Altered-state phenomenology around ketamine may relate to longer-term changes in imaginal processes, but observations across routine care are scarce. We report an educational case focusing on pre-defined dream motifs over time, without making treatment efficacy claims. A 48-year-old Japanese man with severe chronic primary low back pain reported dreams during insight-oriented psychotherapy from...
Ketamine responses vary across patients and sessions, suggesting that dose alone is an incomplete organizing principle. We propose a state-first Gate-Amplifier-Reintegration framework in which awake low-dose ketamine acts primarily as an Amplifier of transient network flexibility, whereas autonomic-salience stability is treated as a candidate Gate that may shape whether this flexibility remains...