Maladaptive daydreaming is a dissociative disorder: Supporting evidence and theory

Dissociative disorders involve a division of an organism-environment or ecological system into subsystems. Each subsystem or dissociative agent brings forth his or her own, however rudimentary, experience and idea of self, world, and self as a part of this world. The disorders manifest in dissociative symptoms. Some are psychoform (e.g., one dissociative agent hearing another dissociative agent speak), others are somatoform, or sensory and motor (e.g., being analgesic while another dissociative agent is in pain). Somatoform and psychoform dissociative symptoms often occur together. Somatoform dissociative symptoms are characteristic of dissociative disorders and proportional to their complexity. The disorders include ICD-10’s Dissociative Disorders of Movement and Sensation, inadequately renamed in ICD-11 Dissociative Neurological Symptom Disorder. Sensory and motor dissociative disorders are categorized in DSM-5 as Conversion Disorder. This is confusing, because the symptoms involve dissociation, not conversion of something mental into something physical. PTSD, which can be seen as a simple dissociative disorder, is associated with marked somatoform dissociation. Adverse events, particularly chronic interpersonal abuse and neglect, and the motivational conflicts this adversity typically implies, constitute an important causal factor of somatoform dissociation.