What Is Maladaptive Daydreaming?
Psychologist Eli Somer and Clinical Social Worker Reut Brenner discuss their research examining the personality traits of people who engage in maladaptive daydreaming.
By Mark Travers, Ph.D. | September 7, 2021
A new study appearing in the journal Personality and Individual Differences offers insight into the personalities of people who are most likely to suffer from maladaptive daydreaming (MD) — a condition characterized by hyper-concentration on internally generated, dream-like content. The researchers, led by Eli Somer and Reut Brenner of the University of Haifa in Israel, found that childhood trauma was associated with an increased risk of MD, and that specific psychological disorders and unmet needs contributed to the types of daydreams people experienced.
I recently spoke with Eli Somer and Reut Brenner to discuss their work in more detail. Here is a summary of our conversation.
What inspired you to investigate the topic of maladaptive daydreaming and what did you find?
Eli Somer: I am a trauma clinician specializing in trauma and dissociative disorders. The lead author of the paper you read, Reut Brenner, a clinical social worker specializing in the treatment of trauma and mental health, was my M.A. graduate student. My associate, Prof. Hisham Abu-Rayya is a social psychologist interested in cross-cultural mental health. At the beginning of the Millennium, I noticed that some of my patients were talking about their extensive fantasy lives. The coincidence of six patients in the same cohort talking about their daydreaming activity captured my attention. I became interested in their inner worlds. Because my practice has been comprised of trauma survivors, naturally, most of these clients had endured adverse childhood circumstances. I concluded at the time, that these patients have been regulating their traumatic experiences by using daydreaming as a distraction or as a soothing mental activity. By dividing their consciousness into external awareness and internal immersion, I believed that these individuals were utilizing a dissociative defense mechanism. Not unlike other dissociative defenses, such as depersonalization/derealization or dissociative amnesia, I believed that MD was a form of dissociative absorption, employed initially as a helpful defense mechanism that had later evolved into psychopathology. I described my observation and coined the term in a seminal paper published in 2002, but because of a lack of interest on the part of the scientific community, I had abandoned the construct and resumed my clinical and research activity in the field of trauma and dissociation.
After a few years, individuals who had Googled their symptoms had discovered this paper. Two developments ensued: I began receiving countless requests to continue my research on MD to promote its acceptance and familiarity among mental health professionals and, the term, that was non-existent before 2002, became viral. Members of online MD communities have been volunteering to take part in our studies, and as a result, we have accumulated ample scientific evidence that MD is a reliable mental condition that cannot be explained by any existing psychiatric condition.
While it is difficult to summarize over 50 scientific research studies in a few words, we can now say with confidence that MD is distinct from normal mind wandering; it is an abnormal form of daydreaming that is intentional, fantastical, very vivid, fanciful, often accompanied by repetitive physical movement and is associated with dissociation and several mental disorders (separately) such as attention deficit disorder — inattentive type, obsessive compulsive disorder, depression, and anxiety disorders, or a history of childhood loneliness and trauma. It is probably best classified as a pathological form of dissociative absorption featuring characteristics of behavioral addiction. We also know now that MD does not help mitigate mental distress. On the contrary, it is associated with worsening emotional wellbeing. Our research shows that MD exacerbates the emotional well-being of survivors of childhood trauma, that it also worsened during the Covid-19 social distancing and lockdown periods, and that its employment tended to harm, rather than improve, people's mental health.
Can you talk a little bit about why you narrowed in on the traits of grandiosity, separation insecurity, and Anhedonia and their relationship with maladaptive daydreaming?
Eli Somer: We hypothesized that individuals with elevated MD would tend to address unmet emotional needs by engaging in compensatory fantasies specific to these personality needs. We thought that would be reasonable because the MD experience is reported to involve a powerful sense of presence, and is, thus, almost as good as "the real thing." Consequently, we hypothesize that daydreaming content would be related to specific traits and, aimed at satisfying unmet psychological needs. The specific traits we sought to explore in this context were based on frequent (but not exclusive) mentions in online MD communities and my own clinical experience with patients who suffer from MD.
