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Why do therapy when you can just use AI?

WHY DO THERAPY WHEN YOU CAN JUST USE AI?

 

Artificial Intelligence (AI) is emerged as a great resource in the therapy arena. Studies, like one conducted recently by Orygen published in the JMIR Mental Health, suggest that one-third of Australians had used AI tools (largely chat GPT) to answer questions relating to mental health, with many using it as a ‘personal; coach or therapist’.

 

AI is good for suggesting strategies (eg how to manage anxiety), and to provide considered, objective perspectives – even advice, eg about what to say in a difficult conversation, or to get an objective assessment or analysis of dynamics between people (eg. in a fight with your partner, or a colleague). ‘Talking’ with AI can have a calming effect, even the dopamine hit felt by feeling ‘listened to’. So using AI for advice or counsel does have value, and certainly, people are turning to AI for therapeutic perspectives.

 

AI is like a good therapy book, or any good psycho-education, but even more so as it can hone address your specific needs and situation. It’s like finding a really relevant book, or podcast, about exactly what you’re dealing with, and being able to ask tailored questions.

 

However therapy is different. Not only does it give your strategies (like AI), and (like AI to some degree) understanding about your patterns and how you function in the world, the process of therapy itself helps you deeply understand and shift those patterns in a sustainable, long-term way.  

 

So AI is like a great book, that can provide often really good understanding … but - as those of us that have done years of talk therapy know – understanding in itself is not enough. As that wonderful Joachim Phoenix and Scarlette Johannsen film Her shows, a relationship with an AI bot is not a real flesh and blood relationship, so it only goes so far in providing an authentic connection, and depth of connection.

 

And of course, a big part of the value of any therapy, including talk therapies, is that it provides consistency and a real holding by another human being. It takes us out of isolation and helps us heal through connection

 

AI cannot provide nervous system co-regulation

 

But even more importantly, with AI, you’re not being interreacted with in a way that fundamentally addresses and repairs wounding at the level of the nervous system. AI cannot provide the co-regulation of an adjacent living, breathing nervous system, which is one of the fundamental benefits of therapy. It is in the contact and alchemy of the therapeutic relationship – in the supportive human connection - that real changes occur.

 

The podcast example is a good analogy. Imagine being able to dial in live, to ask a presenter a question, in real time, and to have them not only answer you, but – in the way they answer, to ‘work’ with you. A good presenter would be knowledgeable and experienced and skilful in the way they handle your question. It’s as much the way they answer you, the way they tune in to you, the way they not just answer your question (the content) but have the emotional intelligence and skillset to meet you and connect and respond to you that is as valuable. As the information they give you.

 

AI cannot provide somatic trauma healing

 

That’s for counselling and psychotherapy. For anything to do with trauma healing, it’s different again. The main differences between a Somatic Experiencing session and AI is simply that AI cannot do somatic experiencing. The experience of nervous system co-regulation that happens in proximity to another nervous system includes the eye contact and many subtle, non-verbal cues that are a core part of healing trauma. AI can give you the theory, but it’s by engaging and working with the actual nervous system, which is a skilful and subtle process, that the repair of somatic-based therapy happens.

 

AI can’t tune in to your nervous system field, your body language, even subtle changes in eye contact, of heartbeat, changes of skin colour that an SE practitioner notices to help guide you in the process of somatic experiencing. And ultimately, AI can’t hold you in a process of trauma release or somatic discharge.

 

So when dealing with trauma, whether an event trauma or more complex trauma like developmental trauma, PTSD, C-PTSD or other complex trauma, the kind of therapeutic intervention AI can provide is different to what’s needed to heal.

 

AI and developmental / attachment repair

 

AI also can’t provide developmental and attachment repair, one if the main reasons people come to therapy.

 

The deep relational, real, connection you have with a good therapist can’t be replicated by something non-human, as it’s based on the sharing of intimate and personal feelings, responses, vulnerabilities, defences, openings etc. It is in the connection and working through these relational dynamics that people learn to heal relational dysfunction. It’s the nuances of real-time connection and co-response that establish not just a sense of safety, but that create the necessary experience of relational repair.

 

Much of the work I do with people is in the area of attachment repair. That is, your fight with your partner, or your colleague, is actually about much more than the fight with your partner. Usually people come to therapy as a way of fundamentally understanding and changing what’s truly going on, deep down, and for supportive, caring, skilful help in addressing and changing patterns and behaviours that are no longer working. Identifying these patterns is one thing - and certainly resources from therapy books to AI are helpful in doing so - but the shifting and healing happens only in the real-time, relational, personal and intimate dynamic of therapy, and in the intimate personal connection with the right therapist for you.

