HealthyGamerGG - Maladaptive Daydreaming

Episode Date: January 3, 2022

Do you daydream too much? Dr. K Talks Maladaptive Daydreaming! Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

Remember, we reviewed the comorbidity data, which suggested that people who maladaptive daydream have a very high likelihood of other psychiatric illnesses. So does that mean that it is a new illness, which is completely independent from these other illnesses? No. So I want to talk to you all today about something called maladaptive daydreaming, which we've seen a lot of. So someone posted this five months ago, addicted to daydreaming. I've never experienced boredom in my life. My addiction to daydreaming is ruining my life. I'm struggling with maladaptive daydreaming.

Every waking day I have, I spend three or more hours obsessively daydreaming about this perfect me achieving this stupidly impossible goal that will never actually happen. This escapism of mine is out of control. Being addicted to daydreaming. Addicted to self-improvement while not improving. It's a little bit different. Hi, Dr. Kay, what are your thoughts about maladaptive daydreaming? So this is something that's huge within our case.

community, you guys can kind of see that this is like, you know, there's a post on this every couple weeks to months. And the truth is that maladaptive daydreaming is something of a new phenomenon. And let me see if I can find a good... So, like, people are not exactly sure. So maladaptive daydreaming is a newly proposed mental disorder characterized by excessive vivid fantasy activity impairing functioning. We'll get to the rest in the second. So today I'd like to talk to you all about maladaptive daydreaming. So this is going to be a little bit more of an academic talk. Okay. So what I mean by that is we're going to go into a lot of different papers. We're going to talk about a lot of neuroscience. We're going to

talk about some fundamental principles of psychology and psychiatry and clinical medicine and diagnosis. And then we'll also talk a little bit about, you know, how to weave this together. So what is the neuroscience of maladaptive daydreaming? How does it manifest? Why does it manifest? What are the issues at play. Why is it happening? Why is it happening now more than ever? Why does it happen potentially in our population, in our community, more than potentially other populations and other communities? And then finally, potentially what to do about it. So the first thing that I want to start out is by talking to you all a little bit about the way that a psychiatric diagnosis works. So in psychiatry, when I say that, you know, someone has depression, do you understand what we mean by

that? Like, what is depression? Do you all know? Okay, so someone's saying checks all the boxes. Okay? So this is the first thing to understand about psychiatric illness. So people are hypothesizing that maladaptive daydreaming is a new diagnosis. So before we kind of get into it a little bit further, we have to understand what the nature of a psychiatric diagnosis is. So if I say that someone has an anxiety disorder or has a depressive disorder or has OCD, the first thing that I want you all to understand are ADHD. Let's do that. Actually, that's a good one.

The first thing that I want you all to understand is that none of these are like real things. They're not objects or consequences. They're not objects. They're what we call in medicine. We call them syndromes. So syndromes are collections. of observable criteria. And what that means is that, as someone in chat put it,

they check the boxes. So in order to have an anxiety disorder or a depressive disorder, you have to check two out of these three boxes. And so any given person may check slightly different boxes. So depression does not, it doesn't exist the same in every single person. It's a constellation of symptoms that we kind of lump together. And then we say, you have this thing. But we're not really, it's not like a physical illness. Like, let's say I have

heart failure. So in heart failure, for example, there's a discrete problem where the heart is not pumping enough, right? So if I have something called congestive heart failure, that means that my heart has become overly congested and is not able to pump effectively because of this thing called Starling's Law. So in physical medicine, we have like discrete, you know, diagnoses that like, actually exist and you can biopsy them, you can x-ray them, you can MRI them, etc. But in mental health, for example, we don't really have those. We have syndromes. And so it's not like I can actually biopsy someone or x-ray someone or do a blood test with someone and discover that they have depression. It's do they check enough boxes? And sometimes in psychiatry, things get really,

really confusing because you can also have something called an anxious depression. So you can actually have an illness that pulls a couple of boxes from anxiety and pulls a couple of boxes from depression. And so does this person have anxiety plus depression or do they have an anxious depression? Do they have two discrete neurological processes or psychiatric processes going on? Or do they have one process going on in their brain that looks like these two sets of constellations, right? So if I have like dots, And, you know, is this something that looks... Shit, I'm screwed up.

