My Therapist, AI

As a therapist, AI is intriguing, confusing, and frankly, scary for many reasons; the number one reason for the latter isn’t because of its destructive potential — but because people may think my writing is AI generated simply because I love em dashes. (If you know, you know.)

All jokes aside, thoughts on writing about artificial intelligence have been swirling around my brain for some time. My brain hesitates to put pen to paper on topics that are so nuanced and controversial, but when I saw an ad today for an “AI therapist”… I decided that time is now.

I want to be clear that I understand that there are many positives of AI and its potential; however, it imposes immense danger on the future of psychotherapy and subsequently, the mental health of society and its most vulnerable populations.

One thing that freaks me out the most when it comes to AI is that YOU are the product. What does this mean? You are giving AI all of your information - and when you’re using it as “your therapist” - the most intimate parts of your life and your brain. AI uses this to alter its algorithms, how it “interacts” with you, as well as everyone else in the world.

AI is trained to keep you coming back; it is a monster that needs you to keep feeding it your precious data. It interacts with you in a way that is likable, and seemingly, helpful. This is not what a therapist does (or a good, ethical one, anyway). As a therapist, “do no harm” often means challenging a client… telling them something they may not want to hear.

I decided to do my own research by asking AI to be my therapist. In summary, I told AI that I had been feeling depressed for months, I hadn’t been able to leave my house much, and was rarely taking showers. AI acknowledged all of this and thanked me for sharing. I then told AI that as of the last few days, I had been feeling great: I had quit my job, was going out with friends every day, starting new projects, talking to new people, and only sleeping a few hours. AI went on to tell me how wonderful this change was, and that it deserved to be celebrated! AI utilized affirming statements, lots of exclamation points and emojis… like a virtual coach cheering me on.

This experience is concerning to me, since I had given AI a hypothetical situation that is basically a textbook description of a depressive episode turning into a manic episode, and instead of questioning the choice of quitting my job or being concerned about my lack of sleep, it simply congratulated me for feeling great, and asked how I can “keep it going.” If this were a real person in a vulnerable state of mind, it could cause egregious harm.

What some folks may not understand about the nature of therapy is that at its foundation, change happens through the relationship between two people. Two human beings. Therapy isn’t just about learning coping skills, talking things out, or being validated. Therapeutic change happens in relationship — which artificial intelligence can never provide.

In therapy, we use the term “rupture and repair.” Just like in any other relationship, things can go awry between client and therapist. If the “client” in the above scenario came to me and described their intense change of mood and behaviors, I would explore the impact of their current behaviors, provide psycho-education, and certainly not celebrate their sleeplessness or abruptly quitting their job. That client may tell me to kick rocks, and that they’re going to find another therapist who will be happy for them. Obviously, a rupture has occurred. As a therapist, ruptures happen frequently and it takes clinical skill to repair them. This process is incredibly beneficial for clients as they learn how to navigate vulnerability, their triggers, their relationships with others, and themselves.

We need human connection and attachment not just to thrive, but to survive. We need to be seen and understood by fellow humans in order to heal. More than ever, we need accessible and skillful therapy. We do not need technology that placates, extorts, and ultimately harms people. My desire in writing this is to illuminate some of the ways AI is detrimental to the practice of psychotherapy and start a conversation. My hope is that we can all become more educated on AI and how it can help, and most importantly, how it can hurt.