The power of the pause – and saying no

Editor’s note: This is the fifth installment of “From Doubt to Discovery,” a six-part series chronicling Eden Prairie Local News contributor Rachel Engstrom’s experience with ketamine-assisted psychotherapy. In this chapter, she reflects on her second and third sessions – a period of emotional clarity, boundary setting, and a growing belief that she is enough.

If you missed the start of her journey, you can read Part 1, Part 2, Part 3, and Part 4.

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When I arrived for my second session, Liz, a psychiatric nurse practitioner, greeted me with her usual calming presence and asked how I was feeling.

Without hesitation, I responded, “Great! Less reactive, more in tune with my needs, and more confident asking for what I need.” She was happy to hear it – but not especially surprised. The confidence I exuded felt incredible – something I hadn’t experienced in over a decade.

As the second ketamine treatment began, I felt a calmness that hadn’t been present during the first session. The medication settled into my system with a familiar ease, bringing clarity instead of unease. About 15 minutes in, Liz offered me a booster dose.

I paused. Did I need it? Was I searching for something unresolved? After checking in with myself, I realized I didn’t. Even though I had already agreed to the booster and she had prepared it, I said no – with conviction.

The declaration – “I have had enough” – marked a powerful moment. It was self-advocacy in its purest form: free from second-guessing, over-explaining, or apologizing for setting a boundary.

I still felt self-conscious during the session, but much less so than in the first. I also noticed I was apologizing about 75% less – which felt liberating.

As the session progressed, memories of my dad’s infectious laughter and thoughtful advice surfaced. I reflected on the kindness he showed in small gestures and the rigidity he sometimes imposed. These memories didn’t feel contradictory; instead, they illuminated the complexity of who he was. They highlighted both the joys and challenges of our connection, bringing a mix of gratitude and clarity.

When the session ended, I left with a profound sense of satisfaction. I wasn’t chasing elusive answers or deeper insights. I felt like I was enough.

Integration after the second treatment

The days following my second session were filled with subtle but meaningful changes. My anxiety decreased, and I noticed a growing ability to assume the best in others – something I’d struggled with for years. Interactions with strangers, like sharing a smile or giving a compliment, felt more genuine.

Driving became a consistent opportunity to practice mindfulness, using techniques like STOP:

• Stop: Recognize what I was feeling and name it – beyond simply “anger.”
• Take a breath: Three deep breaths to ground myself.
• Options: Explore how I wanted to respond.
• Proceed: Choose actions aligned with my values.

I also relied on the RAIN method:

• Recognize: Identify and acknowledge the emotions or thoughts.
• Allow: Permit those feelings to exist without judgment.
• Investigate: Explore them with curiosity, understanding their origin and impact.
• Nurture: Offer myself compassion and respond to my needs with kindness.

Stress often showed up as tightness in my left shoulder. Rolling my shoulders or taking a few deep breaths provided relief. At work, however, I hit a snag when one of my students lied about completing their prep work. Frustration boiled over, and I snapped – a reminder that progress is a process.

Third treatment: Finding balance

By the time of my third session, a month later, the effects of the second treatment had begun to fade. That metaphorical chip on my shoulder had returned – once again manifesting as tension in my left shoulder.

The session began with a mantra I had set: “Be curious. Let go of expectations.” A memory of my college honors advisor, Dr. C, surfaced. His ability to balance academic rigor with open-mindedness left a lasting impression, shaping how I approach critical thinking today.

Later, a memory from my 20s emerged: preparing for the holidays by eating more ahead of time so I could enjoy extra mashed potatoes and gravy. It wasn’t just about the food – it reflected a fear of scarcity, a need to “take full advantage.”

This tied back to scarcity theory, which Alex and I had discussed during integration. The fear of running out – of time, resources, or opportunities – can drive us to hoard or chase more, yet still feel unfulfilled. Recognizing that pattern helped me embrace a deeper truth: I am, and I have, enough.

At the end of the session, I made one big apology – but it felt different. Instead of saying, “Sorry for being annoying,” I shifted to gratitude: “Thanks for your patience with me.” That small change in language felt powerful, transforming self-criticism into appreciation.

Integration after the third treatment

Post-session integration took effort but brought rewards. Music became a daily ritual, restoring a sense of connection and joy. I also bought a massage gun, which reduced my shoulder tension dramatically – an unexpected but welcome physical benefit of KAP.

Skipping mindfulness practice for just two days brought the tension right back. It reminded me that integration isn’t about perfection, but persistence.

Themes of enoughness

Across both sessions, the idea of being enough took root. Saying no to the booster, recognizing the power of a pause, and choosing to see the good in others all reinforced that truth.

While the journey continues, I feel more grounded. More at peace. More equipped to face what comes next – finally knowing that I am enough.

Next week: Moving forward into a new chapter of healing.