Beyond the session: Trauma, triumphs and turning points

Editor’s note: This is the fourth installment in “From doubt to discovery,” a six-part series chronicling Eden Prairie Local News contributor Rachel Engstrom’s experience with ketamine-assisted psychotherapy (KAP). In this piece, she explores the days following her first session – a period of physical recovery, emotional integration, and renewed perspective, shaped in part by a timely Mediterranean voyage.

If you missed the start of her journey, you can read Part 1, Part 2, and Part 3.

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In the days following my first KAP session, small but intentional acts of self-care made a noticeable difference.

By rolling my shoulders 10 times whenever I thought of them, taking daily hot baths, and using a microwavable heat wrap, I found relief in ways I hadn’t thought possible. The tension in my right shoulder, which had once felt like 10 grinding gears, eased to a smoother 8. Meanwhile, my left shoulder, previously overwhelmed by countless gears catching and grinding, became more manageable – about 40 gears working together.

This seemingly small change was profound. It reminded me that I could advocate for and nurture myself in ways I had long neglected.

A UTI and unexpected lessons

The night of my first session, I felt physically fine, but at 2:45 a.m., I woke up with a sharp reminder that I hadn’t rehydrated properly. The strict pre-session guidelines of no food or water had left me vulnerable to a urinary tract infection (UTI).

The discomfort was frustrating, but it also highlighted my tendency toward all-or-nothing thinking — like avoiding all water instead of simply drinking less before the session.

As I waited for my prescription through GoodRx, I realized something important. Normally, an unexpected health issue like this would have triggered panic, forcing me to rely on medication like Xanax to get through it. But this time, I took deep breaths, grounded myself, and used techniques I’d learned in therapy. I rode out the discomfort without catastrophizing.

For the first time in a long time, I handled it on my own.

Integration and insights

The day after my session, Alex, my therapist guide at Intero Psychedelic Therapy, checked in with me via text to make sure I felt grounded and supported. A few days later, we met virtually for an integration session, revisiting themes from my first KAP experience and how they were unfolding in real time.

One key realization? How little grace I extend to myself.

I started to recognize how my insecurities fuel emotional reactivity, especially in my interactions with others. We also revisited a traumatic moment from my teenage years: a day I skipped school with a friend. While driving in St. Paul, a large, muscular man cut us off and forced us to stop in the middle of the road. We were so shaken we couldn’t move. At the time, I told no one, for fear of admitting we had skipped school.

Bringing it up now felt cathartic. I could see how moments like this shaped my reactivity and driving anxiety.

The brain’s window of opportunity

Studies show the first 72 hours after a ketamine session are critical for neuroplasticity – the brain’s ability to reorganize and form new connections. That night, I kept my schedule low-key, choosing to stay in, watch television, and rest instead of going out to dinner.

During my integration session, I reflected on how my impossibly high expectations for myself had led to unnecessary stress. Realizing this felt like an important step toward self-compassion.

A Mediterranean reset

A week later, I embarked on a Mediterranean cruise – something I had planned months before. The timing felt almost too perfect. The beauty and slower pace of the trip provided the space I needed for reflection.

One of the most profound realizations during the trip was how much judgment added to my stress. Whether I was criticizing myself or others, I saw how it only created more tension. So, I began letting go of that judgment. It felt like finally exhaling after years of holding my breath.

Interacting with people on the cruise felt different, too. Small moments – greeting staff, sharing a smile with fellow passengers – stopped feeling like social expectations. They became genuine moments of connection. For the first time in decades, I wasn’t performing joy. I simply shared joy.

Moments of clarity

As I continued working through a packet of anger management exercises, I learned new techniques like RAIN (Recognize, Allow, Investigate, Nurture) and STOP (Stop, Take a Breath, Observe, Proceed). These tools became invaluable in helping me manage my emotional triggers.

Being away from daily responsibilities – including driving – gave me the mental space to reflect. My long-standing driving anxiety suddenly made more sense. It wasn’t just about the act of driving. My frustration stemmed from unmet expectations and unresolved tension within myself.

I realized that many of my frustrations – whether with myself, others or external situations – came from unmet expectations. Recognizing this helped me adopt a more patient approach to life.

This shift in perspective extended beyond driving. I found myself assuming the best in people, and in doing so, I felt lighter, more open, more at ease.

A new baseline

Returning home after the cruise, I noticed a subtle but significant shift. My baseline anxiety was lower. The sharp, reactive edges that defined my days before KAP were softening.

That didn’t mean the treatment was some magical fix.

Shortly after I got home, another driver cut me off. Instead of slowing down, I reacted instinctively, which led to a minor fender bender. The old me would have spiraled into shame and self-hatred. This time, I felt the frustration, but didn’t drown in it. I didn’t apply RAIN or STOP in the moment – but I realized that if I had, I probably would have avoided the incident entirely.

That realization alone was progress.

Preparing for the next step

As I got ready for my second KAP session, I carried these lessons with me. The journey wasn’t linear, but each step brought me closer to healing.

The biggest takeaway? Progress isn’t always about doing more. Sometimes, it’s about allowing yourself to simply be.