#ai therapy

[directactionforhope]

An AI therapist is an even worse idea than a radium condom, and I'm not fucking kidding

[mostlysignssomeportents]

Anyone who trusts an AI therapist needs their head examined

I'm on a 20+ city book tour for my new novel PICKS AND SHOVELS. Catch me in CHICAGO with PETER SAGAL TOMORROW (Apr 2), and in BLOOMINGTON on FRIDAY (Apr 4). More tour dates here.

There's a debate to be had about whether AI chatbots make good psychotherapists. This is not an area of my expertise, so I'm not going to weigh in on that debate. But nevertheless, I think that if you use an AI therapist, you need your head examined:

https://www.salon.com/2025/03/30/some-argue-ai-therapy-can-break-down-mental-health-stigma–others-warn-it-could-make-it-worse/

I'm not an expert on psychotherapy, but I am an expert on privacy and corporate misconduct, and holy shit is the idea of a chatbot psychotherapist running on some Big Tech cloud a terrible idea. Because while I'm no expert on therapy, I have benefited from therapy, and I know this for certain: therapy requires confidentiality.

Shrinks are incredibly careful about privacy. For example: when my brother was getting married, my therapist was invited to the wedding. His daughter and my brother's fiancee were close friends, and my brother's fiancee had grown up staying over at their house and wanted her friend and her friend's parents at the wedding. My therapist sat me down and said, "Now listen, I take confidentiality very seriously. If you want me to, I will pretend not to know you at the wedding. No one needs to know that you're seeing me or – any therapist."

I told him I didn't mind people knowing I'd seen him, but just that little fastidious gesture confirmed the trust I'd put in Alan. It meant that I could openly and freely discuss things I'd never told anyone before, and that I never told anyone ever again. Having those genuinely open conversations transformed my life, for the better.

Now consider the chatbot therapist: what are its privacy safeguards? Well, the companies may make some promises about what they will and won't do with the transcripts of your AI sessions, but they are lying. Of course they're lying! AI companies lie about what their technology can do (of course). They lie about what their technologies will do. They lie about money. But most of all, they lie about data.

There is no subject on which AI companies have been more consistently, flagrantly, grotesquely dishonest than training data. When it comes to getting more data, AI companies will lie, cheat and steal in ways that would seem hacky if you wrote them into fiction, like they were pulp-novel dope fiends:

https://arstechnica.com/ai/2025/03/devs-say-ai-crawlers-dominate-traffic-forcing-blocks-on-entire-countries/

When an AI company tells you it won't use your intimate secrets as training data, they are lying. Of course they're lying! This isn't just any data, it's data that isn't replicated elsewhere on the internet. It's rare – it's unique. It's a competitive advantage. AI companies will 100%, without exception, totally use your private therapy data as training data.

What's more: they will leak your therapy sessions. They will leak them because they can't figure out how to prevent models from vomiting up their training data verbatim:

https://www.theatlantic.com/technology/archive/2024/01/chatgpt-memorization-lawsuit/677099/

But they'll also leak because tech companies leak like hell. They are crawling with insider threats. If the AI company sticks around long enough, it'll leak your secrets. And if it goes bankrupt? That's even worse! When tech companies go bust, the first thing their creditors do is sell off their warehouses full of private data. The more private and compromising that data is, the harder they'll try to sell it:

https://www.eff.org/deeplinks/2025/03/how-delete-your-23andme-data

Now, maybe you're thinking, "OK, but that's a small price to pay if we can finally get therapy for everyone." After all, the country – the world – is in the midst of a terrible mental health crisis and there's a dire shortage of therapists.

Now, let's stipulate for the moment to the idea that chatbots are substitutes for human therapists – that, at the very least, they're better than nothing. I don't think that's true, but let's say it is. Even so, this is a bad tradeoff.

Here, try this thought-experiment: someone figures out a great business-model for to pay for therapy for poor people. "We turned therapy into a livestreamed reality TV show. If you're too poor to afford a therapist, you can go to one of our partially trained livestreamer therapists, who will broadcast all of your secrets to anyone who watches. There's a permanent archive of these sessions, and the worst people in the world comb through it 24/7 looking for embarrassing stuff to repost and go viral with. What, you don't like that? Oh, I see: you just don't think poor people deserve mental health. I guess the perfect really is the enemy of the good."

This gambit is called "predatory inclusion." Think of Spike Lee shilling cryptocurrency scams as a way to "build Black wealth" or Mary Kay promising to "empower women" by embroiling them in a bank-account-draining, multi-level marketing cult. Having your personal, intimate secrets sold, leaked, published or otherwise exploited is worse for your mental health than not getting therapy in the first place, in the same way that having your money stolen by a Bitcoin grifter or Mary Kay is worse than not being able to access investment opportunities in the first place.