Right? Is this something that looks like an A or is it a square or what? Like, what is this? Are these five dots a square or an A? Well, well, sort of both and neither. There are just five dots. And so if I'm looking for a square, I can find a square. But if I'm looking for an A, I can find an A too.

But the dots is what's real. The A and the square are the constant. constellations or syndromes that we kind of apply on top of them. Are you guys getting this? Does this make sense? So now we're going to get to this concept of maladaptive daydreaming as a new diagnosis. So what maladaptive daydreaming is is essentially this like syndrome where people will daydream for hours at a time to the point where it starts to impair their function. they can't concentrate. They can't focus on schoolwork. They're not able to work.

They're not even able sometimes to have fun and play video games or engage in relationships. So they daydreams so much and so often that impairs them from doing other things in life. So let's try to understand what's going on in the neuroscience of maladaptive daydreaming. Okay? And so this is where I'm going to start by saying the short answer is we don't know. But there are some really interesting things that some studies, have taught us. So let's take a look at some, let's take a look at some studies, okay? So this is a study that's looking at the comorbidity of daydreaming disorder. So what this means is that if I have

someone who has maladaptive daydreaming, what other illnesses are they likely to have? And so when you do structured interviews, so what this means is that 74% of people met criteria for three additional disorders. That is insane. 41% of people met criteria for four. So 76.9% of people met criteria for ADHD. This is nuts, right? So if I take someone, what is that? 76.9%. This means that if I take someone with maladaptive daydream, if I take 100 people with maladaptive daydreaming and I test them for ADHD, 76.9% will have ADHD. Okay, so for anxiety, the number is 71.8%. Okay. And, yeah, so we're going to just focus on those two right now.

Okay, so what this sort of means is that if you look at maladaptive daydreaming, there is a very high comorbidity with ADHD, and we know that the brains of people with ADHD are somewhat different, and I go into that in a lot of detail if you look at the ADHD and addiction and ADHD and depression video. Okay. So there's a high comorbidity, which tells me, that when we're talking about maladaptive and daydreaming,

it's not an A or a square. This is a sort of situation where there's a lot of shared points. Does that make sense? And when we look at anxiety, there's a lot of shared points. So this is sort of a situation where if I string these together in this way, I end up with anxiety. If I string them together this way, I end up with maladaptive daydreaming.

So I can make all kinds of shapes, or I can make a house. So as we'll see that there are other things kind of going on as well. well. So maladaptive daydreaming, dissociation, and dissociative disorders. So when it comes to dissociation and trauma, there's a very tight comorbidity here as well, where, you know, people who have a lot of dissociation also tend to have maladaptive daydreaming. And there's also similarities with OCD. Okay. So now this is kind of weird because we have, you know, very high comorbidity with this. let's say like, I forget what the number is.

I think OCD was like 50%, right? And dissociation and trauma, I'm not sure exactly what the number is there, but it tends to be high. So now the question is like, let's just think about this for a second, okay? Does that mean that people are running around with ADHD and maladaptive daydreaming and maladaptive daydreaming and anxiety? So are these two separate, discrete processes? Is this a brand new diagnosis, which is completely different from the things that we've seen before? And this is where my take is that not really.

So I think what we're starting to see, and here's how I'd put it. So let's like think about what daydreaming is. So daydreaming is kind of getting lost in fantasy, right? It's not being able to focus, which in turn means you're kind of losing track of where you are. Okay, does this make sense to people? Ah, people are saying sounds like ADHD. and this is where, okay, so if this is how we define daydreaming, what my hypothesis is is that ADHD and, let's say, dissociation,

can both get here, right? So there's some circuits in the brain, so there's like dissociation circuitry, and there's a tensional circuitry, and both of these circuits. If you have a problem in either of these circuits, you can have this emergent, phenomenon of maladaptive daydreaming. Does that make sense? So you can have problems with your attention.

