Advances in mediacommunication technology have opened up new avenues for understanding consciousness through observation of behaviour in virtual environments. A convergence of progress in cognitive neuroscience and computer science should consider the powerful role of conscious and unconscious states as an interface between self and virtual worlds. In this chapter, we review the premise of presence as a dimension of consciousness from both a phenomenological and neuroscientific perspective. Working from a model in which dreaming consciousness is considered the most archetypal form of media technology, dreams are discussed as a useful metaphor for virtual reality. We argue that presence can be equally compelling whether experienced via self-generated simulation during the process of dreaming, or through an externally generated media simulation. Attempts to use media technology in a therapeutic context need to consider clinical aspects of mechanisms involved in both normal and clinical/pathological aspects of consciousness. A speculative therapeutic approach, “dream simulation therapy”, is discussed as a future possible area of study. Dreaming consciousness reminds us that the key factor in approaching an ultimate technology-mediated presence experience is the sum rather than its parts: a subjective/affective state of being.