Invisible Companions & Dissociation

Imaginary companions, pretend friends, invisible friends, or made-up friends are a common psychological and social phenomenon where a child creates a friendship or interpersonal relationship in their imagination. Imaginary companions are most reported in children aged three to six, and they typically disappear around age eight. These companions can take various forms, such as people, animals, or abstract ideas like ghosts or robots. Research indicates that having imaginary companions is a normal part of childhood, with 45% to 65% of children having an imaginary companion at some point.
 
Children create imaginary companions for various reasons, including companionship, play, support, and to explore a make-believe world. These companions allow children to be in charge and explore their imagination. Children with imaginary companions are often sociable, imaginative, and empathetic. They can understand different points of view and may be less shy. Creating imaginary companions can be a way for children to practice social skills and communication strategies. In general, imaginary companions are not a cause for concern. However, if the imaginary companion is malicious or if a child has experienced a traumatic event, consulting a health professional may be necessary.
 
Although imaginary childhood companions, are generally considered a normal and healthy part of child development, in some cases, they may be associated with dissociation, particularly in children who have experienced trauma or maltreatment. In these children, imaginary friends may serve additional purposes: like providing a sense of support in unsafe environments or helping to disconnect from stressful events (dissociation) and coping with disruptions in family relationships and frequent transitions. Adults with dissociative identity disorder often report having had imaginary companions in childhood and research suggests a higher likelihood of imaginary friends in children who later develop dissociative disorders. It’s important to note that the mere presence of an imaginary friend does not indicate pathology. The distinction between normal imaginary companions and those potentially indicative of underlying issues is complex and requires professional assessment.
 
Normal imaginary companions would stay under the child’s control, and their actions and behaviours are usually beneficial to the child. The child is able to distinctly recall what the imaginary companion(s) had done. However, imaginary companions as dissociative symptoms, in contrast, usually act outside the child’s sense of awareness, controlling their mind and body, and making them do things against their will. Invariably, the child may not be able to remember what was spoken or done when the imaginary companion was in control when the child and the imaginary companion(s) are not co-conscious of each other’s behaviour or speech. Children who are dissociated more often hear the voices of imaginary companions discussing or planning among themselves in their heads. It’s not uncommon that these children would experience their imaginary companions as annoying and be blamed for negative outcomes. Sometimes, these children considered their imaginary companions more than just their imagination and wished that they would leave them. But others would embrace their imaginary companions and be happy leading their ‘double’ lives. Furthermore, the imaginary companions in dissociated cases often keep their own secrets from each other, and from the child. These imaginary companions would normally surface during times of stress faced by the child or when the child is angered by a situation. 
 
In my previous practice, several adult female clients talked about their childhood and adolescent relationship with imaginary companions following their sexual abuse. And as adults, the dissociative symptomology became more apparent. The childhood sexual abuse pathways appear to produce dissociative disorders, and unless early identification and intervention are available, symptom severity will persevere through to adulthood. Dissociative screening tools are now available for children and adolescents to methodically evaluate for dissociative disorders. 
 
References:
 
Davis, P.E., Webster, L.A.D., Fernyhough, C., Ralston, K., Kola-Palmer, S, & Stain, H.J. (2019). Adult Report of Childhood Imaginary Companions and Adversity Relates to Concurrent Prodromal Psychosis Symptoms.  Psychiatry Research, 271, 150 – 152. https://pubmed.ncbi.nlm.nih.gov/30476752/
 
Dissociative Personality Disorder. (2025). ZwavelStream Clinic. 
https://zwavelstreamclinic.co.za/dissociative-disorder/
 
Elmer, J. (2020, January 24). Imaginary Friends: What Does It Mean, and Is It Normal? Healthline.
 
​Huolman, M. & Peltonen, K. (2022). Dissociative features related to imaginary companions in the assessment of childhood adversity and dissociation: A pilot study. European Journal of Trauma & Dissociation, 6, 1 – 7. https://www.sciencedirect.com/science/article/pii/S2468749922000370
 
Imaginary Friendships. (2022, January 19). Baptist Health.
https://www.baptistjax.com/juice/stories/child-health/imaginary-friendships?

Note: In this Blog, I shall presently focus on the Schizophrenia Spectrum and Other Psychotic Disorders, Trauma and Stressor Related Disorders, and Dissociative Disorders. My previous postings on Other Conditions and Disorders will be moved to my BlueSky App.