 

The point of therapy is experiencing what a healthy relationship can feel like. It is the experience of relational repair that is needed to shift entrenched patterns held unconsciously. For example, when working in the tender territory of long-term attachment wounding, as well as with complex trauma / CPTSD, there may be moments of discomfort, or difficulty, or of excruciating vulnerability or awkwardness that comes up in therapy. To be held and supported in these moments is key to working through these experiences. It is the in-the-moment, real time connection with the therapist that allows your system to have a different experience, and to know what it’s like to feel heard, seen, understood, respected and nurtured.

 

What we usually didn’t get to experience as children was being truly attuned to, leading to feeling of unsafety, hopelessness and even a bedrock feeling of despair – reoccurring or even persistent feelings of not being seen, or being misunderstood. A core aspect of therapy is to work with your therapist to heal these wounds – to feel a sense of safety, care and atunement from another human being. This is something AI can’t offer, as it cannot look you in the eye, it cannot smile, or show understanding in all the many non-verbal ways necessary to provide experiences of re-parenting. AI cannot provide the lived, felt-sense experience of genuine, personal, good holding that is a fundamental reason people come to therapy.

 

One of the most valuable aspects of having a therapist is the therapeutic relationship that develops over time. Clients often come in and out of therapy over many years, a bit like having an old-style (but not old-school!) family doctor. Someone who knows you well, and who can be a mentor and ally, over time.

 

Using AI for therapy can misunderstand some of the basic benefits of therapy with a therapist.

 

Studies show that some of the reasons people turn to AI for therapy is that they believe AI will be non-judgmental, and non-demanding. People new to therapy may fear being judged, however one of the main benefits, and roles of therapy is to offer the reparative experience of what it is like to be held and not-judged. It’s in the felt experience of not being judged that the repair to old wounds happens. So using AI for this reason actually keeps the ‘therapeutic’ experience shallow. To do so can be a way of unconsciously defending against what we deeply want, and deeply fear is not possible – to be safe and not judged with another human being. This is one way using AI as therapy keeps us in the shallows, and this can in-itself be painful, like having one-night-stand after one-night-stand if what we deeply want is a relationship. Using AI as a substitute for therapy can be another way of avoiding or defending against learning how to be real an intimate with other human beings.

 

AI is not confronting

 

In terms of AI not being ‘demanding’, another main benefit of therapy is having a therapist that knows you, and whose capability is exactly in being able to challenge you enough to help you grow, but not too much so it feels overwhelming, or too difficult. This is the skill of a good therapist - to know you well enough, to recognise when to help you ‘push the envelope’ enough, to develop and grow, at a pace that can be accepted and integrated by you (and to know when not to push).

 

Sometimes therapy does confront us. If it never does, it’s probably not very effective therapy. The value a good therapist provides is to understand and to offer you this balance. This is an art that can only be practiced in the moment, and is very personal to you, and the success depends on the quality of the therapist, and of the therapeutic relationship.  

Good therapy balances support and challenge

 

As a Somatic Experiencing Practitioner, one of the key ways we work is to honour what Peter Levine calls the ‘energy wells’, a sequence of working with waves of activation and reward (a sense of successful regulation) that is enough of a stretch for a client to know that they are getting something out of therapy, and of shifting in their capacities to regulate, but without feeling overwhelming  or too much. This is one of the capacities of a good therapist. It takes years of experience to be able to guide clients in this way safely and effectively.  For example clients often intellectually feel ready to deal with their trauma, but a skilled SEP will help you to really check this out, a process that usually involves identifying layers and levels that are below cognitive awareness. To do so well is the process that actually makes therapy effective, safe and not re-traumatising.

 

Indeed, one of the functions, and benefits, of a good therapist is to understand how much to ask of you, and how to help you to work through what you’ve come to therapy to address, without re-traumatising you.  This means recognising how much activation to allow during a session, and over time, so that the client gets the most out of therapy, both in terms of short and long-term benefits. Part of this is conducting the session so that you find the experience of therapy nurturing. Many people actually look forward to their sessions and feel they get a lot out of therapy for this reason. And this is an important part of why people come to therapy – to be truly attuned to – that is only really possible from a live human being; one with the skills and experience gained over years of working in these ways with people, and of knowing when and how to push and when not to (which is a key part of attunement).  

 

Those that have experienced good therapy know that a therapist is supposed to help you extend their window of tolerance, or to see when your beliefs of behaviours are keeping you stuck, limited or adding to the problems you’re coming to therapy to deal with in the first place. A fundamental aspect of is to appropriately both challenge and a support you, and to hold you therapeutically in a way that feels supportive, which is outside the realm of what AI can offer.