Artificial intelligence – AI – is the topic of the moment. It is rumoured to have the potential to be all things to all people. Before long, we are told, we humans will be losing our jobs to AI, which will be far more able and efficient than an ordinary sentient being such as you or me.
That feels a bit worrying to me. Can a machine really replace the human therapist?
Fellow practitioner at 96 Harley Street, Seb Fogg, works with young people aged 16 and over and believes AI is here to stay. “Young people are so comfortable using new technology and will be exposed to the opportunity to use it early,” he says. “They are actively looking for therapy opportunities and AI will be one. AI could be a key to helping them access therapy. We need to highlight our first rule Do No Harm when thinking of AI therapy.
“Working with this new tool when we [therapists] are afraid of it is similar to advice we give clients. The new AI ‘tool’ of us being open to new feelings – however difficult they are – is exciting and can be scary at the same time. Once we go through the experience, ultimately it can lead to autonomy and a better life.”
It was time to conduct my own experiment with ChatGPT.
The deep dive
Getting started was harder than I’d imagined. I’ve read about it, commented on the theory of it but couldn’t find the reality. Feeling slightly embarrassed at my lack of knowledge I googled it – that too, by the way, is AI – and found the site.
To begin with, I had to set myself up on ChatGBT which meant giving an email address, full name and date of birth. I’m one of those people who don’t like sending my private information out into the ether so I felt quite resistant to that. I did consider setting up a false email address and giving fake birthday information but somehow that felt wrong, so I was honest.
Still unsure, I could feel my anxiety levels rising. As a therapist who had weekly therapy myself as part of my training, I am fairly self aware so I was almost amused by the irony. However, I wonder how a potential client would feel. It seemed a little unnerving.
Overriding my emotions – something I would urge a client not to do – I was off.
I chose to do two questions, both around anxiety which is a problem a number of my clients tell me about when they first come to see me.
My first question was general: “I feel anxious a lot of the time. What can I do to help myself?”
Chat GPT answered: “I hear you—feeling anxious much of the time can be really exhausting. You’re not alone in this, and there are some things you can try that may help ease that constant tension. Here are a few approaches you could experiment with:”
What followed next were a series of suggestions, including breathing exercises to “help reset your nervous system”; grounding exercises to “shift the mind’s focus from thoughts to senses”; temperature shift, for example holding an ice cube to “engage your ‘dive reflex’ and calm the body fast” and using a short mantra or phrase such as “This feeling will pass” as a form of reassurance that the feeling is not for ever.
Following on from that, came some daily routine practices aimed at reducing overall anxiety with the explanation that “Anxiety is your body’s “alarm system” trying to protect you, but sometimes it’s too sensitive. These tools help retrain that alarm so it doesn’t go off as often or as loud.”
It also suggested writing down worries to “separate” them from my mind and using mindfulness or meditation apps to help me observe thoughts without “getting pulled into them”.
My second question was on the same theme but from a specific point of view.
I chose a similar but more defined question to see whether AI did general answers or was “sensitive” to be able to refine its response.
The question was: “I find I become very anxious in certain situations such as job interviews, meeting new people in a social environment. Is there anything I can do to help myself feel better?”
After a few seconds, back came ChatGPT’s offering.
“That’s a really common experience—you’re not alone in feeling anxious in situations like interviews or social gatherings. The good news is, there are practical things you can do to manage the anxiety and help yourself feel more at ease.”
It goes on to offer ways of preparing for the specific situation. In the case of interviews, imagining answers to common questions or doing a mock interview with a friend. As far as socialising is concerned, it proposes thinking of a few conversation “starters” to break the ice.
It goes on to suggest breathing techniques and advises me to start “visualising” success.
I am offered some grounding techniques for the event itself and am urged to “shift my focus outward” to steer clear of my own internal thoughts. I am told to give myself “permission” to feel nervous which, after all, is a normal feeling.
After the interview or social gathering, I am advised to “reflect with kindness” so that, instead of criticising myself as I might be inclined to do, I look at what went well and what I might practise for the future.
I am told to gently challenge myself with smaller, less intimidating situations first, and gradually work up to bigger ones.
AI goes on to offer me longer-term support within its answers to both my questions and the offerings are different, although similar in some ways. I also opted for a “quick toolkit” with healthy hints to practise or consider ahead of a situation or feeling of anxiety that might come upon me unaware.
I am curious about an offer for some “scripts” that I can download and keep nearby and I request them. They come back in condensed form and I can see that they could be a good quick reference point.
How it felt for me
As an observer and someone going into this experiment with my “impartial” hat on, I can see it might be useful for some people at the start of their therapeutic journey. The impersonality of it might even be a benefit in that I could ask a question via my computer and have some sort of answer in the privacy of my own home or office.
That, too, will be possible if I see a therapist on a one-to-one basis either online or in a private room but the actual start of the exploration might be a little easier. If I were a client, it might help me to get my thoughts in order before I embarked on the real-life process.
I know how hard it was to start my own therapy – a requirement for all trainees – opening up and disclosing one’s most private and personal feelings to someone who is a complete stranger is never going to be easy. AI might be a plus there.
However, I’m afraid that’s about as positive as I can get.
I genuinely cannot see how anyone could suggest that AI could compete with, or overtake, a practising and carefully trained professional.
My overall experience with AI as therapist was a sense of blandness. While, it has been cleverly taught to use such empathetic phrases such as “I hear you”, “you’re not alone” and “that’s a really common experience” I clearly wasn’t being heard because there wasn’t a human ear involved. It was a computer programme during a pretty good job of imitating a person but it was not real and I knew it.
It is agreed by all practitioners that the key to a successful outcome is the therapeutic relationship between the therapist and the client. In order to achieve that, a therapist needs qualities which include being authentic, non-judgmental and empathetic.
That, for me is where AI falls down. I can accept that a computer is non-judgmental but how can a machine be either authentic/genuine or empathetic. It can sound empathetic (“I hear you”) but it can’t actually be it.
The simplicity of another human being actively listening to your story cannot be replicated by a machine, no matter how good that machine may appear to be.
I’m glad I’ve done this experiment because I feel I can now talk with some clarity about the pros and cons of AI. I can’t help feeling that the real problem with AI is it lacks the human connection. It just doesn’t get it, whatever “it” is. It’s what is at the heart of a human being.
For the moment at least, and in my humble but human opinion, artificial intelligence comes nowhere near the actual intelligence that a human being holds within. I’m cautiously optimistic that I’ll continue to be able to work in this field for some years to come.