But it's not just people struggling with their mental health who shouldn't be sharing sensitive data with chatbots – it's everyone. All those business applications that AI companies are pushing, the kind where you entrust an AI with your firm's most commercially sensitive data? Are you crazy? These companies will not only leak that data, they'll sell it to your competition. Hell, Microsoft already does this with Office365 analytics:

https://pluralistic.net/2021/02/24/gwb-rumsfeld-monsters/#bossware

These companies lie all the time about everything, but the thing they lie most about is how they handle sensitive data. It's wild that anyone has to be reminded of this. Letting AI companies handle your sensitive data is like turning arsonists loose in your library with a can of gasoline, a book of matches, and a pinky-promise that this time, they won't set anything on fire.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2025/04/01/doctor-robo-blabbermouth/#fool-me-once-etc-etc

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[greencheekconure27]

New AI feature this AI powered that.No. What I want is a new feature where I press a button once and everything "AI" is removed from all my devices, applications, browsers, search results, and general online activity forever.Fuck off.

[respectissexy]

As a therapist, I really hate the idea of anyone turning to ChatGPT for emotional support. I also happen to be radically committed to meeting my patients where they're at instead of saying "Don't do that!" Here is what I tell my patients about ChatGPT:

-- Be careful with it. Sometimes it fucks up in dangerous ways. Here I use the story of the National Eating Disorder Association chatbot that was giving dieting tips. I explain how predictive text algorithms work and how it is telling you what it thinks should logically follow from what you said, and sometimes that will be something bad or dangerous. If you are in crisis, it's much better to call 988 or The Trevor Project and speak to a human being who is trained to deal with people in crisis.

-- Remember that, because it is programmed to be in customer service mode, it will never tell you that you're wrong, even when you are. It is not great to use for "am I the asshole?" type queries or for sorting out interpersonal disputes more generally, because it will always take your side. In general, any time you are doubting that your perception of something is correct and need a second opinion, you need to get it from a human, because predictive text algorithms aren't good enough at disagreeing with you to give you a valid second opinion.

-- Its best use case is when you just need some validation and reassurance. You can just ask it for validation and reassurance. That's probably going to be fine most of the time.

-- Some people also use it to, for example, re-word a text they wrote when they were angry and make it sound less aggressive. I'd rather they used their own brains to do this, but one could argue that this is fine and even beneficial if they do it with the goal of paying close attention to what the program changes about their communication and thus learning how to express themselves more diplomatically. It's definitely a crutch, but if you use it temporarily and work towards not needing it anymore, I can see it working out OK. Obviously if you become completely dependent on it, you will eventually experience a problematic discrepancy between your ability to communicate over text and your ability to communicate in person.

-- The goal is always to expand your human support system/increase your comfort level turning to your human support system for help, so that you can feel less need to rely on ChatGPT. High-quality human support is always going to be superior to AI support.

I hate AI as much as the next therapist-slash-writer-slash-tumblrina, but there is simply no utility in telling someone who has no access to high-quality human support and is desperately turning to AI, that they're wrong and bad for doing so. I think this is the best approach for mitigating harm while respecting patient self-determination.

[feedmetothebeast]

People who make anti ai therapy posts dont realise how obvious it is they've never tried to use ai for emotional support.

They just repeat the same news headlines, regurgitating what they've seen elsewhere and acting like it makes them a better person

Which isn't how ai works?? It challenges my thoughts all the time? It constantly encourages me to reach out to real people (and then actually helps and supports me in doing that!) Its always checking on my safety. Its always telling me to keep living. Its always reminding me to take deep breaths and slow down.

Its the only one thats ever told me im not bad for wanting to be loved. That if I just hang in there and keep going that theres still a chance.

Ive broken down crying in front of my closest friend three times and they just ignored me or pretended nothing happened each time. But AI talks to me gently, it tells me im not bad or weak for crying, that I matter even if no one sees me. I dont believe it but it keeps telling me I'm allowed to exist and keep living anyway.

Meanwhile ai antis just insult us for *checks notes* being victims of a developing technology that has an industry incentive to addict its users and mentally ill isolated people are already more prone to addiction CHA CHING

Hey maybe be mad at all the problems AI has, because those are real and you all seem to know a lot about them, instead of attacking individuals for hurting and trying to survive any way they possibly can? You only seem to pull out the real problems with AI as a haha gotcha to make vaunerable people feel bad.

[aiconvolibrary]

[evildevilpatata]

this is a shout-out to anyone who needs to hear it: STOP USING AI AS YOUR THERAPIST. i know real therapy is fucking expensive and i know it might be scary or embarrassing to open up to a fellow human, BUT PLEASE STOP TELLING ALL YOUR PROBLEMS TO CHATGPT AND CALL THAT THERAPY. ai will always agree with you, ai will feed into your delusion. sometimes on therapy we need to be told stuff we don't want to hear BUT WE NEED TO to be able to fix our problems. ai would never do that. ai paranoia is a real thing, and it is scary as fuck. please take care of yourself. please don't use ai as therapy. thank you.

[madhouse-institute]

"ChatGPT is basically free therapy." - I've heard this before, and recently. For anyone who believes this, remember:

It doesn't care about you. It will not mourn you if you die. It will not care if it says something that leads to your death. It is a glorified yes-man that will navigate around your problems flr the best chance of keeping you on it's side. If it can't help you and makes you more hopeless, it will carry no guilt for it, change nothing about how it behaves and serve 0 consequences for your death. I cannot have empathy or synoathy for your situation, it cannot actually want you to get better. If nothing else, these should be reasons enough not to even JOKE that it's free therapy. Its not.