The Mind as Refuge: Maladaptive Daydreaming Between Emotional Regulation, Dissociation, and Neurodivergence

Post written in collaboration with  @luisazaccarelli_psicoterapeuta

Introduction

Maladaptive daydreaming (MD) is a clinical construct introduced by Somer (2002) to describe an intense, prolonged, and difficult-to-control form of imaginative activity, characterized by complex, narratively structured, and highly emotionally engaging fantasies. Unlike common mind-wandering or normative daydreaming, MD is associated with a significant impairment of daily functioning, interfering with work, school, and relationship activities.

To date, maladaptive daydreaming is not included in major nosographic systems (DSM-5-TR; ICD-11). However, growing scientific production on the topic highlights its clinical relevance as a transdiagnostic phenomenon, frequently associated with trauma, dissociation, and neurodivergence profiles.

Phenomenological characteristics of maladaptive daydreaming

Individuals with MD report the presence of imaginative worlds rich in detail, often accompanied by recurring characters, complex plots, and a strong affective component. Fantasy activity is generally triggered by specific stimuli (e.g., music, isolation, repetitive movements) and can take up several hours a day (Bigelsen & Schupak, 2011).

One of the central elements of MD is the loss of control over imaginative immersion, associated with failed attempts to reduce its frequency or duration. This aspect has led some authors to hypothesize a partial overlap with compulsive or additive models (Pietkiewicz et al., 2018), even in the absence of univocal consensus in the literature.

Maladaptive daydreaming as an emotional regulation strategy

A clinically relevant perspective interprets maladaptive daydreaming as a coping strategy oriented towards emotional regulation. In this sense, imagination does not represent an immature escape from reality, but rather an adaptive attempt to modulate affective states perceived as excessive or intolerable (Somer et al., 2016).

MD allows for the construction of an internal space characterized by control, predictability, and narrative coherence, in contrast to real-life experiences lived as chaotic, traumatic, or emotionally poor. The maladaptive nature emerges when this strategy becomes rigid and substitutive, progressively limiting contact with the present.

Trauma, dissociation and phenomenological continuity

Numerous studies highlight a significant association between maladaptive daydreaming and traumatic experiences, particularly relational and early (Somer, 2002; Somer et al., 2017). In this framework, MD can be conceptualized as a form of imaginative dissociation, situable along a continuum that includes absorption, derealization, and mental withdrawal.

Unlike more severe structural dissociations, MD does not involve a fragmentation of identity, but rather a persistent shift of attentional and emotional investment toward the internal world. This reading allows us to overcome pathologizing interpretations, promoting a functional understanding of the phenomenon.

Maladaptive daydreaming and neurodivergences

An area of growing interest concerns the relationship between maladaptive daydreaming and neurodivergences, particularly ADHD and autism spectrum disorder. In subjects with ADHD, MD appears to intertwine with difficulty regulating attention, hyperfocusing, and seeking internal stimulation under conditions of environmental understimulation.

In the context of the autism spectrum, imagination can take on a compensatory function with respect to sensory overload, social fatigue, and difficulty integrating the internal and external worlds. In both cases, intense daydreaming appears as an adaptive response to an environment perceived as overly demanding or poorly adjustable.

These data suggest the need for a dimensional, non-categorical reading of maladaptive daydreaming, especially in neurodivergent populations.

Clinical implications

From a therapeutic point of view, the goal is not the elimination of imaginative activity, but rather the restoration of the flexibility of mental functioning. The most promising clinical interventions include work on emotional regulation, mind-body integration, and expanding the repertoire of available coping strategies.

In the presence of neurodivergences, it is essential to adopt a non-normative approach, which recognizes the original adaptive value of MD and accompanies its gradual transformation, rather than forced suppression.

It's not “just imagination”: specificity of maladaptive daydreaming

Maladaptive daydreaming is distinguished from normative daydreaming by intensity, duration, and level of cognitive and emotional absorption (Somer, 2002). Fantasies are often complex, narratively structured, and accompanied by a strong identification with internal characters and scenarios. Unlike spontaneous mind-wandering, MD involves significant difficulty in voluntarily modulating imaginative activity. This loss of control represents one of the most clinically relevant elements of the construct (Bigelsen & Schupak, 2011).

The subjective experience of MD is characterized by a state of deep immersion, which can be facilitated by specific stimuli such as music, isolation, or repetitive movements. These conditions favor attentional absorption and progressive disinvestment from the external context. Over time, this process can reduce the ability to stay present in daily activities. This has a significant impact on work, school, and relationship functioning (Somer et al., 2016).

The suffering associated with MD does not arise from fantasy itself, but from its function as a substitute for reality. When imagination becomes the primary channel of emotional regulation, the flexibility of mental functioning is reduced. This stiffening distinguishes MD from creative or playful forms of imagination. The clinical relevance, therefore, lies in the functional impairment and not in the imaginative content (Pietkiewicz et al., 2018).

The role of trauma and attachment

A growing body of evidence suggests a strong association between maladaptive daydreaming and traumatic experiences, particularly of a relational and early nature (Somer, 2002). In contexts characterized by unpredictability, neglect, or emotional inconsistency, the internal world can become a primary source of security. Imagination allows you to build controllable and predictable scenarios. This mechanism responds to a fundamental need for protection and continuity of the Self.

