If you or your family use AI/ChatGPT as “therapy,” consider this warning that isn’t based on personal usage but from a client suddenly dropping out after years of therapy with me via an email in which she refused to give a reason for leaving or have a wrap-up/goodbye session. Rather than sounding like her, the email felt suspiciously like generic AI advice: no need for a final session or to explain why you’re ending therapy but make sure to express lots of gratitude and appreciation to your therapist for their help.

In a clinical setting, we employ emotional, intrapersonal, social, and interpersonal intelligence. But, because AI “therapists” lack these types of intuitive knowing from personal and professional experience, all they can provide is the impression or impersonation of a human therapist’s take on problems and solutions. 

A major deficit is that AI doesn’t know what it doesn’t know and, therefore, can’t pick up on cues the way a trained therapist can when clients: quickly glance away, shift body position, breathe rapidly, sigh, look about to cry, alter tone of voice, hesitate, or start to say one word then use another. I have clients who without realizing it, pick at their skin or twist their hair when they’re anxious and one who rearranges the pillows on my therapy couch when she’s uneasy. What AI “therapist” is going to pick up on those telling signs? 

AI’s limits as a “therapist” include an inability to: mimic therapists’ empathy; understand human nuance; recognize or interpret nonverbal body language or communication; be aware of its own bias and prejudices; personalize and tailor treatment plans; and utilize ethical and moral judgment. Psychoanalyst Valerie Frankfeldt reminds us that “the concept of Emotional Communication, a way of relating that is viscerally based and unique to humans” is missing in AI. The American Psychological Association concludes that “AI Chatbots are pithy, conversational, and matter-of-fact. They give the illusion that they can provide reliable information and offer deep insights—an illusion that’s very hard to break once cast,” especially if we’re looking for cheap, easy, quick fixes.

Humans who trust other humans turn to them for help. That’s the point of having friends and family—and a real, live therapist. It’s called human connection. Could the attraction of an AI “therapist” actually be to avoid having human contact? A strong possibility, as deep connection is an integral part of the therapeutic process. Lest you think I’m against AI as a “therapist” because I’m afraid of losing clients, that’s not the case. Nor is it for therapists I know. Our fear is that dependence on AI rather than a flesh-and-blood therapist won’t give clients the therapeutic help they really need to become emotionally, socially, and physically healthier

Best,

Karen