I write here as a psychotherapist who sometimes comes across maladaptive daydreaming (MD) in clients, most often self-reported. As always, I write primarily as a learning tool for myself and secondarily to share what my others might find useful, if only as a point of reference or comparison to their own experience. I do not attempt to critique the researchers’ findings.
This paper identifies a clinically recognisable combination of vivid imagery and repetitive movement that might otherwise be assessed only as a movement phenomenon. The paper asks whether this childhood pattern may, for some of them, continue into adulthood and develop into maladaptive daydreaming: immersive fantasy that becomes difficult to control and causes distress or disrupts everyday life. It brings together clinicians and researchers working with childhood movements and adult dissociation to explore what might happen to this pattern over time.
I suspect people experiencing such movements and daydreaming happening together will make the connection for themselves, where there is one. Nonetheless, it may be validating or simply of interest to read the first-hand accounts that can be found in the original paper.
What are intense imagery movements?
‘Motor stereotypies’ are repetitive movements that often begin in early childhood. They can occur in children developing typically as well as in children with autism, ADHD or other neurological or developmental differences.
The term ‘intense imagery movements’ or IIM is used to name those cases where these movements accompany unusually vivid internal stories or images. A child may pace, rock, jump or repeatedly move their hands or an object while absorbed in a vividly imagined world. The movement may seem unrelated to an obvious task, but the person may experience it as helping the imagery feel more intense or easier to enter.
What did the case series tell us about how IIM presents?
The authors present accounts from six adults, aged 18 to 46, who described intense daydreaming beginning in childhood. Five also reported that movement remained connected with their daydreaming as adults. Their examples included pacing, walking, running, swinging, twisting hair and repeatedly handling a pen or pencil. For some, music made the experience stronger.
The accounts differed markedly. Some people valued their imagination and linked it with creativity, problem-solving or emotional relief. Two did not regard their daydreaming as a problem. Others described guilt about lost time, difficulty resisting the urge, withdrawal from relationships, rumination, shame or accidental injury while moving in an absorbed state. The distinction matters and highlights a key point: vivid imagination or repetitive movement is not automatically a disorder. In contrast, the term maladaptive daydreaming refers, by definition, to an experience that causes significant distress or interferes with life.
Does childhood IIM lead to maladaptive daydreaming?
The paper suggests that this may happen for a subgroup of people. It does not claim to show that IIM causes or reliably predicts later maladaptive daydreaming. The six adults were selected were recalling childhood events many years later. They were chosen because their experiences illustrated the proposed connection. The paper is not reporting results from a representative group followed from childhood into adulthood or compare the participants with people without IIM. We do not yet know how many children with IIM continue the pattern into adulthood, how many experience impairment, or which children might be more vulnerable. The safest conclusion is therefore that a developmental connection is possible and deserves proper investigation.
Why might movement and imagery become linked?
The authors discuss several possibilities. Repetitive movement might help a person regulate feelings, reduce attention to outside distractions or become more deeply absorbed in inner imagery. The paper also considers attention, obsessive-compulsive processes, behavioural addiction and dissociation. It discusses brain networks involved in visual imagery and self-generated thought, but it did not investigate the participants’ brain function or determine which explanation is correct.
Trauma may be relevant for some people, but the authors emphasise that it does not explain every case. Some stereotyped movements begin before the age of two, and the pattern is not necessarily associated with childhood trauma.
What might this mean for children and adults?
The paper supports curiosity and further enquiry rather than alarm. A child who moves while imagining is not destined to develop a mental health disorder. What matters is how the experience affects safety, choice and everyday functioning. Relevant questions might include whether the person can stop when needed, whether the activity causes injury or distress, and whether it is displacing sleep, education, work or relationships.
Adults seeking help may find it useful to describe both the daydreaming and any movements, music or routines that intensify it. Parents or professionals can similarly ask about the images accompanying repetitive movements rather than considering the movement alone. This small case series does not provide a diagnosis or treatment plan, but it identifies a pattern that deserves to be understood without shame and studied more carefully.
Primary source: Hedderly et al. (2024), Intense Imagery Movements May Lead to Maladaptive Daydreaming