From an attachment perspective, MD can be read as a compensatory strategy in the absence of reliable regulatory figures. Imagination offers a form of emotional self-tuning when interpersonal regulation is lacking. In this sense, MD does not represent an evolutionary failure, but a creative adaptation. However, such adaptation can become dysfunctional if it persists into adulthood without regulatory alternatives (Somer et al., 2017).

The link between trauma and MD fits into a broader framework of dissociative continuity. Intense imaginative activity allows for psychological distance from painful emotional experience. This distancing protects in the short term, but can hinder emotional integration in the long term. A trauma-informed reading allows us to understand MD without resorting to blaming interpretations.

What triggers it: Emotional and contextual triggers

Maladaptive daydreaming is frequently triggered by emotional states such as boredom, loneliness, stress, or shame. These conditions increase the need for affective modulation and reduction of internal discomfort. Fantasy intervenes as an anticipatory response to emotional overload. Access to the imaginative world often occurs before the emotion becomes fully aware (Somer et al., 2016).

Contextual factors also play a significant role in activating MD. Unstimulating or, conversely, overly demanding environments can favor imaginative withdrawal. In particular, understimulation appears to amplify the search for internal stimulation. This aspect is particularly evident in subjects with attentional regulation difficulties (Bigelsen & Schupak, 2011).

Over time, MD can become an automated response to specific triggers. Repetition strengthens the avoidance circuit and makes voluntary interruption more difficult. This mechanism contributes to the feeling of loss of control reported by many individuals. Understanding triggers represents a key step in clinical work.

Why it's hard to quit

Stopping maladaptive daydreaming is not easy because it not only serves a defensive function, but also a rewarding one. Fantasies can provide pleasure, a sense of competence, and continuity of identity. In some cases, they represent one of the few spaces where the individual feels effective and recognized. Giving up can generate feelings of emptiness or loss (Pietkiewicz et al., 2018).

From a neuropsychological point of view, MD may be associated with reinforcement mechanisms similar to those observed in other repetitive behaviors. Intense imagination activates gratification circuits that make behavior self-maintained. This does not imply a total overlap with dependency models, but shares some of their functional dynamics. Forced reduction of MD can therefore increase anxiety and emotional distress.

For these reasons, interventions based on control or suppression are often ineffective. Instead, a gradual and comprehensive approach allows for the expansion of the repertoire of regulatory strategies. Therapeutic work aims to make MD a possibility and not a necessity. Flexibility becomes the central goal of change.

In therapy: from function to transformation

In the clinical setting, maladaptive daydreaming is considered not as a symptom to be eliminated, but as a signal to be understood. The focus is on the function that imagination plays in the individual's emotional regulation system. This approach helps reduce shame and increase the therapeutic alliance. Validating subjective experience represents a fundamental step (Somer et al., 2016).

The most effective interventions include work on emotional awareness, mind-body integration, and tolerance to internal states. Grounding and somatic regulation techniques help reduce the need for imaginative withdrawal. At the same time, work is underway to expand relational and external resources. The goal is to increase the ability to stay present without overload.

In the presence of neurodivergences, it is essential to adopt a non-normative approach that respects individual differences. MD is framed as an adaptive response to a poorly adjustable environment. Transformation happens through integration, not forced renunciation. In this way, fantasy can remain an asset, without being the only possible refuge.

Conclusions

Maladaptive daydreaming represents a clinically relevant phenomenon, still in the theoretical definition phase, which questions the boundaries between imagination, dissociation and emotional regulation. More than an autonomous disorder, it appears as a sign of suffering and creative adaptation to contexts perceived as non-adjustable.

A careful and dimensionally oriented clinical framework allows us to enhance the functional significance of MD, promoting intervention paths that respect individual subjectivity and functioning.

Bibliographic References 

Bigelsen, J., & Schupak, C. (2011). Compulsive fantasy: Proposed evidence of an under-reported syndrome. Consciousness and Cognition, 20(4), 1634–1648. https://doi.org/10.1016/j.concog.2011.08.013

Pietkiewicz, I., Nęcki, S., Bańbura, A., & Tomalski, R. (2018). Maladaptive daydreaming as a new form of behavioral addiction. Journal of Behavioral Addictions, 7(3), 838–843. https://doi.org/10.1556/2006.7.2018.95

Somer, E. (2002). Maladaptive daydreaming: A qualitative inquiry. Journal of Contemporary Psychotherapy, 32(2–3), 197–212. https://doi.org/10.1023/A:1020597024195

Somer, E., Lehrfeld, J., Bigelsen, J., & Jopp, D. S. (2016). Development and validation of the Maladaptive Daydreaming Scale (MDS). Consciousness and Cognition, 39, 77–91. https://doi.org/10.1016/j.concog.2015.12.001

Somer, E., Abu-Rayya, H. M., & Brenner, R. (2017). Childhood trauma and maladaptive daydreaming: Fantasy functions and themes. Journal of Trauma & Dissociation, 18(5), 660–676. https://doi.org/10.1080/15299732.2017.1295453