The point of contention regarding therapy for me is that I’m literally paying for an impersonal conversation in which I express my deepest insecurities to someone who most likely doesn’t give a shit.
I don’t see how AI fixes that but I also don’t understand why it can’t help if your relationship with your therapist is supposed to be a fundamentally clinical one.
“person I pay to pretend to give a shit about my problems” is such a reductive and unhealthy view of therapy that it should be immediately apparent why therapy has not been helpful and why you’re unable to see why an Autocorrect word regurgitation machine wouldn’t be helpful.
If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg? You should be able to recognize why this would be an unhealthy and unhelpful framing device.
10% odds the problem is that you haven’t found the right therapist. 90% odds you’re building up mental barriers that are actively preventing you from engaging with the therapeutic model in a beneficial way. Acknowledging this and working to overcome these barriers was life-changing for me and has resulted in an astonishing level of change in not only how effective talk therapy has been, but also in how I feel and think about myself particularly in regards to my mental and physical health.
There definitely are crappy providers out there but if you’re at the point where you’ve personally bounced off of multiple dozens of providers, it might be time to start thinking about the “why” of the problem and about your actual needs. Like, what do you want out of therapy? What are your goals? Maybe you need a specific therapy method, or maybe talk therapy straight up cannot meet those needs.
The classic model of a sufferer of depression has them numb to or unable to see positive stimuli in their life and both talk therapy and SSRIs can help people recognise and maximize the positive things in life.
There’s a scenario colloquially referred to as “shit life syndrome” in which a sufferer is living in untenable and seemingly unchangeable circumstances, which are impacting their mental health. Therapy is largely ineffective here because it doesn’t affect the material aspects of life. It doesn’t stop abuse, it doesn’t put food on the table, it doesn’t make your workplace more tolerable, etc. There also seems to be a high level of correlation between this type of depression and cPTSD.
Interestingly, SLS-type depression may be a major cause of paradoxical reactions to SSRIs, where symptoms actually worsen. Unlike the traditional model of a depression sufferer, it’s not that SLS-type sufferers unable to see the positive stimuli in their life: they’re just overwhelmingly exposed to negative stimuli. Heightening the ability to engage with stimuli that were being missed instead results in a worsening of symptoms.
If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg? You should be able to recognize why this would be an unhealthy and unhelpful framing device.
One big issue with therapy is that it’s difficult to afford unless you have a good job or are on a state-sponsored health plan. The people who are in that welfare cliff are arguably some of the people who need it the most.
And then, once you get it, it’s often restricted to “you will have twelve 45-minute sessions to address the issue”. It really cannot function properly in a transactional, capitalist model. To really have an impact, it needs to tie in with the pace of life, and if this doesn’t take the form of a figure who’s present outside the office/clinic, it’s prohibitively costly and/or slow to try to link the professional up with the on-the-ground reality.
What we now have access to is something that’s on-demand, 24/7, for better or for worse. The provider/client model canmot match this.
If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg?
Yes and yes. I’m hiring them because they perform a service in exchange for money. It’s not reasonable to expect them to care on an individual level about my taxes or my broken leg, I just need them to do their job.
You are in fact having someone perform a service in exchange for money. The service is to identify, analyze, and treat a specific, named issue or group of issues which you are facing. But would you walk up to your parent or neighbor and describe either of those professions as someone you paid to pretend to care?
A therapist is supposed to do the same thing: identify, analyze, and treat an issue or issues. So why the fuck would you frame therapy like you’re trying to pay someone to pretend to be your friend? Why is it uniquely normalized to describe just this one profession in this way?
Primarily subjective and patient reported measures (perceived self-esteem, self-reported frequency or severity of events, ability to cope with external pressures) as the physiological measures associated with most of my issues can only be expected to worsen.
I’ve had improvements in terms of things like reduction in negative self-talk, reduction in upsetting intrusive thoughts, and pretty drastic reductions in both frequency and severity of ED events.
Add to that that they are designed to generally agree with and enable whatever you tell them and you basically have a machine that does everything to reinforce a connection to itself and validate the parts of yourself you have concerns about.
There are already so many stories of people spiralling because they started building rapport with an LLM and it’s hard to imagine a setting where that is more likely to occur than when you use one as your therapist
Given the way LLMs function, the will have a hard time with therapy. Chat GPT’s context window is 128k tokens. As you chat, your prompts/replies add up and start filling the context window. GPT also has to look at its own responses for context. That fills up the window as well. LLMs suck with nearly empty context windows and nearly full context windows. When you’re close to having a full context window, it will start hallucinating and having problems with responses. Eventually it will only be able to focus on parts of your conversations because you’ve blown past the 128k token mark.
The ways to mitigate this problem have to be done by the user and they disrupt therapy.
There are already so many stories of people spiralling because they started building rapport with an LLM and it’s hard to imagine a setting where that is more likely to occur than when you use one as your therapist
There are multiple cases where an LLM is alleged to have contributed to someone’s suicide, from supporting sentiments of the afterlife being better to giving practical advice.
If find that it’s helpful being able to talk to someone that you can’t disappoint. Otherwise I will always lie to make them feel better about how I’m doing
The other day someone told me that their partner used ChatGPT instead of going to therapy.
We’re all so cooked.
So many people are going to develop/exacerbate mental illness from doing that.
Turbo cooked
Probing the quicksand with a rod made of quicksand
Sounds safe to me
The point of contention regarding therapy for me is that I’m literally paying for an impersonal conversation in which I express my deepest insecurities to someone who most likely doesn’t give a shit.
