This is the first in a six-part series chronicling one woman’s journey through ketamine-assisted psychotherapy.
I was skeptical. When my good friend told me she was trying ketamine therapy, my immediate thought was, “Why not just try traditional antidepressants first?” It didn’t make sense to me – until it did.
As a 40-year-old woman with brown eyes, I primarily identify as Caucasian, and most people would see me as white. However, I’m deeply proud of my Native American (Choctaw) and Mexican heritage. While these roots are central to who I am, my appearance doesn’t reflect them. Because of this, I’ve been aware of my white privilege since childhood. It’s an important part of who I am, and it affects how I move through the world.
My parents married young – my mom was 19 and my dad was 20 – and they didn’t have me until several years later. I grew up as an only child in Blaine, until I was 6. My father served as a pastor at an Assembly of God church in Columbia Heights, while my mother worked a 9-to-5 job in sales and management.
With both of them working, I spent a lot of time at home with my dad as he juggled his responsibilities – preparing weekly sermons, developing lectures for his students as a professor, and working on his doctorate in theology. Two days a week, I stayed with one of my two grandmothers, giving my dad time to handle church duties like counseling sessions and other tasks that required his presence. While my grandfathers were around, it was my grandmothers who primarily cared for me.
My mom was a supportive pastor’s wife who not only taught me how to present myself as a “good little girl” but also showed me the importance of balancing work, family and community. She made the perfect pastor’s wife because she embraced her role in the church with warmth and connected easily with others, leaving a lasting impression. From watching her, I learned how important it is to be adaptable and compassionate.
My dad grew up in a strict, militant household in the 1960s, but he worked hard to create a warmer, more nurturing environment for me. Every morning, without fail, he would wake me up with a song. Looking back, I see how much love and energy that took. No matter his mood or the challenges of the day, he’d open the blinds, smile, and sing a cheerful tune. At the time, I didn’t appreciate it, but now I recognize it as one of the many ways he showed his love.
He was incredibly intelligent and studied multiple languages – Spanish, French, German, Hebrew, Greek, and Aramaic – so that he could read the Bible in its original form, without relying on translations. I once asked for a pencil, and he told me we didn’t have any, adding, “Pencils are for people who make mistakes.” It was a joke, but it left a lasting impression.

Early struggles with mental health
By the time I reached my teens, I was already grappling with depression and anxiety – struggles that only deepened with time. My Adverse Childhood Experiences (ACE) score is 6, reflecting multiple challenges during my formative years. The ACE score measures childhood trauma based on experiences like neglect, abuse, and household dysfunction. Research shows that higher scores are linked to long-term impacts on mental and physical health.
Over my lifetime, I’ve suffered from agoraphobia, double depression, social anxiety disorder, generalized anxiety disorder, substance use disorder, fibromyalgia, bulimia nervosa, PTSD, and complex PTSD. In 2018, my dad passed away unexpectedly at 60. His death was a profound loss, adding another layer to my ongoing mental health journey.
In my late 20s, I began struggling with alcohol dependency, using it as a coping mechanism to manage the overwhelming weight of my mental health challenges. Four years ago, I made the life-changing decision to quit drinking. That milestone marked a turning point in my recovery and set the stage for exploring deeper healing through treatments like ketamine-assisted psychotherapy (KAP).
Why ketamine?
For years, I was cautious about trying new treatments beyond medications and traditional therapy. When I first scheduled an appointment to learn about KAP, my plan was simply to meet with a therapist and possibly consider starting the treatment in 2025.
My good friend had undergone ketamine therapy. While I was initially skeptical – encouraging her to try traditional antidepressants first – her experience piqued my curiosity.
Ketamine therapy has emerged as a promising option for individuals with treatment-resistant depression, cases where traditional antidepressants have proven ineffective. According to Time magazine, “An estimated 5 million people in the U.S. suffer from treatment-resistant depression, prompting a rise in private ketamine clinics run by psychiatrists or anesthesiologists across the country.”
However, it’s important to remember that ketamine therapy comes with risks. The recent passing of actor Matthew Perry in October 2023 underscored some of these dangers. Perry had been undergoing KAP to manage anxiety. Tragically, his treatment involved high doses administered at home without direct medical supervision, which contributed to his untimely death. His story highlights how essential it is to receive professional guidance and adhere strictly to treatment protocols.
Acknowledging privilege in treatment
While this series reflects my personal journey, I want to acknowledge the privilege that has allowed me to explore KAP. Access to quality healthcare, resources for self-care, and the financial stability to pursue treatments like this are privileges I do not take lightly.
As I continue this journey, I’m realizing that KAP is more than just a treatment – it’s about shifting perspectives and challenging ingrained ways of thinking. Though the journey isn’t over, each step brings me closer to understanding how this therapy can profoundly impact my mental health.
Next week: Preparing for my first ketamine session.
Key takeaways
- Driving scale: Pre-KAP, my driving scale was at an 8–10, showing frequent aggressive behavior.
- Shoulder pain: My left shoulder pain was a consistent 10 on a 10-point scale before KAP.
- Gratitude as a tool: Early insights emerged about using gratitude to anchor myself — like thinking of my nephew Walker during hard moments.
Goal updates
- Reduce reactivity: Began identifying triggers and recognizing how reactivity shows up in daily life — just the start of the journey.
- Address cognitive distortions: Became aware of all-or-nothing thinking and how it shapes self-perception.
- Self-advocacy: Started expressing my needs clearly in therapy and began articulating vulnerabilities for the first time.
From doubt to discovery: Part 1

This is the first installment in a six-part series chronicling Rachel Engstrom’s journey through ketamine-assisted psychotherapy (KAP). A new installment will be published weekly over the next six weeks. In this piece, she explores what led her to KAP, how she found the courage to begin, and the personal revelations that sparked a life-changing path toward healing.
Upcoming installments in the series will cover her emotional and logistical preparation for treatment; the experience and insights gained during her first KAP session; the ways that session influenced her healing and reflection while traveling abroad; the lessons learned during subsequent sessions, including moments of clarity and growth; and her reflections on long-term healing and what comes next.
Editor’s note:
Ketamine is a dissociative anesthetic that has been used in medical settings for decades. In recent years, it has gained attention as a treatment option for depression, anxiety, and post-traumatic stress disorder under clinical supervision. While early studies point to its potential for people with treatment-resistant mental health conditions, ketamine therapy remains a developing field, with ongoing questions about long-term outcomes and equitable access. The death of actor Matthew Perry in 2023, following unsupervised ketamine use, brought renewed attention to the risks of at-home treatment and the need for medical oversight. This series reflects one person’s experience and is not intended as medical advice.
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