So the reason that I get lost in daydreaming is because I have difficulty focusing on particular things. So if my mind is unable to focus, what that means is that I can get distracted and lost into daydreaming very easily. But on the flip side, that's one way to get to daydreaming, but you don't have to get to daydreaming through the unable to focus route. The other way you can get to daydreaming is through dissociation. So my brain is prone to dissociate and separate from what I'm doing in this particular time. It's not necessarily that I can't focus. It's just that the dissociation circuits of my brain are highly active. So I wind up daydreaming because I dissociate from where I am in time and space. And then maybe there's something with anxiety or OCD, which also is like a third track, which can

kind of lead to daydreaming. Okay. So daydreaming in my kind of limited experience, and as especially after looking through the neuroscience and stuff like that, I think is an emergent phenomenon that can come from many different kinds of brains. Okay? And so, like, I think that you can sort of have, this is why we see so much maladaptive daydreaming and sort of why it's been lost as a diagnosis thus far, is because people end up getting diagnosed with ADHD. They end up getting diagnosed with anxiety or trauma or OCD.

And so the daydreaming sort of gets lost within these other diagnoses. I don't know that it is a purely its own kind of unique process going on in the brain. I would rather, you know, sort of suggest that it is an emergent phenomenon that is coming out of the neurocircuitry of these other kinds of processes, which are well described. Okay. Now, let's move on to something else. So then the question is, if it is an emergent process that comes from multiple different neuroscientific mechanisms, why does it emerge? in all three of these situations, right? So if we look at, like, how the brain responds, so let's say daydreaming is an outcome of an ADHD brain, daydreaming is an outcome of

dissociation circuitry, why does it always happen? Like, why isn't it that ADHD circuitry ends up with, you know, manifestation A, and dissociation manifests as B, and anxiety manifests as C. Like, instead of three, if we have three different brains or three different neurological processes, why don't they look different? Why do they all manifest as daydreaming? That's the next question. Are you all with me here, by the way? Is this like too much?

Are you guys following this? Do you all need? Okay. So this is very good. Okay. So now someone is saying very good. So they're saying coping mechanism, right? So very good.

So now there's a really fascinating paper. Okay. So personality traits and maladaptive daydreaming. Fantasy functions and themes in a multi- country sample. So what basically what people did is they analyzed 539 adults who met criteria for maladaptive daydreaming, and then they looked at their personality. And what they discovered is that there are three common things that these people tend to have. So they tend to have grandiosity, they tend to have separation anxiety, and they tend to have anhadonia.

Okay? So like, oh, that's interesting. So forget about the comorbidity. Forget about the brain. This is now a different kind of research. This is sitting down with a human being and asking them or analyzing, okay, if you have maladaptive daydreaming, what is your personality like? And what they also found, and this is what's really fascinating, is that each of these different groups of people actually daydreamed about different things. Okay. So people who are in the grandiosity, had daydreams of power, dominance, and wish fulfillment. People with separation anxiety had daydreams of relationships. This is really important. Of extra attention. And in particular, extra attention given to them by illness or some kind of vulnerability.

And what does that mean? That means that when I daydream, I think about, man, it would be so awesome. I literally I have a daydream. I don't actually think it's awesome. But I have a daydream about, man, if I got cancer, I would be in bed all day, and everyone would be coming to see me, and everyone would be bringing me cake and food. And, like, I just have this, like, I build this complex fantasy in my mind about this scenario in which I'm ill or vulnerable in some way.

And all these different kinds of people are giving me attention. And with An Hoddoa, this is really interesting. For people who have Anhedonia, they have daydreams of escape or physical. violence. Right? So the people who are in Hadonic have daydreams where like something big is happening. I'm feeling something in the daydream. The rest of my life, I don't feel pleasure.

I feel numb all the time. But in my daydream, like, I'm fighting someone. Someone's fighting for me. I'm fighting for my life. I'm wrestling with a shark. You know, I'm wrestling with like some kind of like I get attacked by a jaguar. Like there's, or I'm being hunted by something and I have to run away. So we start to see.

when we look at the personality element, right? So this isn't really neuroscience. This is not talking about attention or the brain's capacity to dissociate. When I sit down and talk to people with maladaptive daydreaming, what I tend to find is that there are three categories of sort of personality temperaments that some people are grandiose. Some people have separation, anxiety, and are afraid of abandonment. And some people are anhedonic, which means that they don't feel pleasure. And that if I ask them what kind of daydreams do you have, they tend to correlate with these three buckets. Okay. And so what we try to, and this is what's really important about maladaptive daydreaming is that people will say, oh, I daydream all the time, but it becomes important what you daydream

about. And so what people hypothesize is that when I have this kind of brain that tease me up to daydream and I have some kind of unmet emotional need in my life, I end up with maladaptive daydreaming. So this is sort of like a, you know, it's like an alchemical process where I combine two ingredients and I end up with a third. So, for example, if I have ADHD brain plus I've been abandoned, I'm adopted or whatever, my dad left, you know, some kind of like thing. equals maladaptive daydreaming. If I have a history of trauma, so I have a dissociation brain, and I'm an hedonic, I can't feel anything, I'm numb, ends up with maladaptive daydreaming.