I don’t see how AI fixes that but I also don’t understand why it can’t help if your relationship with your therapist is supposed to be a fundamentally clinical one.
“person I pay to pretend to give a shit about my problems” is such a reductive and unhealthy view of therapy that it should be immediately apparent why therapy has not been helpful and why you’re unable to see why an Autocorrect word regurgitation machine wouldn’t be helpful.
If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg? You should be able to recognize why this would be an unhealthy and unhelpful framing device.
10% odds the problem is that you haven’t found the right therapist. 90% odds you’re building up mental barriers that are actively preventing you from engaging with the therapeutic model in a beneficial way. Acknowledging this and working to overcome these barriers was life-changing for me and has resulted in an astonishing level of change in not only how effective talk therapy has been, but also in how I feel and think about myself particularly in regards to my mental and physical health.
if therapy was rigorous we wouldn’t have to suffer through dozens of wrong therapists.
There definitely are crappy providers out there but if you’re at the point where you’ve personally bounced off of multiple dozens of providers, it might be time to start thinking about the “why” of the problem and about your actual needs. Like, what do you want out of therapy? What are your goals? Maybe you need a specific therapy method, or maybe talk therapy straight up cannot meet those needs.
probably this. drugs didn’t help either,
The classic model of a sufferer of depression has them numb to or unable to see positive stimuli in their life and both talk therapy and SSRIs can help people recognise and maximize the positive things in life.
There’s a scenario colloquially referred to as “shit life syndrome” in which a sufferer is living in untenable and seemingly unchangeable circumstances, which are impacting their mental health. Therapy is largely ineffective here because it doesn’t affect the material aspects of life. It doesn’t stop abuse, it doesn’t put food on the table, it doesn’t make your workplace more tolerable, etc. There also seems to be a high level of correlation between this type of depression and cPTSD.
Interestingly, SLS-type depression may be a major cause of paradoxical reactions to SSRIs, where symptoms actually worsen. Unlike the traditional model of a depression sufferer, it’s not that SLS-type sufferers unable to see the positive stimuli in their life: they’re just overwhelmingly exposed to negative stimuli. Heightening the ability to engage with stimuli that were being missed instead results in a worsening of symptoms.
I just don’t agree that these are good analogies.
Why? If they are bad analogies, there must be a reason for that to be the case.
One big issue with therapy is that it’s difficult to afford unless you have a good job or are on a state-sponsored health plan. The people who are in that welfare cliff are arguably some of the people who need it the most.
And then, once you get it, it’s often restricted to “you will have twelve 45-minute sessions to address the issue”. It really cannot function properly in a transactional, capitalist model. To really have an impact, it needs to tie in with the pace of life, and if this doesn’t take the form of a figure who’s present outside the office/clinic, it’s prohibitively costly and/or slow to try to link the professional up with the on-the-ground reality.
What we now have access to is something that’s on-demand, 24/7, for better or for worse. The provider/client model canmot match this.
Yes and yes. I’m hiring them because they perform a service in exchange for money. It’s not reasonable to expect them to care on an individual level about my taxes or my broken leg, I just need them to do their job.
You are in fact having someone perform a service in exchange for money. The service is to identify, analyze, and treat a specific, named issue or group of issues which you are facing. But would you walk up to your parent or neighbor and describe either of those professions as someone you paid to pretend to care?
A therapist is supposed to do the same thing: identify, analyze, and treat an issue or issues. So why the fuck would you frame therapy like you’re trying to pay someone to pretend to be your friend? Why is it uniquely normalized to describe just this one profession in this way?
What are your outcome measures for therapy, personally?
Primarily subjective and patient reported measures (perceived self-esteem, self-reported frequency or severity of events, ability to cope with external pressures) as the physiological measures associated with most of my issues can only be expected to worsen.
I’ve had improvements in terms of things like reduction in negative self-talk, reduction in upsetting intrusive thoughts, and pretty drastic reductions in both frequency and severity of ED events.
The problem is that AI does absolutely not provide a clinical relationship. If your input becomes part of the LLM’s context (which it has to in order to have a conversation) it will inevitably start mirroring you in ways you might not even notice, something humans commonly (and subconsciously) respond to with trust and connection.
Add to that that they are designed to generally agree with and enable whatever you tell them and you basically have a machine that does everything to reinforce a connection to itself and validate the parts of yourself you have concerns about.
There are already so many stories of people spiralling because they started building rapport with an LLM and it’s hard to imagine a setting where that is more likely to occur than when you use one as your therapist
Given the way LLMs function, the will have a hard time with therapy. Chat GPT’s context window is 128k tokens. As you chat, your prompts/replies add up and start filling the context window. GPT also has to look at its own responses for context. That fills up the window as well. LLMs suck with nearly empty context windows and nearly full context windows. When you’re close to having a full context window, it will start hallucinating and having problems with responses. Eventually it will only be able to focus on parts of your conversations because you’ve blown past the 128k token mark.
The ways to mitigate this problem have to be done by the user and they disrupt therapy.
We just need to add more tokens then
spoiler
/S
There are multiple cases where an LLM is alleged to have contributed to someone’s suicide, from supporting sentiments of the afterlife being better to giving practical advice.
If find that it’s helpful being able to talk to someone that you can’t disappoint. Otherwise I will always lie to make them feel better about how I’m doing
I’ve had therapists with whom that exact scenario has happened, I’ve literally lied to them about how I’m doing.
can’t imagine why trusting the agreeable electrified foolin’ machine created by sociopaths can’t not help
Just wait for the conversation where they come to you telling you their partner divorced them because “ChatGPT told them to.”