proof of our current safety and well-being is found in what is REAL, POSITIVE, and TRUE about this exact moment in time: a freshly brewed pot of coffee, the first signs of spring in the park, a cozy sweater, comfortable shoes, a fully charged cell phone, or any other positive element from one’s in-the-moment experience — no matter how simple or mundane. There’s no perfect number for how many items one might list, but I like to encourage clients to come up with at least five things that they are grateful for at any given time. 

Step #3: carry on

Once we have successfully stopped the catastrophic fantasy in its tracks, and replaced it with an acknowledgement of what is REAL, POSITIVE, and TRUE about the present moment, then we are ready to take the third and final step…carrying on. 

Here we shift focus back to the thing we were doing when the negative thoughts began to creep in, and we do your best to go about the task at hand — enjoying the sunshine, watching the kids play at the park, settling into the moment of calm. 

The takeaway here is to not perseverate on the prior catastrophic thoughts, but to move on with the task of enjoying the present moment. Or, at the very least, feeling neutral and slightly less anxious about it. Remember, this is a process of undoing an old pattern, so time and patience are key.


To round out this practice, I like to return to the metaphor of the field, and remind clients that the less we travel down a well-worn path in favor of a new one, the more we will begin to notice two natural phenomenon occurring: one, the new path, with time and effort, will begin to take shape and become more easily identifiable and effortlessly traveled; and, two, the old path, neglected by our newfound preference for the positive track, will become overgrown and less of an automatic and unconscious response.

When I introduce the ‘other shoe drop’ practice, I highlight this concept of changing paths to encourage clients to notice how their own experiences of joy, safety, and security shift over time. I remind them that, much like the work of actually creating new paths through a field, changing our relationship to the neutral-to-positive moments in our lives will take time, but that forging a path is not only possible, but well worth the effort.