Michela: What Is the Difference Between Control and Responsibility?

A Note About This Story

This story reflects one person's experience with medically supervised ketamine treatment. It includes Michela's personal interpretations of trauma, altered states and psychological change. Those interpretations should not be understood as established biological mechanisms or evidence that another person will experience similar outcomes.

Learning to Hold It Together

Michela learned early how to function.

Born in South Africa in 1988 to Italian parents, she was raised primarily by her maternal grandparents after her parents divorced.

There was warmth in her childhood. There was also complexity.

She excelled academically, studied law, later earned a master's degree in English and built a career in healthcare communications working with international pharmaceutical companies.

In 2014, she moved to Dubai alone.

From the outside, hers was a story of independence.

Internally, she experienced that independence differently.

“I felt like I couldn't fall apart, even when I needed to.”

Michela describes traumatic experiences beginning in childhood, another threatening experience in adulthood, the death of her best friend at 23, periods of anxiety and hypervigilance, burnout, body-image difficulties and patterns of disordered eating and over-exercising.

Her response was often to do more.

Be productive.

Be organized.

Be helpful.

Be healthy.

Be in control.

And when she couldn't maintain that control, she sometimes moved toward the opposite extreme: disengagement.

What looked like discipline from the outside could feel very different from within.

When Understanding Isn't Enough

Michela wasn't unfamiliar with introspection.

She had spent years in therapy. Yoga had been part of her life since childhood. She explored somatic practices, retreats, self-help literature and microdosing.

Some of those experiences were useful.

But she describes a persistent gap between understanding something intellectually and experiencing it differently.

She could identify patterns.

She could explain where some of them came from.

She could recognize when they were happening.

And still find herself inside them.

That distinction raises an interesting question far beyond Michela's story:

Why doesn't insight always produce change?

Knowing that a response is disproportionate doesn't necessarily stop the response.

Understanding why we're afraid doesn't necessarily make us feel safe.

Recognizing a pattern doesn't necessarily make it easy to behave differently.

Sometimes insight is transformative.

Sometimes it is only the beginning.

A Treatment She Initially Rejected

Michela first encountered Ketamine Lounge in Miami in 2022 while accompanying a friend who had been referred there.

Her immediate reaction was rejection.

Ketamine didn't fit her idea of healing.

She practiced yoga, paid close attention to what she ate and generally avoided medication. She had developed an identity around what she considered natural approaches to health.

Ketamine seemed incompatible with it.

Later, while in London, she listened to Fierce Medicine by yoga teacher Ana T. Forrest.

The book's ideas about confronting pain made Michela reconsider something uncomfortable:

Could her ideas about what healing was supposed to look like also be limiting what she was willing to consider?

The phrase fierce medicine stayed with her.

Eventually, so did the question of ketamine.

The Fear of Losing Control

Her greatest reservation was straightforward.

She was afraid of losing control.

For someone whose coping strategies had often depended upon controlling herself and her environment, voluntarily entering an altered state was not an insignificant decision.

She had previously experienced other altered states that left her feeling emotionally exposed.

She didn't want to return there.

What ultimately made treatment feel possible, she says, was not certainty about what ketamine would do.

It was confidence that she would be supported while she didn't know.

“I trusted them, even before I trusted the medicine itself.”

Michela attributes considerable importance to the preparation, staff and environment surrounding her treatment.

That distinction matters.

A medication and the experience of receiving that medication are not necessarily the same thing.

For treatments capable of significantly altering perception and sense of self, the relationship between pharmacology, expectation, environment, psychological state and interpersonal support remains an important area of investigation.

Michela can tell us what those things meant to her.

Her experience cannot tell us how much each contributed to the changes she subsequently experienced.

Not Every Experience Was Beautiful

Michela's first ketamine experiences weren't serene.

They were difficult.

She remembers emerging from some early sessions crying and emotionally overwhelmed.

“My first few sessions were emotionally overwhelming. I'd come out of the experiences crying, feeling like I had no control over what was happening.”

That is an important part of the story.

Accounts of psychedelic and altered-state therapies can become biased toward extraordinary imagery, revelations and beautiful experiences.

Michela's weren't always like that.

Yet she chose to continue under medical care.

Over time, she began noticing changes outside the treatment room.

She returned to the gym.

Her routines began changing.

Some things she had previously forced herself to do started to feel less forced.

“I began making small but meaningful changes in my routines—things I had previously forced myself to do were now happening naturally.”

Whether those changes resulted from ketamine itself, the experiences surrounding treatment, Michela's extensive previous psychological work, changes in behavior, other factors—or some interaction among them—cannot be determined from her story.

But the distinction between forcing behavior and finding oneself more able to engage in it became important to her.

Control and Responsibility Are Not the Same Thing

One of Michela's most persistent patterns had been control.

Control could look responsible.

Be disciplined.

Do the yoga.

Read the book.

Attend therapy.

Fix the problem.

Manage the emotion.

Improve yourself.

But Michela began to distinguish that from something else.

Responsibility.

The two can look similar from the outside.

Internally, they can be very different.

Control says:

I must make everything happen correctly.

Responsibility might say:

I have to decide how I respond to what happens.

Michela began noticing how much energy she spent trying to manage not only herself, but also other people's perceptions of her.

Over time, she describes becoming more willing to experience discomfort without immediately trying to escape, suppress or solve it.