Reut Brenner: In previous studies, people with MD often described the unbearable gap between their vivid and exciting daydreams to their dismal and painful reality. Paradoxically, the growing need for excitement and instant gratification seems to increase the demand for fantasied thrills and reduces the experience of pleasure in reality, as in Anhedonia. We expected that personal characteristics and unmet reality needs would manifest in compensatory daydreaming themes. For example, we hypothesized that recurring daydreaming themes associated with self-worth, recognition, dominance, aggression, and control will likely be related to narcissistic traits. Similarly, we expected that daydreaming scenarios featuring caring and supportive relationships will be important for individuals with unmet security needs.
What does the research suggest are the most common themes that people daydream about?
Eli Somer: The data showed that some affected individuals spent most of their waking time daydreaming that is so gratifying that they postpone sleeping or even eating for many hours. Respondents reported having rich fantasy worlds with complex storylines. They tended to daydream significantly more about fictional tales and characters, in contrast to the daydreaming among the control group which was usually more akin to mind wandering and anchored in reality. Common mind wandering themes are often work-related, thoughts about finding an attractive partner, rehearsing, or reviewing a conversation with someone, etc.
In contrast, daydreaming contents in MD are often very elaborate and unrelated to the person's reality. One man told us about the 35 characters "starring" in the plots he imagines in his mind. He related how these characters have been with him since childhood, and that he didn't recall a moment when his mind was clear of them. Another man told us of how for 30 years he has continued imagining in his mind the plot of a series that he saw when he was 10 years old, and how the plot is constantly changing and evolving. He related that there were entire days in which all his time was spent imagining, and how he even fought off sleep so that he could continue his imaginings.
There are countless maladaptive daydreaming themes. Many individuals with this condition preferred to weave complex scenes involving love and family relationships. Some individuals contrast unsatisfactory existent family experiences with imagined ones. The compensatory family support in fantasy tends to become highly rewarding to the point where individuals simply prefer to spend most of their available waking hours in that enhanced inner world. Another form of reality embellishment emerged in MD contents involving augmented social status due to personal success. Motivated by similar needs, the other prevalent content theme in MD was related to the achievement of success, recognition, power, and fame. Other common themes include plots of idealized relationships or family life, or fictionalized fantasy worlds featuring violence, power, bravery, or rescue. Survivors of childhood trauma with MD often report fantasies that feature themes of violence, revenge, and rescue. Other commonly reported fantasy themes are romantic relationships, personal fame and celebrity worship, idealized version of self (have desired characteristics), and imaginary relationships.
It should be noted that almost all of our respondents developed a love/hate relationship with their fantasy world, and 97% reported different levels of distress as a result.
Reut Brenner: In this specific study, we identified a range of daydreaming functions and themes in our participants' fantasies. Most respondents used daydreaming as a distraction from an unpleasant current reality (93.1%), as a means of wish-fulfillment (89%), a means to fight boredom (85.4%), and a rewarding pastime (78.7%). Most respondents reported daydreaming about a relationship with another person or finding love (81.3%), being powerful and dominant (72.1%), receiving extra attention (67.5%), and escape (64.7%).
Is all daydreaming maladaptive?
Eli Somer: As I have mentioned earlier, we are investigating a unique form of daydreaming characterized by extensive, absorptive, fantastical, vivid, and fanciful fantasies that are evoked by repetitive physical movement and by exposure to evocative music. We call this form of daydreaming Immersive Daydreaming (ID). It is unrelated to mind wandering, a form of off-task thinking about mundane real-life events (e.g., a conversation with a coworker, or what to prepare for dinner). ID is an exceptional trait, that generates very pleasurable feelings and therefore may develop into a behavioral addiction. However, it cannot be regarded as a disorder unless one conditional criterion is met: What makes ID and, any set of "symptoms", a potential DSM disorder, is the concomitant experience of distress and/or dysfunction. Only if a person with ID experiences distress and/or dysfunction can we determine that they are suffering from MD. The dysfunction can manifest in impairment of the ability to study, work, socialize, or adhere to household responsibilities or personal hygiene. Maladaptation develops, simply because the person prefers engaging in the fantasized inner world rather than the external reality. Distress often comes with the realization of the time wasted and the unaccomplished goals in life. Ironically, individuals with MD often regulate this distress with more MD, a pattern often seen among people who struggle with addictions. Sufferers from the disorder can spend more than 60% of their waking time in an imaginary world they have created, realizing that it is a fantasy, and without losing complete contact with the real world. One man related how for 30 years now he has been repeatedly imagining the plots of a series that is constantly evolving. With time, it takes over their lives.
