Therapy for maladaptive daydreaming disorder – part 2: ‘problem-focussed’ therapies

In last week’s post, I discussed how two ‘skills-based’ therapies, CBT and DBT, can teach you healthy coping mechanisms to help you manage the ups and downs of life. As a result, you become less dependent on your unhealthy coping mechanism – your daydreaming.

Both CBT and DBT rely on basic skills that, once learned, allow almost anyone to better manage their thoughts and emotions, and therefore live a happier life. But some people prefer a more personalised approach that directly targets their particular problems. If you’d rather work with someone one-to-one, talking about the specific challenges you’re facing in your life, then you might do better with what I call a ‘problem-focussed’ approach.

The commonest ‘problem-focussed’ approach is probably counselling, which is something I’ve done several times over the last 30 years. I see it as an integral part of how I manage my mental health. When people think of ‘therapy’, it’s often counselling that comes to mind – two people sitting in a room having a conversation about what’s going on in the client’s life.

Counselling can sound scary if you’ve never done it before. It’s just you and the counsellor in the room, so there’s nowhere to hide, and you can’t avoid talking about your issues. But the fact that it’s one-to-one is to your advantage. Anything you say in that room is between you and the counsellor and is strictly confidential. In addition, your counsellor will always remain non-judgemental. So you can trust that whatever you say in counselling will be met with acceptance and understanding.

Unlike ‘skills-based’ therapists, your counsellor won’t tell you what to do. They might occasionally suggest that a particular action could be helpful, but most of the time they support you in coming up with your own solutions. In any type of therapy, it’s ultimately you who’ll be doing the work, but that’s particularly true for counselling. Your counsellor will ask you questions that will help you understand your situation, or they’ll reflect back what you’ve said so you can see it from a different perspective. Whereas CBT and DBT can feel like learning, counselling feels more like a supportive conversation.

I don’t think it matters if your counsellor doesn’t know what maladaptive daydreaming is. There are three reasons for this. Firstly, maladaptive daydreaming is a type of behavioural addiction. Any counsellor who has helped clients with addictions to gambling, pornography, video games or any of the other things people use to numb out should be able to help someone with maladaptive daydreaming.

Secondly, most of us daydream to escape from something in real life (either in our present or in our past) that feels too overwhelming to face. And that’s really what you should be working on with your counsellor. I’d always recommend telling your counsellor that you’re a daydreamer, but your daydreaming probably won’t be the focus of most of your sessions. You’ll be working out how to manage your anxiety, or process your trauma, or whatever it was that forced you into daydreaming in the first place. And it doesn’t matter if you don’t know why you daydream; that’s something your counsellor will help you figure out.

Third, if your counsellor doesn’t know about maladaptive daydreaming, you have an opportunity to explain how it shows up for you. Everyone’s experience of maladaptive daydreaming is different; everyone’s reasons for falling into it are different. Having a counsellor who doesn’t have any preconceived ideas about maladaptive daydreaming means you can immediately focus on the aspects of your daydreaming that are most important to you.

When I was in hospital, our therapists often said that most progress happens between the sessions, and I think that’s particularly true of counselling. Talking to someone, one-to-one, about very personal topics can be intense. I find I need some quiet time to myself after I’ve been to counselling, just to regain my emotional balance. But in addition, I notice that throughout the week, the topics we’ve discussed keep churning around in my subconscious, and I make connections, reach understandings and come up with new ideas that I didn’t have the mental space for during the session. And I take those insights into the next session to work on further.

In our daydreams, many of us have a character who exists just for us – who accepts us without judgement, who is always there for us without ever needing us to be there for them, who is always on our side and can be trusted to keep our secrets. That kind of one-sided relationship wouldn’t be realistic or even desirable in a real-life friendship or romantic partnership. But when we’re going through a difficult time, we might need a relationship that’s all about us. Counselling can meet that need.  

Image by Penny from Pixabay