Dear Therapist:

I have heard that people are developing AI therapy and that it could be just as effective as in person therapy. Setting aside for the moment the issues that come along with use of technology, I am wondering if you think this is, or can be, and effective method of therapy?

 

Response:

Your question can be understood from a global perspective or with regard to specific needs for specific people within the context of a therapeutic relationship. Between these two extremes there are many other questions that can be addressed.

Will artificial intelligence change the world? This is an example of a very general question. However, in responding to this question, we can begin to comprehend some of the possible impacts of AI on therapy practice.

AI is already changing the world. Information is now being relayed in forms and on platforms that were considered not too long ago to be within the realm of science fiction. We have the ability to conduct conversations with a brilliant “entity” that has a tremendous amount of information. As importantly, this “entity” will respond to our individual inquiries and requests, tailoring its responses to our needs.

Sounds like the perfect therapist, doesn’t it?

For some, this might technically work. Imagine a person who thinks and resolves issues in a very intellectualized manner. This person has many negative automatic thoughts telling him that he is worthless. From a purely cognitive perspective, AI can help this person to identify their negative thoughts and challenge them.

However, will AI pick up on the possibility that this person may be using intellectualization as a defense mechanism? Will it know how to appropriately challenge the person?

Eclectic therapy (use of many therapeutic styles and modalities) is consistently being shown to be particularly effective for most clients. Why? There are no two people who are alike. Think about what this means. There are literally no two people who should be treated in therapy in the exact same manner. Thus, therapy is a combination of science and “art.” A good eclectic therapist will tailor the therapy process for each particular client. This process is not static; it is subject to constant change as information—and the therapeutic relationship—changes.

AI might be incredibly adept at diagnosing. It may be excellent at identifying the particular therapeutic modality that has been proven to work for this diagnosis. However, a person is so much more than a diagnosis. In fact, diagnoses often obscure many of the aspects that should be addressed. There are underlying factors that often are teased out through the therapeutic relationship. Sources of emotional issues, trauma, self-esteem problems, emotional defenses, and many other factors impact on the process within the therapy session.

The therapeutic relationship just by itself is something that could (should?) never be fully replicated by artificial intelligence. It is the emotional connection, along with use of concepts like transference (the client connecting with the therapist as within a past or current relationship) that makes the therapeutic relationship unique. For example, being told by a database and circuitry that your feelings are normal cannot compare to clearly sensing this from a therapist to whom you relate as you did with your father at age eight.

Theoretically, artificial intelligence can reach the point where it could assess, diagnose, identify, and treat all types of disorders—in an impersonal fashion. Again, however, I could argue that the very people for whom this is preferable are those who need a human therapist to challenge their possible need to isolate from the personal aspect of the therapy process.

Also, regardless of how self-learning AI is programmed to be, it is simply that—programmed. Therefore, although it can “learn” to create new associations, it may never be able to come up with completely novel concepts. The very birth of psychotherapy was a completely new idea. Freud’s id, ego, superego, defense mechanisms, and other novel concepts gave birth to psychoanalysis.

 

In addition, people change—and society, as a whole, changes. Use of artificial intelligence will likely be a major catalyst for social and societal change. It will change the ways in which we interact with technology. As we know, technology has changed the ways in which people socialize. Thus, changes in the ways in which we interact with technology will equate to changes in socialization and in society.

Let’s imagine a future in which AI is being used for psychotherapy. AI would—to a large degree—be the cause of changes in how we interact, and it will also largely dictate the course of change within the therapeutic process. If we increasingly become a product of artificial changes to human interaction, we are essentially being led down a road that is being cyclically reinforced by an intelligence that is not human.

For those of us who completely buy into this, I can again recognize that emotional problems that emanate from such an artificial way of thinking and feeling can technically be resolved by the same artificiality. Again, however, the question is to what degree these people are truly in touch with what they are thinking and feeling. It would seem to me that the further one goes down the road of artificial thinking, the less in touch they are with their true underlying emotions. This would lead to a vicious cycle in which the more that people address their emotional issues via artificial intelligence, the more they are distancing themselves from their humanity.

…Perhaps this is the real existential danger of AI.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro University

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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