If I have OCD, and I'm a low-wage worker and my boss is mean to me, and I have unmet needs of power and glory, I end up with maladaptive daydreaming. And this is why it's such a tricky, diagnosis defined is because what we've got is like discrete potentially discrete neurological processes or maybe it's one neurological process over here which manifests or looks like any of these three things and then I have an unmet emotional need and then my brain decides to maladaptive daydream so this is the way that it fixes the

problem so the reason that maladaptive daydreaming is so hard to get rid of is because it's actually a fix to a problem right so I have a brain that's easily distractible, plus I feel abandoned all the time. So what is that result in? It's like, I'm going about my day, I'm trying to study, and I have this deep unmet emotional need of like feeling secure about myself. And since my brain is so easily distracted, it always goes back to that deep emotional need. It's like an itch that I have to scratch over and over and over and over again. And my lack of attentional control plus my unmet emotional need. So a neuroscience vulnerability plus an emotional vulnerability

leads to this maladaptive daydreaming. Okay? And so the interesting thing is, so Dr. K, this is a very fascinating theory, and it sounds really cool that you're saying neuroscience vulnerability plus unmet emotional need equals maladaptive daydreaming.

But is that just like, do you just make it sound good or is there any like data to support that? And this is the coolest paper that I found. Okay. So this is super cool, okay, but it's going to be hard. So say with me, chat. So the first thing is that people looked at, this is something called network theory for understanding maladaptive daydreaming, okay? So network theory sort of is kind of like what I'm saying.

It's sort of this emergent property. But what they sort of figured out is they looked at maladaptive daydreaming, and they said that there are three factors. There are three kind of like buckets of stuff going on with these people. One is what they call kinesthesia and music. So this is where like music triggers their daydreaming or they use music to maintain their daydreaming. They somehow get lost in the music. Another aspect of maladaptive daydreaming is yearning. So they want to return to the daydream.

They're not distressed at all when they're daydreaming. They get annoyed if they get interrupted. They prefer to the daydream. They have a strong urge. It's kind of an enjoyable experience. They call this thing yearning. This has to do with factor analysis if you guys know what that is. We're not going to go into too much detail.

And then the third thing is impairment. So it interferes with their daily chores. The amount of time that they daydream causes distress, it's difficulty to stay focused. They feel hindered in their life goals. They have difficulty controlling the daydream. It interferes with their work. Sound familiar, by the way, chat? So these are the three factors that are associated with maladaptive daydreaming.

And then what these researchers did is they looked at emotional regulation. And what they asked themselves is, if I look at. at emotional regulation, does this correlate with any of these three factors? So if someone has, for example, a lack of emotional awareness, are they more likely to experience factor three impairment? And what they absolutely discovered is that maladaptive daydreaming can essentially be correlated with emotional regulation factors. And the other really interesting finding that they had is that there's one important inverse correlation, which is the lack of emotional clarity,

which is kind of interesting. So what they found is that people who daydream a lot can actually improve emotional clarity over time. So it's almost as if maladaptive daydreamers are using daydreaming as a method of processing their own emotions and understanding what they feel. As they go through all of these like scenarios about feeling loved and being ill,

and people caring from them, they can actually gain insight into, oh, this is me feeling like lonely. They can actually have some kind of emotional regulation benefit or increased clarity, which is really, really fascinating. So what they essentially found, let me find the key sentence here, is, so associations were mostly positive, suggesting that in general, poor emotional regulation was linked. with a higher degree of maladaptive daydreaming symptoms. Right? So this is the key thing.

