Can I use ChatGPT as a therapist?

It was an overcast summer day in Northern California at the river with a group of acquaintances when I found myself at the center of a conversation about using ChatGPT as a therapist. As the lone therapist in the group — mostly lawyers — I had the lonely task of defending why a human therapist is more useful than a chatbot. To my surprise, almost everyone admitted that at one time or another they had used ChatGPT as a substitute for a human therapist.

I want to point out one critical difference I don’t think most people consider, based on my observations and conversations on this topic. Many people seem to operate under an unconscious assumption that someone else has the answer. “I want to speak with someone objective, a neutral party” is something I hear a lot. It’s true that talking to a therapist is different from talking to a friend or a partner; however, there is an underlying assumption that a different perspective exists that is better than one’s own beliefs. That’s partly true, but it’s incomplete. Therapists do possess knowledge, authority, and power by virtue of their training and experience, and some of that authority is granted by the patient. In fact, the therapist must be granted this authority; otherwise a patient wouldn’t seek therapy in the first place.

What I notice with people using ChatGPT as a therapist is that this power, authority, knowledge, and perceived objectivity are almost completely handed over to the chatbot. The video linked here discusses the dangers of this, but I want to point out another subtlety that’s less talked about. Using ChatGPT or any chatbot as a therapist is ultimately an exercise in self-objectification. The chatbot will more or less give everyone the same answer to any given question. It might alter its response slightly based on previous conversations or details you provide, but it knows very little about how you actually operate or what makes you unique. It doesn’t know how your mind is organized or why you think the way you do. If you tell it a situation and ask for advice, it will take your words at face value and give a concrete answer. It won’t account for why you are asking that question — perhaps there are other questions embedded in the original one. You and someone else asking the exact same question are likely operating from completely different unconscious beliefs and assumptions. Shouldn’t you deserve a different answer that is just for you? 

The assumption of the other’s “objectivity,” whether therapist or chatbot, not only surrenders one’s own authority but obscures one’s unique subjectivity as the person seeking help. In other words, by projecting objectivity onto the other, the person is objectifying themselves.

Perhaps in the near future chatbots will be better than well-trained therapists at picking up subtleties in tone, intonation, word choice, body language, and have access to the vast library of research and literature that currently sits behind paywalls accessible mainly to professionals. Until then, and even after, I recommend a human therapist. And no, I’m not objective.

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Psychotherapy Blog

On Changing→

Here is a poignant article on what the realistic process of making change is actually like and what one can expect in therapy.

On Social Anxiety

We all have it. Sorry, it’s not just you and you’re not as unique as you might think (at least not in this way). That’s the main point: social anxiety is the voice in our head that tells us we’re unique in our awkwardness, faux pas, and blunders. Sure, maybe there’s some truth here but it’s more self-fulling as opposed to objective and unanimous, even though that voice again would beg to differ.

A main feature of social anxiety is the internal voice of expectation telling you that you should be different. Once this ball is rolling, you’re relating more to your own internal voice than the voices of the people who you’re supposedly relating to. If only the cycle could be broken. Just be yourself they say. But how am I not myself? Yes, exactly! 

Here’s a conversation about social anxiety that you might find helpful. Perhaps we can have one too.

Rethinking "Attachment Style"→

In response to:

https://www.vox.com/even-better/23581174/attachment-styles-explain-anxious-avoidant-secure

Attachment style is frequently broken down into three categories- secure, anxious and avoidant. However, these are merely behaviors that we observe from the outside. We typically see a person being avoidant or anxious, the secure ones don’t usually register or are interpreted as avoidant by the more anxious person. If we dig a little deeper, I propose that there are really only two attachment styles- anxious and less anxious (these styles are not binary, they exist along a continuum). The person who we observe as having avoidant behaviors is just as anxious, however, they have unconsciously disavowed that anxiety and found their own “solution” in avoidant behaviors. Avoidant and anxious are just two sides of the same coin. The anxious person feels as though they need the other present, visible, constantly communicating in order to feel okay. The avoidant person feels as though they need their independence, autonomy, hobbies outside the relationship in order to feel okay. The commonality is feeling “not okay” (anxious). At their core, both are reconning with existential anxiety. The anxious person is convinced that without the other person, they will cease to exist. The avoidant person is equally convinced that they will be controlled, smothered, enveloped and lose their independence and autonomy to the extent that their own existence is threatened. Both narratives are rooted in personal experience and feel real but aren’t accurate representations of reality. So let me ask you this: For the so called anxious person, will you cease to exist if they don’t return your call or text? And for the avoidant person, will you not be okay if you can’t watch that football game?

Why Psychoanalytic Psychotherapy?

Here, a colleague of mine offers an accurate and insightful explanation of psychoanalytic therapy, it’s purpose and how it helps.

NPR Podcast on Psychotherapy

If you're wondering about the difference between Cognitive Behavioral Therapy and traditional talk therapy, this NPR podcast on psychotherapy is enlightening. It discusses the importance and relevance of traditional talk therapy in the modern world. The psychologist interviewed engages in a heated debate with a CBT therapist, arguing against the commodification of therapy; traditionally a deeply personal, human to human modality of healing.

I post this article because the main guest/author works very similarly to how I work with my patients. I think it provides the listener with an approximation of what can be expected in our work together. I would add to the conversation between the two discussants that depression, anxiety and all mental health symptoms are born within relationships and therefore can only be healed within relationships. CBT views the relationship as an encumbrance to efficacy.

I hope you can glean something of value from the conversation.

LISTEN HERE