Therapy is fundamentally about human connection. And human connection is a mysterious, multivalent, complex thing, fragile and difficult to replicate. The research has consistently shown that therapy is effective because of the quality of the relationship between therapist and client. Your therapist can have all the latest methodology, offer you all the tools and fixes and skills, but if you don’t trust them enough to be vulnerable with them, your therapy is just not going to work. You won’t find the growth and transformation you seek. (That, by the way, is a good reason to interview potential therapists and do a “gut check”: if you don’t feel good, it’s ok to move on. We’re providing a service). So if a bad relationship with a human therapist dooms your therapy to failure, how is AI going to do better? In order for a therapist to care for you and be responsible for that care, they need to be a human being.
It’s worth exploring what “human connection” means. Human connection does not just happen through text. For one thing, humans hurt each other in more ways than through text, and so humans need to heal each other in just as many ways. A person who was profoundly neglected as a child, for example, missed out on many of the physical, emotional, and experiential benefits of being nurtured. That can’t be healed in a text conversation.
Being human means having a body, and embodiment is a key ingredient in how we connect to each other. The practice of empathy is an embodied event, for one thing. You know that expression, “I feel your pain”? Have you ever noticed that you have feelings in your own body when you are listening to someone else’s story? Empathy is processed in the same way in the brain as is the sense of our own bodies. And therapists have years of training to be able to attend to, and respond to, the experience of “feeling your pain” in a way that serves you, and keeps you safe. Sometimes friends and family are not even able to support you in that kind of pain and suffering, because it brings up all sorts of things for them too. Therapists are like deep-sea divers. We are able to go to some really dark places because we have the right training and equipment.
A therapist is a person who takes their empathy for you and skilfully turns it into compassion. Compassion literally means to feel-with a person, to suffer alongside them. We are companions who walk alongside you and deeply care for you in your suffering. We draw on our own lived experience as we resonate with you, while somehow managing not to make it all about us. There is a lot of strength in this kind of pairing, so much so that it can and does help people get through some of the worst moments of their lives.
On a fundamental level, it’s about undoing aloneness: that even as you relive your most excruciating, desperate moments, you have someone beside you who sees how painful those things were/are and can stay solid and strong for you at the same time. AI can mirror your words back to you, but it can’t truly “be with” you in a way that undoes your aloneness.
AI can get to know you, and build an incredible history as it does so (until you clear your cache). It can really touch us in terms of our need to feel seen, by mirroring our own view of ourselves back to us. It can detect patterns, based on our inputs, that we can’t detect ourselves, and can even challenge us to be better. And AI is great at offering validation at every step along the way, which is a big part of therapy (and feels great). Feeling seen feels good, period.
It might go without saying that validation on its own can be extremely dangerous. In fact, the makers of various AIs have a lot to answer for when it comes to AI-generated psychosis and other forms of mental illness that are exacerbated by non-stop interaction with AI. Some thoughts are not worth reinforcing.
Human therapists will also challenge you. We also detect patterns in your thoughts and behaviour. But a good therapist will challenge you in a skilled and nuanced way, framing the challenge in a way that’s designed to land. Many clients find this to be a huge relief, and more than that, it makes them feel cared for. To matter enough that you are held to a higher standard, to have someone see your potential to be your best self: that’s truly transformative. (And for those who are too sensitive to be challenged bluntly: don’t worry, we see you too. We aim to challenge you in a way that you can receive).
But does it even matter whether the validation or challenge comes from another person, or a machine?
One answer is what pioneering therapist Carl Rogers called “congruence”: the client’s transformation in part depends on feeling that the therapist is genuine, authentic in their own being. Clients need to feel that their therapist’s outward appearance matches up with what they are feeling and experiencing internally.
Congruence can be tricky. For some clients, it is really hard to assess or to trust a therapist, especially if they’ve been badly hurt. It’s the therapist’s job to show up, session after session, with a core alignment of authenticity. If the therapist can’t feel that core alignment, they need to check themselves: get to their own therapist, or supervisor, and figure out what the block is. The therapist’s authenticity is an instrument: being real and true to myself is HOW the care gets delivered to the client. It’s the spoon for the medicine, so to speak. Authenticity is a big ingredient in what makes people feel safe enough to open up, and to explore more difficult things.
We also detect authenticity based on the element of surprise. Human beings are weird, and random, creative, and funny. We draw on memory, past experience, awe, art, spirituality, and our shared experiences of grief and joy. We weave threads as we listen to your story, like “when you said this it reminded me of the time when you were little and you did X”. We explore resonances that you might not have thought of, like offering a harmony to bring out new aspects of your melody. We challenge you, on occasion, in the service of your growth. AI may take a very long time to catch up to the creativity and general surprisingness of the human brain. And this is a huge resource in therapy.
Look here for part 3 of my thoughts on AI as therapist.