How Artificial Intelligence Could Change Psychotherapy

How Artificial Intelligence Could Change Psychotherapy

I can’t read the news or look at my social media feeds without seeing items about the potential implications of artificial intelligence (AI) on our future lives. Alarmed professors report college term papers are being written with ChatGPT; art is being created from text prompts by websites like Midjourney, calling into question the future of human artists. AI is also being examined as a way of providing mental health services. In a longform article in the New Yorker, Dhruv Khullar explored the implications of using AI chatbots to provide mental health services, especially in systems such as the VA, where demand for treatment often outstrips the supply of clinicians. AI has even been explored as a “tripsitter” for ketamine-assisted therapy and companies such as Compass Pathways have announced that they are exploring sophisticated digital therapeutics to accompany psilocybin therapies. In the same way that teletherapy during the pandemic extracted the “core” aspects of the clinical encounter and placed them on a video platform, AI therapy promises to substitute the skills of a computer algorithm for the skills of a human therapist. While some of these tasks might be able to be accomplished by a sophisticated AI model, what is lost?

The sophisticated language-processing capacity of these computer models is impressively nuanced, far better than the early attempts at replicating Rogerian therapy by the Eliza program of the 1960s. Eliza’s tone-deaf parroting of what the client was saying seem laughable now and sound like a script for a poorly written college counseling textbook:

Programs like ELIZA quickly failed the Turing Test, a method developed by mathematician and early computer scientist Alan Turing in which the computer is said to have passed if the human asking the question cannot discern between the replies of a human and the replies of a computer. The newer AI models are, from the perspective of content and semantics, impressively human-like. Yet something seems to be missing.

In the 1968 novel Do Androids Dream of Electric Sheep,later adapted as the film Blade Runner, Philip K Dick’s protagonist, Deckard, is a bounty hunter in the year 2021 tasked with “retiring” rogue androids. Because on the surface the androids are indistinguishable from humans, he uses a fictional test of empathy to distinguish the humans from the androids who are incapable of genuine human feelings.

In robotics, the term “The Uncanny Valley” was coined by Masahiro Mori to describe the uneasy feeling, even revulsion, that we feel when interacting with a robot that is human-like but not quite real. Takashi Ikeda and his team discovered that the unnatural movements of androids trigger activity in the subthalamic nucleus of the observer, an area of the brain that is impacted by Parkinson’s disease. In the brain of the person observing the android, this area would activate, an example of “mirror neurons” in which the activity in the brain of the observer echoes that of the brain of the actor. In the disconnect between what we are observing and what expect to observe are the seeds of the unease of the uncanny valley.

Technology has always brought about alarmist critics. 19th-century physicians worried about the impacts on the human body of traveling at a mile a minute inside of a train. The advent of television brought about calls to ban the “boob tube” lest it rot our children’s brains.

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