So the two nodes in the expanded network with the highest strength centrality were limited emotional regulation strategies and difficulty controlling the daydream. Okay. So what this essentially means is that when I have a maladaptive daydreamer who has limited emotional regulation strategies, what are they more likely to do when I take this person these are the strongest correlations this leads to maladaptive daydreaming right

and so this is the kind of situation where essentially we can tie things together now where we can see this paper is a really good example of our hypothesis that when I have neuroscience vulnerabilities and I have unmet emotional needs and there's a key thing here

plus no other way to deal with it. This equals maladaptive daydreaming. Do you guys get that? So essentially, what we see is that the more limited you are in your emotional ability to regulate your emotions, the more limited you are in your... Right? So let's look at these factors. So the more likely you are to not accept your emotional responses, right?

What does that mean? That means I have to escape. The more difficulty you have with goal-directed behaviors, what does that mean? It means I get lost in the daydream. The more impulse-control difficulties, and by the way, is this starting to look like ADHD? Oh, yeah, that's right. Remember, if you guys remember the neuroscience of ADHD lecture, you remember that impulse-control difficulties and emotional dysregulation are a key part of the brain of ADHD.

The more lack of emotional awareness that you have, the more limited emotional regulation strategies you have, and the lack of emotional clarity you have, the more likely you are to retreat into the daydream. Right? So we can sort of include those six factors right here. And so there's one more thing that I'm going to add, which is really unfortunate. So this is sort of this ambitious cycle of maladaptive daydreaming. So when you have maladaptive daydreaming, it leads to poor performance, right? There's no awareness of this stuff or this stuff. So if you talk to people with maladaptive dayduring, maybe what we can do is like look at a post.

So we'll test our hypothesis in a second. We'll pick a random Reddit post from our subreddit. And we'll see if this person has any sense or talks at all in their post about unmet emotional needs or their comorbidities. Because I would suspect maybe this is different because it's our community and our community tends to be super self-aware. But what we tend to have is maladaptive daydreaming leads to poor performance. This in turn leads to emotional frustration. I don't understand what's wrong with me. Why can't I just focus?

Why am I cursed with maladaptive daydreaming? Right? This leads to self-blame. Can you guys see where this is going? And this leads to maladaptive daydreaming. Right? And so as the emotional need increases through maladaptive daydreaming, and by the way, you shouldn't smoke pot.

Because marijuana seems to make this worse. That's the one thing about drugs. Sorry, chat. Right? Because remember, marijuana is also a coping mechanism. I'll pull up that paper if you guys want to see it. And so as the unmet, emotional unmet needs increase, and if you don't have abilities to cope with it,

if you're not in therapy, you don't have good friends, et cetera, things like that, meditation. We'll talk about this in a second. Then this is going to increase your maladaptive daydreaming. And then once we increase it, then we go the second round, right? We do it again. We do it again.

And then this goes on for a while, and then you're 30 years old. And then it's like, me, my life is empty. And this is when you start thinking about Gigiing out, right? I'm not trying to be callous here, but this is what can happen. So maladaptive daydreaming can be a really devastating diagnosis. So just to summarize, maladaptive daydreaming is something that is increasingly common, right? And so let's look at why is that?

So this is the last thing. So why are so many people posting about maladaptive daydreaming now? What's going on? Has it been that for 50 years, maladaptive daydreaming has sort of existed and people have just ignored it or like is it a new thing? Is there some maladaptive daydreaming virus going around? What's going on? The first is that it seems to correlate with a lot of the vulnerabilities that lead to gaming disorder.

So there's some correlation between using gaming as an escape and filling unmet emotional needs. So there's something going on here where, like, gaming and maladaptive daydreaming, essentially serve the same adaptive mechanism, right? Second reason is, can anyone guess it? Highened levels of maladaptive daydreaming are associated with COVID-19 lockdown, pre-existing psychiatric diagnosis, an intensified psychological dysfunction. You can always blame COVID, chat. You can always blame COVID.

So it seems like there are reasons. why maladaptive daydreaming is worse. So remember, what is maladaptive daydreaming? It is a unhealthy coping mechanism which the mind relies on due to some way that it's wired. So if I have intentional problems or I dissociate, right? Or I'm obsessive. My mind has an obsessive thinking quality to it.

Like I'm on the OCD spectrum. So my brain is wired in one of those three ways. And then maladaptive daydreaming emerges is a way to manage your emotional needs. given those that sort of neuroscience backdrop and once we add COVID into the mix it also escalates our emotional needs and we end up being with more maladaptive daydreaming okay now people are probably wondering what do I do about it so I'm gonna echo once again this is not a place where we can give medical advice but here is how I would approach

actually let's stop for a second anyone have questions How do you fix dissociation? Okay. Summary, please. Okay. So let's start with a summary. Can you repeat all that? Okay.

