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In order to live in fantasy, one would have to pretty much immerse oneself in the idea. This could involve what we commonly call obsession, but could also be a form of schizophrenia. In either case, if it is interfering with a person's life in any way, they should speak with a therapist. Such behavior makes it increasingly difficult to cope with everyday living (which may be the whole point).

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Q: Can living in fantasy as opposed to reality have some similarities of obsession?
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