She began setting clearer boundaries.

Communicating more directly.

Allowing uncomfortable feelings to exist.

And becoming less interested in performing the appearance of having everything together.

“Ketamine didn't just change how I felt. It changed how I related to myself.”

That is Michela's interpretation of her experience.

The distinction is important because psychological change isn't always experienced as becoming a different person.

Sometimes people describe it as having a different relationship with the person who was already there.

What Does It Mean to Feel “In Your Body”?

Michela often describes the change in embodied terms.

Before treatment, she says she could understand many of her struggles intellectually but couldn't “feel different” in her body.

Later, she describes feeling “more in my body and less in my head.”

Language like this is increasingly common in conversations about trauma and healing.

It can also become scientifically imprecise.

Trauma isn't literally stored in the body like a file stored on a hard drive.

But psychological stress and traumatic experiences can involve interconnected changes in attention, memory, emotion, threat perception, physiological arousal and bodily sensation.

So when someone says:

“I understood it, but my body didn't.”

the statement may be metaphorical—but the experience it describes can still be meaningful.

Michela's language doesn't establish a biological mechanism.

It tells us how the difference felt from inside her own experience.

Forty Sessions and Three Years

Michela's relationship with ketamine did not end with an initial treatment series.

She reports undergoing approximately 40 treatments over three years.

That number requires context.

It represents Michela's individual treatment history—not a recommended schedule, standard protocol or indication that other patients should receive a similar number of treatments.

Longer-term and maintenance ketamine treatment remains an area requiring individualized medical decision-making, including consideration of potential benefits, adverse effects and uncertainties around repeated exposure.

The number is nevertheless important to her story because this wasn't a single dramatic experience followed by a clean transformation.

Her account spans years.

And the change she emphasizes most isn't an extraordinary altered state.

It's what happens when discomfort appears during ordinary life.

“When discomfort arises, I can sit with it. I don't spiral or run.”

She describes more space between an experience and her reaction to it.

That space became valuable.

Healing—or Another Project?

Michela had spent much of her life working on herself.

There is an interesting paradox in that.

Self-improvement can be enormously useful.

But for someone already driven toward perfectionism and control, healing itself can potentially become another performance.

Another retreat.

Another practice.

Another teacher.

Another technique.

Another version of oneself to achieve.

Michela says one of the changes she values most is becoming less interested in that search.

“I've stopped outsourcing my healing.”

She doesn't mean that people shouldn't seek help.

Her own story includes therapists, medical professionals, teachers, practices and treatment.

Rather, she describes a shift in where she believes responsibility ultimately resides.

Not with a retreat.

Not with a teacher.

Not even with ketamine.

With her.

The Difference Between a Catalyst and a Cure

This distinction may be one of the most important in any story about psychological transformation.

A treatment can matter enormously to someone without becoming the entire explanation for who they subsequently become.

Michela brought decades of life experience into treatment.

She had already spent years examining herself.

She had relationships, practices, knowledge, habits and vulnerabilities.

Ketamine entered that existing system.

Her experience doesn't allow us to isolate one variable and say:

This caused that.

Nor does it diminish what the experience meant to her.

Perhaps a more useful way of understanding treatments like these is sometimes not as something that does the healing for a person, but as one possible catalyst within a much larger process.

Even that remains an interpretation rather than a universal mechanism.

What happens afterward still matters.

Responsibility

At the end of her interview, Michela was asked to describe her experience in one word.

She didn't choose:

Transformation.

Freedom.

Healing.

Awakening.

Her word was:

Responsibility.

For Michela, responsibility no longer means controlling every variable.

It means deciding how she wants to meet what arrives.

It means boundaries.

Honesty.

Discomfort.

Choice.

And recognizing that no treatment can permanently outsource the work of living.

She describes ketamine as giving her “space to remember that.”

The experience belongs to her.

What she does with that space belongs to her too.

The Question That Remains

There is a strange tension at the center of self-improvement.

We are told to take responsibility for ourselves.

Work harder.

Become healthier.

Fix our weaknesses.

Master our emotions.

Optimize our lives.

But taken far enough, responsibility can quietly become control.

And control can become another thing from which we need relief.

Michela's story leaves a more difficult question:

If healing requires us to take responsibility for ourselves, how do we do that without turning ourselves into another problem that constantly needs to be fixed?

Experience Disclaimer

This story reflects Michela's individual experience. Individual experiences should not be interpreted as evidence that ketamine or another treatment will produce similar outcomes for others.

Medical Note

Ketamine is FDA-approved as an anesthetic. Racemic ketamine is not FDA-approved for psychiatric treatment; psychiatric use is off-label. Repeated or maintenance ketamine treatment should occur only under appropriate medical supervision based on an individual's circumstances.

This article does not provide medical advice or recommend a particular treatment schedule.

Disclosure

Michela received treatment at Ketamine Lounge. The founder and publisher of The Brazen Word is also a founder of Ketamine Lounge. This relationship is disclosed because it is directly relevant to this story.

Research Context

Research supports rapid antidepressant effects of ketamine in some patients with treatment-resistant depression, but questions remain regarding longer-term treatment, maintenance, durability of benefit, optimal frequency and the relationship between ketamine's subjective effects and clinical outcomes.

Michela's descriptions of trauma, embodiment, responsibility and psychological change represent her lived experience and interpretation rather than established mechanisms of ketamine treatment.