It's a lot. Okay. So I'm going to just talk to you all. Okay, we're going to move away from this. So here's how to understand maladaptive daydreaming in a nutshell. So the first thing is, remember, we reviewed the comorbidity data, which suggested that people who maladaptive daydream have a very high likelihood of other psychiatric illnesses. So does that mean that it is a new illness?

which is completely independent from these other illnesses, no, it actually suggests that there's some kind of common process going on. The second thing that we discovered is that it appears that the type of daydreams that people have correlate with certain unmet emotional needs and personality characteristics. Okay? So, and what that sort of, the third thing that we kind of talked about is that we found a very tight correlation between, inability to understand or regulate your own emotions and maladaptive daydreaming. So what does this mean?

Why do so many people have maladaptive daydreaming and why has it been so damn hard to diagnose? Why are people just learning about it now? So my take on it is that there are multiple different brains that can get to maladaptive daydreaming. So one is the ADHD brain, in which case you can't really control your attention. So since you can't control your attention, your mind wanders into the daydream very, very easily. Another kind of brain is the obsessional brain. So 50% of people with maladaptive daydreaming will also have OCD or meet criteria for OCD. So this is a brain that obsesses over some thoughts.

This is not attentional wandering. This is actually the opposite, where it holds on to a particular thought extra, extra tight, which happens to be the daydream. The third kind of thing that we tend to see is an association with trauma, okay, or dissociation. And so this is a brain that is able to pull myself out of my current circumstances. If I'm sitting at a cafe and someone has left me the bill, my mind will dissociate and I'll go off into la-la land and I'll enter the maladaptive daydreaming for like three hours and I'll just be sitting at the cafe. So the dissociative brain, the inattentive brain, or the obsessional brain can all result in maladaptive daydreaming. The reason that each of those brains, daydreams, is because there are unmet emotional needs.

They're the grandiose emotional needs. I want to be rich. I want to be powerful. I want to be respected. There are the essentially loneliness needs, separation and anxiety. So I don't want to be abandoned. And I'm going to fantasize about being cared for and loved. The third thing is the an hedonic personality, which is my life is numb.

My life is empty. I don't feel anything. So the daydreams that I have are about survival, escape, physical violence, things like that. It's not necessarily violence against other people. It's just very emotional. charged fighting for your life, feeling something kind of dreams. So what we tend to have is when you have one of those people who has one of those emotional, unmet emotional needs, and then you stick that emotional need in the brain

of someone with ADHD, dissociation, or obsession, plus an inability to process that crap through healthy coping mechanisms or a lack of emotional awareness, you end up with maladaptive daydreaming. that's kind of like where it comes from, right? So it's sort of a combination of a brain that is predisposed to particular things plus unmet emotional needs. So now people are going to say, okay, what do I do about it, Dr. Kay? And that's where I'd say, that depends, but here's what I'd kind of, here's how I'd write it out. Okay, so I don't have a whole lot of clinical experience with maladaptive daydreaming, so take this with a grain of salt. But I do feel pretty confident

when I'm about to say. So if you're talking about what to do about it, first thing, you've got to do is figure out what kind of neuroscience vulnerability do you have? Do you have attentional problems, dissociation, or identity problems, or obsessional kind of thoughts? Right? Maybe anxiety is in here too. I'm sort of skipping that, past that one for reasons. But, and then what you have to figure out is what's my unmet emotional need, right? Do you fall into the grandiose camp? Do you fall into the separation anxiety camp? Or do you fall into the anhedonic camp? And then what you have to do is figure out coping strategies and EQ stuff.

And so here what you've got to do is gain emotional clarity, develop emotional regulation strategies. Okay? Next thing you've got to do drugs. Stop weed. Question. start SSRI. Some evidence of this. Okay?

So if we kind of think about tackling maladaptive daydreaming, what I would do is address each of these buckets. This is just how I practice psychiatry. So what I would do is with the attentional person, you know, I teach a particular meditation that trains their attention, which we'll do today. For your unmet emotional need,

you could do psychotherapy for something like this, right? So if you have separation, anxiety, you could do psychotherapy. Right? So here you could even do meds for ADHD or meditation. And then to gain emotional clarity, you can also do meditation or psychotherapy. But I think actually this is like where some of those like wellness retreats, like out in the woods, go find yourself. This stuff is really great here.