What are the key lessons or takeaways from your research that might help people who struggle with maladaptive daydreaming?
Eli Somer: If one wishes to better control their fantasy life, we suggest seeking help from a mental health professional who specializes in treating habits and behavioral addictions. Careful monitoring of one's MD activity by keeping a daily diary can help with gaining awareness and improved control of this activity. We now have evidence that mindfulness training is beneficial because it provides a necessary skill for staying present in the external reality. Because solitude is conducive to MD among those prone to engage in it, minimizing solitude and improving social interaction skills could be helpful. Since in many cases, MD is employed as self-medication for underlying distress, it is advisable to engage in concomitant psychotherapy and address it.
Reut Brenner: This paper demonstrates that daydreaming content in MD may be a valuable diagnostic aid. Furthermore, to treat MD, it may not be enough to eradicate the compulsive behavior without seeking to get to the bottom of the content of daydreams, and from there, to find a more effective response to patients' real unmet needs.
Did you find any differences between men and women?
Eli Somer: MD is reported more frequently among younger females, however, women's over-representation in clinical samples and online research may reflect their increased readiness to take part in therapy or research.
Is it true that people with Borderline Personality Disorder are more prone to engage in maladaptive daydreaming?
Eli Somer: There is still no controlled research data available on individuals with borderline personality disorder (BPD). However, it is conceivable that this clinical group might be more at risk for MD than other groups, because of the childhood trauma history many report. Persons endowed with the trait of ID can use it to soothe and distract from distress associated with real-world adversities or adverse experiences and traumatic memories. Lonely or traumatized children, like many with BPD, use imaginary friends for companionship and emotional support. They may daydream interactions with their cartoon heroes and scenes inspired by books they read or video games they play, to compensate for their needed experiences of safety and emotional sustenance. Our research, indeed, showed that there is a statistical relationship between trauma history and MD. Since most individuals with MD report trauma history, one can predict that MD will be more prevalent among people with BPD.
Where would you like to see this research go in the future? Do you have any plans for future studies?
Eli Somer: Concomitant physical restlessness is a key feature among most maladaptive daydreamers. Our respondents report using gestures and, pacing while daydreaming. For example, one responded told us when talking about her daydreaming behavior: "Whenever I'm alone, I pace a lot. I'll smile to myself or run around the house". Whenever she's surrounded by people, she's able to suppress it, but it does happen sometimes that she'll laugh out loud. Whenever this happens, she'll quickly look at her phone, so that it won't come across as comical to others. Some individuals with MD can hardly suppress their movements. In order not to stand out, they'll retreat into their room from time to time, leading them to spend more and more time on their own. Future studies should shed light on the link between this kind of kinesthesia and MD. Why do people need music to enhance their MD and what is the precise role of music in facilitating this form of absorptive fantasy also requires further illuminating research? We also hope to find more in the future what are the brain mechanisms involved in this form of fantasy and what are the most effective treatments to help people gain better control over this troubling habit.
Reut Brenner: To determine MD's ontology and its distinctiveness more precisely, future studies should look further into its relationship to particular personality structures.
In addition, I believe Dialectic Behavior Therapy, an evidence-based treatment that teaches mindfulness skills (being present in the present moment in the real world), enhances self-awareness and interpersonal abilities, and instills emotional regulation techniques is worth investigating in more detail in terms of its application to treat MD.
Furthermore, one clinical case study on MD reported that magnetic resonance imaging (fMRI) during daydreaming performed on a person with MD showed an increased reward-related neural response. More extensive brain imaging studies are necessary to shed light on the unique brain mechanisms associated with this distinct form of daydreaming.