Treatment of maladaptive daydreaming disorder

You’re either an immersive daydreamer or you’re not – that’s a function of the way your brain is wired and will never change. But whether or not an immersive daydreamer develops maladaptive daydreaming disorder (MaDD) depends on a whole range of things, many of which are still not fully understood. MaDD is not officially recognized as a mental disorder, and only a limited amount of research has been done on it, mostly by Professor Eli Somer and his team at the University of Haifa. Because MaDD is only just beginning to be recognised by mental health professionals, no treatment has yet been scientifically proven to help sufferers.

In this video, Professor Somer discusses in detail some treatments that he believes have the potential to help sufferers of MaDD. Although I recommend watching the video in full, below is a brief summary of the treatments he discusses.

Motivational interviewing

Motivational interviewing is a conversation between the client and a therapist. It explores the reasons why the client might want to change their behaviour (in this case daydreaming). Often, a person with MaDD is torn between wanting to stop daydreaming, thereby reclaiming the time they’re currently losing to the habit, and wanting to continue daydreaming, because it’s fun and provides a temporary escape from real life. Motivational interviewing is known to be helpful in treating substance abuse, and in theory should be helpful in any situation where a behaviour or habit is enjoyable in the moment but causes problems or distress over the longer term.

Address any coexisting conditions

MaDD is known to be associated with depression, social anxiety, substance misuse and several other mental health conditions. Research is ongoing to discover the cause-and-effect relationships. For example, it could be that having MaDD makes it more likely that you will develop depression, or it could be that having social anxiety causes you to withdraw from others and therefore makes it more likely that you will develop MaDD. At the moment researchers simply don’t know what other conditions cause or maintain MaDD. But if you have one or more mental health conditions in addition to MaDD, it makes sense to address the other conditions in the hope that doing so will improve your MaDD.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) has been shown to be effective in treating a wide range of mental disorders including anxiety, depression and obsessive-compulsive disorder. CBT involves changing our feelings and behaviours by changing how we think. It involves noticing and challenging unhelpful thoughts so that we can treat ourselves with kindness and compassion, and thereby feel better about ourselves. The skills learned during CBT can be applied to many areas of life.

Self-monitoring

Recording when and why you daydream, and for how long, can be helpful in several ways. It can help you to identify, and then avoid, situations or triggers that make you more likely to daydream. It is also a way of holding yourself accountable to yourself – you may be less tempted to daydream if you know you’re going to have to log the time on your self-monitoring form. It can also help you track your progress, which allows you to celebrate even small reductions in the amount of time you spend daydreaming.

Mindfulness

I’ve mentioned mindfulness many times. Meditation involves focussing on one thing, for example your breathing or the sounds around you. This means that your focus is away from your own thoughts and daydreams. You are focussing on something outside of your mind. Meditation can be a difficult skill for daydreamers to master. But mindful awareness of the present moment can also help to take your attention away from your daydream world and can raise awareness of your daydreaming triggers. (See this post for an explanation of what I mean by meditation and mindfulness, and the difference between them.)

Research into MaDD is continuing. The first clinical trial of a treatment for MaDD has been conducted by Professor Somer and Dr Oren Herscu. Until the results of this trial are published, we won’t know exactly what treatment they used. But Oren Herscu’s doctoral dissertation (abstract available here) indicates that it involved an online self-help programme consisting primarily of mindfulness and self-monitoring. This trial offers a glimmer of hope that a scientifically proven treatment for MaDD could be available even before the condition becomes widely known and understood among mental health professionals.

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