Develop emotional regulation strategies. So this is also where meditation works great. But maybe you can do things like ice diving or Wimhoff breathing. etc. Okay? So this is sort of like where you've got to like figure out, okay, which one of these is it? And you have to attack it from all angles. So you have to address this from, okay, what's going on in my brain?

Do I have a problem with attention? Then if you increase your mind's ability to focus, then you won't get lost in the daydream as easily. You'll remove the neuroscience vulnerability. If you can meet the unmet emotional need, either through psychotherapy or even like get into a good relationship. Right? Get promoted. Go do something fun. Like, go hiking.

Actually, hiking's not right here. Go white water rafting. Right? And then gain some emotional clarity. Like, go find yourself. Go meditate. Go talk to someone. You know?

Develop emotional regulation strategies. So, there are a couple of interesting things. So, by the way, one of the things that we've sort of figured out recently is that, so the outcomes from our coaching program seem to be really good, and we've had a lot of data points now. and we were really confused. So the coaching program appears to be about as efficacious, maybe about 70 to 100%

as effective as antidepressant medication or anxiety medication or maybe even as good as psychotherapy. It's not a treatment for those things, so it's not designed to treat depression or anxiety. But we were just really confused why our coaching intervention appears to be effective

for treating illnesses, which it's not, don't sign up for coaching if you have a mental illness that you're looking for for treatment for, you should go see a medical professional. But we were confused why it seems to be helpful. Hopefully that doesn't sound like a contradiction to people. Do people understand the nuance there? And the reason is that we think that our coaching program essentially boosts EQ. So we're actually studying that right now. And that's simply by giving people emotional clarity, by giving people emotional regulation strategies by bringing awareness and self-understanding that it somehow seems to like negate this stuff over here, which we're not quite sure how that works. We're just as

confused as y'all are. Right. EQ is emotional quotient. So it's like IQ but for emotions. The other thing is that there is, if you guys, if this is ringing true to you, there is a video in Dr. Kay's guide called the Fantasy Trap, which, Targets, sort of talks about these unmet emotional needs and sort of like goes into detail about why we get stuck in fantasy and what goes on in the mind when we're having a fantasy. But in short, if we're talking about targeting maladaptive daydreaming, you know, what I would do as a psychiatrist if I were your doctor is to try to approach each of these. Figure out what is the neuroscientific vulnerability, what is the unmet emotional need, and what are

the ways in which you process your emotions. And if you can work on all threes, all three, I would have a hypothesis that your maladaptive daydreaming would get better. Ah, in what order? There isn't an order, right? These are all discrete processes. This is like sort of saying like, if we have a soup, this is an emergent property, remember? This is an emergent property. So it's like, if I have, you know, water plus tomatoes, plus salt to make a crappy soup. And I end up with soup over here, right? The order isn't important.

What's important is that all three end up in there. I mean, I guess technically order is important because culinary stuff is different. So maybe you want to like roast the tomatoes first and then add the salt and later add the water. So that's a bad analogy. But and maybe that could be true for the, the, you know, this stuff too. Maybe there's a particular order. We just don't have any data on treatment. Right?

So I don't think it's about order. This is where people like, what order do I do it in? So generally speaking, when I work as a psychiatrist, I don't like, sometimes you have to do order, but when someone comes into my office, I'll give him a prescription. I'll teach him to meditate and I'll give him a diet plan, like all on day one. Like, do it all. Right? They're all independent things. You can do it in whatever order you want.

But ideally, you'd actually do all three. Okay. So now, just do it all. You're damn right. So here's the thing. So it's possible if we want to look at it technically that doing any one of these is sufficient to deal with the daydreaming. It's possible that you don't need to do all three. But this is the kind of thing where if maladaptive daydreaming is ruining your life, I'd work on, I'd fire on all cylinders.

Right. So it's possible that if you just get rid of the emotional need that the maladaptive daydreaming will fall apart. It's very possible. We just don't know that. There's no data to support, you know, what's. effective for maladaptive daydreaming. Okay?